And another thing...If you, Dr. Zoffis, are calling me, Herr Pharmacynic, to authorize refills, confirm prior authroization approval, give new prescriptions, or do any other professional work, please be prepared. Let us remember the healthcare cycle: patient goes to doctor, doctor writes prescription, patient brings Rx to pharmacy, pharmacist fills Rx. When refills are done, we go back to the beginning. This means everything starts with you. The doctor. Lather, rinse, repeat.
I implore you, as a former Scout, Be prepared! Again, I do not work in your office but if you expect me to do your work I am going to have to charge you every time I have to have this conversation:
Nurse: Calling in to refill a patient's prescription.
ME: OK
Nurse: They didn't give me their prescription number but it's for HCTZ.
ME: OK. What strength?
Nurse: Can't you just look it up?
ME: Yes. But can't you just look it up?
Nurse: I don't have the chart but it's the same as before.
ME: Correct me if I am wrong (and I rarely am) but did you not originally prescribe this medication? And did you not put it in a chart? And if you knew you were going to call me (because I didn't know you were going to make me do your job too before you dialed my numbers) how did you not know I would need all of this information? If you knew to call me for his refill then you knew you were going to do this to me. Therefore, I am going to send you a bill for looking up each piece of information you don't have. How do you know he even (still?) takes HCTZ? How do you know the doctor didn't change it since the last visit? Does he get 30 days or 90 days? Is this even the right pharmacy? What's his date of birth? Help me! Then pay me!
Thursday, December 8, 2011
Monday, December 5, 2011
Pharmacist vs. Doctor II
Pharmacist. Magician. Receptionist. Thinker. I can do it all. Just ask every customer who tried in vain (allegedly) to reach their doctor. Why does everyone think we can work through to their doctor faster?
Patient: "You need to call my doctor because I can't get through."
Pharmacynic: "Wow. Neither can I. I have to call the same phone number you do. Did you hear the magic 'pharmacists press now to have all your questions answered' prompt?"
(Im)patient: "Well what am I supposed to do now? You need to help me!"
Pharmacynic: "Okay. Revolutionary thought here but bear with me. Drive. To. Your. Doctor. Ta-da!
I think all offices should have a dedicated Pharmacist option on their phone lines. We have an option for doctors to leave voicemails but the most we usually get in return is a refill line. That doesn't help if I couldn't read a prescription for someone who just left your office and is here now. It doesn't help with any questions about interactions or answer any questions I have about the voicemail your nurse left just seconds ago. She is apparently charged for each second she spends on the phone and can't afford to enunciate or spell anything and now I can't get her back on the phone to answer my question.
Most doctors' lines include options for other doctors or hospitals, for making or canceling appointments, for lab work, for billing questions, a refill line (if they don't require us to fax them), a worker's compensation option, and an option to give hours, services and directions. Why don't we rank? If we are expected communicate frequently with these offices, we need a pharmacist-only line. I have asked some offices if they have back lines and have occasionally been granted these numbers, but only after swearing to not share it with anyone. Right. There's a whole black market looking to exploit doctor's private office numbers.
Make it easier for me to get my job done and your life will be easier as well. Since you are already expecting me to fax all refill requests and look up the refills you are calling in to me when you have their chart, it's the least you could do.
Patient: "You need to call my doctor because I can't get through."
Pharmacynic: "Wow. Neither can I. I have to call the same phone number you do. Did you hear the magic 'pharmacists press now to have all your questions answered' prompt?"
(Im)patient: "Well what am I supposed to do now? You need to help me!"
Pharmacynic: "Okay. Revolutionary thought here but bear with me. Drive. To. Your. Doctor. Ta-da!
I think all offices should have a dedicated Pharmacist option on their phone lines. We have an option for doctors to leave voicemails but the most we usually get in return is a refill line. That doesn't help if I couldn't read a prescription for someone who just left your office and is here now. It doesn't help with any questions about interactions or answer any questions I have about the voicemail your nurse left just seconds ago. She is apparently charged for each second she spends on the phone and can't afford to enunciate or spell anything and now I can't get her back on the phone to answer my question.
Most doctors' lines include options for other doctors or hospitals, for making or canceling appointments, for lab work, for billing questions, a refill line (if they don't require us to fax them), a worker's compensation option, and an option to give hours, services and directions. Why don't we rank? If we are expected communicate frequently with these offices, we need a pharmacist-only line. I have asked some offices if they have back lines and have occasionally been granted these numbers, but only after swearing to not share it with anyone. Right. There's a whole black market looking to exploit doctor's private office numbers.
Make it easier for me to get my job done and your life will be easier as well. Since you are already expecting me to fax all refill requests and look up the refills you are calling in to me when you have their chart, it's the least you could do.
Friday, December 2, 2011
Pharmacist vs. Doctor
In the beginning there was a doctor. He wrote prescriptions. There was also a pharmacist. He filled prescriptions. And the world was good. I am not a doctor, nor do I play one at work. However, it seems that we as pharmacists have let the lines blur a little too much in what is each person's role in the whole healthcare dynamic. One of my favourite quotes to customers is "I don't work in your doctor's office and he doesn't work in my pharmacy". I often use this to great effect after a customer is sent directly over from his doctor after being told any or all of the following: "your prescription will be ready by the time you get there", or "it's on their $4 list", or "Augmentin is only a few dollars, don't worry". Well, I can't tell you the last time I saw your doctor here, let alone actually spoke directly with him, so don't believe everything he tells you.
Today I realized it has gotten so out of hand that we pharmacists haven't even noticed we are now employed by every doctor in town. While waiting interminably on hold (pharmacy hold times aren't always better, I concede), to clarify a poorly written prescription, I heard this message: "We are requesting that all refills be faxed. Please contact your pharmacy and they will fax us for you". Another office used the similar "please notify your pharmacy to send a fax to us".
Excuse me? What? When did we allow other people to tell us what our job is? (Oh yeah, when we sold out to mail order and PBM's over the last 10-15 years. But this is different.)
Anyway, I have decided that I need paid. If the doctor requires I fax your refills to her, I am going to send her a bill at the end of each month for every one that I send. Yes, most faxes are generated electronically but I still have to answer your phone call after you have already talked to the office. Since the doctors would like to place the onus on us if a refill is not authorized, I would like to be compensated for this responsibility. We all know that faxes do not get received, doctors ignore them, lose them, forget to sign them, etc. As I have mentioned before, I cannot fill prescriptions I do not have. The patients know we are the only ones they can yell at directly and therefore, since the doctor requires we fax them, we must be the most culpable if the process breaks down somewhere. If the fax number is incorrect or missing or a doctor enters or leaves the practice, I have to track this down for you. A precedent has already been set in other similar situations. Doctors requiring pharmacists do NOT send faxes will charge the pharmacy for each one they receive. Doctors also charge patients a full copay for any refills they require outside of an office visit.
To further support this, my second resolution is to post on my hold message the following script: "Our pharmacy requires that all new, paper prescriptions be sent electronically or faxed. Please contact your doctor and ask her to invest in this new technology and to stop hand writing prescriptions as we will no longer accept these." Perhaps we should charge to fill illegible scratch. I may be on to something here. But that's another story.
Today I realized it has gotten so out of hand that we pharmacists haven't even noticed we are now employed by every doctor in town. While waiting interminably on hold (pharmacy hold times aren't always better, I concede), to clarify a poorly written prescription, I heard this message: "We are requesting that all refills be faxed. Please contact your pharmacy and they will fax us for you". Another office used the similar "please notify your pharmacy to send a fax to us".
Excuse me? What? When did we allow other people to tell us what our job is? (Oh yeah, when we sold out to mail order and PBM's over the last 10-15 years. But this is different.)
Anyway, I have decided that I need paid. If the doctor requires I fax your refills to her, I am going to send her a bill at the end of each month for every one that I send. Yes, most faxes are generated electronically but I still have to answer your phone call after you have already talked to the office. Since the doctors would like to place the onus on us if a refill is not authorized, I would like to be compensated for this responsibility. We all know that faxes do not get received, doctors ignore them, lose them, forget to sign them, etc. As I have mentioned before, I cannot fill prescriptions I do not have. The patients know we are the only ones they can yell at directly and therefore, since the doctor requires we fax them, we must be the most culpable if the process breaks down somewhere. If the fax number is incorrect or missing or a doctor enters or leaves the practice, I have to track this down for you. A precedent has already been set in other similar situations. Doctors requiring pharmacists do NOT send faxes will charge the pharmacy for each one they receive. Doctors also charge patients a full copay for any refills they require outside of an office visit.
To further support this, my second resolution is to post on my hold message the following script: "Our pharmacy requires that all new, paper prescriptions be sent electronically or faxed. Please contact your doctor and ask her to invest in this new technology and to stop hand writing prescriptions as we will no longer accept these." Perhaps we should charge to fill illegible scratch. I may be on to something here. But that's another story.
Friday, September 9, 2011
The Future of Pharmacy
Brothers and Sisters in Pharmacy-Dom, please allow me to show you the future. Thank you all for being here today. Prepare to be amazed, dazzled, awestruck, and even a little weepy. Over the next few paragraphs I shall outline for you the business model that will revolutionize pharmacy practice as we know it.
Having spent a few years in practice and devoting my life to studying the practice of pharmacy, the general public, and the evolution of our customers from thoughtful, reverent patrons to resentful, demanding, impatient douchebags (sorry, "guests"), I have arrived at the following plan for us all. I call it "Pharmacy As Total Healthcare (P.A.T.H.)" Licensing agreements will be available to all levels of government.
The Basic Plan: For a regular monthly fee assessed to the patient, we will perform all of the following:
6. Notify you when refills are coming due and start again.
The Basic Plus Plan: Includes all of the above while also providing
7. Deliver all of your filled prescriptions to your house.
The Premium Plan: this will add
8. Have all lab work and diagnostic tests performed FOR you.
The Executive Plan: will include
9. We will keep your filled prescriptions on-site and take them FOR you. This will minimize side effects and the potential that you will miss doses.
The Platinum Plan: is only available for our patients with narcotics
10. This will enable us through networking to sell your narcotics on the street FOR you so you need not risk your own life. As a bonus for enrolling in this Plan, you will earn a 5% commission on sales, the industry standard, which is the same commission provided to our sales force.
You will find this new, innovative model will take the worry out of your life and put the Care back in healthcare. As you can see, we offer a wide variety of plans to meet your every need and options can be changed as your healthcare needs change. This program eliminates all of the blocks to quality healthcare in America: no longer will you have to worry about making appointments, seeing specialists, missing medication doses, running out of medication and asking for a few pills until your doctor calls, or even taking many medications and dealing with side effects. From the safety and security of your own couch, you too can have worry-free healthcare. We will also know what medications are the most cost-effective for you and formulary-approved through our exhaustive research and collaborative agreements with the largest health insurers. By forcing doctors, while at your appointments for you, to only prescribe approved medications, we can save you and the pharmacy (me, again) a lot of time that we can spend on more improvements to the P.A.T.H. system.
Overall, this is a win-win-win situation. Insurers don't have to inflate their costs since they are only paying for cheaper, approved medications. Pharmacists know the drugs are covered when prescribed and don't have to make multiple calls to offices to track down refill requests and prior authorization. Patients have finally achieved what they have been wanting for years-Totally Hands-Off Healthcare! They can finally say they have absolutely no personal accountability in their own healthcare (as long as the check clears each month).
Thank you for your time. All persons interested in investing in this world-changing idea should contact me directly and we can work out the details.
*Fees and services are non-negotiable, but may be subject to change based on volume of subscriptions, street/market value of certain substances. Previous performance is not an indicator of future anything.
Having spent a few years in practice and devoting my life to studying the practice of pharmacy, the general public, and the evolution of our customers from thoughtful, reverent patrons to resentful, demanding, impatient douchebags (sorry, "guests"), I have arrived at the following plan for us all. I call it "Pharmacy As Total Healthcare (P.A.T.H.)" Licensing agreements will be available to all levels of government.
The Basic Plan: For a regular monthly fee assessed to the patient, we will perform all of the following:
- Schedule you doctor's appointments for you.
- Go to your scheduled appointments FOR you.
- Get your prescriptions from these appointments for you.
- Take these prescriptions to your pharmacist (me).
- Fill all of your prescriptions for you.
6. Notify you when refills are coming due and start again.
The Basic Plus Plan: Includes all of the above while also providing
7. Deliver all of your filled prescriptions to your house.
The Premium Plan: this will add
8. Have all lab work and diagnostic tests performed FOR you.
The Executive Plan: will include
9. We will keep your filled prescriptions on-site and take them FOR you. This will minimize side effects and the potential that you will miss doses.
The Platinum Plan: is only available for our patients with narcotics
10. This will enable us through networking to sell your narcotics on the street FOR you so you need not risk your own life. As a bonus for enrolling in this Plan, you will earn a 5% commission on sales, the industry standard, which is the same commission provided to our sales force.
You will find this new, innovative model will take the worry out of your life and put the Care back in healthcare. As you can see, we offer a wide variety of plans to meet your every need and options can be changed as your healthcare needs change. This program eliminates all of the blocks to quality healthcare in America: no longer will you have to worry about making appointments, seeing specialists, missing medication doses, running out of medication and asking for a few pills until your doctor calls, or even taking many medications and dealing with side effects. From the safety and security of your own couch, you too can have worry-free healthcare. We will also know what medications are the most cost-effective for you and formulary-approved through our exhaustive research and collaborative agreements with the largest health insurers. By forcing doctors, while at your appointments for you, to only prescribe approved medications, we can save you and the pharmacy (me, again) a lot of time that we can spend on more improvements to the P.A.T.H. system.
Overall, this is a win-win-win situation. Insurers don't have to inflate their costs since they are only paying for cheaper, approved medications. Pharmacists know the drugs are covered when prescribed and don't have to make multiple calls to offices to track down refill requests and prior authorization. Patients have finally achieved what they have been wanting for years-Totally Hands-Off Healthcare! They can finally say they have absolutely no personal accountability in their own healthcare (as long as the check clears each month).
Thank you for your time. All persons interested in investing in this world-changing idea should contact me directly and we can work out the details.
*Fees and services are non-negotiable, but may be subject to change based on volume of subscriptions, street/market value of certain substances. Previous performance is not an indicator of future anything.
Friday, September 2, 2011
The Death of a Profession
Pack it up, pack it in. Call for the bugles, the bagpipes, the fiddles and the drums. Pull out your best black dress attire and line the streets. Sound the call to mourning and join this solemn event. Today is the day pharmacy died. Perhaps we can get Don McLean to sing about it.
Now this is not a "back in my day" rant for I am too young for that. However, much has changed in the last two decades that seems to have pushed us at an incredible pace over the precipice. Pharmacy people I say to you "We Have Lost"!
Today a pharmacist is measured by his customer service. We've most always had a remarkable rapport with our customers. Back when it mattered we were "the most trusted profession". Today, in order to get a raise, a bonus, a job even, you have to hit certain customer service indices. What makes this all the more unbearable is that people running our profession as well as our businesses are treating us like infants.
How many times have you had an irate customer who didn't understand the problem we were explaining to him, threaten to actually call your boss?, or the corporate 1-800-COMPLAINT #?, or the front end manager? Of those times, how often did someone step in and say "the pharmacist is correct and you're a douchebag"? In the last week alone, I have had the following customer interactions: Woman at drive-thru hands us 4 new prescriptions and asks for them to be ready at our other location (25 minutes away) in 30 minutes. I told her we don't do that and she said "but you DO transfer prescriptions, what's the problem?" Next we have the lady who cut all the information off her coupon except where it says ($$$Gift Card) and complained to a manager who told us to take it. Someone whose doctor requires the patient to call for refills asked us to call then got mad when we didn't call her to tell her they denied our request (even though the office said the patient is fully aware of this because they are habitual problem patients).
Since when did we ever believe our profession would change from one of healthcare to one of service bitch? I understand that as we have tried to do more things to help our patients (faxed requests to doctors for refills, automatic monthly refills, immunizations, consultants) we have also made everything an expectation instead of a gratuitous, professional service. How much stuff do we give away for free in the name of customer service? People come to us expecting us to hand everything to them. There is no longer personal accountability when it comes to one's own healthcare.
With the transfer coupon frenzy already having sullied our profession, we have to deal with the new scourge of retail: The Entitled Customer. He simply wants to complain to get what he thinks he deserves. My least favourite quotes are "it pays to complain" and "the customer is always right". When Mr. E.C. is unhappy with us as pharmacists and he complains, what happens? Someone at the next level fields his complaint and guess what?--we get docked for poor service while he gets a letter of apology, a gift card for his trouble, the keys to the pharmacy, and the satisfaction and courage to do it again. We are rewarding bad behaviour in the name of customer service.
It's not just my employer or my state. This is a national problem. I have said before, we stopped being respected when we stopped respecting ourselves. When we had the industry at our mercy during the massive pharmacist shortages, employers begged us to work overtime, offered huge sign-on bonuses to jump ship, or to stay, this was the time to improve our lot. Alas, that ship has sailed and we are like every other corporate business in this weakened economy--doing the work of more than one person for less money and big corporations telling us "so what?". Their attitude is if you don't like it, leave. We'll replace you with someone who will.
Check back next week for the ultimate business solution that will change the practice of pharmacy forever.
Now this is not a "back in my day" rant for I am too young for that. However, much has changed in the last two decades that seems to have pushed us at an incredible pace over the precipice. Pharmacy people I say to you "We Have Lost"!
Today a pharmacist is measured by his customer service. We've most always had a remarkable rapport with our customers. Back when it mattered we were "the most trusted profession". Today, in order to get a raise, a bonus, a job even, you have to hit certain customer service indices. What makes this all the more unbearable is that people running our profession as well as our businesses are treating us like infants.
How many times have you had an irate customer who didn't understand the problem we were explaining to him, threaten to actually call your boss?, or the corporate 1-800-COMPLAINT #?, or the front end manager? Of those times, how often did someone step in and say "the pharmacist is correct and you're a douchebag"? In the last week alone, I have had the following customer interactions: Woman at drive-thru hands us 4 new prescriptions and asks for them to be ready at our other location (25 minutes away) in 30 minutes. I told her we don't do that and she said "but you DO transfer prescriptions, what's the problem?" Next we have the lady who cut all the information off her coupon except where it says ($$$Gift Card) and complained to a manager who told us to take it. Someone whose doctor requires the patient to call for refills asked us to call then got mad when we didn't call her to tell her they denied our request (even though the office said the patient is fully aware of this because they are habitual problem patients).
Since when did we ever believe our profession would change from one of healthcare to one of service bitch? I understand that as we have tried to do more things to help our patients (faxed requests to doctors for refills, automatic monthly refills, immunizations, consultants) we have also made everything an expectation instead of a gratuitous, professional service. How much stuff do we give away for free in the name of customer service? People come to us expecting us to hand everything to them. There is no longer personal accountability when it comes to one's own healthcare.
With the transfer coupon frenzy already having sullied our profession, we have to deal with the new scourge of retail: The Entitled Customer. He simply wants to complain to get what he thinks he deserves. My least favourite quotes are "it pays to complain" and "the customer is always right". When Mr. E.C. is unhappy with us as pharmacists and he complains, what happens? Someone at the next level fields his complaint and guess what?--we get docked for poor service while he gets a letter of apology, a gift card for his trouble, the keys to the pharmacy, and the satisfaction and courage to do it again. We are rewarding bad behaviour in the name of customer service.
It's not just my employer or my state. This is a national problem. I have said before, we stopped being respected when we stopped respecting ourselves. When we had the industry at our mercy during the massive pharmacist shortages, employers begged us to work overtime, offered huge sign-on bonuses to jump ship, or to stay, this was the time to improve our lot. Alas, that ship has sailed and we are like every other corporate business in this weakened economy--doing the work of more than one person for less money and big corporations telling us "so what?". Their attitude is if you don't like it, leave. We'll replace you with someone who will.
Check back next week for the ultimate business solution that will change the practice of pharmacy forever.
Sunday, July 31, 2011
Expectation vs. Reality--Redux
When do you eat dinner? Let us suppose you make dinner reservations at a lovely bistro where they open for dinner at 5pm. At what time do you arrive? At what time will you have eaten? Expectation-5pm. Reality, depending on aperitifs and dessert and all that comes in between, 6 or 7?
Now how in the hell are you going segue this into the real world of retail pharmacy, Mr. Cynic? Watch carefully as those creative writing classes bear fruit. Please pause here to reread "Refill Too Soon", I'll wait. Welcome back. Continue.
A fine upstanding customer, usually on some type of controlled medication is told it is too soon to be filled until some day in the future. On that bright, sunny morning, the birds are singing, the sky is clear, and a car is parked at my drive-thru. The time: 08:35 am Pharmacy opens at 09:00am. As the work day dawns and the gates rise and the curtain at drive-thru lifts, the first customer of the day asks for his prescription and, after a lot of searching, is told it is not ready. This angers Mr. First-customer-of-the-day, he who has been in line all alone for 25 minutes. "But I was told it was too soon until today. Why isn't it ready?"
Well, see sir, we just opened, literally. The restaurant doesn't prepare your food before you arrive to order it and I don't process prescriptions before I arrive at my store. Unfortunately, we had tried to train little gnomes to sneak in at night and process that day's refills between 3am and 7am, but they were not reliable. They kept leaving little presents for us in the bottles and ate all our donuts. Don't even get me started on what we found in the coffee pot. Therefore, since I cannot fill anything, as in do any work until I am physically in my store and we are actually open, you need to wait. About 20 minutes ought to do it.
Hey, what time did you wake up today to be here so early? I see. Did you eat breakfast before or after that?
Now how in the hell are you going segue this into the real world of retail pharmacy, Mr. Cynic? Watch carefully as those creative writing classes bear fruit. Please pause here to reread "Refill Too Soon", I'll wait. Welcome back. Continue.
A fine upstanding customer, usually on some type of controlled medication is told it is too soon to be filled until some day in the future. On that bright, sunny morning, the birds are singing, the sky is clear, and a car is parked at my drive-thru. The time: 08:35 am Pharmacy opens at 09:00am. As the work day dawns and the gates rise and the curtain at drive-thru lifts, the first customer of the day asks for his prescription and, after a lot of searching, is told it is not ready. This angers Mr. First-customer-of-the-day, he who has been in line all alone for 25 minutes. "But I was told it was too soon until today. Why isn't it ready?"
Well, see sir, we just opened, literally. The restaurant doesn't prepare your food before you arrive to order it and I don't process prescriptions before I arrive at my store. Unfortunately, we had tried to train little gnomes to sneak in at night and process that day's refills between 3am and 7am, but they were not reliable. They kept leaving little presents for us in the bottles and ate all our donuts. Don't even get me started on what we found in the coffee pot. Therefore, since I cannot fill anything, as in do any work until I am physically in my store and we are actually open, you need to wait. About 20 minutes ought to do it.
Hey, what time did you wake up today to be here so early? I see. Did you eat breakfast before or after that?
Thursday, July 28, 2011
Manners--Pay Attention
"Shut up when I'm talking to you!" (Linkin' Park)
"Children should be seen, not heard" (Some grumpy old guy)
Both of these fittingly apply to the Pharmacist-Customer interaction. You ask me a question. Pause. I answer your question, uninterrupted and you nod accordingly. When I am done, you may follow with another question or statement, perhaps a simple "thank-you". If you want an answer, shut up and wait for it. If I am talking and you keep interrupting me, you are not hearing me and I'm getting quite irritated. At this point, it would be unwise of you to ask a favor of me.
Everyone can identify with the customer who asks for a refill only for us to tell her it is too old. While explaining that prescriptions do expire (it's like a law thing, ya' know?), you are always interrupted with "but I have to have this or I'll die! My doctor said I'd be on it every day until I die. I've been out of this for 3 days now (and yet here you are, undead, at my counter, dammit!) so you need to call my doctor and get me a refill right now!".
Um, I went to school to be a pharmacist, not your Bitch! Had you been nice (oh dear, it expired, but what is a poor little old lady to do sweetykins?), I would have gladly offered to front you a couple pills and call your doctor. But don't expect it. Don't demand it. Don't threaten me either. My favourite threat is when people say "I'm going to Derelict's Pharmacy across the street". Good. It's about time. Go treat someone else like shit for a change. However, the thing that really bothers me, is that they're like a boomerang. They keep coming back. Why?
"Children should be seen, not heard" (Some grumpy old guy)
Both of these fittingly apply to the Pharmacist-Customer interaction. You ask me a question. Pause. I answer your question, uninterrupted and you nod accordingly. When I am done, you may follow with another question or statement, perhaps a simple "thank-you". If you want an answer, shut up and wait for it. If I am talking and you keep interrupting me, you are not hearing me and I'm getting quite irritated. At this point, it would be unwise of you to ask a favor of me.
Everyone can identify with the customer who asks for a refill only for us to tell her it is too old. While explaining that prescriptions do expire (it's like a law thing, ya' know?), you are always interrupted with "but I have to have this or I'll die! My doctor said I'd be on it every day until I die. I've been out of this for 3 days now (and yet here you are, undead, at my counter, dammit!) so you need to call my doctor and get me a refill right now!".
Um, I went to school to be a pharmacist, not your Bitch! Had you been nice (oh dear, it expired, but what is a poor little old lady to do sweetykins?), I would have gladly offered to front you a couple pills and call your doctor. But don't expect it. Don't demand it. Don't threaten me either. My favourite threat is when people say "I'm going to Derelict's Pharmacy across the street". Good. It's about time. Go treat someone else like shit for a change. However, the thing that really bothers me, is that they're like a boomerang. They keep coming back. Why?
Tuesday, July 26, 2011
Mail Order Bitches
I am your bitch. Not only has my profession sold out with transfer coupons, free meds, 15-minute guarantees, and a lack of respect on Capitol Hill, we've given way too much power to mail order over the last 15 years that we're just their bitch as retail pharmacists.
It began inauspiciously enough. They were a bastard stepchild of retail pharmacy. When Rite Aid acquired PCS insurance in 1998, the entire industry was in an uproar that it would stifle competition and force customers to only utilize Rite Aid pharmacies. Under a lot of pressure and SEC issues, the partnership was dissolved. Around the same time, Merck bought Medco. No one batted an eye at this collaboration. Suddenly, employers forced their employees to use mail order and Merck brands were preferred everywhere. Surprising, no? What happened next was a way for mail order to not only push us down, but to kick us in the head, piss on our faces, and ask us to smile about it all at the same time; it was called the 14-day mail order override. Instead of us just billing a prescription and getting a receipt, we needed to process it, get the rejection from the insurance, call the insurance, wait for the override, reprocess it, then finish the prescription. In other words, it took at least double the work for half a prescription. Until Walgreen's stood up and said "NO!", we continued to take it.
A side effect of all of this was customers came to us for their non-maintenance meds, but continued to ask questions about their mail order stuff. Great, that's my job. However, it has evolved to where we field questions such as "my mail order sent me something different than what you gave me. What is it? Is it the same thing?". My recent interaction went like this: "I used to get this prescription, but they sent me this instead. I went to my doctor who sent the prescription to mail order and he said he can't help and that I should come here". Awesome! So your doctor who wrote your prescription wouldn't help you? So he sent you to me, a pharmacist, at a store where you do not do business? And somehow, with only the fact that you are standing in front of me as proof that this is real, I am supposed to answer a question about a new med your doctor wrote and you had filled at not only another pharmacy, but a mail order pharmacy? Great, could you give me less to go on?
Yes, this is no different than if you went to a competitor across the street, except that they are just as accessible as I am. In fact, I can call them myself. Mail order has traditionally not had that easy connection with its customers. I will pick up my phone when someone calls and asks for a pharmacist, usually within a minute. It's like buying produce at one grocery store and complaining to the other grocery store about the first's selection. Even better, it's like ordering books from Amazon.com, then walking into Barnes and Noble without the book and asking why the cover is different, it has fewer pages, and it costs more here. If they're where you do business, call them.
I realize pharmacy options have grown, but if I don't have your information on file, I can't give you the best, correct answer. I am sorry you chose them over me for whatever reason is personal to you. I don't really care what the reasons are. It's akin to transferring your prescriptions to an independent that delivers, but is closed after 5 pm and on weekends and you expect me to bail you out. You decided to use their services, now you have to learn to operate within them. I am tired of being your bitch just because you like some of their services better than what I have to offer.
It began inauspiciously enough. They were a bastard stepchild of retail pharmacy. When Rite Aid acquired PCS insurance in 1998, the entire industry was in an uproar that it would stifle competition and force customers to only utilize Rite Aid pharmacies. Under a lot of pressure and SEC issues, the partnership was dissolved. Around the same time, Merck bought Medco. No one batted an eye at this collaboration. Suddenly, employers forced their employees to use mail order and Merck brands were preferred everywhere. Surprising, no? What happened next was a way for mail order to not only push us down, but to kick us in the head, piss on our faces, and ask us to smile about it all at the same time; it was called the 14-day mail order override. Instead of us just billing a prescription and getting a receipt, we needed to process it, get the rejection from the insurance, call the insurance, wait for the override, reprocess it, then finish the prescription. In other words, it took at least double the work for half a prescription. Until Walgreen's stood up and said "NO!", we continued to take it.
A side effect of all of this was customers came to us for their non-maintenance meds, but continued to ask questions about their mail order stuff. Great, that's my job. However, it has evolved to where we field questions such as "my mail order sent me something different than what you gave me. What is it? Is it the same thing?". My recent interaction went like this: "I used to get this prescription, but they sent me this instead. I went to my doctor who sent the prescription to mail order and he said he can't help and that I should come here". Awesome! So your doctor who wrote your prescription wouldn't help you? So he sent you to me, a pharmacist, at a store where you do not do business? And somehow, with only the fact that you are standing in front of me as proof that this is real, I am supposed to answer a question about a new med your doctor wrote and you had filled at not only another pharmacy, but a mail order pharmacy? Great, could you give me less to go on?
Yes, this is no different than if you went to a competitor across the street, except that they are just as accessible as I am. In fact, I can call them myself. Mail order has traditionally not had that easy connection with its customers. I will pick up my phone when someone calls and asks for a pharmacist, usually within a minute. It's like buying produce at one grocery store and complaining to the other grocery store about the first's selection. Even better, it's like ordering books from Amazon.com, then walking into Barnes and Noble without the book and asking why the cover is different, it has fewer pages, and it costs more here. If they're where you do business, call them.
I realize pharmacy options have grown, but if I don't have your information on file, I can't give you the best, correct answer. I am sorry you chose them over me for whatever reason is personal to you. I don't really care what the reasons are. It's akin to transferring your prescriptions to an independent that delivers, but is closed after 5 pm and on weekends and you expect me to bail you out. You decided to use their services, now you have to learn to operate within them. I am tired of being your bitch just because you like some of their services better than what I have to offer.
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