The Pharmacy Chick

October: the month of Oktoberfests, pumpkins, Halloween and Flu-shots.  It gets to be rather busy at Pharmacy Chick’s drugstore at this time.  We attempt to manage the flow by taking appointments.  This little man had an appointment.  He KNEW he was going to get a flu shot. AND, it was close to 70 degrees outside today, an absolutely beautiful day.( remember this).

He came to the counter to tell us he was here for his shot.  We directed him to a table to complete his consent form, which he did promptly and turned it in. 

I processed the paperwork and brought everything out to give him his shot.  He is wearing an overcoat.  He takes it off without any prompts. 

 He is wearing a heavy ragg wool sweater.  I tell him he will have to take it off.  He obliges.

He is wearing a sweatshirt UNDER the sweater.  I tell him he will have to take THAT off.  He obliges.

He is wearing a white turtle neck shirt under the sweatshirt, under the sweater.  He tries to pull it up but only gets above his elbow.  I tell him he will have to take THAT off also.  He obliges. Surely we must be reaching skin by now….

nope.

He has on a T-shirt, under the Turtleneck, under the sweatshirt, under the sweater, which was under the overcoat.  Good God Almighty,  is there a man under there somewhere? or is this like those nesting dolls where the final doll is the size of a fingernail?

Thankfully the T-shirt was short sleeved.  He finally got his shot, then got about the business of reassembling his ensemble.

Remember the weather?  Its close to 70 degrees. Bright sunshine.  Fabulous day for October.  I casually mentioned ” Thats a lot of layers for a warm day”.  He tells me he gets cold easy. 

Heaven help him when things really cool off.

Tags: interesting customers, pharmacy life | |

Pharmacy Chick’s pharmacy has two windows: Intake and Pick-up.  They are about 20 feet apart.  Unless I am down a bay or in the back room, I can see the whole pharmacy.   99% of the time, customers who walk up to the counter are greeted before their feet have quit moving. 

 Occasionally however, circumstances are such that somebody is going to have to wait a moment before they are addressed.  I may be on the phone.  I may be in the bathroom or out on the sales floor with some ditz who cannot decide between between Benadryl Tablets and Capsules and wants my rapt attention to discuss the difference. Tech Extraordinare may be already helping somebody else. Regardless of the circumstance, we will get to the counter as soon as possible.   Unfortunately there seems to be an abundance of people who think they have to announce their presence.  Without exception, they are obnoxious.

1. The Tapper.  Do not tap your bottles on the counter.  My blood pressure rises at the thought.  My counter is not a drum and you aren’t auditioning for a band.

2. The Cougher- Please keep the contents of your lungs where they belong.  

3. The Jingler. Leave your keys and coins in your pockets, and do not give your keys to your toddler to play with. I swear, if he/she throws them into my pharmacy, I will keep them.

4. The Yeller.  Do not yell “is there anybody here?”  If the lights are off and the gates are closed, THERE IS NOBODY HERE, if those conditions aren’t met, we are here, cool your jets.

Unless you see my eyes closed and drooling over my counting tray,  trust me, I see you and will get to you as quickly as possible.  The phone you see attached to my ear is there for a reason.  Somebody is on the other end. They called me first.  Do not tell me I need a bell.  Pharmacy Chick’s pharmacy had a bell…for one day…it was in the trash by the end of that day…it will never be seen again.

If you want my attention try this.  “Hi PC, I’ll just drop this off and come back tomorrow.” 

That works.

Tags: customers, pharmacy life, the little irritating things they do | |

It was a tough day at work. Everybody who came in seemed to have a chip on their shoulder and dared me to knock it off.   With the decline of American civility and courtesy, there seems to be more of these kind of days than nice ones.

Then Sophie came in.  Sophie is a kick…and very unique.   “I need some pricks” she said loudly.  Here, take some of mine, I am thinking…..I know what she wants, but my tech doesn’t. ” You want what?!?”.   “PRICKS….you know…for my fingers” she said.

Lancets…for the more genteel.

A delightful lady, gifted with a nice personality but not great intelligence, probably as a result of a lifetime of seizures and seizure meds. Her  handwriting is reminicent of a child learning cursive: big loopy letters. Her innocent choice of words was always a source of entertainment.

She switched HMO’s a while ago, but she still stops by and always says hello.   

If she ever fills prescriptions with us again, I’ll have LOTS of pricks for her.

Tags: memorable customers, pharmacy life | |

October is officially Pharmacist’s month (whatever that means), but after living thru thru several Octobers as a vaccinator, it should be renamed  Stampede-the-pharmacy-and-get-your-flu-shot Month.  In the past several days,  over 200 shots have passed thru the walls of Pharmacy Chick Pharmacy.  Most of them are the regulars who check to make sure the Chick herself is wielding the needle.  Its flattering indeed if not exhausting.  I have been given NO extra labor to help with this added work, but I try not to let the customer see the frustration.  They just see the happy face of Chick.

A few years ago, I found a little treasure on the internet: A Halloween prop-a 24 inch plastic syringe that looks like it belonged to Frankenstein.  It goes with me to every flu clinic I give and when I feel particularily feisty (especially around men), I bring it out.  I’ll come out and say “I hope you dont mind, I am out of my regular needles, I’ll have to use this (and bring the prop out from behind my back).  Guffaws usually follow and everybody is relaxed and smiling.  Or I’ll say “You better behave or you will get THIS one” (whipping out THE needle). 

I possess a rather sarcastic sense of humor sometimes. It keeps me sane at work. I have learned over the years that you cannot take yourself too serious or people think you are no fun.  This prop has gotten a lot of mileage over the years and even those who have seen it before love to see it brought out.

Our job sucks…alot of the time. We take crap for stuff that is out of our control and not our responsibility to bear the blame.  However,  there are some times we can have some fun.  

This one thing is my avenue.  What is yours?

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Mr Chick was out of town this weekend. 

1. He locked his keys in the car   2.  He left his alarm clock in the motel room  3.  He contracted food poisoning and puked in the bushes 4. He was late for his tee time and got a 2 shot penalty. 5. It rained all weekend.

He stayed at a Holiday Inn Express….I think he should ask for a refund.

Tags: Life with Mr Chick, personal life | |

There are a lot of things that the Pharmacy Chick needs, some I get, some I don’t.

Lately I have been thinking about the stuff I don’t need…its just as interesting.

What I don’t need:

1. Buttheads who whine about their copays: Its your insurance, not mine.  Either pay it or walk out empty handed. I don’t care…really.

2.  Corporate Brass (rhymes with ass) who wear a suit and not a white coat who think they know how to run my department better than I do.

3.  More reports to print, initial, date, and file away…reports nobody will look at again.

4. Another policy or procedure to make CMS happy.  Screw them..

5.  More shifts short staffed.  (pay better and you’ll hire first…not last…)

6.  People who think I should do their work for them. Its YOUR insurance, YOU do the footwork.

7. Any more recall notices. Make it right the first time!  If I make a mistake can I “recall it”?  Nooooo…

8. More phone lines.  Why do I have 6 anyway?

9. Lazy Dr’s.  Just write the damn prescriptions, quit telling your patients to “just have the pharmacy call”   unless you put in a dedicated line right to your ear.

10. Drug Seekers…nuff said.

11. Trash.  I don’t care what color it is, if you CAN work, and you DONT work, and you are living off the dime of those who do, you are trash.

12. Being open on holidays.  Geez, give us a break. 

13. One more person who tells me how he pays my salary with the money he spends at my pharmacy. Unless you pay cash, you aren’t helping much with that AWP-40% + 10cents your PBM pays. You’d be embarrassed if you knew how little we make off your drugs.

13a  People who use the term “rich pharmacists”.  Yea, I make a living, but I’m no Sultan of Brunei and if I was rich, I’d surely not be wearing the white coat anymore.

14.  Any more prior authorizations. 

15. Loyalty cards. Coupons…  If you want the rebate, mail the thing in. quit wasting my time trying to get Solodyn free.

15a. Split billing ANYTHING-If you’ve got 2 insurances, count yourselves lucky. There are millions who don’t have even ONE, so quit copping an attitude when I can’t double bill.

16. Insurance cards without enough information to process a claim.

17. Prescriptions on generic blanks.  Look, businesses won’t take checks unless the customer information is pre printed on the check, why do we continue to take blanks without Dr info pre printed on them? 

18. Price Matches

19. Gift card promo’s

20. predatory pricing by  mass retailers who prostitue their ”pharmacies”.

Any contributions? What don’t YOU need anymore!

Tags: cleaning out the mental junk drawer, whine fest | |

Our pharmacy friend Jim Plagakis hasn’t posted in a while and I’ll bet it has much to do with the influence of Hurricaine Ike in his life.  He lives in Galveson.  Say a prayer today (to whatever diety you may choose, I personally choose the Christian Lord) for Jim and his family that whatever happened to his home is fixable and he can get back to normalcy soon.  All the crap we put up with all day is no comparison to having your home messed up, or worse yet, no place to GO HOME. 

Jim, I prayed for you today.

Pharmacy Chick.

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Right out of the chute this morning comes this prescription:  Bactroban Ointment 19gm.  yada yada yada.. Of course I filled it with Mupirocin Ointment 22gm.  I found humor in the prescription because the Dr wrote for a tube size of 19 gm.  Where did she ever get the idea to write for 19gm?  Why not 15 or 30 gm? Did she actually think I was going to dispense exactly 19gm?  And, why 19?

Its weird enough that it comes in a tube size of 22gm.  I’d love to get inside the head of the guy who decided on 22gm was the appropriate size for this tube of ointment.   

Then came the Effexor XR 100mg Rx.   Sometimes one glance at a prescription tells you that you are gonna have a problem.  You are NOT going to dispense XR 100mg capsules because it is not MADE.  You aren’t going to mix and match to make XR 100mg either.  Joe customer wants to wait for it.  That’s not going to happen either. 

 I wasted time to call the office,  the patient had to leave and come back, the nurse had to chase the Dr. down, then somebody had to call me back. 

October 1 meant that the entire planet thought they needed to get their flu shot…at Chick’s pharmacy…today, and thanks to a brilliant ad campaign that told people to Just Walk In,  they did…in droves…and all the promised extra help?  nope,  not there.

The real head-slapping moment arrived with the C-2 without a signature.   Its bad when the signature is unreadable.  It sucks bigtime when I have to hand the script back to the patient because its not signed. The situation was made worse because it was a discharge pain med,  the family had to go back to the hospital and chase down a doctor who likely wasn’t there anymore.  I dunno,  they didn’t make it back before I closed. 

After 11 hours behind the counter, I had enough.  I didn’t need any more problems. I was behind on my work, I had 3-4 flu shots waiting, and my sanity was declining fast. The Coke had worn off, and my stomach was gnawing at me. Then Mr Lexapro came in.  His profile consisted of two cash transactions for citalopram $4.00 rx’s.  I am guessing since he had insurance now he could afford the fancy stuff.  Problem is, he handed me the wrong card.  “Can’t you just GIVE me a few til I get it straightened out? The other pharmacy does when they don’t have enough..”  no, I am not going to give you a few.  I will SELL you a few. I have enough medication, you are the one with the problem. Then this brilliant brain trust asked “Can you (my emphasis) call my insurance company? I have their number.”  Wrong thing to ask this very tired pharmacist.  I wrote down the following on a piece of paper: ” bin:  Pcn:   Group:  ID:   ” “I have absolutely no time today to do this, everybody you see here is waiting for something from me RIGHT NOW.  You may call your insurance and get those 4 numbers for me. If you get them,  then I can bill your insurance.  Make sure YOU get them right.”  I’ll bet his wife was on the phone for 20 minutes before she presented me those 4 magic numbers and 10 minutes later he was out of there with is $25 Lexapro.  He wanted to know what the difference was.  “Honestly?  about $21″ 

It was a hard day. It took me about 45 minutes after closing to leave the pharmacy presentable for My Man Friday who was working the next day. He was going to be one person short tomorrow.  I felt for him.   Tired as I was,  Pharmacy Chick doesn’t like to leave work for the next day’s staff. She does think her life expectancy  was cut short by a few years today however.

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Pharmacy Chick has 3 major social outings:  Work, church, and my sport activity of choice.  My chosen church is a larger church and has opportunities for many after-service social functions.  The women’s ministry is very active with all sorts of luncheons, retreats, meetings, speakers, culture nights, craft nights, card nights, you-name-it-nights.  And, for 99% of them, I stay home.  Not that they are bad,  they aren’t. In fact they are wonderful.  I get invitations for all of them by my friends from church.  “you’ll have FUN, come on!”  The largest majority of these events I have an automatic “out” because they happen to be scheduled when I am working.  However most of these invites are from my stay-at-home mom friends.  I have a lot of them.

I respect (and am envious to some degree) that they can stay at home and I believe their children will be better for it.  I think kids are better off if they are raised by full time parents instead of spending 40 hours a week in day care. ( no hate mail from working parents–I understand why you have to work too OK???) BUT where I am going with this post is this: to me, these social outings are like being at work, and I am at work too much already.  Stay with me here.

When I am at work, I am in a very noisy public setting, being at the beckon call of patients, their family and caregivers, doctors, nurses, drug reps, and fellow employees. Every one of them wants a piece of the Chick and I have little say as to how my pieces are doled out. I cannot control when the phone rings,  or when I am summoned for a counsel. I put out a hundred fires a day all on somebody elses time table. I eat between prescriptions and when a patient  interrupts me with an insincere ”sorry to interrupt your meal BUT….”  I want to scream “SO DON’T OK?” 

I have gotten to the point where my FREE TIME is not free..its very valuable to me.  It is my most valued non-tangible posession, and I like to be in control of how (and with whom) I spend my free time.  The last thing I want to be doing in my free time is spending it in more noisy public situations, where I have to make small talk with people I don’t know very well.  Once somebody finds out what I do for a living, the inevitable questions start next and BAM, I am at work again.

Its not that I am antisocial,  I love to hang out with my friends.  I do however, love my quiet time at home with just Mr. Chick and myself.  Home is a special place for me. Caller ID determines if I am going to answer the phone, and when I see “800-service” on the screen, I ignore it.  I can see who is at my door with out being seen and if I see a stranger, I may not answer it. I’ve picked up a few hobbies I can pursue at home and it feels good to be able to do them.

I feel this is a casualty of the exposure overload I get all day at work. Maybe if I worked at a desk all day or if I was a stay-at-home-mom, I’d appreciate the social stimulation.  For now, give me some yarn and  a crochet hook, turn off the TV and leave me in peace.

Tags: personal life, quiet please, thanks but no thanks | |

Pharmacy Chick would like to believe that the prices that the pharmacy charges to cash payers have been researched by a department of very smart people who have devised complicated formulas for each drug to remain competitve in every market.  Either that or its a random collection of prices set by a bunch of drunk executives trying to justify their existence.  Lately I am leaning towards the “drunk executives”.

When some poor (literally) soul without insurance comes in with a clindamycin 150 #56 2 TID,  my cost is something like $4-6 dollars.  The price to the customer comes out at $70+.  I suspect this goes back to the pricing schedule based on a percentage of the brand.  Brand Cleocin would be at least twice that, so $70 is still a great savings over the brand.  Regardless, if you dont have any money, $70 is as out of reach as that Astin Martin I saw in the parking lot.

I usually try to encourage the uninsured to at least obtain some kind of discount plan, preferably a free one. (why should a PBM make money for nothing?) Not all do and Pharmacy Chick gets to make a decision: Charge the full price and hope they dont balk and leave, or sell it competitively to keep the sale.

Therefore, I will occasionally give somebody a break on these one-timers.  I try not to override prices on monthly rx’s because it means somebody has to remember to do it every month, and invariably it will get forgotten.  Then something weird happens:  the customer who was oh-so-grateful for Chick’s price reduction, now considers it an entitlement and gets indignant and pissy when this price reduction is accidentally forgotten.  It happened enough times that I have decided its not an exception.  By bad luck or fate, these special cases always seem to show up when relief pharmacists or techs or on duty.  They either don’t notice or don’t care that the price is different.

I had one today but it wasn’t my own price override.  I had a transfer from within our own company.  The retail price was $21.  It was a non-covered item. She bristled at the counter when the tech rang her up. Apparently the pharmacist at the original store sold it to her for $10 and neglected to tell us that when we did the transfer.  Her pissy attitude put me off right away.  “He apparently gave you some kind of special deal, because this is the standard retail price.” I told her and offered to call to find out what he had been doing.  We obtained the information, decided to grant her the same offer and redid the rx.  The ungrateful wench grabbed her bag and walked off muttering something about getting ripped off.

The Tech was pissed because she was the one who did all the work.  “You’d think she might be grateful we agreed to charge the same price…we didn’t have to.” she said.  I agreed with her on that one. I just told her that some people look their gift horses in the mouth.

Thought for the day:  No good deed goes unpunished.

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