She Hate Me

If you hate a business enough to take the time to call the complaint line after every single visit or give a "0" on every survey you can find, why are you still going there?

(I call bullshit on insurance requirements. You're not limited to only the Big 3 and even if you are, they have multiple locations. You have options. This is a bigger picture issue.) 

Seriously. Do you really think that by bringing down their scores you are helping improve their operations? If I had a problem every time I shopped a business, I'd leave. Perhaps it's me. Perhaps it's luck. Perhaps that's how they run their business and our expectations are quite dissimilar. Either way, that is the definition of insanity; repeating the same thing expecting a different result. After a time, it becomes habit. 

Odds are, if you've made a name for yourself, we don't want your business either. You are toxic to our environment and you unfairly poison others against us. 

Move on. 

Like a bad BF or GF. 

Move on. 

You both deserve better. 

Getting pissed off because you always come at us with a pissy, uppity, challenging attitude will only further reaffirm your strongly held belief that we are bad. There is nothing we can do to change your opinion. The slightest misstep, as if we weren't already walking on eggshells, will set you off anew. 

Maybe you're the type of person that thrives in a toxic relationship. 

Maybe you like to be treated poorly. 

If that gets you off, let me know. I can arrange to treat you accordingly. 

In the end, I am still left wondering why, if you hate a business so much, you voluntarily and consciously continue to do business with them? 

Phlu Shot Issues

Guys, rolling up your dress shirt to receive a flu shot is like trying to roll up your jeans to take a leak.

Conspiracies

As far as #ExcusesToNotGetAFluShot go, I've always been amused by the "conspiracy theories".

So I ask, if Big Pharma and vaccines are a government conspiracy for mind or population control, then why are colonoscopies not a conspiracy to map our asses for alien probing?

Flu Shot Season

DM: It's flu shot time!
CP: Already?
DM: Yes. Why haven't you met your quota yet?
CP: It's August. I got them yesterday.
DM: And your goal is 1082.
CP: Rather arbitrary, don't you think?
DM: Scientifically proven to be obtainable this year.
CP: Not sure what science you're using. Sounds more in line with L. Ron Hubbard's Scientology. Besides, you only sent me one box of shots.
DM: All you have to do is ask and people will throw themselves at you.
CP: Yeah. That didn't work for me getting dates in high school so I doubt it'll work now.
DM: Everyone wants one, they just need to be asked.
CP: When is the last time you worked in a store and twisted patients' arms to get flu shots?
DM: If you don't ask, you don't care.
CP: I ask. And despite getting rejected almost as much as I did in college, I keep asking but people still say "no". Great for the self-esteem.
DM: Why?
CP: For whatever reason, perhaps decades of marketing to people to get their flu shots in October, people want to wait. Patients and prescribers have it stuck in their heads that October is flu shot month.
DM: But all you have to do is ask, and inform them.
CP: I know. The CDC recommends the flu shot to be administered as soon as it is available. I know this. You know this. Others do not and don't care what we tell them. Once old people in particular get an idea in their heads, it is nigh on impossible to change their minds. They know only two things: Early Bird Dinner times at all the local restaurants and October is flu shot month.
DM: What about all the other people?
CP: There are a few insurances that won't pay until September or October.
DM: So focus on the other people.
CP: Sure. Did you get yours yet?
DM: I'm waiting.
CP: For what? Here are the excuses I have received so far and we are only 1 week in to the 2019-20 campaign.
a. I get mine at my doctor.
b. I get mine for free at work.
c. I already got mine.
d. I want it to last all season so I always get mine in October.
e. I am in the 55% of persons annually who never get a flu shot.
f. I'm not mentally prepared to receive it today.
g. I don't believe in them.
DM: You have to try harder.
CP: Why? I believe in flu shots. As long as my patients get them somewhere, anywhere, then that is all that matters. I hate doing business with places that force their employees to push services on their customers. I know what is available. I know what I want. I know I can return for other services should I so desire. After awhile, it gets to be annoying. Companies have marketing departments. Honestly, if people don't know by now they can receive a flu shot, or any other vaccine at any pharmacy in the country, then they've been living under a rock.
DM: You don't care about your patients.
CP: Right. I only care about filling the other 500 Rx's safely and accurately today. If patients miss the 11 signs, counter stickers and mats, syringe-juggling clown, and neon sign on their circuitous journey to my counter, me pleading to stab them won't help me get a flu shot from them.
DM: I'm watching you.
CP: Before you go. . .
DM: Yes?
CP: <sings> Do you wanna get a flu shot?

If It's Measured It's Not To Help You

CP's Partner: Okay. Let's just jump into this one with both feet. How do you feel about metrics, especially as they regard flu shots and other vaccines?
CP: First off, I'd like to thank the Academy for allowing me to speak today. Secondly, as you are well aware, I am all for vaccinations and believe pharmacists are well-positioned in the community to meet the need. I love being able to help patients in this way.
CPP: Great. Now about the metrics related to shots?
CP: Yes. It is my personal belief that if you are truly interested in helping your community, if your stated goal is to provide healthcare to your patients, then you absolutely cannot set goals on how much help you provide.
CPP: Basically, telling your pharmacists that they don't care about their patients if they don't administer their minimum number of 1082 shots, runs contradictory to the statement about being in the business to help people.
CP: Precisely. Let's put a metric on preventing opiate overdoses. I can just see the email now: "Why didn't you administer any Narcan last week and save a life?! Don't you care about your community?"
CPP: Like a funeral home. People die all the time! Why didn't you bury more people this month?
CP: They said they were dying to get into the place across the street.
CPP: You need to bury more people to meet quota!
CP: Do they have to be dead? Is kidnapping illegal? Or just slightly frowned upon?
CPP: I also love how corporate loves to give us statistics but I wonder if they ever read them or, better yet, know how to interpret them.
CP: I had to laugh. Remember a few years ago I ran the stats on how many patients receive flu shots, on average, each year?
CPP: Yeah. It was around 45%.
CP: Yes. And that number is relatively unchanged year over year. What's funny is our DM recited that stat back to us the other year in one of her meetings.
CPP: Really?
CP: Yes. I did the research and she unknowingly repeated my own stats to me.
CPP: That's funny. You never told me that.
CP: The point is, the acceptance rates of patients remain relatively unchanged, perhaps increasing by 1% or 2% per year. If the goal of community pharmacy is help people, to become a full service healthcare destination, they need to stop treating our services as a competition; they need to stop holding these metrics over our head like Damocles' sword.
CPP: Agreed. Allow us to do our jobs.
CP: I went into this business to help people; cliched, I know. I did not go into pharmacy to be bullied by corporate overlords. So far, we have had flu shots for 7 days and had 3 conference calls, multiple texts to report our numbers, phone calls to report our numbers and a few stores have been visited by Ramsay Bolton.
CPP: It's either you care about people and want them to be healthy, or it's a competition.
CP: Just like you can't force people to compete in a marathon, or Monopoly, or D&D, you can't force people to make a competition out of healthcare.
CPP: You also can't force people to receive something they don't want.
CP: Enemas all around! Seriously though. You simply cannot claim to be focused on patient health and all the valuable services you provide whilst also telling your employees they don't care about their patients or their jobs if they don't meet these arbitrary metrics tied to this one sector of healthcare.

#IfTheyMeasureItItsNotToHelpYou
#ItsAllAboutTheGreed
#GetYourFluShotSaveMyJob

Filter/Translator

CPP: That was an interesting conversation you had.
CP: Thanks. It got me thinking.
CPP: I'd hate to be inside your brain.
CP: Why?
CPP: Your brain never stops. I'm believe I'd get tired and afraid of what I'd see. Does it ever take a break?
CP: Unfortunately, no. And I can't keep up with it most times. It works faster than I can write. That's why my handwriting is so sloppy. And I can't type fast enough either.
CPP: People are already bored. What was this thought you had?
CP: You know how no matter how well we explain something, people will still not get it?
CPP: Yeah.
CP: You also know that there seems to be a disconnect between the words we speak and the words patients hear?
CPP: Yeah. Something gets lost in translation. It's as if we and the patients are speaking different languages; or having two distinctly disparate discussions.
CP: Precisely. And not just in a medical, learned context either.
CPP: Of course. Simple explanations about no refills, prior authorisations, and copays seem to be met with a look of confusion. What do you propose?
CP: With apps allowing us to learn languages and translate so we may communicate while abroad, what is next? I'm thinking we need a common sense translator.
CPP: Oh yeah?
CP: You've seen video of UN meetings, right?
CPP: Of course.
CP: Each nation's representative has a headset for receiving the translation of the speaker's language into their own.
CPP: Right.
CP: What if we employed an automated translation device for our patients?
CPP: Right. We could each pick up a telephone at the counter. As you spoke into it, it would speak patient-ese into the patient's brain.
CP: And as the patient spoke, it would translate his gibberish into a logical, understandable question.
CPP: This would be quite practical.
CP: Similar to the telephone game we used to play in kindergarten, or the grapevine scene in Johnny Dangerously.
CPP: No more misunderstandings.
CP: We would finally be able to communicate in the same language.
CPP: Do you think we could make one for sarcasm?
CP: That would be awesome. We could give our sarcastic response to all our "favourite" patients, nurses, and prescribers, and the translator would change it into something more acceptable.
CPP: We'd probably break it.
CP: Clearly.

Quote of the Day: "If words of command are not clear and distinct, if orders are not thoroughly understood, the general is to blame. But if his orders ARE clear, and the soldiers nevertheless disobey, then it is the fault of their officers." Sun Tzu

Why Are All Patients Canadian?

ME: I have made an observation.
MICE ELF: Do go on.
CP: Please do not encourage ME.
ME: <ahem> Whenever we say anything to a patient?, particularly with regards to price?, they always become Canadian?
MICE ELF: Nice. I too? have noticed that?
CP: They do?
ME: Yes! Just like that?
MICE ELF: Everything is inflective?
CP: So when we tell the patient?, "That'll be $200?", they respond with?
ME: "$200? For an eye drop?"
CP: Right? Or your copay today is $50.00?
MICE ELF: "$50? For an antibiotic?"
CP: Right? Everything is a question? Whatever happened to people just saying "okay" and being done with it?
ME: Right? It's not as if different medication classes have different pay tiers.
CP: Imagine extending that argument to anything else; shoes, houses, vehicles, etc.
MICE ELF: Though that would be something; flat-rate pricing based on class.
CP: Or if the prices were based on how old they are? Medications over 50 years old, $5.00. Medications 30-49 years old, $10.00. Medications 15-29 years old? $25.00. Anything newer than 15 years is market price.
MICE ELF: Imagine what would happen if there were a list of medications moving off the <15yo list! Can't wait until Pregabalin falls onto the 15-29yo list!
ME: Yeah. Imagine how cheap Tetracycline would have to be.
MICE ELF: Or Penis-Illin.
CP: You know it's pronounced PEN-uh-SILL-in, right?
MICE ELF: <shrugs> Tomato. Penis. Whatever.
ME: There's something wrong with you, eh?

You're Still Wrong

CP: Good Morning! How may I help you on this beautiful Sunday?
Her Early Arrival Reminds She's Not On Time: I am here to pick up my prescription.
CP: It is not yet ready.
HEARS NOT: Why not? I was told it would be ready today.
CP: You were also told both days you called this week that it would be ready 2 hours after we opened by both myself and my tech who is here right now.
HEARS NOT: You open at 9am.
CP: No. We open at 10am on Sundays.
HEARS NOT: Since when?
CP: About 20 years ago. Give or take.
HEARS NOT: No one told me that.
CP: Again, both I and my tech explained our hours to you when you called, twice, during the week.
HEARS NOT: I thought it was 9am.
CP: Even then, the current time is 10:23am. That is not 2 hours after opening at 9am either. You would still be early.  You're either a little early or a lot early. However you look at it, you're still wrong.
HEARS NOT: Well when will it be ready?
CP: Really?
HEARS NOT: Yeah. You're open now. So how much longer?
CP: What's 10 + 2?
HEARS NOT: I don't know. 12?
CP: Is there a 12 on your clock?
HEARS NOT: Yes.
CP: Come back when your clock shows 12. Or when you get the text. Something tells me these two events will miraculously occur simultaneously.

Returns Not Allowed

CPP: Plans for tonight?
CP: Drinking with a friend.
CPP: Who?
CP: Mr. Vesa. Or as he prefers to be called, Sir.
CPP: Sir Vesa?
CP: Yep.
CPP: You need a day off.

<a woman approacheth>
CP: Good evening mademoiselle. How might I help thee?
Lady Exchanging Merchandise: As my name clearly states, I am here to make an exchange.
CP: I see. I see. And what is it that you wish to exchange?
LEM: <lays toothbrush on counter> This toothbrush I purchased last night.
CP: I see. I see. And why do you wish to return it?
LEM: I used it and found the bristles to be too hard for me.
CP: You used a toothbrush, found the bristles to be too hard, and now wish to return the used toothbrush?
LEM: Correct. I believe I need softer bristles.
CP: Rather than simply purchasing a new toothbrush for a few dollars, you expect me to exchange it for you?
LEM: Correct. I did not become wealthy by wasting my money on frivolity.
CP: Of course not. Have you not used toothbrushes for most of your adulthood? It seems you should have some experience in what types of bristles you would prefer by this point in your life.
LEM: I am not here for a lecture. I simply wish to exchange this for a softer one.
CP: Alas, that is a request I cannot honour.
LEM: Why not?
CP: Well, first off, it's used. It's not as if I can sell it now. No one comes to my pharmacy asking for the "used toothbrush" section. Can't you see that now? "Previously tested! Already broken in! Save 15% off the full price of a brand new toothbrush. Only used once!"
LEM: You're mocking me.
CP: A little.
LEM: It's a simple request.
CP: No. It's an outrageous request. Imagine watching the ubiquitous commercials for toilet paper. Seriously though, why do we need ads for TP? Who hasn't heard of it and doesn't use it? Anyway, after watching these commercials you decide your whiny heinie requires Charmin Ultra. After using it, you discover its softness level does not agree with your tushy, or it rubs your no-no square the wrong way. Do you attempt to return the used portion of said TP?
LEM: No. That would be preposterous.
CP: Why?
LEM: It's disgusting and I'd never touch it.
CP: Nor would I. Nor would I expect you to attempt to return a half-used roll. Also disgusting and unsanitary.
LEM: Well I am going to talk to the owner.
CP: Okay. You're putting in an awful lot of work for a $3.00 oral cleansing device.
LEM: It's the principle.
CP: Of what? Proving you can bully people into doing whatever you want, bending them to your will simply because you want it that way?
LEM: Yes.
CP: Please. Feel free to discuss it with the owner.

<next day>

Owner Of Our Pharmacy's Stuff: Anything exciting happen while I was away?
CP: A lady asked to exchange a toothbrush. Said she was going to call you.
OOOPS: Did you exchange it?
CP: It was used.
OOOPS: Seriously? People never cease to amaze me. It used to be all you had to do was explain the rules and they'd obey. Now everything is a challenge.
CP: Can I get more tech help?
OOOPS: Sure.
CP: Thanks.

Phollower Submissions

Not sure if you need any new stories but I have to share what happened today. Quite possibly the dumbest phone call ever.

A dad of a 4 year old just called to complain that we didn’t tell him how to take his daughters medication.

I asked him if there was a label on the bottle.

He said yes, it says to shake the powder and add water.

I told him that was the manufacturers label. Is there a Pharmacy label?

Him - yes, it says to shake the liquid well and give her.... oh. Well what happens if I already added water?
Me - Sir, why did you add water?
Him - because y’all didn’t tell me it was already mixed.
Me - How much water did you add?
Him - I don’t know, I turned on the faucet like I was making a bottle.
Me - ok, so you don’t know how much water you added to something you didn’t need to add water to?
Him - nobody told me it was mixed. Y’all should have told me it was already mixed.
Me - you’re complaining that we didn’t give you information that I haven’t had anyone ask me for in nearly 20 years? I’ve never had anyone not recognize it wasn’t mixed
Him - how would I know it was mixed?
Me - Um. It was liquid. In nearly 20 years I’ve never had anyone not know. I’m not sure what to say.
Him - you need to chose your words more wisely because what you're saying is calling me an idiot and I’m not. I don’t appreciate you and your 20 odd years and if I need to come down there and complain to the store manager I will. I’m not scared.
Me - ok, I’m not sure what to tell you at this point.
Him - well what am I supposed to do with this medication?
Me - well you have some options. You can guess how much water you have added and try to mathematically calculate the correct dose off of that. You can give her 5 mls of the bottle you diluted and hope she gets better, or you can buy a new bottle for 74 dollars.
Him - well I don’t have that kind of money.
Me - I guess you can underdose her then.
Him - fine.

And he hung up

CP: All I can think of is a Kool Aid analogy. Imagine you're thirsting for Tropical Punch Kool Aid. You stride into the kitchen to find a pitcher and packet of mix, already torn open, on the counter. You observe the pitcher contains a red liquid. Do you pick up the packet, read the directions and, again, observing there is a red liquid in the pitcher, continue to follow the directions and ADD water to the nearly full pitcher?

In the immortal words of Joe Hallenbeck, "water is wet, the sky is blue, and women have secrets".
That's all I can think to say. 
#WaterIsWet.