tag:blogger.com,1999:blog-46101739615279807772024-02-23T21:04:28.605-05:00TheCynicalPharmacistPharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.comBlogger993125tag:blogger.com,1999:blog-4610173961527980777.post-10798659187660119522024-02-19T22:43:00.000-05:002024-02-19T22:43:27.081-05:00Do They Forget?CPP: What's the most frustrating thing about taking a vacation or not having a partner?<div>CP: Floaters. Hands down. </div><div>CPP: All of them?</div><div>CP: Not necessarily all of them. This is always a debate and you hate to paint ALL floaters with the same brush. </div><div>CPP: But?</div><div>CP: No "but"; I choose to complain about the floaters who are managers or staff at their own stores, stores they run on the daily, who come to my store and decide to change things. </div><div>CPP: I've been a manager and staff and had my own stores for most of my career. I have floated to help on short days or to cover vacations and I have never gone on a redecorating spree somewhere I am moonlighting for only a shift or two. I can understand moving the label or fingerprint scanner or mouse if you're opposite-handed. It's a pharmacist station setup and you have to be comfortable but. . . </div><div>CP: The last time I was sans partner, I came back to work to discover the phollowing: </div><div>1. Someone changed my order points to keep all the expensive drugs they ordered in stock (for someone who hadn't even picked up their initial Rx yet). STOP. We don't stock it for a damn good reason. </div><div>CPP: That's a dick move. Order what the patient needs for today and let me decide if I want to keep it or not, especially if we have trained this patient to call in their 90 days supply a few days early each refill. It makes no sense to keep $3k worth of a drug on my shelf for 90 days for one patient. </div><div>CP: 2. Someone took my computer/monitor desk down and placed it on the floor because the terminal was too high, and didn't replace it. </div><div>CPP: It's one thing to adjust your work area where you need to function for 12 hours, but put everything back the way you found it. </div><div>CP: 3. Someone literally rearranged my shelves: they moved my inventory around and shifted the heights of the shelves! </div><div>CPP: Okay that's a bridge too far IMHO.</div><div>CP: That would be like being invited to a friend's house for dinner and to spend the night and deciding to rearrange their kitchen because you don't like their work triangle, where the silverware and cups are located, then moving all the furniture in the bedroom because the feng shui felt off, rising in the morning, and leaving without explanation or replacing everything, all before your friend wakes. </div><div>CPP: Your friend walks around the house all day shaking her head going "WTF!?", unable to drink her coffee because the spoons are now in the bathroom and the fridge is in the den all the while questioning your relationship. </div><div>CP: But she can't complain because you're her only friend who will visit. </div><div>CPP: That's a rather dark picture of floater coverage. </div><div>CP: Dark times, indeed. </div><div><br /></div><div>Part Deux:</div><div>CP: What makes a good floater?</div><div>CPP: If you have a policy or procedure specific to your store, believe the store to which you are floating has one as well. </div><div>CP: Correct. The pharmacist is the interchangeable cog in the mechanism. When you walk in, ASK how they handle their fridge items, their reconstitutes, their oversized items. Don't presume to do it your way if it flies in the face of how this store appears to do things. </div><div>CPP: I'll ask when I arrive and do it their way all day. I may ask why they do it this way and explain how and why we do it differently at my store, but I'm not there to change things; I'm there to be YOUR pharmacist and I respect that. </div><div>CP: Just as we expect the same courtesy from those who fill in for us. </div><div>CPP: Naturally. </div><div>CP: That's not a lot to ask. </div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0tag:blogger.com,1999:blog-4610173961527980777.post-52759745452768213762024-02-14T10:47:00.000-05:002024-02-14T10:47:29.679-05:00Magic 8 Ball<div style="text-align: left;">CP: I've got one for you today. </div><div style="text-align: left;">CPP: Let's hear it. </div><div style="text-align: left;">CP: I called Dr. Zoffis to have a prescription verified/changed due to an incorrect dose and had to leave a voicemail. </div><div style="text-align: left;">CPP: Nothing out of the ordinary there. </div><div style="text-align: left;">CP: Except for her outgoing message which said: "Sorry I could not answer your call. I am either on the phone or with a patient in a room. You can leave and message and I will call you back or "you can call back at a less busy time". </div><div style="text-align: left;">CPP: Huh? Less busy for whom?</div><div style="text-align: left;">CP: Right? I'm not busy right now which is why I called. I may not be this less busy until I close to go home. </div><div style="text-align: left;">CPP: She's probably one of those that thinks we know everything and tells her patients "it will be ready when you get there". </div><div style="text-align: left;">CP: <sings> "I don't practice Santeria; I ain't got no crystal ball". </div><div style="text-align: left;">CPP: <sings> "I don't predict the future. I don't care about the past."</div><div style="text-align: left;">CP: Nice one. </div><div style="text-align: left;">CPP: Isn't that like when we ask people when they want to pick up their prescriptions and they reply "at lunch". </div><div style="text-align: left;">CP: Yeah. Whose lunch? Your lunch? My <giggles> lunch? The other office I called is open 9-4 and takes lunch from 11:30-1:30. Would it be during their lunch? </div><div style="text-align: left;">CPP: That's like the people who say "after work". What if you work second or third shift? </div><div style="text-align: left;">CP: I always tell them if they come after work, I'll be closed. </div><div style="text-align: left;">CPP: Do they get it. </div><div style="text-align: left;">CP: Almost never. </div><div style="text-align: left;"><br /></div><div style="text-align: left;">#Dropkick</div><div style="text-align: left;">#Sublime </div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0tag:blogger.com,1999:blog-4610173961527980777.post-92086986400792147042024-02-08T22:45:00.000-05:002024-02-08T22:45:38.204-05:00Like, Why?<helping another patient, watches Little Old Lady saunter up to front of counter><div>CP: I'll be right with you. </div><div>LOL: I just have a question. </div><div>CP: And when it's just your turn I will just take the time to just answer it just phor you. </div><div>LOL: <scoffs></div><div>CP: What is your question?</div><div>LOL: Do you have Sweet Oil Drops?</div><div>CP: Yes. Aisle Seven, with the other ear drops. </div><div>LOL: "You don't have it here?"</div><div>CP: Did I say I had it here? If I did have it here, why would I tell you where to find it, just answering your "just a question"? Would I not just turn around, procure it phrom behind where I am standing, and say "here ya go!"? </div><div>LOL: <scoffs again></div><div>UT: Well that was one way to give her her just desserts. </div><div>CP: <snickers></div><div><br /></div><div>UT: Hi. CP's Cornucopia of Pastilles calling. Do you have new insurance?</div><div>Patient Ornery On Phone Yelling: I do not. </div><div>UT: According to the insurance, you were terminated at the end of last month. </div><div>POOPY: That can't be. </div><div>UT: I would advise you to call them to help you sort it. </div><div>POOPY: "I am definitely not terminated; I am still paying my premium!"</div><div>UT: Well that's between you and the insurance as they believe you to not have coverage. </div><div>CP: That's the equivalent of "I watched him send it!". Sure you did. But did you ask him WHERE he sent it? Did they ask to WHICH insurance their premiums are going? </div><div>UT: Silly rabbits. </div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0tag:blogger.com,1999:blog-4610173961527980777.post-20850145861228188942024-01-30T08:16:00.000-05:002024-01-30T08:16:40.650-05:00Deep ThoughtsWatching a "You Are What You Eat: A Twin Experiment" on Netflix<div><br /><div>CP: He just said "subscription". </div><div>Other Person Also Looking: Yeah. </div><div>CP: Even the subtitles said "subscription". </div><div>OPAL: Okay. </div><div>CP: It's wrong. It's prescription. </div><div>OPAL: Well, isn't a prescription just a subscription to keep getting your medication?</div><div>CP: <blank stare> You've ruined my professional life now. </div></div><div>OPAL: You're welcome. </div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0tag:blogger.com,1999:blog-4610173961527980777.post-1102657640056055092024-01-29T07:57:00.000-05:002024-01-29T07:57:03.597-05:00Which Do You Prefer?CP: I have seen a variety of ways to type sig codes on bottles. Each pharmacist, and technician for that matter, will have her own preference when it comes to wording and phrasing. The one area on which there is rarely agreement is liquid dosing. <div>CPP: I hate liquid dosing sigs, if they're not done my way. </div><div>ME: ME too. </div><div>UT: Everyone is so picky. </div><div>MICE ELF: I'm guessing you have a poll or something?</div><div>CP: I took a transfer the other day and really felt uncomfortable reading the directions the pharmacy had typed. </div><div>UT: How were they typed?</div><div>CP: "Give seven point five mls . . . "</div><div>ME: <shivers></div><div>CPP: Yeah, I don't like that one bit. </div><div>UT: WTAF?</div><div>MICE ELF: Had to be Chronic Vaginal Secretions. </div><div>CPP: Yeah, if it's sent that way electronically, they don't take the time to fix it. </div><div>ME: We were taught to translate it from doctor-speak to patient-speak. </div><div>MICE ELF: Dumb it down. </div><div>CP: Assume everyone is stupid. You will never be surprised and you will never be disappointed. </div><div>UT: How do we prefer these written?</div><div>CP: "Give 7.5 ml by mouth. . . ". I like the space between the number and the mL. Also, mL can be plural. the added "s" on mls looks weird and is unnecessary. But let's see what else is out there and what everyone else has to say. </div><div><br /></div><div>a. 7.5ml</div><div>b. 7.5mls</div><div>c. 7.5 ml </div><div>d. 7.5 mls</div><div>e. seven point five ml </div><div>f. seven point five mls </div><div>g. other?</div><div><br /></div><div>CPP: Oh, and always remember to use a "0" before the decimal but to omit trailing zeroes. </div><div>CP: I still see .50ml and just know that's a mistake waiting to happen. </div><div>CPP: I was always mystified as to why it was drilled in our heads to never abbreviate "u" for units and to use a leading zero before the decimal but the actual prescribers writing them seem to have not been required to attend that class. </div><div>CP: It was an elective. We know how to write but don't. </div><div>CPP: They write, but don't know how. </div><div>UT: People will blame the e-scripts software. </div><div>CP: They are welcome to do so, but there is still a correct way to write prescriptions and the provider is the one who signs off on it. Much like the Curvy Vivacious Sluts Pharmacists who don't take the time to edit the data on the incoming e-script. </div><div>UT: It happens every day. </div><div>CPP: That's "everyday" if you work for Chocolate Violated Starfish. </div><div><br /></div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0tag:blogger.com,1999:blog-4610173961527980777.post-14865747481136598732024-01-25T08:02:00.000-05:002024-01-25T08:02:02.159-05:00Policy? Or Professionalism?CP: I ordered another case of Bromfed DM today. <div>CPP: Great. I'll let our competition know when we speak. </div><div>CP: Good. I spoke with Chronic Vaginal Secretions yesterday and explained we have it with no issues getting it. </div><div>CPP: Good. Let's hope they send people our way. </div><div>CP: They have been, which is great, but they're annoying about it. </div><div>CPP: How so?</div><div>CP: If I knew you were the only pharmacy around that had it, and I verified it with you that morning, I would send my patients to you. </div><div>CPP: Great. I would reciprocate in kind. </div><div>CP: <blushes> I know. I'm just confused by this interaction, which I have had with multiple pharmacists at the same store. </div><div><br /></div><div>CP: CP's Chronic Perturbations. How may I help you?</div><div>Patient In Need Of The Bromfed: I'm calling to ask if you happen to have Bromfed DM in stock. </div><div>CP: I do!</div><div>PINOT Bromfed: Great. Can you transfer it for me?</div><div>CP: Sure. Where is it?</div><div>PINOT Bromfed: Conjugal Visits/Satan. </div><div>CP: Yeah. I can call them. What's their number?</div><div><hears PINOT Bromfed asking the pharmacy staff for their information></div><div>CP: Are you at the pharmacy counter?</div><div>PINOT Bromfed: Yes. </div><div>CP: They have my information and I spoke with them this morning. Do they really need me to call? or can they send it without?</div><div>PINOT Bromfed: They want you to call. </div><div>CP: Of course. Instead of them, with the Rx presumably on their screen, exiting it and faxing me the copy directly, I now have to stop what I am doing to call them to repeat what this patient already established. </div><div>UT: They must be run like a PBM: The first person asks for your information, transfers you, and that person asks for it all again. </div><div>CP: Except I spoke with the pharmacist this morning, and multiple times since the backorder on this began, and she said she would just transfer them to me. Why do I have to call? Especially on this one.</div><div>CPP: Please don't tell me they pulled the "it's the receiving pharmacy's job to initiate the transfer". </div><div>CP: No. I expected that. Which, granted, is how it should be done and I am a staunch believer in adhering to it. However, I have worked out with other pharmacists in the past to send my prescriptions for the day without them calling, in these instances. It's especially galling if the patient is right there and the pharmacy told them to call around and they suggested my store because they know I have it. </div><div>CPP: It does seem a little selfish. </div><div>CP: Not to mention unprofessional. </div><div>CPP: Did they give you a reason?</div><div>CP: Nope. They just didn't want to do it. According to the patients who have come to pick up these prescriptions. They were surprised the other pharmacists made it so hard. It wouldn't be so bad if they answered the phone when we called. Or didn't have to wait 30 minutes for the fax. I mean, it's not a control and most of us do fax transfers more than verbal anyway. </div><div>CPP: Guess they didn't read your post yesterday. </div><div>CP: Or they did and are still stuck on "ignore the phone, the patient here comes first". </div><div>CPP: Except they made the patient waiting there wait here. </div><div>CP: I guess that's the surprise. </div><div>CPP: What surprise?<br />CP: At CVS - Cloaca Vent Surprise!</div><div>CPP: How much time do you spend on your acronyms?</div><div>CP: All day. </div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0tag:blogger.com,1999:blog-4610173961527980777.post-42861897457455129972024-01-23T10:58:00.000-05:002024-01-23T10:58:37.219-05:00I Disagree ME: What's with the long stare?<div>CP: I'm ruminating. </div><div>MICE ELF: Uh-oh. On what?</div><div>CP: Something someone wrote on a post I made the other week. It wasn't exactly related, but I find I can't let it go and that I ultimately disagree with it. </div><div>ME: What was it?</div><div>CP: "The customer at the counter is more important than the one on the phone." </div><div>MICE ELF: An immediate, knee-jerk response would be "what's wrong with that concept"? The person who entered the business is a priority. </div><div>CP: Not necessarily. </div><div>ME: Why not? They are here. They are present. </div><div>CP: But the phone rang first. Yes, I can ring out their lone prescription, but for how many patients do I ignore the phone? All three in line? The drive-thru? </div><div>MICE ELF: I'm going to argue "yes, the person is front is more important" but only because that's what people will say. </div><div>CP: To which I will reply where do you draw the line? I got really good at ignoring a ringing phone thanks to the Culture of Virgin Suicides allowing 10 lines to ring with only 3 employees staffed. But that is not the point. If you are going to live by a policy, it has to applied equally at all times. IF you agree the patient in front of you is more important, then you MUST never answer a phone call while someone is in the store. Agree?</div><div>ME: Right. You cannot arbitrarily apply the rule. </div><div>CP: BUT, there are two things people forget today: </div><div>1. Our customers are PATIENTS because </div><div>2. We are a HEALTHCARE PROFESSION. </div><div>We just happen to practice our business in a retail setting. Imagine if your doctor had the same policy, or the hospital. The nurses would be checking in patients and checking out patients; they would not be answering phones from other offices, from pharmacies including yours, scheduling appointments, answering patient questions about their test results, or any of the other jobs with which they are tasked because "the customer at the window comes first", right?</div><div>ME: Right. </div><div>MICE ELF: But they have multiple people. </div><div>CP: True. And we do not. If I am working alone, or even with one technician, my prioritization and phone calls must operate differently. People are calling seeking medical advice, clarification on prescriptions, transfers, information. We don't take messages for the doctor so she can review them at lunch, or her designated time to approve refill requests, etc. WE ARE the professionals! WE have to answer those calls. Sure, many are refill requests and "do you have this in stock" queries, but many are not. The guy ringing up his Latanoprost Eye drop along with the bag of peanuts he gets every 4 weeks and I see in my store three days per week is NOT as important to me. He can wait. </div><div>ME: What if the person at the counter has a question?</div><div>CP: It's always about balance. Remember how I wrote about Amoxicillin capsules and how pharmacists' views differ on subbing (tabs vs caps and how you don't get to pick and choose how you apply your rule)?</div><div>MICE ELF: Yes. </div><div>CP: Same here. If you are going to say "the person in front of me took the time and effort to walk in to my store, he is more important, then you MUST 100% apply that to ALL people who walk in. If you do that, those who call with real healthcare questions and needs will be pushed aside. What if you miss the lady calling with heart attack symptoms? Your "customer" that doesn't need your well-trained, professional brain will cause you to waste your time because you're stuck on an antiquated notion of "well he's here". </div><div>ME: I'm not going to say I disagree with you, but many will. </div><div>CP: And they can. Keep in mind, I am talking about the absolutists. Those who say "the customer in front of me is more important" are flawed in their thinking. We are a profession. We are paid for our brains, not our ability to use a register. You can make the person in front of you a priority, but please, don't ignore the phone call. You can visibly see if that person needs your medical help, but the call is a mystery until you answer it. </div><div>MICE ELF: While we're at it, can we address the "HOLD" that places use now instead of "such-and-such pharmacy/doctor, can you hold please?" when they DO answer the phone?</div><div>CP: It's annoying. I'd rather you let it ring. It doesn't allow you to prioritise calls. If I'm calling for a transfer, take my information, have the pharmacist fax it at her leisure, move on. Simple. But "hold" without providing an option is unnecessarily rude. </div><div>ME: But at least they answered the phone. </div><div>CP: And I'd be finding another provider. </div><div>MICE ELF: Must be waiting on all those people who walked into the store. </div><div>CP: Glad I wasn't having a stroke. </div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0tag:blogger.com,1999:blog-4610173961527980777.post-30944904463434189312024-01-20T19:13:00.000-05:002024-01-20T19:13:37.393-05:00Somebody Once Told MeCP: Thank you phor calling CP's Chronic Plaints. How may you ruin my day phor me? <div>A Little Lady Still Talking About Rejects: I want to know if my doctor called in my prescription. </div><div>CP: They did. I was just about to call you, in fact. </div><div>ALLSTAR: To let me know it was ready?</div><div>CP: No. To tell you it's not covered on your insurance; they require a prior authorisation. </div><div>ALLSTAR: Okay. But I have insurance. </div><div>CP: Uh-huh. Stay with me now. You're falling a little behind. You have insurance but this insurance does not cover this medication. </div><div>ALLSTAR: "Somebody told me if you run it through and it rejects 3 times, they have to pay for it if you run it a 4th time". </div><div>CP: Uh-huh. All my life has been a lie. I usually stop at two times. All these years wasted on prior auths when all I had to do was to continue submitting the prescription until it was covered. Oh me. </div><div>ALLSTAR: "Well my friend's insurance covers it". </div><div>CP: Uh-huh. I'm going to assume she works elsewhere?</div><div>ALLSTAR: Yes. </div><div>CP: Well I have two suggestions phor you: you can either call your office and ask them to complete the prior auth, which may bring a large copay with it, or, and this is probably the fastest option, you could get hired by your phriend's employer, join their insurance, and know they will cover this medication once benefits kick in in 90 days or so. But that's a long way to go for Mounjaro, Ozempic, or Zepbound. </div><div><br /></div><div>#TrueStoriesWithCP </div><div><br /></div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0tag:blogger.com,1999:blog-4610173961527980777.post-62476077913203366892024-01-15T21:09:00.000-05:002024-01-15T21:09:55.695-05:00Things People Say. . . <div style="text-align: left;">. . . if only they took a second to let their grey matter process it before it escaped. </div><div style="text-align: left;"><br /></div><div style="text-align: left;">1. Why is the bathroom door locked?</div><div style="text-align: left;">CP: I don't know. Have you never ever in your life locked a bathroom door while in there? Never had someone lock you out at home? At work? At a rest area? While getting busy in a Burger King? </div><div style="text-align: left;"><br /></div><div style="text-align: left;">2. What took so long to answer?</div><div style="text-align: left;">CP: Never been on a call and heard a busy signal? You're old enough to remember those. Never had another call come through while you were talking to someone else? Call waiting? Ring any bells? </div><div style="text-align: left;"><br /></div><div style="text-align: left;">3. Would it be cheaper somewhere else?</div><div style="text-align: left;">CP: How much does a 10lb bag of potatoes cost at Costco? Oh, you don't know? Neither do I. </div><div style="text-align: left;"><br /></div><div style="text-align: left;">#LowerYourExpectations </div><div style="text-align: left;">#ThinkBeforeYouSpeak </div><div style="text-align: left;">#BetterYet </div><div style="text-align: left;">#DontSpeak </div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0tag:blogger.com,1999:blog-4610173961527980777.post-33078314374596571492024-01-15T21:02:00.000-05:002024-01-15T21:02:07.718-05:00If The Real World Worked. . . <div>CP: What a great day we are having today. </div><div>UT: You know you're never supposed to say that. Just like you never say "it's awfully quiet/slow today" or "after I check this one I'm going to use the bathroom or eat". </div><div>CP: Or say a patient's name in passing as it will magically speak them into existence. </div><div>UT: Right. So why the optimism?</div><div>CP: I just figured we were overdue for someone to call us from an alternate reality. </div><div>UT: And you just expect. . . </div><div><phone rings> </div><div>CP: All yours. </div><div>UT: Thank you phor calling CP's Crepuscular Pharmacy where we like to keep people in the dark. How may I help you phrustrate me?</div>Highly Illogical Sans Possession Of Common Knowledge: I was calling to see if you have [insert backordered drug-of-choice here] in stock. <div>UT: We do not. </div><div>HI SPOCK: Can you tell me why you don't carry it?</div><div>UT: First, that is the wrong question. </div><div>HI SPOCK: What would be the correct question?</div><div>UT: Any of the following: Do you usually carry it? Are you out of stock at the moment? Is there a reason I can't find it anywhere? Any of these would be better than your choice of "Can you tell me why you don't carry it?" as your question implies an intentional hole in my inventory as opposed to a phorced one. </div><div>HI SPOCK: Interesting. </div><div>UT: I will, however, answer the question you posed. <ahem> </div><div>CP: <mischievous grin></div><div>UT: Do you have any gluten-free pancake mix or any asparagus in your kitchen at the moment? </div><div>HI SPOCK: Um, no. And that's another question, not an answer. </div><div>UT: Can you tell me why you don't carry these items in your kitchen?</div><div>HI SPOCK: I don't use them. I don't need GF products nor do I like asparagus. </div><div>CP: <whispers> SATC funky spunk lol</div><div>UT: <shhhh> You don't stock them because you don't use them.</div><div>HI SPOCK: Correct. </div><div>UT: And therein lies my answer to the question you asked. However, had you asked any of the other questions, I would have replied with "it's on manufacturer backorder at the moment so, whether I stock it, which means I USED to have it, or don't stock it, which means I never carry it, the answer is it is currently unobtainable. </div><div>HI SPOCK: Thank you. Honestly. That is the best answer I have received from anyone. I wonder why no one else could explain it that well. </div><div>UT: You kept asking the wrong question and we don't suffer fools, we post about our conversations with them. </div><div>CP: We should start naming all of these product like a Marvel Metal - Uhnobtainium, abbreviation Uh-NO.</div><div>UT: Dorque. </div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0tag:blogger.com,1999:blog-4610173961527980777.post-43878262180785999372024-01-11T20:57:00.000-05:002024-01-11T20:57:06.173-05:00I Forgot. Remember?<div style="text-align: left;">CP: Thank you phor calling CP's Choice Pessaries. How may I help you?</div><div style="text-align: left;">Does One Remember Yet: I couldn't find my bottle to give you the refill number. </div><div style="text-align: left;">CP: No worries. I can find it through your profile. Which medication?</div><div style="text-align: left;">DORY: The water pill, I think.</div><div style="text-align: left;">CP: Your "I-just-wanna-die-inside"?</div><div style="text-align: left;">DORY: Yes. That's it. </div><div style="text-align: left;">CP: I see here we filled a 90 days supply 45 days ago. </div><div style="text-align: left;">DORY: Are you sure?</div><div style="text-align: left;">CP: More certain than you.</div><div style="text-align: left;">DORY: You're sure I picked it up?</div><div style="text-align: left;">CP: I have the fill date, your signature at the timestamp of pickup, and video of you scrawling that signature across my tablet so yeah, I'm sure. </div><div style="text-align: left;">DORY: Well I can't remember back that far so I'll have to take your word for it. </div><div style="text-align: left;">CP: You couldn't phind the bottle and, despite me having all evidence of you being in my store and retrieving said prescription, you're going to go with "I'll have to take your word phor it"? </div><div style="text-align: left;"><br /></div><div style="text-align: left;">UT: I miss when people trusted us. </div><div style="text-align: left;">CP: This is why people question everything. News agencies put an expert next to a person with an opinion but no expertise up against each other in a "debate" and people say "yeah, that guy makes more sense than the expert who has studied this phor 35 years". Let's go listen to the conspiracy theorist who lives in his mom's basement. </div><div style="text-align: left;">UT: <cough cough> Aaron Rodgers. I really miss when people would reply with "okay" and "thank you" instead of making everything an argument. What do I hope to gain by lying to you? This little tete-a-tete has already wasted our time and brain cells more than it should. </div><div style="text-align: left;">CP: "Trust me, I'm a Doctor" has never felt so empty. </div><div style="text-align: left;">UT: You don't even have to stay at a Holiday Inn Express. </div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0tag:blogger.com,1999:blog-4610173961527980777.post-3034677883440080942024-01-10T22:23:00.000-05:002024-01-10T22:23:33.442-05:00How About NO!?<div style="text-align: left;">Pt: Do you cut those?</div><div style="text-align: left;">CP: I don't take them so no, I don't cut them. </div><div style="text-align: left;">PT: They said you would. </div><div style="text-align: left;">CP: My favourite pronouns. Who are "they"?</div><div style="text-align: left;">PT: The nurses at Dr. Zoffis. </div><div style="text-align: left;">CP: Of course. Well they don't work here so they cannot speak to what I do or do not do. However, upon your return to the office, please tell them you are going to walk straight back to the room without checking in, see the doctor, and leave without a copay because "they" said so - when they ask who "they" happen to be, please tell them the pharmacy staff. </div><div style="text-align: left;">UT: At least they are good patients about it; now it's a running joke between us. </div><div style="text-align: left;">CP: True. </div><div style="text-align: left;"><br /></div><div style="text-align: left;">PT: This is Dingus, father of Mingus, son of Wingus, Destroyer of Good Days, Waster of Time. </div><div style="text-align: left;">CP: Oh, joy. Thanks, Colin Robinson. How may I help you?</div><div style="text-align: left;">PT: My son. </div><div style="text-align: left;">CP: Mingus. </div><div style="text-align: left;">PT: Can you tell me what he needs?</div><div style="text-align: left;">CP: No. </div><div style="text-align: left;">PT: What do you mean by no?</div><div style="text-align: left;">CP: Is he out of anything?</div><div style="text-align: left;">PT: I don't know. </div><div style="text-align: left;">CP: Almost out of anything?</div><div style="text-align: left;">PT: Not sure. </div><div style="text-align: left;">CP: Well, the general rule of "needing something" is that you are out of it and need to either get it to start on it, or you are out of it and need to replenish it. Do you call the grocery store to ask if you need milk? or eggs? or cat litter? </div><div style="text-align: left;">PT: No. </div><div style="text-align: left;">CP: Now you got the hang of it. You DO know the definition of "no". And that would be silly, huh?</div><div style="text-align: left;">PT: What would?</div><div style="text-align: left;">CP: To call a business to ask THEM if you NEED THEM to fill something for you. </div><div style="text-align: left;">PT: Right. </div><div style="text-align: left;">CP: Then, as I stated earlier, no. No, I cannot tell you what he needs. </div><div style="text-align: left;">PT: So you refuse to help me. </div><div style="text-align: left;">CP: It is not a refusal. You have established that you and he are beyond my help. Maybe put your heads together, along with his bottles, and you may be able to determine the answer to your quest. It's not a true quest without some hardship along the way and this, this is your hardship for I shall not allow it to be mine. Fare thee well. </div><div style="text-align: left;"><br /></div><div style="text-align: left;"><br /></div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0tag:blogger.com,1999:blog-4610173961527980777.post-40995202726575694812024-01-09T10:05:00.000-05:002024-01-09T10:05:08.814-05:00Huh?CP: What is the definition of a prior authorisation?<div>CPP: A payor, usually the patient's prescription insurance, requires prior auth for a medication that is not typically listed on their formulary. The provider, usually the prescriber, must make a case to the payor, pleading their case that the patient needs this medication. The prescriber will indicate failure of previous, step-therapy treatments or allergies, or other reasons as they plead their case. </div><div>CP: And if the provider does all this? </div><div>CPP: The payor, in this case the insurance, can choose to cover it or deny the claim. </div><div>CP: And if they approve it?</div><div>CPP: Then the prescription should be covered but still may incur a large copay. It could be a normal copay, but this is often not always the case. Why the lesson today, CP?</div><div>CP: Oh, just making sure it hasn't changed in the last week on me. </div><div>CPP: I feel a story is imminent. Do share. </div><div><br /></div><div>CP: Hello Dr. Zoffis!</div><div>DZ: Hello!</div><div>CP: I was calling about a p/a for our mutual patient. I see you faxed us a novella regarding the p/a. </div><div>DZ: I did. </div><div>CP: It's still not covered and when I called Cover My Meds, they said you deleted the request. </div><div>DZ: I deleted this one because we already did one in November and it was approved for a year; which is what we faxed you. </div><div>CP: Curiouser and curiouser. I shall call them, armed with this fax from you. </div><div><br /></div><div>Stupid Ass Insurance Department Now Obfuscating: How may I frustrate your life today?</div><div>CP: I was calling about a p/a that was approved in November that I, for some soon-to-be-explained reason, cannot get to go through. </div><div>SAID NO: Let me check. Which drug? </div><div>CP: The patient had it approved while they were still using Causes Virgin Suicides as their pharmacy, but transferred to us the beginning of the year. </div><div>SAID NO: Ah yes. I see they have 4 NDC's for this. </div><div>CP: They don't. </div><div>SAID NO: Well my system shows 4 are available. </div><div>CP: Can you order them through your fancy system?</div><div>SAID NO: No. </div><div>CP: Then they are NOT, in fact, available. I have all 3 of my suppliers pulled up and there is exactly one NDC, brand only, available for this product. Which, may I ask, is covered?</div><div>SAID NO: None of them. </div><div>CP: Ok. But I have an approved p/a. For which NDC was it approved?</div><div>SAID NO: The one you are billing. </div><div>CP: Yet here we sit, you telling me the drug is not covered. </div><div>SAID NO: Yes. </div><div>CP: And I have an approved p/a, complete with approval number and date of approval. </div><div>SAID NO: Yes. But it's not covered. </div><div>CP: Explain. </div><div>SAID NO: This drug is not covered so the p/a should never have been approved. </div><div>CP: Yet it was. I am going to need you to fax that information to the DZ. They would never believe me and I'm going to get yelled at. </div><div>SAID NO: Done. </div><div>CP: Thanks. </div><div><br /></div><div>CP: Hey, DZ. You're never going to believe this. <recounts story></div><div>DZ: Damn. That's epic. I guess I'll contact them and figure out how to get it covered. </div><div>CP: <does double-take> It's. Not. Covered. Period. Good luck in your endeavour!</div><div><br /></div><div>*side note: as I was listening to SAID NO explain this to me, Unbelievable by EMF was playing on my XM</div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0tag:blogger.com,1999:blog-4610173961527980777.post-4409255609537950222024-01-04T07:27:00.000-05:002024-01-04T07:27:07.931-05:00Who? ME: What should we discuss to begin 2024?<div>MICE ELF: Do Indiana University bookstores sell "Hoosier Daddy" T-shirts? </div><div>ME: Why is this relevant?</div><div>MICE ELF: It's nor worse than the South Carolina jokes out there. </div><div>ME: But the relevance to pharmacy today? </div><div>CP: It's an honest question because I was ruminating earlier about Who's Your Doctor so you can see where the inference was drawn by MICE ELF. </div><div>ME: True. So we are discussing Who's Your Daddy, I mean Doctor? </div><div>CP: Yes. The real question to answer is this: Are you a patient of the PROVIDER? or of the OFFICE? </div><div>MICE ELF: Context? </div><div>CP: A patient comes to the counter and we explain we have faxed her refill requests multiple times. She asks to which provider we are sending it and we tell her Peter Gozinya. She says "I've never heard of him". </div><div>ME: <snickers> </div><div>CP: . . . and we explain it's another provider in Dr. Zoffis, probably the CNP who signed off on her previous refill request. She will ask: "why did THEY call it in? I've never seen them" and I'll reply with "are you ever not home? Who answers your phone or takes your messages? Same concept".</div><div>MICE ELF: Or, as often happens, she will respond with "I switched providers last year! I don't know why you'd send it there". </div><div>CP: When we send refill requests, they go to the person who approved them last. Now, the wrinkle we all are expecting: what happens if the provider either </div><div>a. leaves the practice to practice elsewhere or</div><div>b. dies?</div><div>ME: Do you follow the provider to their new location? If so, you are a patient of the PROVIDER. </div><div>MICE ELF: If you do not move with them, or they died, do you remain a patient of the "PRACTICE"?</div><div>ME: <sarcastically> Jeez, CP. Why is this knotting your knickers today?</div><div>CP: Because of the refill requests we send that are returned to us with notes like these: </div><div>"not our patient" - really? because she was last month. </div><div>"provider not at this location" - really? because this is the e-script I received from this location last month.</div><div>ME: Okay. Then I suppose I shall follow up with the obvious final question.</div><div>MICE ELF: Which is?</div><div>ME: Whose responsibility is it to know where the patient is being seen?</div><div>ME, MICE ELF, CP: THE PATIENTS'!</div><div><and they all laughed and laughed until they burst into tears></div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0tag:blogger.com,1999:blog-4610173961527980777.post-46876056482572505552023-12-21T14:02:00.000-05:002023-12-21T14:02:49.360-05:00Christmas CarolsJingle Bells<div><br /></div><div>scriptions I must count</div><div>patients want them now </div><div>questions they all shout</div><div>phones are ringing too </div><div>bathroom's over there</div><div>you'll find shoelaces too </div><div>we're so busy now</div><div>just leave us alone</div><div><br /></div><div>counting pills, counting pills</div><div>counting all the way</div><div>once I fill up your Rx </div><div>I'll stop counting pills, hey</div><div>counting pills, counting pills </div><div>I'm still counting pills </div><div>five by five I'm counting pills </div><div>I wish they'd go away, hey</div><div><br /></div><div>another script I have</div><div>to count again by fives</div><div>they think we're all just bums</div><div>out here saving lives</div><div>doctor cannot spell </div><div>math here is not right </div><div>pharmacist is still </div><div>slaying it tonight </div><div><br /></div><div><div>counting pills, counting pills</div><div>counting all the way</div><div>once I fill up your Rx </div><div>I'll stop counting pills, hey</div><div>counting pills, counting pills </div><div>I'm still counting pills </div><div>five by five I'm counting pills </div><div>I wish they'd go away, hey</div></div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0tag:blogger.com,1999:blog-4610173961527980777.post-21508312484002378912023-12-10T17:55:00.000-05:002023-12-10T17:55:43.108-05:00Pet Peeve of the Week #2CPP: What pet peeve set your hackles aquiver most recently?<div>CP: The number of people this week who asked "why did my doctor prescribe that for me" is too damn high!</div><div>CPP: For the uninitiated, this is where I play Devil's Advocate, to prove we thought of the boring reasons patients are asking this question. </div><div>CP: Right. There's a difference between "what is this for?" and the following indictments of annoyingly obtuse offenders. </div><div>CPP: Shall oui?</div><div>CP: Lettuce. </div><div><br /></div><div>Uber-Tech: Is this Mr. VEM?</div><div>Better Off Forgetting About Various Electronic Medications: Uh-huh. </div><div>UT: We received a couple new prescriptions from Dr. Zoffis today and we have to order them for tomorrow. Also, I wanted to give you the prices before we order them. </div><div>BOFA VEM: I didn't ask for any medications. </div><div>UT: Well your Dr. Zoffis apparently thought you needed them.</div><div>BOFA VEM: What are they for?</div><div>UT: Did you see your provider today?</div><div>BOFA VEM: Yes. </div><div>UT: Did you just randomly bump into him on the street? Or did you schedule an official appointment for a particular illness/reason?</div><div>BOFA VEM: I did. </div><div>UT: Did you discuss these issues with your provider? </div><div>BOFA VEM: Yes. We discussed both of them. </div><div>UT: And. . . what was the result of your discussion?</div><div>BOFA VEM: <shrugs, even though this is a phone call, I can feel it> I don't remember. </div><div>UT: You had a problem. </div><div>BOFA VEM: Or two. </div><div>UT: And scheduled an appointment with your provider. </div><div>BOFA VEM: Uh-huh. </div><div>UT: To hopefully run some tests or give you, I don't, maybe medications to improve your symptoms?</div><div>BOFA VEM: I guess. </div><div>UT: Yet you are surprised to hear from me. Me, telling you you have a prescription and acting put out by my call. </div><div><br /></div><div>CP: I truly wonder what happens during these visits. It used to be so simple, formulaic even. Get sick. Go to Doctor. Get a prescription. Go to pharmacy. Trade paper prescription order for actual prescription medication. Take medication, get better. Now it's so convoluted people don't even know why or when or even IF they went to the doctor within the hour, let alone any day this week. </div><div>UT: It's amazing how many of these calls I make every day and people are surprised we have something for them. </div><div>CPP: Maybe they're used to Chronic Vaginal Secretions not calling them for weeks since they are so far behind that the patients can't comprehend how we can contact them while they are still in the office! </div><div>UT: That's always great. You get them on the phone and they say "I didn't know anything about that" and you find out they are literally still in the room with the provider. ASK! How did you not just hear her say "I'm prescribing you THIS!"????</div><div>CP: And how many days will that prescription sit in our waiting bin because they forgot they went to the prescriber earlier in the week. </div><div>CPP: Yeah, that's the other one that gets me: how did you forget you were at the doctor on Tuesday? </div><div>UT: Especially when it's a specialist! You had to have made that dermatologist appointment months ago. How can you forget you went two days ago? </div><div>CP: As the saying goes: "<span style="background-color: white; color: #181818; font-family: Merriweather, Georgia, serif; font-size: 14px;">The best thing about being dead is that you don't know about it. It's like being stupid - it's only painful for others.”</span></div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0tag:blogger.com,1999:blog-4610173961527980777.post-72396201447793357202023-12-07T11:06:00.000-05:002023-12-07T11:06:36.579-05:00Climate Change Is Real CP: I challenge you that climate change is real. <div>ME: Yeah. We know. </div><div>MICE ELF: How is this relevant to #Pharmacy?</div><div>CP: I'm talking on a smaller, yet global scale. </div><div>ME: Again, we know. What of it?</div><div>CP: I posit that climate change exists, in microclimates, in every pharmacy and retail outlet in the world!</div><div>MICE ELF: <best Goody impression> Settle down. </div><div>ME: <resigned exasperation> I'll entertain it. </div><div>MICE ELF: Let's hear it. </div><div>CP: There exists, at every pharmacy counter, a microclimate that negatively affects all humans who enter or even approach it. </div><div>ME: How do you mean?</div><div>CP: Ever notice how, before you can see or acknowledge a person at a pharmacy window, the weather affects them?</div><div>MICE ELF: Like how?</div><div>CP: Like just by getting within the area of the drop off or pickup window, all patients seem to manifest the same side effects. Our counters should come with warnings: Danger! Achtung! Warning! Approaching the pharmacy counter has been shown, anecdotally, to cause a dry, scratchy throat, sudden coughing, sniffling, instant urge to clear throat, loss of decorum, and an inexplicable loss of dexterity and motor control rendering patients unable to hold on to their keys or to place them gently on a countertop. </div><div>ME: <laughs at "inexplicable loss of dexterity"> </div><div>MICE ELF: I've had the same thoughts. </div><div>CP: I almost want to go back to school to study Sociology. My thesis would focus on people behaving differently from the time they park, to the time they near a retail building, to the time they enter the outer doors, to their standing at one of the windows, waiting for another human with whom to interact. </div><div>ME: Like, are they coughing in the parking lot? or as they cross the threshold of the store? or once they abruptly halt their momentum at the counter? </div><div>MICE ELF: Right?! And is this common among pharmacy shoppers only? Is this only in my neighbourhood? nationwide? globally? </div><div>ME: We are humans. Humans do human things. Behaving poorly in public is universal. </div><div>CP: We already established what I do when people knock on my counter. </div><div>ME and MICE ELF: "IT'S NOT A DOOR!"</div><div>CP: I think the next time they cough or clear their throat, I should reply with: "Are you dropping off? Or do you just have a question about that cough and mucous you just ingested in front of everyone?"</div><div>ME: What about when they drop their keys? </div><div>CP: We sell wrist braces in Aisle 13 so you can grip those keys as well as purses and pants with pockets for you to place the keys so as not to lose them or forget them on counters. </div><div>MICE ELF: Not bad. Better than "you must be a janitor; sounds like you dropped a whole school's-worth of keys on my counter". </div><div>ME: Idiots. Both of you. </div><div>CP: How about #CoughMedicineIsInAisle13?</div><div>MICE ELF: I so want to take this class now. </div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0tag:blogger.com,1999:blog-4610173961527980777.post-7838907408545852092023-11-13T21:47:00.000-05:002023-11-13T21:47:40.189-05:00MovedCPP: What did you find particularly annoying last week?<div>CP: Dr. Zoffis. </div><div>CPP: Care to elaborate?</div><div>CP: I'm tired of their shenanigans. </div><div>CPP: Care to elaborate?</div><div>CP: Patients call all the time, as do offices, to say "we watched them send it. we sent it last week. we sent it wesentit wesentitwesentit!". </div><div>CPP: Yes. And?</div><div>CP: And what happens? We receive a refill too soon rejection at best or, the office says "can't you just call and transfer it from the other pharmacy?" making it our job to do their job since they failed the first time(s). </div><div>CPP: What's also annoying is when patients are IN the office and specify they want their prescriptions sent to my pharmacy. They put it on the app at checkin, review with the receptionist, verify with the nurse, and confirm with the prescriber. Yet they still manage to send it to the wrong place, if it's sent at all. </div><div>CP: Right. Well you know how we received those Sharpie-fied refill request denials from Dr. Zoffis? </div><div>CPP: The ones that say "not our patient" or "patient died" or "no longer our patient"? </div><div>CP: Yes. Those. Well now I've been seeing a new one: "moved office location. update your records". </div><div>CPP: I can see why that would be bad. </div><div>CP: How about no? </div><div>CPP: Pushing more work onto us. </div><div>CP: From now on, when the office sends it to the wrong pharmacy, I'm telling them that, no, I cannot do that. When I move, I fill out a change of address form alerting the post office of my new location. It is not their responsibility to inform the senders of MY mail my new address. </div><div>CPP: It's even worse when you have providers that have multiple office locations listed but the only one from which we receive e-scripts is the "home address" of the e-rx software. </div><div>CP: Yeah, good luck trying to discern which of the 11 offices she is working today. Maybe its #7, maybe it's #46 and #2. Maybe she's off today. Who knows. No one has even heard of her at most of the offices because she travels. </div><div>CPP: Providers should be forced to sign in at their prescribing location when they first login to their e-scripts for the day. If they leave for another location, they need to again login to the new place. Easy. </div><div>CP: You mean like we do when we work multiple stores?</div><div>CPP: Genius, right? </div><div>CP: But I am not playing Where's Waldo all day. </div><div>CPP: Let's remind people of something here, or rather ask a key question: Are you a patient of the DOCTOR? or a patient of the OFFICE?<br />CP: If the doctor leaves a practice for a new one, do you, as the patient, follow them making you THEIR patient? If so, then I need to know the new location to send your refill. </div><div>CPP: Which will likely update anyway as we will continue to send requests to the DOCTOR on your file. </div><div>CP: But, If your doctor dies/leaves and you continue to see a provider in the same office, then you are a patient of that OFFICE. </div><div>CPP: Which means when we send refill requests, the OFFICE shouldn't send us nasty notes about "not our patient" or "doctor no longer at this location/office/practice" or any other form or quick dismissal. </div><div>CP: Especially when the office policies "require that your pharmacy contact us for refills". </div><div>CPP: Easier said than done when we don't know WHERE to send them. </div><div>CP: Or TO WHOM! </div><div>CPP: I thought e-scripts were going to make everything easier? </div><div>CP: It certainly made it easier for Dr. Zoffis to lay blame everywhere else and shirk many responsibilities. </div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0tag:blogger.com,1999:blog-4610173961527980777.post-15015003067736072022023-11-06T08:10:00.000-05:002023-11-06T08:10:55.030-05:00PetsCP: I don't believe animals should be allowed in stores. <div>CPP: I bet the people with service animals would have a few words about that. </div><div>CP: I'm fine with the real, honest, working service animals; not these made up "emotional support" guinea pigs and alligators and pipsqueak rat-like dogs people bring in to stores. </div><div>CPP: Yeah, the line has been erased. <br />CP: And no one says anything because we can't offer "poor customer service" or be perceived as "intolerant". I do have pets. They stay at home. </div><div>CPP: Why the anti-pet rhetoric today? </div><div>CP: I was thinking we should get a pharmacy phriend; a pet. </div><div>CPP: You confuse me. </div><div>CP: Well, it started as a post about what would make the best pharmacy pet and I ME, MICE ELF, and I were discussing it, we thought of a better topic. </div><div>CPP: Oh do tell. </div><div>CP: Pharmacy Mascot!</div><div>CPP: Uh-huh. </div><div>CP: What would make the best animal representative for our profession?</div><div>CPP: I don't know. </div><div>ME: ME! Pick ME! </div><div>MICE ELF: I have one! Ooh! OOH!</div><div>CPP: Why can I hear the voices in your head?</div><div>CP: <shrugs> </div><div>CPP: Okay. What did you decide? </div><div>CP: The perfect animal would be the duck-billed platypus. </div><div>CPP: Since you put a lot of thought into this, why is the Platypus the perfect spirit animal for pharmacy?</div><div>CP: We are simultaneously two things at once, like the DBP: we are both salaried and hourly, respected and disrespected as professionals; retail workers yet professional license holders. No one believes we exist. </div><div>CPP: I don't think Travis Kelce will make another "two things at once" commercial based on your description of pharmacy and the platypus. </div><div>CP: Could be fun. I think I'm going to make Pharmacy Platypus Pins. #ThePlatypusIsThePharmacySpiritAnimal </div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0tag:blogger.com,1999:blog-4610173961527980777.post-61595806415376218672023-11-03T16:24:00.000-04:002023-11-03T16:24:59.300-04:00Where Did They GoCP: Let's play a game of where did they go?<div>ME: Why?</div><div>CP: I have this hatred of Outcomes and MTMs in general. </div><div>MICE ELF: Why? Are you saying these aren't helpful? </div><div>CP: Another post for another time but I'm saying they're a waste of time for us to fight to keep the money the insurances paid us and that it is improbable the 90 days supplies and phone calls from MTMs make patients take their medication correctly. </div><div>ME: Thanks for the clarification. </div><div>CP: Where do these medications go? People always say "I take these EVERY DAY! I never miss a dose. I never take more than I am supposed to take", yet here we are, 120 days in to a 90 days supply and you still have plenty of loaves and fishes to go around a few more times. </div><div>MICE ELF: Where DO they go? </div><div>CP: I had a guy this week looking for his one refill; no, not that one, the other one he can't remember. </div><div><br /></div><div>CP: Your two other medications are past due. </div><div>Maybe It's Meth, Eh?: No I don't. I just picked them up. </div><div>CP: If by <spits word> "just" you mean 99 days ago, then yes, you "just" picked up your 90 days supply 99 days ago. Which means you should have run out <checks math, does air calculations for dramatic effect> 9 days ago? </div><div>MIME: I still have at least month left. </div><div>CP: You take them every day. </div><div>MIME: Yes. </div><div>CP: Never miss a dose? </div><div>MICE ELF: <they don't call him never-misses-the-mark-michaels> </div><div>ME: <let's see who gets that reference> </div><div>CP: Stop, you two!</div><div>MIME: Never miss a dose and it's still once a day. </div><div><br /></div><div>ME: I guess you're asking "where do they go" in a rhetorical sense?</div><div>CP: NO! I really want to know where they go! How do they make these supplies last so long? Outcomes tells us patients are more compliant if they receive 4x90 days supplies per year, right?</div><div>MICE ELF: So they say. </div><div>CP: But just because we FILLED THEM, it does not mean the patients TAKE THEM! As evidenced by our MIME up above. </div><div>ME: You could also ask: "How do they make them last so long?'</div><div>MICE ELF: <sings "marijuana in your brain. . . "</div><div>ME: Stop. No one will get that one. </div><div>CP: Ho DO they last so long? Four fills of 90 days should last 360 days. EVERYONE tells us patients are more compliant yet all I see are patients requesting to be taken off of automatic refills and being habitually late when they call the refills in themselves. </div><div>ME: I have the solution. </div><div>MICE ELF: An Epi-Fanny? </div><div>ME: You mean epiphany? </div><div>MICE ELF: Tomato -To-mah-to. </div><div>CP: Let's hear it. </div><div>ME: We start a service like DoorDash or Uber and send an employee to each patient's house to ensure they take their doses of medication. </div><div>CP: Don't let the PBMs hear that. They'll make us do that to collect our own DIR fees. Each visit nets us tenths pennies on the dollar.</div><div>ME: Call it DrugDash?</div><div>MICE ELF: Either way, patient responsibility is not OUR responsibility. Just like you can't mandate personal hygiene or car maintenance, you can't mandate personal prescription compliance AND have NOT be the end users' responsibility. </div><div>CP: You can give a person an education, but you can't make him use it. You can give a person medication. . . </div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0tag:blogger.com,1999:blog-4610173961527980777.post-22161990791460817922023-10-31T22:43:00.000-04:002023-10-31T22:43:11.967-04:00Rhetorical CPP: I see here in your bio that you like asking and answering rhetorical questions. <div>CP: I do. It's unexpected. </div><div>CPP: What other ways do you like to buck normalcy?</div><div>CP: Asking people to explain answers they supply that are quite unexpected. </div><div>CPP: You are a fan of the comic, and the term itself, non sequitur. </div><div>CP: Indeed. You are familiar with the Geico Airport commercial? </div><div>CPP: Of course; the one where the traveler replies "you too" to the TSA agent wishing him a good trip. </div><div>CP: That's the one. Have you ever stopped and asked a patient, or anyone, for that matter, why they said what they just said? </div><div>CPP: Questioning the origin of their non sequitur to determine if they didn't understand what you were saying; to determine if they had their response prepared and, no matter what you said, they were going to reply the same; or if they really didn't understand the assignment and were looking for a way to safely exit the uncomfortable conversation? </div><div>CP: Right. Like this example:</div><div><br /></div><div>CP: Welcome to the Machine. What did you dream. This is CP's Playhouse. How may I help you?</div><div>Do I Look Dumb Or What: I need a refill on my medication. </div><div>CP: You have no refills left. I sent a request to your office and I would suggest you call them as well. Maybe if we both attack them, they'll get back to us sooner. </div><div>DILDOW: I've been coming here for years. </div><div><br /></div><div><Option #1 - We reply with equally useless knowledge></div><div><br /></div><div>CP: Oh wow. I've WORKED here for years </div><div>or</div><div>CP: Oh wow! I once scored 4 touchdowns in one game for Polk High. </div><div>or </div><div>CP: Oh wow! Giraffes and Humans each have 7 vertebrae. </div><div><br /></div><div><Option #2 - We ask the relevance of their reply></div><div><br /></div><div>CP: Oh really? Wow. And what does your loyalty to our business have to do with your lack of refills? Are you implying "I've never had this problem before" or something else sinister towards me? </div><div>PT: But. . . </div><div>CP: Or are you letting me know that you know that I know you should know by now, due to your years of loyal servitude, that you should know better that you have to call Dr. Zoffis yourself for your refills? </div><div>DILDOW: But. . . </div><div>CP: Seriously. What possessed you to reply with "I've been coming here for years"? That doesn't follow the conversation. Appropriate replies wold have included:</div><div>"Oh. Ok. I shall ring my provider forthwith."</div><div>"Oh. Fiddlesticks. What are my options so I do not go without?"</div><div>"My bad." </div><div><br /></div><div>CPP: Sometimes that's a fun rabbit hole to investigate. Often, it's short. </div><div>CP: It's fun watching them struggle to comprehend what just happened. That's why I have so many fun facts on hand. They always get distracted by shiny new things. </div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0tag:blogger.com,1999:blog-4610173961527980777.post-64299691348595651982023-10-20T08:10:00.000-04:002023-10-20T08:10:39.366-04:00No One Believes Us Anymore<div style="text-align: left;">CP: You know what I miss? When people used to take our word for something. We were seen as the experts and our answers were The Final Word on everything pharmacy-related. Now it's just become another answer patients wish to argue with you. </div><div style="text-align: left;">ME: If we tell you it's on backorder, it is. We aren't artificially presenting a mass market conspiracy. </div><div style="text-align: left;">MICE ELF: Now people like to argue. "Well I'll just get it where my girlfriend fills hers; she never has an issue getting stuff."</div><div style="text-align: left;">ME: Right. Somehow we are the only ones experiencing a shortage. Maybe she got lucky each time previously, but today? Today it's on backorder. Why does this have to be an argument?</div><div style="text-align: left;">CP: Or this one: You gave me expired Paxlovid. </div><div style="text-align: left;">ME: OMG! I hate this so much. </div><div style="text-align: left;">MICE ELF: Never mind trying to explain about concurrent trials or the company being forced to put A date of expiration on the box. </div><div style="text-align: left;">ME: They don't want to hear it and don't care. </div><div style="text-align: left;">CP: I was handed a box, explained the "outdated" medication and how the FDA had extended the date, so far at least, to the end of 2023. She still insisted I give her another box with a better date. </div><div style="text-align: left;"><br /></div><div style="text-align: left;">Tries Wasting All Time: This is expired. </div><div style="text-align: left;">CP: It is not. </div><div style="text-align: left;">TWAT: It is. </div><div style="text-align: left;">CP: I assure you it is not. The FDA extended it through 2023. </div><div style="text-align: left;">TWAT: Well I want a new box that says that. </div><div style="text-align: left;">CP: Well I don't have one. They all have the same date from the last order I received. It's not Harry Potter where I can change the newspaper headline when something changes; much like I can't change the number of refills on your bottles in your house. </div><div style="text-align: left;">TWAT: Well that's not good enough. <br />CP: Hand it to me, I'll wave my hand over it and hand it back. Satisfactory?</div><div style="text-align: left;">TWAT: No. What should I do?</div><div style="text-align: left;">CP: You got two choices of what you can do: one, take the medication to treat the covid you apparently tested positive for, yet stand here spitting venom at me at my counter without a mask or, and I like this one better, you can find a DeLorean and go back in time to 9 months ago and and get covid then and I will STILL hand you the same box but it will be in date. Your choice. </div><div style="text-align: left;">TWAT: <harrumphs> </div><div style="text-align: left;"><br /></div><div style="text-align: left;">ME: Yeah that was pretty surreal. I pine for the days when we were the most trusted profession. </div><div style="text-align: left;">MICE ELF: Everyone wants to question and argue about every answer, no matter how trivial. </div><div style="text-align: left;">CP: I used to say "just because you don't like the answer doesn't mean it's a wrong answer". I still say it, but I used to too. </div><div style="text-align: left;">ME: Yeah. Everything is an argument or a battle. Just say "oh, ok" and move on. If you have a follow up question, ask it. </div><div style="text-align: left;">MICE ELF: Like "where can I get it" or "do you have an ETA" or something better than blaming me for your suffering. </div><div style="text-align: left;">CP: Hell, people will complain about this post (TL:DR, or "paxlovid is a waste anyway" or whatever. Just enjoy the ride). </div><div style="text-align: left;"><br /></div><div style="text-align: left;">#RIPMitchHedberg </div><div style="text-align: left;">#ICanExplainItToYouICantUnderstandItForYou </div><div style="text-align: left;">#TrustMeImAPharmacist </div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0tag:blogger.com,1999:blog-4610173961527980777.post-68177923571823394162023-10-17T20:25:00.000-04:002023-10-17T20:25:29.418-04:00If The Real World (And People Behaved) Like Pharmacy <div style="text-align: left;">ME: Hey, CP. What's your annoying-behaviour-of-the-human-population-of-the-day for today?</div><div style="text-align: left;">CP: Randomly shouting, or even speaking at normal volume which is somehow worse, the product(s) you are seeking at a retail establishment. Or even for people for that matter. </div><div style="text-align: left;">MICE ELF: Yeah. How many times are you standing behind the bench and you overhear someone in a rather forgettable conversation questioning where something is, only to find out they are directing it at you without warning. </div><div style="text-align: left;">CP: Right? I can't see you from here. If you're on your phone or speaking with your friend next to you, you have to get my attention if you are expecting me to respond directly to you. Especially when you don't change cadence or tone or volume; it sounds like a natural part of your conversation. </div><div style="text-align: left;">ME: It often sounds rhetorical sometimes. You didn't direct your question to me, so don't expect an answer. </div><div style="text-align: left;">CP: You know the ones who are worse?</div><div style="text-align: left;">MICE ELF: Worse than those?</div><div style="text-align: left;">ME: Who is worse than the people who think we are always paying attention to them?</div><div style="text-align: left;">CP: The people who enter a store and proceed to shout random products into the atmosphere. </div><div style="text-align: left;">ME: Like when we are typing or otherwise doing downward facing dog at our counter and you hear "DEPENDS!?" and you're not sure if it's a question "where are the Depends?, a proclamation "Look! Depends!!" or a noncommittal response to "are you busy tonight? it depends.". </div><div style="text-align: left;">MICE ELF: Lol</div><div style="text-align: left;">CP: Or they shout for anything with the same ambiguous interrobang inflection - Bathroom?! Halls?! Condoms?! </div><div style="text-align: left;">ME: Why do they shout? And they don't even break stride as they're gliding past your counter. </div><div style="text-align: left;">CP: I think I'm going to walk in to stores from now on and just start shouting everything I'm looking for too; I'll be at Lowe's with like a brand-specific Tourette's: "Nails?! Tools?! Machines?! Chains?!" </div><div style="text-align: left;">ME: I mean the least they could do is make eye contact with a few seconds. </div><div style="text-align: left;">CP: Pervert. </div><div style="text-align: left;">MICE ELF: Or get within 11 feet of the counter before drawing the attention of the entire building to them and their needs. </div><div style="text-align: left;">CP: Remember: "All animals are equal, but some are more equal than others." All animals are important, but some are more important than others" right now. . . </div><div style="text-align: left;"><br /></div><div style="text-align: left;">#Interrobang </div><div style="text-align: left;">#AnimalFarm </div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0tag:blogger.com,1999:blog-4610173961527980777.post-21034415127143580202023-10-11T16:18:00.000-04:002023-10-11T16:18:13.664-04:00A Little Knowledge Is A Bad Thing CP: I posit that a little knowledge is a bad thing. <div>ME: I support this. </div><div>MICE ELF: I think you mean "too little knowledge". </div><div>CP: No. Simply "a little". It's the start of something. The problem is, people may discover this little bit of knowledge but not possess the ability to interpret it or use it as intended; mayhap it takes on sinister or nefarious connotations in their possession. </div><div>ME: Agreed. If they remained blissfully ignorant, they would be less likely to cause harm to themselves or others. </div><div>MICE ELF: What you're saying is these people tend to wave their limited, out-of-context knowledge like a sword simply cutting into things without any appreciation for the damage it can cause. </div><div>ME: They don't understand the power that comes with this responsibility. </div><div>MICE ELF: Why do you pester us with these mind exercises, CP?</div><div>CP: Package Inserts. </div><div>ME: And the medication pamphlets we have to distribute with every prescription. </div><div>MICE ELF: I wasn't a fan of those from the beginning. I understand the requirement, but I, MICE ELF, am not a fan. </div><div>CP: Nor am I. Our biggest fears have become reality. </div><div><br /></div><div>CP: Thank you phor calling CP's Chancroids and Pustules, how may I help you?</div><div>Getting Independent Research Lady: I'm so glad it's you. The cardiologist wanted to start my husband on a new medication and it's expensive. I wanted to research it first and I don't want him to take it. I was online last night for hours. </div><div>CP: If you know everything, why are you calling me?</div><div>G-IRL: To tell you we aren't going to fill it and you can put it back or whatever. </div><div>CP: Ok. Did Dr. Zoffis explain why your husband should be on the medication? </div><div>G-IRL: Yes. But we don't want the side effects. It causes UTIs and low blood sugar and sinus problems. He doesn't need any more problems than he already has. Why didn't Dr. Zoffis tell him this? Why did he give him this if causes all of these side effects?</div><div>CP: It doesn't "cause these side effects" in everyone. You omitted a couple of key words in your studies; it "may cause" or it "can cause". Nowhere does it say "everyone's gonna get this!". The most common side effects for this medication occurred in 0.1% to 2.8% of the people taking it. While 34.2% of those studied experienced side effects, similar to placebo, the highest reported number of any specific adverse event was single digits. </div><div>G-IRL: But I read them and it says he will get these. </div><div>CP: Is he also going to get vaginal discharge and neutropenia? Or just the ones you hand picked for him? </div><div>G-IRL: Well he hates diarrhea and has had UTIs before so those would be bad. </div><div>CP: Ok. Just so everyone is clear - Dr. Zoffis recommended a new medication to help your husband and, despite my attempts to support this decision and to allay your concerns, you are going to ignore our advice, the advice of two healthcare experts, and use your own research to make healthcare decisions. Do I have it right?</div><div>G-IRL: Yes.</div><div>CP: GIRL, bye. </div><div><br /></div><div>MICE ELF: You're right. A little knowledge is a bad thing. </div><div>ME: In the wrong hands. More often, it's a dangerous thing. You can give a person an education but you can't make them use it. </div><div>CP: Well, at least not all of it. They play "Pick and Choose". </div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0tag:blogger.com,1999:blog-4610173961527980777.post-18979458157540674902023-10-02T22:09:00.000-04:002023-10-02T22:09:49.554-04:00CP And Me And Mice Elf ME: Why do you use both of us for your conversations?<div>CP: Because people prefer a dialogue as opposed to a diatribe. </div><div>MICE ELF: Then what are we discussing today? </div><div>CP: Pharmacy protests/walkouts. </div><div>ME: Why do you need us? </div><div>CP: To help be a sounding board and make our points. </div><div>MICE ELF: And those would be?</div><div>CP: The surprising argument people have against walking out is "I care about my patients". </div><div>ME: Oooh. That seems a little out of touch. </div><div>MICE ELF: And selfish. </div><div>CP: I would be willing to say that most pharmacists, when polled, would say they care about their patients. </div><div>MICE ELF: Well, except for that one conversation you had last week. </div><div>ME: Another story for another day. Continue. </div><div>CP: We all care about our patients. You are concerned about not being open for one day and how disruptive that will be and that it will, sadly, put you behind a day <sniffs> </div><div>ME: I sense no sympathy for these people. </div><div>CP: Correct. The rest of us are concerned about every patient we will see in the future. These pharmacists are concerned about the short-term whereas we are looking long-term. If we bite the bullet and close a day here or a day there and effect change, then all our future days will hopefully be easier, better staffed, and less chaotic. That's the goal: better working conditions for everyone, even you short-term, it-doesn't-affect-me-why-do-I-care pharmacy peeps. </div><div>MICE ELF: I sense you are seeing pushback from colleagues. </div><div>CP: I'm not sure if they are out of touch with the practice of pharmacy, retail in general, have great stores that are never behind, or only got into the profession for the money, not the true, altruistic reason people join the ranks of healthcare workers. I'm concerned when people are more worried about "their patients" than their working conditions. We have seen a steady decline for decades now and we always wondered where the bottom of the slide would land us. Just when we thought we found it, the corporations handed us a spoon and said "keep digging". </div><div>ME: To those pharmacists concerned about their patients: You'll still be open tomorrow. There will still be work to do. Surely you can suck up the extra volume at your store to help those who are trying to help you. If you really, truly cared about your patients, you'd want to fight so you don't have to risk their lives to protect your livelihood. </div><div>CP: Too many people have left the profession under these worsening conditions. And while for new pharmacists this is the only working environment they have known, the rest of us should know better. </div><div>MICE ELF: Oh, and let's not forget: THERE. IS. NO. PHARMACIST. SHORTAGE!</div><div>ME: Right. Only a growing group of dissatisfied professionals who are tired of being thrown to the wolves and getting yelled at for 12 hours a day with no help and the Fear Of Making Deadly Mistakes. </div><div>CP: Exactly. If there were a shortage, any one of us could walk out, for good, tomorrow, and get that shiny new job wherever we pleased. Not so easy to do. I get it. We all also fear for our jobs, our livelihoods. But what good is it if we burn out and kill ourselves in the process? Or, worse yet, someone else? Stop being the people who claim to care more about our profession than those who are actually doing something to help you. Be a bandwagon fan, but don't claim to not support us; don't claim you care more about your patients than we do. You know nothing, Jon Snow, and I'm ashamed you're my colleague. </div><div>ME: On the plus side, most of these handfuls of people have been taken to task over their holier-than-thou attitudes, but a rising tide lifts all boats; they will benefit regardless and take our gains willingly. </div><div>MICE ELF: And ask for seconds. </div><div>CP: As long as we remain a fractured profession, corporate wins. As long as we remain splintered amongst ourselves, they win. </div><div>ME: Be helpful. Be supportive. Be positive. </div>PharmaCYNIChttp://www.blogger.com/profile/01445600000016751449noreply@blogger.com0