RING RING

Customer:  I just received a reminder call that I have a prescription there..what is it?

Employee:  Let me check (goes to shelf) We have Viagra here for you

Customer:  Oh I forgot about that…do you think I need it?

Employee:  I have absolutely no idea..

If it had been me…I would have said…Why dont you ask your wife?

Loestrin 1.5/30

#100

One teaspoonful once daily.

does ANYBODY look at these things before they sent them?  ( but if I layer them really carefully I may get about 15 tabs in one level teaspoonful)

puhleeze….

(look on shelf…no Brown)  “no, dont have a prescription for any “brown” family today”

” ARE YOU SURE?”  ( oh my favorite line)  “They said they called it in”. (of course they did)

I go to the computer…”and what is the first name?” and he gives me his first name…we dont have him in the computer at all. 

“ok, John Brown”. I dont have you in my computer and I haven’t received any phone call, fax or escript for you at all today.

“Oh, its not for me…its for my dog.”

(do a quick check of fax pile and see a vet rx for a Sally the dog Johnson)  “The only vet rx I have is for the last name Johnson”.

“Oh, thats me.  See? they did call it in”  (restraining the Dilbert fist of death).

(cant resist)  “So how was I supposed to get Brown out of Johnson?”

“Its actually my girlfriend’s dog”.

Girlfriend…do us all a favor..dont breed with this one.

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“Hey, can I get a flu shot today?”

“Sure” (and I give him proper instructions to fill out form…etc)…which he does…

He hands me the form and his insurance which is not accepted yet.  Most contracts havent’ been finalized..after all, it is FRIGGIN AUGUST and its 97 degrees out side.

“Sir, your insurance won’t pay for a flu shot yet, it hasn’t signed contracts for billing yet..check with me after Sept 1″.

He launches into a diatribe ” Yada…I am high risk, and must have a flu shot” (its August..and still 97 degrees out side) “I cant believe they won’t pay for my shot..they did last year” ( yes they did..in October)..stammered on…and on…

I offered him the shot for the usual $28 if he HAD to have it today. 

I guess keeping his $28 was more important. 

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“your insurance is terminated”…..”NO, THIS IS MY NEW CARD”.  “Yes, I see that, but its marked as terminated. I have all the right numbers”  “HERE, LOOK AT MY OLD CARD”. (matches new card except for color) “  I agree with you sir, it should work, but it doesn’t and I can’t fix that”  “GIVE ME MY PAPERS BACK”  “Ok, here you are sir,  good luck”. 

 I would love to be a fly on the wall at the pharmacy down the street when he hands these same rx’s to some pharmacist…who looks at my half peeled of labels and wonders why he is there…but will find out soon enough..”coverage not active on date of service”.

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If I have a prescription for Dog food, can I bill it to my insurance?

no, we cannot bill dog food to your health insurance.

“But its PRESCRIPTION dog food”.

no can do…not even if you are eating it yourself.

“Have you had your compounding class yet?” I asked.  “No, we dont have that class.  but we watched a video”…….A VIDEO… “But we made some lip balm and some sun screen last year”.  oh thats useful..who is ever gonna need to make lip balm or sunscreen?

She had never heard of the word triturate….she had never used a torsion balance.  She had no idea the difference between a balance and a scale. She didnt know what a eutectic mixture was.  I showed her a glass pill tile and asked her “Do you know what this is?”..she shook her head “no”.

Compounding class was the most fun class I took.  It was where I felt I was learning a secret skill.  I made rectal rockets, rolled pills (yes, rolled PILLS), made calamine lotion from scratch,  prepared a bunch of different ointments, creams, emulsions, etc…and had an all around good time.  We learned how to properly fill ointment TUBES and JARS ( do NOT let the cream stick to the lid students…an automatic F)  We made capsules and filled powder papers. I watched what happened if you put camphor and menthol crystals together…  Of al the classes I took,  compounding was the one I looked forward to the most and wished I could take over again.

Rewind 22 years.. The class before me was the last class offered Pharmacognosy…the study of drugs of plant origins.  We weren’t even offered it as an elective..it was discontinued.  I really felt I missed out on that one.

Is compounding  a class discontinued in pharmacy schools today?  How sad if its true.  Its our gift…Its our heritage…its OURS!

When Pharmacy Chick was working at an independent pharmacy, we had a contract with a pharmaceutical supply house.  I had access to any compounding supply I needed.  while I didn’t need to make a whole lot of stuff, I got to make stuff a lot more often than I do now.

Pharmacy Chick Pharmacy is a conglomerate.  No contracts with supply houses..Im lucky to be able to buy sulfur powder.  When my glass graduate broke, my wholesaler didnt’ even have one.  I found it on ebay! In fact, when I opened my store, I was given NO compounding supplies.  I imported them from the store we had purchased.  One of my graduated cylinders has actual etched glass. Truly an antique.

I showed my intern how to make this cream…Step by step.  And in one day she learned all of the answers to the questions she couldn’t answer earlier in the day.  And I think she really enjoyed it.

So on this day it was Aetna’s turn..beep beep beep boop boop boop…ring ring.

Some dude from someplace off the shore answered the phone and I’m thinking..”Great, some guy from Manilla who isn’t going to understand anything I want” so I launch into my spiel.  “Hello, this is Pharmacy Chick from Pharmacy CHick Pharmacy and I need a dosage change override for one of your clients.”

I hear a pause and he says, “Do you have your account number?”

and I reply,  “dont you mean the patients ID number?..I dont know what my Aetna account number is.. but I need a dosage change override for a patient please..”

And he says:  “Ma’am this is technical support for an Adults only website, so unless you have your account number or visa on file with us, I dont think I can help you”.

and I say..”YOU ARE CERTAINLY RIGHT!”  “Never mind…”  click.

I checked my number dialed.. it  missed one digit.

and it was a doozy!  LOL.  Years ago, I was trying to dial McKesson by memory and got a phone s*x service…long before the days of 1-900 numbers..whodda thought there was technical support for such a website?  and who would call anyway???  ” UM, hello, my videos wont play…”

Puhleeze..

1. Script from ER>  Symbicort 250/50.  From the get go, somebody has no clue.  I call the Urgent Care clinic and actually get Dr on the phone.  Apparently he knew nothing of what he was prescribing because ” Thats what she said she was on”.    He said to have patient  figure out what she was on, give her that, and let him know. She swears its Symbicort.. We finally had to resort to “what color is the box you used?”  She said red… I said, “thats not one of the options… Blue or Green?   blank stare…

2.  customer calls us and wants us to fill some simvastatin for her.  We discover she had never had it here.   She said she got it mail order and wants to know if we can fill it.  We say sure, we can transfer it from mail order…but NO, she doesn’t want us to transfer it….just fill it.  Must be the slow class..  We think we are moving in the right direction when things get weirder.. ” Can you check my chart to see if I am supposed to be on simvastatin anymore?”  Um, we dont have your chart records Ma’am.  This is the pharmacy. Call your physician..” Do you have his phone number?” Sure, what is his name?  “I dont know, dont you have it on your chart?”

moving on…

We get a script for Suboxone.  12mg for 1 week, 16mg the next then back to 12mg.. (!?!)  We call for clarification and the nurse says “we wondered if we would get a question about that”.  yea well thanks for helping the pharmacy out by NOT clarifiying anything, thereby making us call.  Turns out the patient is having some procedure that week and may need MORE suboxone.  How about not getting hooked on narcotics in the first place.?

” Do you deliver?”  No we dont have a delivery service   “well do you suppose one of your underlings would like to make a quick $20 by delivering my prescriptions?”  um, not likely and I am sure they appreciated being thought of as “underlings”.(thought but not said)

RING RING…   ” do you have 480 OxyContin 80mg?”  Not in a million years.

“What do you mean I have to take Generic Effexor now??”  State welfare doesnt’ pay for brand anymore now that there is a generic. “what a ripoff”..  (free is free, I fail to feel a lot of compassion right now)

But the winner of the day goes to :

“Do you have Lovenox 150″  (we affirm that we do).  ” OMG! you do??? I have called every pharmacy in town and nobody has it and I gotta have it today! wow!.  can’t believe my luck…(we fill the rx..and ring it up…cash rx)  “Oh thats too much money…do you price match?” 

I need a beverage…

“Can I ask you a question?”

(me) “Sure”

“What do YOU recommend to cover your gray?”

(me, appalled) “Um, nothing, I dont color my hair”

“Oh, yea…(looking at my hair) I see that”..(walks off).

What the….?

We are unfortunately becoming accustomed to large doses of narcs from the pain clinic nearby.  Many nary blink an eye when given a script for 180 Percocet-10.    I have no doubt that I have some forgeries in my filled file.  I have however, tried to give more scrutiny to scripts that do not originate at the pain clinic and their very distinctive blanks.

Forgery 1 had been filled here before, 6 times in fact which pisses me off to no end.  This was a very good forgery using same computer format as the doctor,  and comparing his real signature with the fake one yeilded little difference.   He had as much variance in his real signature examples as the fake one.  He got found out when he filled it at a different store and they forgot to put a pill in the bottle (when it was discovered under the counting tray).  The phone number was no good on the script and a call to the doctor for more information, discovered the sad fact that they had no patient by this name.    He hasn’t been back to MY store but if he does he will have a police escort and an arrest to take with him also.

Forgery 2 I was ready to fill, til I noticed that the DEA number I had on file for the guy was different than the one on the blank.  Feeling I should better check, I told the guy I would fill it in the morning.  He said he would come back…and of course..never did because it too was a forgery. He managed to get nice security paper for it too.  I am aware that some Dr’s have changed their DEA numbers so I wasn’t so much calling to VERIFY the script as to determine which DEA number was correct…tho I had mentioned to the tech. “Well at least I have a valid reason to decline this script..I really want to check on it”.

Forgery 3 never looked right from the get-go.  150 Oxy IR and 14 Bactrim DS?  He too had the special paper from a big clinic nearby which even had the clinic name imbedded in the paper and the heat sensitive logo.  This was the real deal as far as the paper goes.  How he got it is beyond me, but  I am sure the guy didn’t believe anybody would check on the rx on a saturday.  He was wrong.  The doctor confirmed that the script was fake and wanted me to call 911 and have him arrested.  Geez, it was 10 minutes before closing and I doubted I could keep him in the store that long, but she insisted, so I played the game.  He got skittish and meandered (the best word I could find) away.  He was gone before the police got to the store, but his curiosity may have cost him. He came to the counter a couple of times while I was working, putting him in full view of our cameras.  (the cops got a nice DVD of that face).

The Chick wants to catch the bad guy as bad as any pharmacist, but I also know the reality that we have a pretty narrow window before the customer leaves and when the cops show up. I usually just keep the script and say ” the doctor said he never wrote this,  do you have anything to say about that?” “Please call your doctor”.  There are some nuts out there and I really dont want a backside  with a bullet in it. 

It was a bit nerve wracking and I got home nearly an hour late.  You know what? I really prefer boring days to this kind.

Pharmacy Chick and Mr Chick decided to take in a MAJOR LEAGUE BASEBALL GAME to see, among other things, grown men spit, scratch their body parts, and throw tantrums that would make a 2 year old jealous.  Because OUR town doesn’t have a MLB team, this endeavor involved a 3 hour road trip.  Being smart, we left 5 hours early and thanks to road construction on nearly the entire stretch of freeway, we arrived to the stadium mere moments before the opening pitch.  This disappointed Mr Chick because that meant we had to eat stadium food and not at Rib-O-Rama nearby. 

We passed all sorts of lots to park at ( $10 here,  $15 there..) and finally settled on the screaming deal of $20 in a parking structure right next to the stadium.  Being ever frugal Mr Chick would have preferred to try to negotiate the maze of traffic to re-find the $10 lot but considering 1) we werent familiar with all their one-way traffic patterns in the city and 2) the price of our tickets WAY trumped the parking fee, we decided that seeing the GAME was a better option that spending another 1/2 hour trying to park for 10 bucks less.

We ponied up $3 for a program from Mr “My program is way better than the ones they sell inside”, got in the gate, then learned yet another “murphy’s rule” of events:  Your seat will always be on the opposite end of the building from the door you entered.  Our seats were on the first base line and the door we came in was left outfield.  We leafed thru the program and found it to be of little value except for the animated discussion we had over the listing of salaries of each player….  I am clearly in the wrong profession.  Give me enough time and I’ll figure out a way to throw a ball 95 miles an hour and make 14 million dollars.

I’ll give Mr Chick credit, we got GREAT SEATS…Until Larry Bird sat down..No, not the REAL Larry Bird.. but might as well have been.  This guy has to shop at  Tall and Taller Menswear and clearly had been told by his mother “sit up straight!”.  His head was directly in front of me and nearly blocked the entire path between pitcher and batter.  Mr Chick and I traded places and he claimed he could see just fine.  Our worthless program came in handy as an umbrella when somebody above us spilled a beer and it cascaded over the railing and dripped into Mrs Bird’s lap.  We made a mental note for future reference:  Stay away from row 31….the drip zone. 

The people surrounding us were nearly as interesting as the game.  By accident rather than by design, we were surrounded by people who for the most part (like we were) there to watch the OPPOSING team.  We met:

Mr Statistics:  Must be a bean counter, because he had all his implements out to keep score of the entire game. He had a radio strapped to his arm and buds in his ear as he grinded over keeping an accurate assessment of every play.  He had a most animated disagreement with his companion over who an error was to be charged to.

Ms Smorgasbord.  She didn’t come to the game to watch ball,  she came to eat.  And eat she did.  Bringing enough food to feed the aisle, she sat down and began the shoveling.  If she caught a game ball, she’d have eaten that too I think.

The Drunkard and his friends.  None of this group caught much of this game and openly said to whomever was listening ” I dont care who wins, where is the beer guy?”.  At $7.25 a glass, I have no doubt they spent more on beer than they paid on their tickets.  They left shortly after the 7th inning when the beer guy called “last call”.

The Screamer.  She and her friend were in their early twenties, she in her home team jersey and her friend in the opposing team jersey.  They asked me to take a picture with her Iphone, which I politely agreed.  When the opposing team was PUMMELING the home team she was quiet but when the momentum shifted, she began to scream…this blood curdling shriek to which I was sure I should be calling 911.   She was either demon posessed or in labor…or both.  Regardless, I told Mr Chick we were either going to move or I was going to rip her lungs out.  He chose the former option and we moved down to an empty couple of chairs several rows away.  

IBBC( itty bitty bladder club).  Up and down, up and down.. excuse me …pardon me…back and forth to the bathroom.  I am thinking an aisle seat would have been better for this gal.  Because she felt the need to explain her every passage, I decided the next time I would give her a card to the best urologist I knew. 

The soldier.  Right next to us was a man and his wife. While he was out getting snacks we entered into a casual conversation with his wife.  She mentioned they had just moved to the area and are ’stationed’ nearby.  I asked if they were military and she said he had just completed his 5th (read that number..FIVE) tour in Iraq..and is heading back soon.  Later on while SHE was out getting something I just said ” Hey, thanks for all you do,  a lot of us appreciate you guys”.  He was quiet and gracious and as we chatted about his service over there he said ” after a while, it just becomes the new normal”  Wow.. I could never think of Iraq as anything resembling NORMAL.  I pray he makes it back from tour number 6.

The opposing team (OUR TEAM) won the game and I was pleased that the Screamer was made mute by the final score… 

After a 3+ hour trip back home we were snuggly in our beds by 3 am.  Another fun day in Chickville!

For the last several years, Pharmacy Chick has endured both feasts and famine when it comes to her tech help.  I have had the best…I have had the worst..I have also had the late, the absent, the sick, the no shows, the home-dramas, the babysistter crises, and the show-up-at-wrong-store techs also.  During these droughts of quality I have struggled with keeping up the facade that Pharmacy Chick pharmacy runs like a fine automobile. 

It wasn’t always easy…or successfull.

I recently had the opportunity to hire a new tech, when one of my other techs failed to return from a scheduled leave.  I had several applicants but one stood out.  She had been in the store before and knew tech-ing like she was born to do it.  So I hired her.

It has been a blessing BEYOND blessings in the recent weeks and I pray to the Lord above that all stays the same.  Here is what I have to “endure” now.

I get to “endure” two techs who like each other and enjoy each others company.  I get to “endure” techs that show up to work on time.  I get to “endure” techs who are capable, know how to do the job and work independently without drama, self aggrandizing, or prima-donna-ness. I get to have days off where I return to work and everything has been done as it should be. 

And this is what I do not have to endure:   competition,  backstabbing, gossip, excuses, and  passive agressiveness. 

So, even tho my techs do not know I  write this blog, I say thanks!  My job is 100 times easier than it was 6 months ago. I dont even have as much to whine (and therefore WRITE) about.

Now I am going to go back and sit on my patio, enjoy the afternoon sun, drink a Coke and toss a wet slimy tennis ball to my dog.