"I have three overrides for you," Flynn the tech spits out. The first one is alerting me to the fact that yes indeed, the patient did get Simvastatin about 30 days ago (and has been getting the same medication for over a year). The computer wants a pharmacist to make sure its all ok. The second one is alerting me to the fact that we had to switch one generic for another because our supplier is sending us a new generic for Zolpidem. Oh, the patient has had both generics before a number of times... but... The computer wants a pharmacist to make sure its all ok. The third override involves a day supply issue for a birth control. The computer has in it's programming that all birth control is for 28 days, yet this birth control is one of those 21 day formulations. The computer wants a pharmacist to make sure its all ok. I'm flattered the computer thinks I'm so smart, but this is just the start. The overrides will continue, ad nauseum, all day long. On rare occasion, maybe ONCE a day, the override will involve something that's actually important. Pharmacists are buried in nonsense overrides. It disrupts the flow of everything and is actually a hindrance. If everything requires an override... then nothing does, really.
At my Goofmart location, our business has grown quite a bit over the past few years, but The Authorities insist on trying to run the place with a minimal number of technician hours. It's like they're oblivious to the fact that we're now as busy as some other locations that have 50% more tech hours. Oh, we've complained. We've whined. We've cried out from the wilderness. "We don't have anyone to send you," is the usual reply. BECAUSE of this, the pharmacist in charge runs the place alone on the weekend so that we can have technician hours during the week.
BECAUSE of that, sacrifices have to be made. The first sacrifice is the phone. If I'm working alone on the weekend, the phone doesn't get answered if I'm at the register or on the phone with someone else or out on the floor counseling a patient on the virtues of Pepto Bismal. The Authorities don't like that. They want the phone answered each and every time. "Go back to the phone and put the caller on hold," they will say. So if I'm counseling a lady on her genital itching and the phone rings, I'm supposed to politely excuse myself, run back to the pharmacy, answer the phone, put the caller on hold, and rush back to the customer. I might also mention that the phone system will ring back in two minutes and I'm expected to repeat the process. Somehow, The Authorities are just not getting it. Do they ever get it? Or do they just sit in a tower somewhere sitting around a table talking about this kind of thing all day and deciding how things should work without really giving it any thought? I just let the phone ring. If it is important, they'll call back.
I was off for a week. You'd think that by being out of the pharmacy that long I'd be good for a couple of weeks before losing my mind again. Nope. Three hours into my shift a lady comes up to the window. "My name is Darla Dweeb and I'm here for my prescription. My doctor said it would be ready when I got here." I look deeply into her eyes, trying to ascertain if there is any sense of intelligence within her. My pulse quickens as the rage within me builds. "How would the doctor know that?" I ask her. I detect a slight bit of understanding within her. A glimmer of intellect putting it all together formulates within her gray matter... the realization that no, the doctor couldn't possibly know that. Flynn the tech, sensing my intense displeasure, steps up to tell the lady that we did get an e-Script for her medication moments ago but that we would need time to fill it... 15-20 minutes. Flynn goes back to the computer to work on her script. I pull up the information on another computer and immediately dial the doctor's office. "Vandaley Family Practice... how may I direct your call?" For some odd, unknown reason, I am able to get the doctor's assistant on the line within a minute. I explain what has happened to the assistant, then I ask her, "How is it that Dr. Vandaley is able to know our workflow here at the pharmacy? Do you have cameras installed? I'm really curious to know why you're telling patients that their prescription will be ready when they get here?" Silence... then finally a response, "Uhhhhh..." I continue, "I would appreciate it if you would STOP telling patients that their medication will be ready when they get here. You do not know our workflow. It's discourteous to us and unprofessional." "I will pass that on to Dr. Vandelay," she responds. If I have to call EVERY doctor in the entire UNITED STATES to get this message across, I will. STOP DOING THIS!
Many pharmacies place an X on opened bottles of medication. This is necessary to keep others from labeling up an open bottle as a sealed bottle when it really isn't. I can't tell you how many people have called after getting home and finding out that their bottle of Nexium was open and capsules were missing. Argh! But if you're like me, you grow weary of marking every new bottle you open with an X. Weary as in SICK to DEATH of it. It takes time, seconds actually, and ain't nobody got time fo dat!
Make your life easier. Keep the easy open bottle caps and put an X on the top. Then move the cap to newly opened bottles! No more X'ing bottles! No more wasting time and getting Sharpie on your hands! No more confusion with open bottles versus sealed bottles. No more cats and dogs living together. Chaos, be ye therefore no more... get out! #PharmacyHack
A lady drops off a new prescription. We haven't filled anything for her for eight years. She's been going to the Flea Circus Drugs across the street (which has a minimum wait time of one hour). Today she's interested in getting a prescription at our location, not for a chance to mingle with the incredibly handsome Crazy RxMan... no, she's here for the $25 gift card for a new prescription. I type it all in, adjudicate, and tell her that her co-pay is zero. Oddly, she asks me what the co-pay will be for cash. I tell her again, on her insurance there is no charge to her, and again she wants to know the cash price. I tell her $12.39 or something. I don't remember. She asks, "Isn't it $4? The nurse said it would be $4." I tell her, one more time, that it is ZERO on her insurance and that we don't do $4 prescriptions anymore. "How long will it be?" she asks. "Twenty minutes," I tell her. The tech is about to leave for the day and people are pooling out there in the periphery. "TWENTY MINUTES?" she asks, startled? "Or 30 minutes. You decide," I respond, straight-faced. She looks at me for at least 30 seconds, trying to figure out what I've said. "Ok, I'll be back in 20 minutes."
1:39 pm ~ Mr. Limp appears at the pick up window (why can't people get it right?) with a prescription for Viagra and Cialis. He also has coupon information on his swell smartphone. (I'm beginning to understand why police officers don't care to see that you have proof of insurance on your phone). We bring Mr. Limp down to the drop off window. We get Mr. Limp's info, type in the prescriptions, and badda bing, they're not covered. the cash price is more than he wants to pay. Mickey the pharmacy manager tells him we might have more luck with his insurance if he gets the doctor to write a prescription for the 5mg Cialis. Mr. Limp rushes off to make the call. 2:00 pm ~ Mickey leaves for the day. 2:14 pm ~ Mr. Limp calls to tell us that his doctor will be calling in a prescription for Cialis 5mg. This is so not helpful. 2:16 pm ~ Unknown to the pharmacy staff, the doctor leaves a voicemail for the Cialis 5mg. There are no bells and whistles. The only thing we get is a tiny red light indicating a message is waiting. 2:17 pm ~ Mr. Limp calls AGAIN to ask if we got the message. I see the red light and tell him I'll call him back if the message is about his prescription. 2:18 pm ~ I get the message off the phone. I have to rewind several times because YOU FREAKING DOCTORS WON'T SLOW DOWN WHEN YOU LEAVE A MESSAGE. 2:18 pm ~ While I'm on the phone, Mr. Limp calls and the tech puts him on hold. 2:19 pm ~ I get on the phone with Mr. Limp and try to process the Cialis 5mg on the fly. It is also not covered. Thanks, Mickey. So I tell the guy the cash price for 10 tablets. He agrees and we hang up.
2:23 pm ~ I'm NOT KIDDING... Mr. Limp is at the drop off window (nothing learned about the previous encounter) asking for his prescription of Cialis. (And no, he wasn't on his way to the airport or headed out of town.)