The Pharmacy Chick

Wow,  today is the 364th day of my blog.  I made my first entry on Saturday Feb 2 2008.  If you consider go with a 52 week “year” and ignore the leap year, Today is Saturday Jan 31 and I am writing exactly 52 weeks later.

First, I want to say thanks to everybody who has stumbled upon my blog and continue to read it.  I honestly wondered how long I would do this.  As long as I think I have something interesting to write (in my opinion) and you think its interesting to read (in YOUR opinion) I’ll keep doing this.

Second, I have found this blog as a way to relieve some of the pressure of being a retail pharmacist. I think I get as much out of reading your comments as I do writing the posts, so keep them coming!

Thirdly, I highly recommend this theraputic activity!  If you havent started your own blog, do it! It’s fun and makes us a part of a community, albeit an anonymous one!

Heres to another year!

Humbly yours,

The Chick!

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I may be 20 years older than he, but Fernando Verdasco is  one hot tennis player…and I don’t mean the temperature.

Whoa Nellie.

Yes, Mr Chick knows….

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I highly doubt that any physician, unless he is terribly bored, has ever stumbled upon the Chick’s blog.  I mean, there has to be thousands of blogs designed for doctors who hate their patients, just like there are blogs for pharmacists who hate theirs! That being said however, sometimes I wish I had the ear of a room full of them just to ask them one question:

Do you really have any idea how much medicine costs when you prescribe for a patient? Or do you care?

When insurance meant “everything is covered” prescriptions weren’t terribly expensive.  Cosmetic prescriptions hadn’t been invented yet. There was no Retin-A, Viagra or Vaniqa.  If you had acne, ED or chin hair…well, sucks to be you.

Those days are gone.  We have designer drugs and generics.  Reps diss everything generic in favor for their own drug of choice.  You give new hypertensives get prescriptions for Avalide, Cozaar or Coreg SR. Then they come unglued when their copay is tier-3.  Their tummy hurts and you give a prescription for Prevacid.  A pink rash gets Vanos or Taclonex.  A little acne gets Doryx or Solodyn.  The diabetic gets Glumetza.

Its just shameful. You may try samples, and its awfully nice of you to hand out a loyalty card, but has it ever occurred to you WHY you get those loyalty cards in the first place?   To make your patient’s copay go from $50 to $10 STILL means their insurance paid way more than was necessary.  To make matters worse, you might get a fax from ME telling you that YOU need to get a Prior Auth because what you deemed necessary isnt’ covered.  Your office staff gets pretty good at ignoring my repeated requests. Its even more clever when I ask you for a PA for Doryx and you fax back a rx for generic Doxycycline….

And, you know what else? I get tired of catching hell because you didnt discuss alternatives with your patient.  I don’t like to make you look like a dope when your patient asks me “What else could I try?” I also feel its a waste of my time to go back and ask you to change your prescription.

I filled a prescription today for DIAPER RASH.  Big friggen deal… What did the patient get?  Vusion.  Have any idea what is in this $200 tube?  A new miracle drug for a red butt?  Not exactly:  Petrolatum, Zinc oxide and miconazole.  All OTC items.  My pharmacists heart quivers with excitement. Her PBM paid $165.

The next time you complain to your colleagues about reimbursments, think about the piece of the pie you prescribe.

Tags: doctors and patients | |

We all have compliance issue with patients.  For most, its issues of NON compliance, or UNDER compliance.  For many of our narc users, its OVER compliance (read: abuse).   For whatever reason,however, there is a core group of people who think that if they miss one pill of something, they will be ostracized by their friends, lose their birthday and then die a slow painful death.

Ms Wang came into pick up her Crestor prescription.  She works for one of the major companies in the area.  This company split its benefit package for the first time.  Choose plan 1 get one kind of drug plan and card,  Choose plan 2, get a different drug plan and card.  Everybody who chose plan 2 got new cards, with new id number and groups.  I know this for a fact.  No, ifs, ands or butts.  She brought in her new ‘card’.  It was the card she was to use at the doctors office only.  (turn head away and roll eyes)

If Pharmacy Chick were queen of the world,  everybody with insurance would be issued one card.  This is the card you would use at the dental clinic, the dr office, the vision center and the pharmacy.  You would have one (repeat ONE) ID number.  The card would have all eligible people listed, and their person code next to it.  In one corner would be the BIN, Group and PCN number.    There would be joy throughout the land, and all medical providers would rejoice. 

But no, there must be card-s (plural).  I am one of those unfortunates.  I have a drug card and a medical card. I do, however know which one to bring to which place, and do not try to pass my drug card off at the dr office or vis-a-versa. In fact I dont even have a dental card.  I dont understand this. “tell them you have Utna dental” I was told… WHAT?!  Is that some kind of universal plan the dentist will understand?  Apparently.  Its been 17 years and I still haven’t gotten a dental card..and I still have Utna dental, and my dentist still takes my business.  But I digress…

I wish I had a dollar for everybody who told me “This is the only card I have” and then returned the next day with the correct one.  She looked at me like I was speaking Swahili when I told her she had given me the wrong card.  She kept telling me we had her on file.  There was to be no grasping the fact that last years numbers had no value now.

She thought for sure she would die without her evening Crestor.  In fact when I told her otherwise, she looked at me like I was lying to her face.   I didn’t loan her any.  This is not a pharmacy issue, nor a doctor issue.  This is HER issue. 

I know all the stories behind why we dont use social security numbers.  I’m for it frankly, but I will tell you this: everybody KNOWS their number and there used to be a time where all I needed was that number and I could get most insurances to process.  I have a good memory.  I can remember the groups and processors for the major players around here.  I cannot however, pull ten thousand 14 digit id numbers out of my cranium, and have no intention of sitting on hold at Neverland PBM getting the numbers the patient was supposed to have. 

Call me picky, but I don’t require much from the patient.  Mainly all I need from them is INFORMATION. Give it to me and things go well, withhold it or dont have it? , well….you go to bed without your Crestor.

Tags: customers, insurance, pharmacy life | |

Pharmacy Chick is asked a hundred times a year about diets aids etc.  She is not a fan of diet pills, doesn’t recommend any and has never tried any herself. She tells everybody that if you want to lose weight, eat right and exercise.   There used to be a time when I could just “decide” to lose a few pounds and by eliminating soda from my diet, off they’d come.  Those days are gone. 

I grew up in the midwest and hence, grew up eating like any kid of my time, lots of meat and potatoes. Potatoes always had lots of butter and gravy, and every sandwich I ever made had both butter and mayonaise on it. Every meal mom made was many courses. Starting off with a salad,  we had meat, potatoes or rice or pasta, vegetables, bread, and dessert.  I learned these tendencies.  In my own mind, that is what “dinner” was.

Fast forward 20 some years.  I decided that I was going to eat healthier this year.  No, its not a “resolution”, because I never do those.   It was a just a decision to see how I would look and feel if what I put into my body was a little less white, a little less processed, and a little less fatty.

I have eschewed butter and mayonaise on sandwiches. I am practicing portion control, eating small pieces of meat/chicken instead of big pieces.  Real soda out, diet soda or water in.  Fresh steamed veggies in, pasta side dishes out. No second helpings, a real diet buster. Everything in moderation.

So far, I like how I feel.  I certainly have a lot less stomach aches and bloat.  The Chick has struggled with GERD for years.  I’d like to lose about 10 lbs, that all.  Its not like I look like the “before” picture in a diet ad, but I do carry about 10 lbs more on my frame than I did a dozen years ago.

I am not sure what I will do with my pantry full of these boxed meal helpers, but I foresee a time they  may go to the food bank.  These I call “heavy” foods,  they feel heavy in my stomach.  I don’t think it likes to digest these things very much. 

There is, however, one food group that the Chick will not be cooking: fish.  I hate the smell of fish, and how it lingers long past the dishwashing…yuk. I’ll only eat fish if it was cooked in somebody elses kitchen.

Maybe my arteries will be grateful.  OH, and I can buy new clothes maybe.

Tags: personal life | |

Pharmacy Chick has a long time customer named Ben.  Of independent spirit, he is a business owner and has a witty, friendly demeanor.  He is also a quadraplegic that gets around with the aid of a wheelchair and a service dog.  To this day, I have no idea what happened to cause him to end up in the chair because the Chick respects people’s privacy almost to the point where people assume I know more about their personal life than I really do. I figure that if he wants to share with me the where withall of his life, he will do it.  Once he mentioned his “accident” as an “indescretion of youth”.

At no time has he ever complained to me about the unfairness of life or his situation.  By all appearances, it is what it is. Pablo the dog is always ready for a greeting and Ben has no problem with us saying hello to Pab. He  (the dog) usually responds with a huge tail wag.

 His humor, however is fully intact. Once, we were yakking it up at the checkstand, talking about people in general, he made the comment: ” You know,  I have learned that there are 2 people I will never piss off:  My medical team and my wheelchair repair man!”

I am pleased to be part of his medical team. He has no aspirations to be an INspiration, but nevertheless he is to me.

Tags: memorable customers | |

I filled the prescription for 60 Risperdal (BRAND) 3mg.  The new year brought a new copay.  Surprisingly enough it went only from $25 to $50 considering the man wanted BRAND only.   Still the pharmacy chick said outloud “There WILL be whining, no doubt about that”. 

A few hours later Mr B came in.  Without a blink, I scanned the rx at $50.   “Did the price go up?”.  yes, it went from 25 to 50 dollars. “That seems like a steep increase”. This prescription costs $1147 dollars cash, and you want the brand name. $50 sounds like a good deal to me. Then of course I launched into isn’t-it-terrible-how-much-things-cost routine. 

Sheeeet,  you want sympathy?  look in the dictionary.  He won’t take generic which is something like $40-50 now.  He should count the blessings that the insurance didn’t charge him the difference in cost. 

I think next month we will have a little talk. Maybe a $40 difference in copay might just persuade him. His insurance company should buy me lunch if he switches.

Tags: Brand name drugs, customers, pharmacy life | |

Go away for a week and everything changes!  I leave with a white Republican as our president and come back to…well… Obama.  I’ll give him credit however, even tho he had a bit of a flub on the Oath of Office, he had an amazing speech and near as I could tell, had it memorized because I never saw him look at notes.  Pretty good since Pharmacy Chick cannot remember her shopping list by memory anymore.

Let me tell you,  there is nothing going on vacation to see and meet weird people.  I have written before about all the weirdos I have seen at the airport.  They must congregate there.  I got off the plane at my destination and immediately headed to the bathroom (who doesn’t?).  In there was one seriously scary chick.  She was wearing a black leather mini skirt, a black leather shirt, and black chunky heels that were so high I was afraid she’d fall.  She also wore massive sunglasses that only allowed the tip of her nose and her lips to peek thru.  She didn’t look comfortable. 

On my flight was a man I thanked all Heavenly beings that he was not my seatmate.  He was so fat his belly had to have touched the seat in front of him. He probably required an adjustment of luggage beneath him for even weight distribution.  HE could have been used as a flotation device.  Since airplane seates are not noted for their preponderance of space, he clearly would have been taking some of the space I had paid for.

The most talked about viewing was one we saw on the golf course one day.  “Adam and Evan” were frolicking in their backyard pool/hot tub.  Their cameras came out and they were posing for each other in their best Mr Universe poses. Most interesting things one sees on vacation.

We vacationed at a spot noted for people who have lots of money, second homes, and lavish lifestyles, none of which we have.  Fortunately we have a friend who has 2 of the 3, hence the invitation. The temps were like 10 degrees above normal (Thank you God) and we had a wonderful time.  Being there is surreal however.  Even tho there were signs that the economy had affected even this place, there were obviously still a core group of people for whom money is still no object.  Pharmacy Chick wishes it could be her. I would love to run out of material to write about!

Time to return to Earth, hopefully land softly, and head back to work. With any luck, I will have found things went well in my absence.  History tends to prove otherwise. 

And you will hear all about it.

Tags: personal life, vacation | |

SOMEWHERE IN US- Rumors are flying as to the whereabouts of the pharmacist known as Pharmacy Chick.  Her customers have been asking store employees but as of yet, they have denied knowing anything about her disappearance.  Authorities have been hesitant to suggest foul play but they have been interviewing known acquaintances for clues.  A friend who declined to be identified said ” She is always talking about ‘blowing this popcicle stand’. I guess she finally did it”.  She was last seen with a golf bag on her shoulder.  Authorities believe this may prove to be the crucial clue since there was 14 inches of snow on the ground at the time. Anybody knowing anything about her whereabouts are asked to…..keep quiet!  She is on VACATION!

See you in a couple of weeks!

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She came to the counter to pick up a bag full of prescriptions.  She had her granddaughter with her.  The first thing the tech noticed was that the camisole under her cardigan had worked its way a bit high and her bra was sticking out thru the sweater and the cami was “riding high” on her chest.  She didn’t know what to say, so I just said “you are peeking thru just a bit over here today”.  She didn’t figure it out right away and only somewhat corrected her attire by yanking the cardigan shut.

She fumbled with her purse and couldn’t find her credit card amongst the mess so she asked her granddaughter to help. She was DEFINITELY not with it.  Giving up, she asked if she could write a check. I handed her a pen.  “The date?” she asked.  I said ” 1-11-09″.  She wrote down 11-11-09.  Uh Oh.

The total was $287.43.  She got the numbers right, then she tried to write out the check and wrote “two hundred twenty thousand dollars and 43/100’s”   Uh OH , part 2.   I explained to her that she had written her check for essentially $ 220,000.43. and dated it November 11, 2009.  Would she like ME to write it out and she sign it?  “Oh yes, please…”.

I wrote out a new check correctly (though I likely could have funded my next vacation on her and she’d not notice) and she signed the check. And, left……with her granddaughter in tow.

Its clear, you dont have to drink to be impaired.  She takes over 90 Lorazepam 2mg per month.  I have no doubt she drove home.

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