The Pharmacy Chick

Pharmacy Chick is not the techno geek that some people are. I do however have a failsafe security measure on my laptop that makes it impossible for the un-informed to boot it. Because its old, there is some short in it someplace. I have to perform some kind of squeezing/massage exercise on certain places of the unit in order for it to “connect” and boot. Otherwise, the darn thing blinks at me for a few seconds and remains dead. Therefore, If I disappear for a few weeks, you can bet that the massage no longer works and PC had to buy a new PC! haha…

However, the Chick did indeed had to buy a new cell phone, and in doing so, learned 2 valuable lessons: 1) cell phones do not float and 2) they do not like to get wet.

I rarely have to carry the thing, and when I do, its usually because I have one specific call I am waiting for or My Man Friday is on vacation so I make myself available for the relief pharmacists in case of an emergency. This particular day was such an occurrence. I had to visit the bathroom and against all conventional wisdom I put the phone on the back of the toilet. As I flushed I picked up the phone, and bumped the toilet lid. Bad move. It dislodged my phone from my hand and unceremoniously dropped into the flushing receptacle. As fast as you can say “expensive plumber visit” I had my hand in the bowl retrieving the phone. There are worse things than having to pick a phone out of pee-water, one of which was telling Mr Chick what I did. “Does it work?” he asked. I tried to make a call on it but nothing happened. Once I succeeded in turning it off, it never came on again.

Thankfully I had owned the phone for the prescribed contract so I was able to upgrade for free. My new phone has a camera on it (I never use) and can text (I dont know how). If I pay a lot of money I can read my email on its teeny tiny screen also. I did not opt for the fancy I Phone style. Remember, PC thinks cameras should take pictures and phones should make calls.

When I upgraded my phone the cute sales clerk asked if I wanted to donate my old phone for the women’s shelter…uh, no…not this time thanks.

Tags: cell phones, mistakes, non pharmacy stuff, personal life | |

Every now and then we have a day that causes us to check the calendar to see if its a full moon. This day was one of them. She was in her 30’s, a yuppie type lady with high heels under a smart suit. She handed me a prescription from a clinic very nearby. She was not in my computer so I collected the basic bio-data from her and told her it would be ready in 20 minutes or so. “Oh no”, she said “I dont want to fill this here. I want it at the 99th and Standish store next week” (insert blank look here) I told her that if she drops it off HERE, it wont be THERE next week, it will be HERE at the 12th and main location (where she is NOW). She exhudes a look that says “can you be THIS stupid?” and said “Can’t you call this to them?” Just being a tad pissy that day I responded with “Cant you TAKE this to them, since you want to pick it up there anyway?” She huffily responded “I don’t have time”.

OK, lets recap. Miss I-dont-have-time drove a prescription to a pharmacy she didnt’ want to fill it at to put it on hold so WE could call somebody else next week to fill it elsewhere and she could drive and pick it up there. Perhaps I am missing something but wouldn’t it have been just as easy to have Dr Wonderful pick up the phone, call 99th and Standish, have the rx filled there? Just a thought.

I put the rx on hold and forgot about it. I have no idea if 99th and Standish ever called. I don’t care.

Tags: customers, pharmacy life | |

One of the things Pharmacy Chick thinks is important is the presentation of the prescription given to the patient. I do not like wrinkled tape on the label, the labels crooked on the bottle, and I don’t like to have mispellings. I cannot tell you how many times I have sent a label back to be retyped because pain was spelled “apin” or THE was spelled “hte”. To me, having something spelled wrong tells my customers ” I do not care enough about this process to handle the details and do it right”

Therefore when I got (for the thousandth time) a prescription given to me with the prescribed drug spelled incorrectly, I had to shake my head. Care to guess which two drugs are mis-spelled most of all? Vicodin and Percocet. Give me a break! These two drugs are so common that even the most newly hired medical assistants should be able to spell them correctly.

So why then, do I still see Vicodan and Percoset? What does that say to the patient when the physician’s office gives him/her a drug that they seemingly cannot even spell right? Its not like we are having them spell Afluxihydrodoxyaminodinodab (don’t bother looking it up, you won’t find it). I have seen Vicodin spelled wrong so many times that “vicodan” starts to look normal…

There are times I wish I could just hand the script back to the patient. “There is no such drug”, but for obvious reasons I can’t do that. So I just decided to add it to my gripe list….and blog about it.

Tags: pharmacy life, rambling | |

This morning as I padded sleepy-eyed from the bed to the dresser, I commented to Mr Chick “Today’s going to be a good day!” He asked why and I said “Because its WHITE sock day” We both had a little chuckle because we knew exactly what it meant.

The Chicks do not have a large diversity in the sock drawer. We have a drawer of white socks and a drawer of black socks. When I draw from the black sock drawer, it means I have to go to work. When I draw from the white sock drawer, Its a play day. Today is a WHITE sock day. Poor Mr chick. He put on black socks today

My only exception is this: If I ever make it to Boston, I’ll be RED SOX all over! Boo Yankees.

Peace!

Tags: drivel, letting you in to my life, non pharmacy stuff | |

Going to work on a monday is like beating myself over the head with hammer. It hurts, but for some stupid reason (money??) I keep doing it. You’d think that after a while, I’d get out of the way of the hammer.

Since people who receive faxes from pharmacies probably look at them for 7 nano seconds before passing them off, I have tried to dumb them down to their basic components. I try to use simple terms (first grade) and sharpies to make my point. TWICE today, it was ignored like I was writing sanskrit or something.

Case in point number 1. We asked for a refill for a patient for 90 days supply of Atenolol 50mg She had been on 1/2 tab BID, #90. A couple of hours later a prescription was faxed for same lady for Atenolol 50mg #90 1 po BID. with 11 refills. Because this was inconsistent with what we asked for we sent it back for clarification “Did you intend to change directions from one-half tab twice daily to one tab twice daily?” Please Verify and fax back. … A few hours later we got yet another prescription from the same office–no note, nothing, Atenolol 50mg #180 1 po BID….with 11 refills. First off, do they have any idea that they just ok’ed refills for this woman for 36 months? Secondly, they did not specifically address my question. The other pharmacist said “Fine, it will be filled as written and the patient can talk to the dr if they disagree, just make sure they know whats been changed”

Case in point number 2. Armour Thyroid is on backorder in all strengths. We gave Mrs Jones the last 5 of the 120mg tabs (1qd) we had over the weekend. The patient asked US (not my job) to contact the dr to find out what she should do. We send over a nicely crafted note that said in summary ” ALL Armour thyroid is on back order, is there an alternative you’d like to use in the mean time?” He faxes back (God’s honest truth here…) Use Armour thyroid 60mg 2qd. Brilliant…Hello? is there anybody in there? Can you read? I’m not an ignoramus. If I HAD 60mg Armour, I’d have used it….

It was such a Monday…

Tags: doctors, pharmacy life | |

For the umpteeth time this year, I have had to process and respond to yet another drug recall sent out by manufacturers. As I was stuffing yet another confirmation of recall response into my file cabinet I commented outloud (perhaps too loud for my employees) “Do we live in a freaking third world country? Are we simply incapable of making drugs anymore that work and last thru their expiry date?” It set off an interesting conversation.

Honestly lets ask ourselves that question. In my early years of pharmacy, we’d have 3-5 drug recalls per year, maybe less. Gads, I process hundreds a year now. Most say something like “drug my not maintain potency thru expiration date”. Some recent ones like the ever popular Digoxin recall, required a lot of work of notifying patients and processing returns and reimbursements. Who is going to reimburse me and my staff for the TIME? Nobody. And then, on the heels of that one, we got the morphine recall of an erie similarity: tablet might be of double size. Back to the drawing board: notify patients and accept returns. Ironically on this recall , of the 3 patients I had, nobody would bring theirs back. Seems they get a little possessive of their narcotics. Whatever, I am not going to beat down their door. Honestly I’d think I would notice a tablet DOUBLE the size coming out of a bottle, but hey, apparently they don’t have much quality control in the plant.

Does anybody remember the ABLE Pharmaceutical fiasco a few years ago. My company was out several thousand dollars on that one when they declared bankruptcy on the heels of their own company wide recall. Now I hear the FDA wants into Ranbaxy to look at their records.

Ya know what? Maybe we need to start manufacturing our drugs in the US again. It seems I get more and more people wanting to know WHERE their drugs come from. And since India seems to be the driving force of generics nowdays, “India” seems to be the meek answer I give people more and more. I do not feel comfortable with this. I believe I have a personal responsbility to my patients to provide them with safe and effective medications and if I dont feel very confident about the source of the drugs, why should they?

I have no more control over what I carry anymore than I do the price of gas. The company negotiates contracts with whomever and we get whatever they agree to. It creates interesting conversation at the cash registers every year at this time when the “new contract” goes into effect and just about every generic I have been using has changed. I cringe when I hear a patient say something like “oh it changed again? I quit looking, it changes all the time”. Apotex this month, Ivax the next month, Aurobindo the next month after that.

It used to be that I could identify a loose tablet just by looking at it. When I carried the same generics for years, it was easy and sometimes a fun game: Identify this loose tab: and more often than not, I got it right the first time. Now, who knows.

How many times did we have a levothyroxine recall? three? four? AND, Daytrana recently sent out their second one for the same patches. Purpac (actavis) recalled most of the vitamins they manufacture. I could go on and on.

What is going on? Are drug manufacturers slacking on their manufacturing practices? recordkeeping? Do they make it and hope nobody asks? or is the FDA crossing the line and saying “hey you didn’t dot this “i” and we are going to pull your entire product line”?

Any opinions?

Tags: law, pharmacy life, recalls | |

One of the results of my recent pitching fit was the abundance of returns. This time was no exception. As much as I try, I cannot keep from having returns. I can send anything back within 30 days without a restocking fee but most of the time I have to keep stuff for longer than that. My Man Friday is good for ordering stuff that one person asks about but nobody buys. In my opinion, if something doesn’t move in 6 months, then it needs to go back. Sometimes it becomes more problematic than I think it should: partials, outdates, etc. I try to send what I can back to my wholesaler, the rest goes to the company who handles outdates.

I have some specific gripes about returns. When I first came into practice we bought a significant amount of merchandise directly from the manufacturers. When they would introduce some new and wonderful drug, they would “guarantee” the sale for us. If we bought X amount of Wondermycin, they would take back whatever we couldn’t sell if we returned it within the specified time. What happened to that? Taking possession of something nowdays is like burning a bridge behind you. “Thank you very much, good luck with that…”

AND in the olden days of pharmacy our wholesaler rep used to come by a couple of times a year and handle returns for us. He’d sit in back with his Telxon unit amongst the boxes of outdates and make them vanish for us. That service is gone too.

I tried to return some Zyrtec syrup. I purchased it before it went OTC and now I cannot return it because its “discontinued” . Well I dont give a flying whup if its disontinued. It wasn’t discontinued when I purchased it, its unopened, in date and as long as I purchased it from my wholesaler, then they should take it back. Let them decide what they want to do with it. I only bought it 5 months ago. Now I get to sit on this til next year when it finally outdates and get squat from DrugDestroyers INC.

I’m learning also how to play their game. I send back anything that arrives to me less than perfect. If the box is bent and I keep it for more than 30 days, they will refuse to accept it because it “damaged” even tho that is exactly how they sent it to me. Therefore, if its not pristine and perfect, back it goes.

When I send back my outdates I get a report from DrugDestroyers INC telling me what they are crediting me for and what I get nothing: nada: zero: the big goose egg. I get $0 for too many items now days. And, for everyone of those items there is a reference letter directing me to the bottom of the page as to WHY I got no credit for that item. There are about 30 reasons for them to deny me credit. If they can think it up, its on this page: No partials: Missing seal. Product returned is less than mfr minimum. Not in original container. Item not returnable…And it goes on. They have a lot of ways to deny credit.

I just boxed up another $4000 worth of outdates. $4000 worth of drugs I didn’t sell. $4000 I spent on inventory that didn’t move. What really gets my goat is some of the items in the box. The bottle of Synthroid 200 (1000ct) I had to order because the 100ct were out…its mostly full, The bottle of Prilosec 40mg capsules and I used 7 on a coupon offer. It was never refilled. The Cozaar 25 (#90) that I special ordered, labeled and returned to stock when it was transferred to a nearby competitor for their gift card promo. The brand name Flonase that Mr. I-gotta-have-Brand wanted until his copay went from $25 to $75. The bottle of Dyrenium (triamterene) that I used 30 out of because the Dr didn’t like HCTZ….then put the patient on Dyazide anyway. A big tube of Elocon that we werent’ successful in removing the label (therefore non returnable to the wholesaler) and since its gone generic…never moved again. A box of Arixtra with one syringe out of it…the patient got the rest of the rx at the hospital pharmacy. A box of Nitro-Dur patches with 10 missing (ok, HOW many times do I have to say–no broken boxes of nitro patches??) 2 bottles of Meridia (30ct) because they come 3×30ct and I used one…

No wonder my old boss used to pop a vein when he did returns. Its like flushing hundred dollar bills down the toilet.

Tags: pharmacy life, rambling, returns | |

You know, in recent days Pharmacy Chick has been convinced that Mr Chick has been seeking comfort in the presence of other women. Don’t ask me how I know, I just do. After much handwringing, I finally got my proof. Devastated as I was, I am sure it was just as much of a suprise to the other woman when I caught them in the act, but you would never know it by the look on their faces. I am not sure if I’ll ever get over this betrayal, especially in Pharmacy Chick’s own bed. Scroll to see my proof!

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Meet the other women in Mr Chicks Life!

Tags: having fun, personal life | |

You know the routine, a sketchy character comes with a couple of rx’s usually an antibiotic and a pain killer and only wants the pain med. Happens all the time. We have an urgent care center nearby so this happens quite a bit. Thankfully the Dr. writes all his prescriptions on one blank so the patient cannot pocket one and fill the other. Today we had a guy bring in one of these rx’s for Ery 500 and some Vicodin. On the script the tech wrote “hold” by the Vicodin. I took a second look and asked Are you sure you got this right? Fill the antibiotic and hold the Vicodin? It was affirmed and I filled the rx. When I did the counseling he said the Dr thought he’d need some pain relief, but he didn’t hurt that much. He didnt’have insurance so he didnt’ want to buy something he wasn’t going to use.

Hell didn’t freeze over, Pigs didn’t fly…Cool.

Tags: customers, pharmacy life | |

It was Pharmacy Chick’s day off so Mr and Mrs Chick frequently use the time to run a few errands. Because we live in a metropolitan area, it often involves hopping on a freeway to get from point A to point B. Every freeway has an on/off ramp and on every ramp is a beggar. Your community may have them too, I dunno if panhandling on the freeway is allowed in your state, but it is apparently legal around here. Dirty men (and yes, women) holding a handmade cardboard sign extolling their hard-luck status in attempt to dislodge a few coins (or bills if you are a big enough sap) from your tight fist.

They are even more pathetic when its raining out, but they are out there, rain or shine. They have their corners staked out and God help you if you try to horn in on a prime spot. You’d have better luck ripping off the Mafia than stealing a good panhandle spot. Some bring a dog.

A few years ago our local paper ran an article exposing them for the scam artists that they are: a fairly well organized operation of panhandlers designed to rip you off, by pretending to be homeless, or veterans, or both. “every coin helps” says one sign. “homeless vet” says another “I have 3 kids” said a third, which was interesting cuz this guy looked to be about 65, so his kids would be, what, 30-40 years old by now??

One day I was in a long line by a metered on-ramp. It was almost 6 pm. This guy was standing there with his sign, staring off into space. He had a pack on the ground. Then he acted startled, looked at his watch (6pm), then folded up his sign, grabbed the pack and began to walk off the ramp. WHAT? Quittin time? The watch alarm went off? Time to head home? Trade places with Beggar on the opposite side? Who knows?

PC doesn’t have a heart of stone, she and Mr Chick donate over 10% of their income to charities of our choice, usually our church and a variety of non-profits of our choice. There are organizations in place for the homeless to receive meals each day, a shower and a bed. I am not going to give one man a fish when somebody more able than I can teach hundreds of them to fish and feed their entire families.

One brave soul I know spends a lot of time down town and was panhandled. He wanted money “for food” he said. Being the savvy city dweller, my friend wasn’t fooled. “lets go buy you some food” she said. “No, man” the beggar said, “I’ll buy the food, you just give me $5″. No dice.

I’ll never give them a penny, but I maybe I should keep a bag of dog bones in my car for the next time I see the dog.

Tags: non pharmacy stuff, personal life, rambling | |