The Pharmacy Chick

“Do you have a prescription for Brown?”

(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.

Tags: customer interactions, memorable customers, pharmacy life | |

“Hey Intern, will you please compound this cream?”   It was a pretty simple Salicylic Acid Aquaphor and steroid mix.    She looked at me like I had spoken a foreign language.  whoa…code red…

“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.

Tags: interns, pharmacy life | |

For the third time in as many weeks, PC has been given a blatant forgery.  For reasons I cannot explain, that “gut feeling” that most of us have when we are given something unusal was kicking in full gear.  All were brought in after normal office hours.  Each wanted to pay cash because ” I dont have insurance” and each wanted to wait. 

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.

Tags: ethics, pharmacy life | |

I think we all agree that, as pharmacists, we live and die by our support staff. Gone are the  days where pharmacies were staffed by pharmacists only, with an occasional clerk to ring up sales.  Even more so now with our labor cuts, we have to have support staff that measure up.

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.

Tags: employees, pharmacy life | |

Summer finally arrived in Chick-Ville THANK YOU VERY MUCH!   After the winter that lasted far to long and a spring (I use that term loosely) that resembled winter,  we finally are baking in the 90’s.  You will NOT hear the chick whine about the heat.  Bring it on!

After golf today, Mr Chick and I decided to head to the club pool.  The cool refreshing water felt wonderful on a body that had just played 18 holes of golf in 95 degree heat.  It was packed with hottie teeny boppers in their bikinis (sigh, I remember the days) and many I shall describe only as “others”.

Can I just say one thing?  At some point, even BLACK quits being slimming. 

Just an observation!

On the frontlines of the pharmacy,  the Chick got a new intern for the summer…whoo hoo!  I only wish I had interns when I needed them MOST, during flu shot season.  Unfortunately thats when they migrate back to the books.  She’s a smart cookie and for the first time in X years, my intern has ENGLISH as her first language.

Interns sure have changed over the years.  I no longer accept first  year interns simply because I don’t have the time to teach them the stuff they should have learned in class.  When I was in school, we had a true “dispensing” class. It was a mock up of a pharmacy, complete with a pharmacy full of outdated donated drugs that have been pulled and counted thousands of times no doubt.  We were given “rx’s” that we were to interpret, type labels (yes TYPE…as in typewriter) then count, label and show the teacher.

The school nearest to us that we get our interns from have never been to a dispensing class. I guess the teachers assume that is the preceptors job.  “Here, this is a spatula and a counting tray..you hold the wooden end and count with the metal end, usually by 5’s unless you are some savant and prefer to count by 4’s or 6’s…”.

One of the things I always tell my students is this.  “Pharmacy school is going to teach you how to BECOME a pharmacist.   I am going to teach you how to BE one.”  Big difference. 

Every one tries to talk like their professor…”Do you have a special project for me this summer?”.  ” Yes…learn how to become an awesome retail pharmacist, since that is the setting you are in for 10 weeks.  The customer is your judge.”.

Its so competitive in the pharmacy schools now, that I know these kids are brilliant minds to even have been accepted into the program.  I want to teach them to be brilliant communicators and empathetic people too..

Time to get my Dale Carnegie books out!

Now, its time to dip my feet in the pool again!

Tags: personal life, pharmacy life | |

So, Pharmacy chick wrote a post about legit narcotics users being treated like second class citizens because their drug seeker counterparts make them look bad.  Because I implied that Doctors contribute to the problem by continuing to give narcs to seekers (cant seem to see thru their lame stories), one commenter added that it “wasn’t that easy” to deal with them.

I countered that a few phone calls to pharmacies around would garner enough info to determine the status on a sketchy patient.  Most would be more than helpful to provide dispensing information for the MD to make informed choices about servicing certain patients.

I don’t know how many PROVIDERS read my blog, but I am inviting you to comment.  Tell us why you give narcotics to people you suspect are scamming or lying to you and how  you stop,  when you finally have had enough, and finally, how often do you call pharmacies or other providers to see if the (said patient) is popping up there too.

Because…Pharmacy Chick really wants to know both sides!

Tags: doctors, drug abuse, pharmacy life | |

Recently, PC had the opportunity to have an email string with a person who had some questions about being a better pharmacy customer despite her many needs including high dose narcotics.  She felt frustrated at the treatment she received at certain pharmacies when she filled her prescriptions, and tho she said she prefers to use the same pharmacy each month, they have suffered supply issues and occasionally has to find it elsewhere.  She took pains to remind me that she uses ONE doctor for all her meds and she she has never lost/stolen/ or otherwise needs “early fills”.  Never the less, she is often treated with disdain. 

In her opinion she is doing everything by the book….ordering early enough to get the stock(but not TOO early to be inappropriate), using one doctor, being polite and friendly..you know..playing by the rules that we pharmacists like our customers to play by.  And yet, she described a story where she was berated by a pharmacist as being a f’n drug addict and to get the f**k out of the store.

Wow, strong words.  All things being said, I have not met her, seen her, and my only communication as been thru email.  She could be blowing smoke..but I am not thinking so.

Pharmacy Chick has a pain clinic near by so we dispense a lot of narc’s.  Ive had my own share of scum in and out of the store.  You know the kind, the ones that leave a trail of slime as they leave the counter.  They are good at working the system to their advantage and are so good at it, they could probably teach a class.  Why the doctors dont see thru this act is beyond me.

However, I also have  a sizeable client list of people who are on high dose narcotics from a lifetime of illness or injury. Henry was in a car accident…I guess you could call it that.  He was working on a car and it fell on top of him. He was broken in a lot of places and most of them aren’t fixable.  Not that the doctors haven’t tried, but he is so full of pins and screws that his insides look like a toolbox.

Ralph lost his leg at work.   It confuses him because he takes pain meds for pain in a leg that isn’t there anymore.  I told him that his BRAIN doesn’t know the leg is gone.

Steven was a police officer shot in the line of duty. 

Tim had a kidney transplant and it didn’t go every well. He has so much scar tissue pulling on stuff he was going thru 2000 oxycodone 5 per month.  Everytime they did surgery to remove the scar tissue, more came back in its place.   Eventually he was managed on Oxycontin 80mg, twice daily.  Dunno how he managed that, but he is.

Linda has bone cancer…she is fighting it like her life depends on it…because it does.  She takes a lot of pain meds to control the suffering.  She knows she is going to lose this battle by years end likely, but she isn’t giving up.

Everybody you just met, are nice people.  They use 1 doctor.  They come to me each month for a prescription.  They  never lose it. They never have it stolen.  They never ask for early refills for suspicious reasons.  They treat their meds like blood pressure/diabetes/asthma meds, like clockwork.

If there is one thing I have learned in this life is that not all boo-boos can be fixed…and some only LOOK fixed..  If you remember in school,  there is no ceiling to narcotic doses.  You dose to pain control.  What would kill me, barely holds another. 

Its wrong to treat pain management patients as second class citizens.  Now granted, there are WAY more that deserve to have the book thrown at them when they resort to sneaky ways to get their stuff.  I’m not writing about them and I don’t go out of my way for any of them.  But I also haven’t called anybody a f’n drug addict to their face, which is inappropriate on every level.  When you wear the white coat,  you can at least hold some professionalism.

At the very least, you could be wrong about the patient..and get hauled into corporate to explain your behavior…at the very worst, you could get your butt shot off in the parking lot by somebody who took exception of your tirade.

We bloggers write frequently about drug seekers and the trash that they are…lets just remember not to paint all our patients with the same brush.

Tags: customers, pharmacy life | |

One of my readers/commenters asked if I might write a post on how to select a pharmacy.  I had to think about that one for a while because it seemed rather “elementary” of a question to be honest.  My initial response was “pick one near your home”.  But I think that a better post might be “how to get the best experience out of the pharmacy of your choice”.  And THAT is how I think I will answer this reader’s question.

When you choose your pharmacy initially, CONVENIENCE is king.  REALLY.  You want to pick a pharmacy that is near your home or someplace you go regularly..like the grocery store.  If the pharmacy is in the back of the store, even better, you are in the grocery already, no extra steps are involved to take care of your pharmacy needs.  If its in the same complex,  thats fine also, you don’t have to get into your car and make a separate stop.  Whether you really need a 24-7 pharmacy is debatable. I am an organized and efficient person and  I really dont see the need personally to have a pharmacy THAT accessible to me but then again, I am a pharmaCIST 24-7 anyway and I posess the keys…(tho I have never needed to open the pharmacy for myself…and its probably not a good idea anyway). 

Therefore since that question is easy enough to answer, lets work on the EXPERIENCE of  using a pharmacy.

First off, it is important that you develop a friendly relationship with your pharmacist.  He or She is a human being foremost and coming into the pharmacy on your first visit with a chip on your shoulder or an adversarial attitude because of whatever experience you had at your LAST pharmacy is not going to endear you to anybody at THIS pharmacy ok?  Once you establish a postive realtionship with the staff, it goes a LONG WAY, but likewise, if you start out bad, it will take a long time before you will get into their good graces.  I love the saying “you get what you give” and it applies well here.  There are a lot of little things that we do that are purely optional that can make your life easier.

Have all of your information at the ready, and at the BEGINNING of the transaction, not at the end. That means be prepared to present all of your bio data, and have your CURRENT insurance cards at the onset.  If there is anything quirky about your plan, dont keep it a secret.  an aside:  I had one guy that I absolutely tore my hair out over his insurance and he admitted that he had been a “she” and his insurance had him as a female.  He knew this but didn’t bother to inform me. The less we have to fuss over, the quicker we achieve what you want…the finished product.

Decide what you want your pharmacy to be…a health care service or a cost cutting device.  If all you want out of a pharmacy is “CHEAP” then shop at stores that only really focus on cheap and advertise their $4 stuff.  I’ll be frank with you,  we dont like to be asked if we price match. Not all pharmacies do the $4 thing.  We may price match  because our company tells us to, but its a hassle to keep track of and we think its a little cheesy and tactless.  Likewise, if all you care about it cheap, don’t expect special services from that pharmacy. They likely don’t do them.

Help us with your initial transfers.  If you have moved to a new area and need to transfer prescriptions, we are happy to accomodate. Just give us the proper information and some TIME to do it.  Be sure to tell us all pertinent information like IF YOU HAVE A NEW DR.

Special needs:  If you have special needs or some really expensive drugs,  please order ahead of time. Most pharmacies would prefer not to keep (and hold) a drug for you for 29 days of each month so you can order and pick it up the same day.  At Pharmacy Chick pharmacy, we make it a rule to call patients on rx’s that we are short on.  We value your time as much as you do and dont want you to make more trips to the pharmacy than necessary. Likewise, understand that we aren’t a warehouse.  We don’t stock EVERYTHING on the planet, and since we do 200-500 scripts a day, what we may have had at 9 am might be out of stock by 7pm..

Learn a bit about the biz.  We are the middle man between your doctor and your prescription, and your insurer and you…  Understand that we may  have to ASK to refill your prescription. If el-doctoro hasn’t oked the rx, its not going to be done and getting mad at the pharmacist isn’t going to make that rx magically appear.  Likewise, if your insurer rejects a prescription, we may not have the ability to fix that.  When your insurance company sends you new cards, information, etc…read it all.  Be informed about your choices, your limitations and your benefits.

The worst day of the week to  want something fast is Monday. Its the pharmacy’s busiest day.   The worst day of the week to need a call to the doctor is Friday.   Also, beating the door down at opening time isn’t the ideal time of the day to need special favors any more than racing to the counter at 1 minute before closing is.

“How long is this gonna take?”  and “When should I return for this?”  are basically asking the same thing but #2 is going to elicit a much nicer response than #1..trust me.   If you want your pharmacist to love you, say “I’ll be back for this in a day or so”.  He/She will throw rose petals at your feet.

Planning 1-3 days ahead isn’t just a favor for us.  It is really to your advantage, resulting in less trips to the pharmacy and leaving empty handed. I have never met a pharmacist who scolded a patient for calling ahead to see if a prescription is ready.  What IS frustrating is to see the same faces over and over at the counter bemoaning the fact that something hasn’t been authorized yet “man, dont you have a phone? Call before you come down!”

Changes:  Tell the staff when you have : 1) changed a dose  2) stopped taking a medicine 3) changed physicians 4) changed addresses 5) changed your name, or 6) developed an allergy to something.

Poly Pharmacy. We advocate using one and ONLY one pharmacy.  We understand its your right to chase the deal.  And if you want to have profiles at every pharmacy in the county chasing the gift cards, understand you are forfeiting the advantages of having your entire profile at one pharmacy. You will not have proper drug interaction checks and it will be up to you to keep track of it all.

Please, No whining.  We all know drugs are expensive.  We aren’t big fans of expensive copays either. We are only charging you what we have to. If you dont like what you have to pay for a prescription, there are contact numbers on the back of every insurance card out there. We also know you think your time is more valuable than the guy sitting next to you.  We, however, think that getting a prescription filled accurately trumps both of you.   (and you might mysteriously find that the nicer you are, the sooner things might be done)

Ive been doing this for 23 years, and I can pretty much sum a person up after 1-2 visits.  I can usually sniff out  ”high maintenance” from the get-go, and I can almost always single out the jerks.  That being said, I am also pretty good and recognizing a really neat person too.

Remember:  You get what you give….

Tags: customer interactions, pharmacy life, words of wisdom | |

Overheard at the pharmacy today:  A mom and her daughter (probably 7-8ish by the looks of it)…and Mom was giving the daughter an ECONOMICS lesson:

Mom:  “You see this?  Claritin costs almost twice as much as the store brand.  Do you know why?  Its because the company that makes it has to pay for all those ads we see on TV for it and the company that makes Pharmacy Chick brand doesn’t.  Its the EXACT same stuff only we save a lot of money by using the generic!  That is smart!  Isn’t that INTERESTING??

Daughter:  No.

I put my head on the counter and laughed out loud.  Tech Extradordinare was off putting the order away and didnt’ hear this exchange.  She wanted to know what was so damn funny..

Tags: pharmacy life | |

Ok, so I haven’t REALLY posted 122 other drug seeker stories, but lets just say I could have! 

One of the suckier parts of being a pharmacist is when I have to wear the police uniform also.  And while I don’t actually have to arrest anybody, I dont like that “policing” role that we are often thrust into.  THIS day however was just too easy.

We had been filling for  “Steve Anderson” for almost a year.  He’s been in my sights for his prolfic use of urgent care centers, his adoration of Percocet, and his chagrin for anything BUT Percocet.  He is the boy toy of some chick who lives nearby, and really not bad looking I suppose if you are into sleeping with guys about the same age as your eldest child.  Ewww.

About the only think I could do to thwart Steve was warn UCC’s (urgent care centers) after the fact that he gets around.  All of his scripts were legal..aside from the fact that he probably lied about his so-called pain to get them.  Near as I could tell, they all had his legal name and DOB on them.

Last week I got a call from one of my competitors.  Despite the fact that we ARE competitors, we all share the same disdain for drug seekers and try to help each other out by sending out a phone chain when an obvious seeker is making the rounds.  This time it was Big Box.  “Hey Chick,  we got a dude here that my tech recognizes from earlier this week.  He is using a different name than he used last time. We sent him packing, he may be headed your way”.  ” He has used Steve Andres and Steve Hintman is on the script he has now.”.

I was busy at the time and just wrote the name down on a scrap of paper and stuck it to the wall.  I didn’t have EITHER of those names in my computer. 

About a half hour later I was at Terminal 1 when Steve Anderson (behind dark glasses–a poor disguise by the way) comes to the counter and Tech Extraordinare 2 greets him.  He hands her a script.  She is not privvy to this phone call and since she is my newest tech, she doesn’t know Steve.   I look up and immediately think You have to be sh**ing me, let me see that script.   I walk over and say  ” Hi Steve, whatcha got today (as if I dont know)…. And sure enough it has Steve Hintman on it with a different date of birth than his other one.

“Steve, I see you have a new last name!”  to which he replied ” Um, yes its a MARRIAGE thing…its complicated…” Sure Stevie……

“I see you have a new date of birth also…” I said,  and I left that question open ended. 

I didn’t even wait for his answer.  “Dude, we can’t help you here”.  He snatched his paper back and stomped off.  I called the other close-by pharmacies and they were all prepared for him.  He would have to do some serious driving before he was going to get THAT script filled.

So a word of advice for all you drug seekers out there.  If you are gonna pass a script with a fake name on it AT THE VERY LEAST do it at a pharmacy that DOESN’T already know you on a first name basis.

Sheesh. 

(and if you are really named Steve Anderson, Steve Hintman or Steve Andres)..my apologies..so get over it…they are made up!

Tags: customer interactions, drug seekers, pharmacy life | |