The Pharmacy Chick

Fred came to the counter clutching a pharmacy bag. He had been in a few hours ago picking up a prescription for his wife. I was at the other end filling a prescription and our poor tech got the brunt of his tirade. “You shorted me 3 pills”. He was waving his bag, going on and on about who is going to take care of this, what kind of business we run around here, ripping off old people, etc. I let him rant for while. He was going to have his say, and I was going to let him. After all, Pharmacy Chick knew exactly where this conversation was going to end up. After the cork holding in his steaming brain blew off, I walked over with an overly big smile and said ” Hi Fred, Do you you remember when you came in on Friday and wanted a refill on this and we had to call the Dr?” He nodded ” And do you remember you told me you were OUT and I loaned you 3 tablets AT NO CHARGE (my emphasis added)? The blood began to drain out of his face. “well, 30 minus the 3 we gave you is 27, so your bottle had 27 tablets in it, and was marked as such, if you look at your receipt” . “oh, yes, so it was” he mumbled “never mind” and he slinked away. No apologies offered, and no apologies accepted. Marvelous tech said “He didn’t even say he was sorry?” I guess embarassment trumped traditional social graces.

Another day, Another issue: Eileen comes to the drop off window with her bag from moments ago. She was literally shaking with irritation. “This rx is $121.00? I only paid $5 for it last month.” We had had this discussion at the register on an different rx, different day day but apparently it went completely over her head. “you are in the Donut Hole remember?” “Yes, but I only paid $5 for this last month” She paid $5 for everything last month… Could it actually be she thinks this eye drop only costs $5?? I tried to explain that she wasn’t in the donut hole last month and that her $5 copay was only a very small part of the cost. “You mean I am the one who has to pay for it while I am in the donut hole?” Uh, hello, who else would you expect would be paying for it?…. yes that is exactly what it means…the unwelcome reality of the Donut Hole.

Had she asked SOMEBODY, we might have been able to keep her out of the dreaded Hole. Dump the Lipitor the Cozaar, try the Simvastatin and the ACE or Beta-blocker first. Accept my recommendation to not get the Vanos with the $35 manufacturer loyalty card, “But its FREE!” and use the Fluocinonide cream.

The donut hole has a purpose. It’s a reverse incentive to not waste the drugs you take, and be ever watchful about what these things cost. If you play your cards right, many people can get thru the entire year before reaching the donut hole. $2500 ads up right quick when your profile is full of single source brand products like the Lipitor Cozaar, Advair, Januvia, Nexium, Alphagan, and Effexor. Toss in a few infections treated with Levaquin and TaDa, YOU are in the hole.

I offered to take back her unopened box of eye drops. “but I have to have them!” She kept them but said she would get samples for the rest of the year.

Hey, I tried.

Tags: behavior, customers, insurance, pharmacy life | |

One of the things that makes or breaks a day for Pharmacy Chick is the general smoothness of the day, in other words, how many petty annoyances I have had to deal with. You all know what I mean, its all those little straws that add up and finally break this camel’s back. What bugs me may not bug another pharmacist, and vis-a-versa. Here are a few “straws” that start adding up after a while. Best stay away from PC when they do.

1. Visitors: when some guy from the corporate office comes by and pretends to be interested in talking to me when actually all he is doing is keeping me from getting my own work done. Giving me a firm handshake as he leaves, I have no doubt he had forgotten my name before he hit the door. Meanwhile I am 15 minutes behind from this 5 minute encounter….Any Rep who wants my time to extol the virtues of his new $400 a bottle me too antidepressant/PPI/antihistamine enantiomer.

2. The pointless cash register questions: why is it that some people cannot take one prescription from the counter without having to have it taken back to the computer for SOMETHING? “How much would this cost without my insurance?” Why? are you losing your insurance? “Just curious.” Well, I am sure the 6 people behind you are more curious as to why you are holding up the line than you are about the price of this rx. OR “I only paid $25 for this last month…why is it $35?” (trudge to computer and find that she has paid $35 every month since Jan and tell customer..to which she replies) “Are you sure?” NO, I AM A COMPULSIVE LIAR!”

3. Out of everything: Some days we get RX’s for every weird item under the sun, none of which I have and have to special order. Must be the moon.

4. The price checker who wants to know BEFORE she fills her 4 prescriptions what her copays are…right now…while she stands there….Come back in 15 minutes. If you dont want them fine, but go away for now.

5. The refill auths that have to go back because something is different and no notes are added. We ask for Fiorinal, they fax back Fioricet. We ask for Levoxyl 112, they fax back 125. We ask for TAC 0.1% cream, they fax back ointment. We ask for 90 +3 and they fax back 30+11 refills. Geez, dont they even READ the refill requests?

6. I have a transfer max. Give me more than 2 copies a day and you are pushing the Annoyance Quotient dangerously high. Same for price match requests. (an aside: Pharmacy Chick is of the firm belief that when you put the control of price in the hands of the customer, you have lost control of your business) …probably a entire other blog post on that one statement.

7. No time for food. Pharmacy chick needs to eat something between 2 and 3 pm. Thats when her body speaks to her and says “feed me or I will become surly”. I get testy when people annoy me and keep me from eating my food…especially for piddly, pointless, petty questions like “My dr told me to take Advil–should I take tablets or caplets?”

8. The normally brilliant Tech who left her brain at home. “How do I ring up this WIC?” Its on the wall, follow the procedure..” Where on the wall?”. Look up! ” I dont see it” (walk over and almost hit her nose taking it off the wall) “Oh, thanks” Then she still F’s it up despite the fact its written so clear a 6 year old could follow the directions. AND “Do you want me to ring up this insurance check?” We do it every day. why would this day any different?.. “Do we carry Harry’s Hair Potion?” I am apparently the all knowing psychic because I am assumed to know if we carry everything without having to check.

9. Any more than 2 calls per day from any customer wanting to know if a prescription is ready when they have called it in only 2 hours ago…on a friday afternoon…

10. Any more than 2 conversations that begins with ” I know you are busy, but….”

11. my Annoyance Quotient gets into the red zone when too many people come back to pick up their prescriptions BEFORE they are done. I tell them 20 minutes, they come back in 10 and hover over the counter. I dont lie folks, 20 minutes means 20 minutes. I get testier when I hear a tech say “yea, its ready, all the pharmacist has to do is check it”, like its no big thing. Sometime I have to remind my techs that THE PRESCRIPTION ISN’T READY UNTIL ITS CHECKED, SO DON’T TELL THE CUSTOMER IT IS. THATS THE FINAL CHECK, AND ITS NOT TO BE RUSHED OR TAKEN LIGHTLY. I have caught a fair number of mistakes on this final check.

12. anybody who orders a refill at the checkstand…and wants to wait…right there..and the clerk lets them… They come in bunches, they do.

Some days I skate thru a day with few of these annoyances, other days they make me ready for the loony bin. I find that its rarely the big things that make me crazy but the little ones that bring me to the brink. I dont mind the challenge of a big project, but when you tap on my shoulder every 15 seconds, the breaking point comes into view.

….I’m just sayin’

More to come. I have decisions to make.

Tags: behavior, customers, employees, pharmacy life | |

Mary is one of my longtime customers. She is nice enough, in an obnoxious sort of way. She buys a few things here and there ( I think she uses mail order for most), but because of a particularily annoying habit, Pharmacy Chick doesn’t like it when she asks for help. You see, Mary disses every piece of advice she asks for. She not only did it again yesterday, but I told her she was going to do it in advance. And, of course, Pharmacy Chick was right..

Mary has a cold…or allergies…its hard to tell because Mary has already dissed the advice of her doctor who suggested she had allergies…but Mary said she NEVER has allergies. Either way, she was complaining of nasal congestion, a runny nose, headache and a cough. She came to me yesterday for advice.

Now every pharmacist knows that in their cough/cold section, they have probably 30 linear feet of merchandise that has maybe 10 drug ingredients in it. They are just mixed up and market-shared to death.

I said to Mary in a playful tone: “I seem to remember we had this conversation in November and everything I suggested, you said didn’t work, are we going to try it again?” She laughed, but I was telling the truth.

“Don’t make me drowsy” she said. Ok, I suggested DayQuil for the day, and Claritin for the “possible” allergies. Claritin is not my personal favorite because I find it rather weak, but she didn’t want to be drowsy so that excluded Benadryl and even Zyrtec. “I’ve tried Claritin, it doesn’t work, and I have the Dayquil Capsules at home, they dont work either”, she replied.

I couldn’t resist. ” See, Mary? Everything I suggest, you say doesn’t work…what do you want me to do?” “I’d rather you try Zyrtec, I think its stronger, but it may make you drowsy, and there isn’t anything in all these other products (she was holding a box of Tylenol Allergy/sinus whatever)that are any better than whats in DayQuil, so if they don’t work, nothing will and you are just gonna have to suffer”. People are just to accustomed to thinking that life should be like the TV ads, and their symptoms will vanish once they take a pill. It doesn’t work that way. “OK, OK” She said, tossing the Zyrtec in the cart. She still had Dayquil at home. “I’ll try it”

“Give it more than 1 day ok?” I asked her.

2 hours later her Doctor called in Hycodan Cough syrup

Whoo Hoo! Dissed again.

Tags: behavior, customers, pharmacy life | |

She wasn’t the most stable of individuals. Her profile was a plethora of antipsychotics and anxiolytics. She was also the poster child for the non-compliant patient. She wasn’t taking her meds regularly and given that fact, she might have saved her $2 copay and not taken them at all for what good they were doing her.

She came in for a refill on a Friday afternoon. She complained she was out (it had been around 45 days on a 30 day supply of meds)but she didn’t have the $2 until Saturday, so being the kind and benevolent pharmacist that I am, I gave her 3 chlorpromazine to “tide her over”. Even if she never showed up again, we’d be out about 15 cents of meds, 1 vial and a label. So what.

I filled the rest of the meds and put them on the shelf, minus the 3 tabs, marked as such. I finished the day and went home.

Unfortunately (as it turned out) the next shift was to be covered by a relief pharmacist from an outside agency. I got a call late Saturday afternoon from the pharmacist. No conversation starts out well with “I thought you should know about this”….

This gal had decided to go to a different store (in our same chain) to pick up the chlorpromazine. It was about 5 miles away. In her unstable mind it didn’t matter where she went. The pharmacist went to the shelf, discovered we had advanced her 3 tabs and refused to transfer the prescription to the other store. This enraged the patient. (remember: profile filled with antipsychotics and anxiolytics?) She drove to our store, made a complete scene at the counter, pretty much ruined the day for the pharmacist and the tech, and just just to complete the tirade, grabbed a display of wine sitting on an endcap and pulled it to the ground, shattering about 2 cases of wine in the process.

I was speechless. All I could think of was “Linda (fake name), it was 15 cents worth of drug. Do you honestly think it mattered that much?” She muttered something about the principle and her not being in a position to make that kind of decision. The tech thought I would be proud of them for not transferring the prescription.

For 15 cents of med, an enraged woman brought $200 worth of wine crashing to the floor.

The next monday, I had a LONG discussion with the tech about looking at the big picture.

Tags: behavior, customers, employees, pharmacy life, words of wisdom | |

Pharmacy chick was enjoying a leisurely lunch at a local restaurant. She doesn’t mind dining alone on her days off. Mr Chick was working. Its normally a quiet restaurant by the time I go in, usually after the normal lunch hour. I prefer the non-peak times to eat. About half way thru my meal, I heard a commotion at the front of the store. Some guy was giving the host a bad time. I couldn’t see what was going on, but I could certainly HEAR it. His wife had come in to ask to use the bathroom, and this place has a sign CLEARLY on the door stating “no public restrooms”. Its for good reason. Its a small eatery in an area that gets a lot of foot traffic. They simply cannot have people traipsing thru their restaurant just to pee. Besides, they only have a one-holer for each gender. Its their right to limit their bathrooms for their customers and thats how it is.

Well, this woman’s husband took exception to them telling her they have no public restrooms. He was making a scene. The voice sounded familiar but I couldn’t place it. “YES!, we WERE intending on eating here”I heard him say.. I gathered that they had perhaps intended on buying food but made no mention of that fact before she asked to use the bathrooms. I had no idea if they decided to eat there or not from my vantage point.

I finished my lunch and got up to pay my bill. There was only one other table seated in the restaurant, and older man in a hat and a woman. OMG, NOW I knew that voice! That guy had given me hassles at my pharmacy for a couple of years before moving to a different part of town and transferring his files (lets have a party!) to a competitor. He was an ass from the first day he blew in til the day he finally left. He was from a small town and thought that we were going to bend to his every will. No, I don’t have charge accounts, you pay when you come in. No, I don’t have a direct line to the dr’s desk. Call in your refills 2 days ahead of time. No, I don’t deliver either. If you want 90 days, then the Dr has to write it for 90 days. No, I cannot carry the oval furosemide, I carry the round ones. And all holy Hell burst out when his plan introduced the dreaded “tier 3″ drugs.

In short, he was a consumate butthead. Jerkface. Ass. Blowhard. Whatever. He never used the automated refill line, he always had to Talk-To-The-Pharmacist to give us his precious refill number. AND, he always had to tell us some accompanying story. There was no short phone call with this guy. He also preferred to have the white-coats ring him up. If the techs had to ring him up he would always have some “question” to drag the pharmacist over to the counter.

He was Mr Self Important, and Pharmacy Chick is not impressed with that kind of attitude. I have no respect for people to treat others, subordinate or not, disrespectful. We need waiters, hosts, grounds keepers, and maintenance people, just like we need brain surgeons and nuclear physicists. I used to wait tables in my student days. As far as I am concerned we are all working stiffs in some capacity.

He saw me leave the restaurant. We made brief eye contact. I’d like to hope he was embarrased to know somebody heard him rant. I doubt it however. His type is hard to embarass.

I hope somebody spit in his beer.

Tags: behavior, customers, general junk, rambling | |