The Pharmacy Chick

Flying the Coop in Retail

Common sense and looking at the big picture

Filed under: Uncategorized — pharmacychick at 5:23 pm on Wednesday, May 21, 2008

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.

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To all you new pharmacists who know everything…

Filed under: Uncategorized — pharmacychick at 10:11 am on Tuesday, April 8, 2008

This is specifically for new pharmacists, or at least those who might have been practicing for a short period of time…ok and even interns who are just about to take their boards.

Smartly dressed with a crisp white jacket with a gleaming new “RPh” after her name, she was overwhelmed by the reality of working in a busy retail store. She snapped at the techs, got lippy with a customer. She was disorganized and didn’t take constructive assistance very well. It was her way or the highway. The problem is, she wasn’t experienced enough to have a “way” that worked well. She was also floating, a position fraught with difficulty already. I heard all about the day.

When you became a pharmacist you probably figured it out right away: its completely different than when you were an intern. Overnight, all the rules changed. No longer could you hide behind a counting tray while the pharmacist ironed out all the messes. You now hold the iron. Gone are the days of being the “extra” person. You work alone. Forget about coming in late or leaving early for dinner plans/a play/a wedding/CE seminar..whatever. Tag! you are IT! Welcome to Jail: Do Not pass Go, do not collect $200. Most likely you weren’t quite prepared for it. No newbie is. I certainly wasn’t. I waved my just-arrived-license in the air and the pharmacist dropped his spatula and announced “I am taking the rest of the day off”. Once I picked my chin off the floor I realized he was serious. He grabbed his coat and left. Just like that, he was gone. Whoa.

The safety net was gone.

I have a few words of advice for the newly minted pharmacist (or rph soon-to-be)

1. Pharmacy school only gets you a license, it does not teach you to BE a pharmacist. That takes time and a good mentor. You are not done learning just because you passed your boards. In fact, you are just starting. Everything in school was black and white. In reality, everything is a thousand shades of gray. What works for one person will fail miserably with another. Don’t expect to have a policy that works in all situations. It won’t and when you understand that, you will have a better chance of surviving your career. Be flexible or you will get broken.

2. You are not better than everybody just because you make 6 figures now. You may have all sorts of facts and figures memorized, know every therapy course for every disease state, but you have nothing on Clyde the 60 yr old pharmacist who has a following that can only be described as “cult”. He takes care of them. They love him back. He may not have the most current protocol in the anti-coag clinic memorized like you do, but he has the respect and admiration of a thousand people. Try to pull that out of your palm pilot!

3. A haughty attitude will get you nowhere. Trust me. I learned the hard way. If you have chip on your shoulder, somebody is gonna knock it off. You will not command respect or believability simply because you got the white coat. In fact, expect that people will look to your OLDER techs for advice instead of you until you age a bit. It will be harder on you if you are young and female than if you are young and male. You are gonna look like children playing dress up to some senior citizens. Get over it and move on.

4. Look at people thru different eyes. People tend to see what they want to see. If you train yourself to find some good in everybody, you’ll be able to forgive them when they disappoint you, and more importantly, they will forgive YOU when you disappoint them.

5. You never have the right to be rude. N.E.V.E.R. Unless you are signing your own paychecks, you will always have a higher authority to answer to and rudeness will never be defended by your boss, even if its seemingly justified. You will just end up looking like a dink.

6. It is rarely the message that offends somebody, its usually how you say it. If there is one thing I would teach in Ph- school is Effective Communication. Don’t talk at somebody, Talk WITH them. Use your ears, and not your mouth. Its ok to say to somebody “If I understand you correctly, you are saying…..” If they think you understand them, you have won half the battle. Empathize. If somebody believes that you are on their side, they will likely not give you as much grief. For example: Nobody likes to hear that their refills aren’t ok’d by the dr and its been 2+ days. But to curtly drop the news on the table like a sack of potatoes will irritate the patient. Try this: “I understand your frustration! I makes us crazy too–who needs that kind of time? It seems way too long doesn’t it? We have asked them twice and they still have not responded. Perhaps you might like to ask them, since its your dollars that pay their wages huh?” If the patient in my previous post had heard that (instead of the curt response he did hear) I’d likely not have had to spend a half hour listening to him chew my rump.

7. Read How to Win Friends and Influence People by Dale Carnegie. I mean it. READ IT. Twice. Its a small pocket book with a wealth of information. It changed my practice forever. His principles are timeless and people will pay $1500 for a seminar teaching his techniques.

8. Be friends with your customers. Do not create an adversarial relationship with them so when you mess up, and you WILL mess up, they will be less likely to sue your butt into poverty. They will also be more inclined to do things your way if they LIKE you! Think of this common example: if you grab a dog by the collar and pull towards you, what is gonna happen? He is going to resist! Its his nature. So it is with people.

9. Your techs are your ass-savers. They can make or break you. Some are better than others, but try going it alone for a few hours and even the sketchiest of techs help you more than you know. Just because they don’t have a degree doesn’t mean they aren’t valuable, so don’t condescend to them. Actually dont treat anybody condescendedly.

10. Don’t drop the ball. If you say you are going to do something for somebody, then you better do it. And if you couldn’t do it, then you better have tried everything in your power before you failed. You will be called to be accountable for what you do or don’t do, and you will look darned silly if you drop the ball. I can honestly say that if I couldn’t do something for a patient, they KNOW that I have done my best.

11. Don’t roll the dice: you will be surprised at who knows who in the community. I’ve always been surprised at the few degrees of separation some of my patients have. People I would have thought had no connection whatsoever are best friends, or neighbors, or go to church together, etc. Its often AFTER the fact that I hear from a (sometimes challenging) patient (that I would have liked to get rid of) “Thanks, Joan Jones sent me here”.. Whew..that was a close one.. I go to church with Joan…SEE?

I guess what it boils down it is live the golden rule when you step behind the counter. Your patients may not be as good to you as you are to them, but they’ll never have the upperhand on you if you keep your composure, have realistic expectations, learn your limits, behave properly, and become their advocate.

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