The Pharmacy Chick

I had a customer come in one day, who also happens to be the Chick’s family friend. He had a prescription filled, we had a few friendly words a the counter, I sent my well wishes and off he went.

A few days later I saw this man and as our conversation wound around, he learned that Mr Chick had no idea that he had been in to see me..

“You can’t tell him that?” “nope, unless you say something like, :say Hi to Mr Chick for me:, I don’t say anthing”.

“Its THAT confidential?..even me?”

Yes, even you. And for that you might be very grateful someday.

Tags: customers, ethics, pharmacy life | |

I stumbled upon the scene quite by accident, delivering some papers to the back room. I hadn’t been a pharmacist very long, maybe 2 years or so. She was sitting on the concrete floor with her hands handcuffed behind her back, and was wearing a pink shirt (why do I remember the shirt?). A police officer was standing over her writing something in his pad. Her face conveyed an expression of shameful embarrassment. She couldn’t have been older than 15. It was an awkward moment and I hustled thru quickly. She dropped her gaze when she saw me. She had been caught shoplifting. My employer prosecuted shoplifters and this one was no exception. He was the owner and shoplifting was stealing from his own back pocket in his opinion. Later on, I asked what she was caught stealing…..Makeup. I guess I could have guessed that. What else would a teenager want in a drugstore? Aspirin? At the time I also felt pity for her but now that I think about it, pity is the last thing I should feel.

20 years have passed. So, if she was 15, she is now 35. I wonder if this event altered her future? Did she feel shamed enough to never steal again? Or did she harden her heart and determine to never get caught again? She didn’t look poor. The place that I worked at the time was in a pretty swanky neighborhood–and she was a resident of this neighborhood. I wonder how that first evening back home went when she had face her parents after they learned of her arrest.

Now I work for a corporation. They hire security people that occasionally patrol the store looking for shoplifters. I have no official stats to share with you, only that which the patrollers (who patrol for several companies) have told me. What they told me surprised me:

Most of the shoplifters have money to spend, they just chose to steal. Most of the time they weren’t stealing necessities. They were caught stealing makeup, expensive cuts of meat, wine, beer, and high ticket otc items. They were usually suspected chronic shoplifters that they just happened to catch one day. I can attest that pregnancy tests rate high for theft, because I find empty boxes quite often on the shelf.

Everyday around 3:30, school lets out and a flood of students pour into the store. I don’t know what they are looking for in a drug store, but they hang out, poke fun at items we carry, play with the blood pressure machine, spill their Starbucks on the floor, and occasionally ask me if I have samples of Vicodin they can have. “ha ha, so funny….not” Their presence usually alerts the staff to keep watch. I don’t suppose that students are any more likely to steal than any other population group, but we catch more students stealing than any other group. Maybe we are more attentive when they are there, I dunno.

I do know this, we all pay for it. Everything we buy has some “shrink” included in the price. “Shrink” is that missing product that comes up when we calculate what we buy minus what we sell. The shoplifters have gone high tech too. Some bring box cutters to cut open items that have security features imbedded in the package. Some actually use their kids as a ruse or diversion. Others have been caught being “green” bringing in their own bag, but conveniently forgetting to pay for the items they have self-bagged.

Even our own employees haven’t been immune to the temptation. We tossed one employee who was caught stealing a tea bag. Sounds trivial until you realize they had been watching him for a year. The tea bag was what did him in. Another had been very creative in “refunding”. He was caught when he “refunded” an item that our reports showed we hadn’t sold in a long time. One employee even stole another employee’s cell phone. Geez, how low is that?

I am repulsed now when I hear about these people. Its because of them that I have a camera on my pharmacy 24-7. Its because of them that we have scanners at the door. Its because of them that I can’t hang my coat in the pharmacy anymore. It takes an act of congress to open the cash pan without a sale anymore. “Can you make change for this Ten?” “No, not unless you buy something”.

Its just too bad isn’t it? I often wonder what happened to the pink shirted shoplifter. She was part of the problem. I hope that if she is now raising children of her own, that she is raising them to be part of the solution.

Tags: customers, ethics, pharmacy life | |

I met this guy many years ago. I’ll call him Stew, for the lack of a better name. He was a big chested guy, a salesman by trade, and by all appearances, used to getting his way (by bullied persuasion, if I guessed correctly). We met outside of the pharmacy, when he happened to notice I was wearing a shirt with his (and mine) alma mater on it. It begat a conversation that ultimately begat him coming to the pharmacy. For a while it worked quite well. Everybody is jovial when things are going their way. The wife was a sourpuss but she didn’t come in very much.

I seemed to have inherited an inordinately large number of high maintenance people over the years, those who have been disenchanted by the treatment they get at Big Box Pharmacies. And yes, I am a chain store, but I have always tried to create a friendly and intimate environment for my customers. I was grown in an independent pharmacy (cards, gifts, and drugs in the back) and only became a chain pharmacist when my options of independents ran out. I am, at heart, an independent pharmacist. I am willing to take care of these people…provided they don’t cross the line.

Stew didn’t require too much special care, but he was loud, boorish and impatient, which meant that nobody really liked waiting on him. The clerks became strangely blind and deaf when he approached the counter, leaving me (remember the drive-me-nuts posting?? read it) to wait on him most of the time. I didn’t care–he didn’t give ME too much grief. Must have been the white coat, or the fact we went to the same school that spared me I suppose. He did travel alot however.

Frequently he would call for vacation overrides, and with the insurance he had at the time, it was nothing more than a quick code entry on a screen and bam, he had his meds. He changed plans after awhile and getting vacation overrides became more complicated. Not only did they require a departure date, but they also limited him to a certain number of overrides (2) per year. Therefore, it became complicated. We didn’t want to waste any uneccessary overrides for him should he use them up before he REALLY needed them. The problem was, he didn’t grasp that concept.

As usual, he called early for his meds and they rejected. I called Stew and he said he was leaving on a vacation. I obtained his departure date and his arrival date. He was calling almost 2 weeks before he was leaving. I was sure he would be able to fill his prescriptions without needing to waste the precious override if he waited just one more week. He would still be filling them a full week before he left.

I called his insurance and they confirmed that he didn’t need an override and said they wouldn’t even give one to him because he didn’t need it. I thought that was interesting. Never heard that from an insurance before, I suppose to preserve the limited overrides he could obtain?? I didn’t ask.

So, I called Stew back, expecting him to be happy that he didn’t have to waste the override. I told him that since he was leaving on the 22nd, he could pick up this meds on the 17th or later. It was currently the 12th or something. He responded “ok then, I am leaving on the 16th.” I asked him, “Are you really leaving on the 16th now?” and he said “No, but when I come to you, I expect superior service, I dont expect to have to make a special trip to pick up my meds”. Special trip?-he lived about 4 blocks away, and it’s not like he was having to pick them up on the way to the airport.

I was shocked. I told him I had already called his insurance once, and I dont think they would believe me if I called them 15 minutes later and changed the date of his departure. I was not willing to lie to them. I tried to explain (again) that he only got 2 vacation overrides per year and there was no point in using them when he didn’t need to. He was on some rather expensive meds. Paying for them out of pocket would be out of the question. He was a bully, yes, but not a rich one. He travelled several times a year. This was significant.

I was there on the 17th when he came into pick up his prescriptions. He was as cold as an iceberg at the register when I rang him up. I wished him a good trip and he replied ” I want all my, and my family’s drugs transferred to Big Box Pharmacy by the time I get back” and he walked off.

I never spoke another word to him. I transferred his whole profile to BBP that very next day. A couple of months later I called BBP and asked them about Stew. The pharmacist sarcastically replied “Oh, THANK YOU for this one!” “Want him back?”

No thanks.

Now looking back I wonder, in the grand scheme of things, would it have mattered to fudge the dates? No, probably not. But it would have set a precedence. I would have lied to somebody to appease a customer. Every break starts with a crack. Every flood starts with a trickle. To me, he crossed a line that day. He sold insurance. Would he lie to the agency to get me covered, cover up some disease I had to secure a policy? Probably not.

So why is it ok to ask me to do the same? Little lies dirty the character as much as big lies. It just takes a little longer.

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

Today was a rather routine day, thankfully not super busy when we got the call. “Do you have oxycodone and morphine xmg, 60 of each?” It was our competitor up the street. They were out, actually they are chronically out of narcotics–we get calls quite often. They didn’t say whether the morphine was IR or ER so I told them to verify it and call me. Note: I didn’t tell them if I had either in stock, and they didn’t call me back. Twenty minutes later this pathetic looking man was at my counter, in a cart, obviously in distress. It was clear that he had been in the hospital. He had bandages over his IV line, bald (cancer?), awfully skinny, and his skin was a weird shade of grey.

” Big Box Drug said you had these” he said. Actually I had said nothing of the sort. Looking at the scripts, it was clear the morphine was IR. What he said shocked me. “I have been waiting in Big Box Drug for over an hour before they told me they didn’t have these.”

Over an hour. Now Pharmacy Chick has her own “angry pharmacist” persona when she feels like it. Just put me in front of some white trash welfare mom with an attitude and you will see it. But come on! If you have some guy who looks like he might just expire while he is in your wait room, getting discharge meds from a hospital, might it be just a teeny bit appropriate to 1) make sure you have the drugs before you leave him there for an hour and 2) perhaps boot him to the front of the line so he can go home?

After 20 years in this business, I may be a little low on the compassion side of things, but I do have a little left. I do however, have some serious common sense. Frankly, we all know that, if we MUST, we can fill a given prescription in as much (or as little) time as we need. I always try to under-promise and over-deliver. I am just not going to que this guy along with everybody else when its quite clear that he has a need that pretty much supercedes everybody else. In fact, Pharmacy chick has a few unwritten rules for who trumps who:

1. Blood–if you are oozing blood from your injury, you are likely not a seeker and will probably get pretty quick attention.

2. Vomiting–If you (or your child) has any risk of puking anywhere near my counter, I’ll likely trump you to the front of the line. Wait in the bathroom til I call you–oh, and here’s a towel–Pharmacy Chick does NOT clean up anything that does not come from her own body.

3. Cancer/Hospice/Chemo. Ya know, these folks have probably not had a good day…in a long time. Wanna walk a mile in their shoes? While I am not a believer in Karma, I do believe in the golden rule and if I was so sick that I needed a cart to get to the pharmacy, I’d be pretty grateful for anybody who could make my time there brief.

We had him out in 10 minutes. He was shocked. And grateful. He had no drug insurance so we sent him home with an application a free discount plan thru the state, and I gave him a fair price on the ones he filled.

And you at Big Box who left him there for an hour? Shame on you.

Tags: customers, ethics, pharmacy life | |

We have a urgent care clinic fairly near our pharmacy. For the most part, they write for the Blue-Plate special: antibiotics, pain meds and cough syrups. Its been open for less than a year. As every pharmacist knows, urgent care clinics can attract some seriously sketchy folks looking for a new ears to hear their sorry lies. Since its a pretty small operation, we can usually call and get the dr on the line if we need to “confer”. Today was such a day.

Mr. Clean-cut-nicely-dressed handed me a one of the clinic’s rx’s. Now, I can’t speak for all pharmacists but most of us have a pretty strong 6th sense when something doesn’t seem right. A dead giveaway for me was when he quickly (a little to quickly) announced “I’ve been here before and I am paying cash for these”. He had scripts for an NSAID and a C-II narcotic. I looked at his profile and the same pair of rx ’s has appeared from same clinic 3 additional times. We had insurance on file for him.

I decided to diss his request to “pay cash” and thought I’d run his insurance to see if my intuition was right on. The NSAID went thru fine….the C-II rejected: filled yesterday, someplace else. Intuition:1 Customer:0

Hmmmm Pharmacy Chick wondered if the Dr at the urgent care clinic was in on that bit of information, so we rung him up. Dr didn’t know (duh) and cancelled the C-II, which left me with the rather dicey duty of telling this guy that all he was going to get was the NSAID.

I decided to play it cool and called Mr Nicely dressed back over. My hands were a little shaky and it wasn’t the caffeine from my coffee. I told him that I saw we had insurance on file for him and wanted to save him money. I was hoping that he wouldn’t get pissy if he knew he was busted, but was spared embarassment. I explained that when the pain med rejected, we had to call the doctor for further advice, and in doing so, the Dr. cancelled the prescription. I could see his jaw tighten when I asked him if he had this drug filled yesterday, but he admitted to me that he had. (I wish I had a blood pressure and heart rate monitor on him–or me for that matter– right then).

He took the NSAID, and I highly doubt that neither Mrs Chick or the Dr. will be seeing him anytime soon.

You know, I didn’t take a lot of pleasure in doing this. In fact, there was a moment when I truly considered doing the easy thing and just filling it, knowing full well what he did yesterday. But I also know that I would be feeding a multi-headed monster, one head being his drug problem, and one head being my apathy at not doing the right thing. It would have been easy to rationalize: it was just 15 tabs, it WAS a legit script (until I called the office to confer), it would have been a decent profit on about $.50 cents worth of inventory, and I wouldn’t have to worry about getting my head ripped off. However, I would also be compromising my ethics, something I have always felt was was important in my practice. If I lose my ethical practice of pharmacy, I lose my credibility in my own mind. I would have sold out. I am not ready to sell out. I may not be popular with those “sketchy folks” ,and I might risk an unruly customer, but I will go to bed at night with a clean conscience.

So if you read this and nod your head and think “yea, I’ve been there”, I’d love to hear about it.

Tags: customers, ethics, law, pharmacy life | |