Saturday, July 30, 2016

Why did you ask me?

"How may I help you?" I ask.

"We're from out of town. My daughter has a rash."

I look at her daughter. She clearly has a case of urticaria. Mom tells me that it must be from a new necklace she was wearing.

Now I'm not a prescribing physician, but it is clearly just a typical little textbook rash.

I recommend an antihistamine.

Mom looks at me. "Are you sure that's what you want to recommend?"

Sensing a quibble, I tell her that there is an Urgent Care on across the street and she should take her daughter there.

"Oh no, I trust your judgment. Absolutely."

Once again I recommend an antihistamine.

"Are you sure?"

Please, someone, somewhere, euthanize me.

Friday, July 29, 2016

Here I am...

...counseling a patient
and not directly answering their questions.

Thursday, July 28, 2016


Some people think the Pharmacist has ULTIMATE POWER.

Consider if you will the story of Mrs. Advent, one week away from needing her Advair and Ventolin inhalers. Now I suppose you can't fault her for wanting them filled today, except for the fact she's already on Automatic Refill and we always have it ready for her in advance.

No, she wants them right now.

Flynn the tech sends a claim. "Coverage Terminated as of 12/31/2014." He tells Mrs. Advent the results.

"No. It's not terminated."

Aladdin rubs his magic lamp again. No Genie. He tells her she must have a new card or a new ID number.

"No. It's the same number and still active. May I please see the pharmacist?"

He comes to get me. I was actually doing something important but Mrs. Advent needs to speak to me, immediately. By all means, let's distract the pharmacist while he's dealing with medications that save people's lives.

I step up to the window. Mrs. Advent starts by telling me about her asthma condition and that she can't be without her medication.

Let's see, I've been filling for you for YEARS and you think I didn't know you have asthma? Really?

Then she tells me that the technician doesn't know what he's doing because her insurance information hasn't changed. She's sure that if I step up to the computer and process the claim, I will be able to use my almighty power over the heavens and earth to get it through. 

I'm up to the challenge. I send off the claim...

"Coverage Terminated as of 12/31/2014."

Now of course I have to tell her all the same stuff Flynn already told her about her insurance. I even told her we'd be happy to call and confirm that information... AFTER we're caught up on the current SNAFU at present in the pharmacy.

Mrs. Advent gets upset and once again tells me she can't be without her medication... 

Thanks for that, I completely forgot what you told me like three minutes ago. a week or so, because she's really not out yet. We're pre-emergency right now, and that's almost like an emergency when you're asthmatic.

I assure her that no matter what happens we won't let her go without her medication. I tell her to go home and relax then call her insurance and find out her new information. She agrees that she'll call the insurance, but only to find out why it's not working today or what we've done at the pharmacy to keep it from working.

The next day...

In walks Mrs. Advent. She called the insurance which told her about the change that was made and that they sent out new cards. Fortunately she didn't throw away the envelopes and has the info for Flynn to process.

He puts in the new info... sends off a claim...

"Claim Denied. Prior Authorization Required. Step Therapy Required."

Flynn tells her the bad news, but because she's been on the medication for a long time her doctor will be able to call her new insurance and straighten it out, no problem.

And of course... she's NOT satisfied... and she asks...

"May I please see the pharmacist?"

Euthanize Me!

Tuesday, July 26, 2016

Aspirin is Free?

We have a patient (Magic Mike) that gets a bunch of prescriptions at our Goofmart Pharmacy. He's from Austria. For awhile he was on taxpayer-funded Medicaid and all of his medication (22 different prescriptions) were no charge to him.

I admit I don't know how it all works, but it seems like if this guy can afford to fly back and forth to Austria three times a year he should also be able to afford his medication. It also seems like taxpayer-funded Medicaid should be for UNITED STATES CITIZENS, but what the hell do I know.

Anyway, he let his Medicaid renewal lapse and there was a gap in in coverage. Suddenly his medication wasn't paid for by you and me. Apparently the fact that he was dependent on these medications wasn't important enough to him to pay out of pocket, so all 22 meds just sat on the shelf.

Yesterday he called me and said that he really needed his aspirin. Out of all the diabetic, cholesterol, and blood pressure medications we have for him, the one he thought he needed the most was his aspirin. Or maybe he just wanted it because he was under the impression it is free.

Magic Mike told me that when he was in Austria, aspirin was free. And when he had his prescriptions at Wagmart, it was also free. I told him that's not the way it is at Goofmart but that he can get a 100 count bottle over the counter for $4. 

Magic Mike scoffed.

And I'm sick to death of people like this. To all the people out there that aren't paying a dime for their medication... here's a little heads up for you. NOTHING is FREE. It may be NO COST to you, but it is NOT FREE. Someone else is paying for it FOR YOU.

If this was just one isolated incident, I could live with it. But I can tell you after years of being a pharmacist, and from talking to other pharmacists, that there are PLENTY of people scamming the system. And they're not just scamming the system, they're hurting YOU and ME. When someone gets his damn aspirin for free, it comes out of my pocket, and it comes out of your pocket. Are you ok with people stealing from you? I'm not. I'll be happy to donate to charity, and I do, but forcibly taking money out of my pocket for people who are taking advantage of the system, uh... NO.

Aspirin is cheap. Yep, sure enough. If you can get a bottle of 100 for $4 at my pharmacy, it's probably even less at Cost-So-Low, I'm sure. But it still COSTS money to make it. People are paid to work in the factories that make it. People are paid to ship it. People are paid to unpack it and put it on the shelf. The acetylsalicylic acid used to make it costs money, as did the fillers and dyes. The cotton in the top of the bottle cost money, as did the cap itself. Everyone along the entire production line must be paid. NO ONE works for free. I'm sure there's some very benevolent people in that workflow, but it still costs money to make it and distribute it.

To suggest that it should be free, is well, pretty damn stupid. When Magic Mike said that, he may very well not be aware that it actually costs money to make it. But the reality is that he EXPECTS someone else to pay for it for him.

Someone tell me why Magic Mike is ENTITLED to get free aspirin? Why did he get his medication for free (and I have no doubt he'll figure out a way to get it reinstated) when other people have to PAY for it?

He's NOT poor. He has plenty of money to travel to Austria three times a year. I'm not traveling to Austria three times a year... and I'll bet you're not either. But we're being led down an evil path by idiots who want people to feel entitled to aspirin at no cost to them.

This is the continuation of a very disturbing reality that's growing every day. If you're a pharmacist or pharmacy technician in a retail setting, YOU KNOW what I'm saying here is spot on. 

For the rest of you, it's time to WAKE UP.

Monday, July 25, 2016

Bottle Looks Different and Patient Fears the Worst

Recent phone call:

Ring... ring....

"Hello, this is Goofmart Pharmacy, where we say 'no way' to a high co-pay. How may I help you?"

"Uh, yeah, Crazy?"

"Yes, this is Crazy RxMan."

"Uh, yeah. I just picked up my medication. It looks different. I was supposed to get montelukast. This pill looks different. Are you sure you gave me the right thing?"

I get the name of the patient and discover that we had changed our generic Singulair to a new manufacturer which comes in a completely different bottle.

"That's a new manufacturer," I tell him. "In fact, We just labeled the bottle it came in. What's the bottle say?" 

I'm thinking he'll see the name of the medication on the bottle and realize that everything is cool.

"It says 'montelukast' on the bottle. But the pills look different."

"Was the bottle sealed?"

"Uh, yeah. I had to poke into it to get one out. But it looks different than what I had before. That one came in a different shape bottle that said montelukast."

I had to spend the next five minutes explaining to him that what he has is a completely different manufacturer, right down to the size, shape, and color of the tablet. 

It's our fault, really. In a world where you have to warn people that coffee is served hot, you also have to tell people every single time you change a generic. The mere fact that the bottle itself says the name of the drug is inconsequential. 

Basically, just assume all patients have no brains, whatsoever, and you're good to go.