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Thursday, November 8, 2012

If McDonald's was like your Pharmacy

People always act as if pharmacies are fast food joints. We do have drive-thrus. We also have a dollar menu (okay, it's more of a free, $4, $10 menu but you get the gist). To help people understand the differences, however subtle, I have written the following guide:   If Mcdonald's was my Pharmacy...

-You would need to visit a doctor to make sure you need the meal you are here to purchase.
-Your doctor would write you a prescription for the exact meal and quantities you need today (no ordering a la carte or upsizing without prior authorization).
-Your order, after being entered into the touchscreen, would generate individual receipts (read:labels) for each item on your order (fries, apple pie, quarter pounder, Coke). This is provided, of course, that he can read the doctor's directions. Even though the doctor only had to circle a picture of the sandwich he wanted, he managed to circle two pictures (one from the dollar menu and one from the regular menu). Now she will have to call the doctor for clarification. 
-One person would then take these receipts (labels) to fill your order. He would pour a pile of fries on a tray and count them to get you the prescribed amount. He would use a graduated cylinder to pour you the correct volume of your beverage and count out the ice cubes for each cup. The quarter pounder would be weighed out on a scale or balance to ensure accuracy. Each of these would then have its own receipt (label) attached to it.
-The manager would receive the tray from the filling station. She would scan the receipt to bring up an image of the food product you ordered and make sure it matches what is in her hand. She would check the order, one item at a time, to make sure it exactly matches what the doctor ordered (wouldn't want to forget an order of hash browns first thing in the morning) and to make sure they can all be eaten at the same time (no interactions). She would also check to make sure you didn't forge any refills on the Coke or change the small fry to a large fry--you know, to prevent abuse. Then your history would pop up on the screen. She could see if you always get this order or if your doctor changed something since your last visit. She would also check your medical history to make sure you are healthy enough to receive today's meal. (Heart problems?-No Big Mac for you. Diabetes?-No Diet Coke. High Cholesterol?-No fries with that!) She would also check with other chains to make sure you are not getting these meals prescribed by another doctor and using two different fast food chains for the same thing. She wouldn't want you to accidentally overdose on cheeseburgers because they're called something else at Burger King and you didn't tell her you just filled an order there. If you are healthy enough, your food moves down the line. If not, we have to call your doctor to ask why he prescribed this particular meal for you. In some cases, he may tell us you need the large fries and a milkshake, but she will tell him it needs prior authorization through your insurance. Once he calls for the prior authorization and the insurance calls him back (usually 24-72 hours later--long wait for lunch!) either to approve the large fries or change the prescription to apple slices, your order will move on.
-Now your order proceeds to checkout. We give you a cash total. It's the first of the month/year and your insurance has changed but you didn't provide it immediately. The cashier takes the new information and hands it off to someone else for correction and an update to your file. She hands the tray back to the checkout person who tells you the new copay, collects the copay from you, then smiles and says "Have a nice day!".
-Refills on beverages will not be authorized without a new order from your physician.
-Medicaid patients will have copays and the formulary will only include items on the $4 and $10 menus board. This means no milkshakes, no medium or large sized portions, and no sundaes. 
-All the while, every person involved in your order in the back- the person cooking, dropping a basket of fries, wrapping the sandwiches, pouring drinks, waiting on drive-thru-is also answering the phone that is ringing off the hook. At this McDonald's, doctors are phoning/faxing/electronically sending in orders for other hungry diners. There are hungry diners sitting at home calling in orders they want to pick up later or checking to see if their doctor called in their orders yet, or calling for our hours. The manager is also out administering espresso shots to those who have prescriptions for caffeine because she is required to do so. She is also walking out to help people find the bathroom, the condiments, the napkins, the trash can, and a place to sit all in the name of good customer service. (She's not allowed to just point to the stand behind the customers and say "everything is right there.")
-Drive-Thrus. Remember, drive-thrus are about convenience, not speed! What takes so long, then? It can actually take longer because managers are required to do counseling if someone asks and if they ask at the drive-thru the wait can seem interminable. When this happens, the manager patiently, expertly demonstrates how to open a straw, insert it into the "X" cut into the plastic lid, and use it to deliver himself a mouthful of ice cold beverage. He then demonstrates how to properly open a packet of ketchup and apply it to your burger as well as the proper method to dip fries into it. Next, he'll answer a question about the appropriate number of bites to take for this particular sandwich and how much mastication is required for each bite. 
-When the fries look different, the patient may be confused. It is up to the manager to patiently explain that this is McDonald's, not Wendy's, so there is not skin on the fries here. He will also have to explain why the wrapper looks different (different burger joints use different wrappers) or why they may have changed colors (the new Christmas cups are in at McDonald's).

Everybody got it? Please remember this the next time you visit either of our establishments and maybe it will change your perception.   

Friday, September 28, 2012

The Golden Rule of Pharmacy

We were always taught to obey the Golden Rule-treat others as you would have them treat you. Great for kids, bad for business.  The Pharmacy Interpretation should be-Treat others the way they want to be treated. Business books agree with this, and I adopted it in my pharmacies without realizing how relevant it truly was. In fact, I was practicing it before I read its witticisms.
We all deal with the same customers every day. I have worked inner-city, affluent suburb, blue-collar, college, and every other town in which there is a pharmacy. In every one of these, the customers are the same: quiet ones who cause no problems; loud, boisterous ones who want you to know they are there; dedicated ones who love their pharmacy staff; fickle ones looking for an excuse to leave you; and the whimsies-those who shop wherever they happen to be at the moment they decide they need a refill.
I am truly focused only on the ones who make our life hell at work. Why do people find it necessary to yell and argue with pharmacy staff? I am very good at conflict resolution and solving problems. I often find that most perceived problems are misunderstandings that we have not been allowed to explain. At my most recent store, I was warned of a number of customers who cause problems every time they call or visit. My staff always find it necessary to tell me so-and-so is on the phone, or here, and that he always causes a problem. Why do my staff feel threatened or intimidated by these people? Because this is the situation the customers have fostered and the staff have felt powerless to change it. (To that I say, Thank You Corporate 1-800 Customer Service Calls! Thank You for making my staff feel powerless to stop abuse from customers.)
ATypical (True) Interaction: Lady complains that she had to wait for something until the next day and was gracious enough to bring it in the night before to give us plenty of time to work on it. (Nice, but her doctor put a Do Not Dispense date on it until the next day so she wasn't exactly trying to help us.) She arrived earlier than we told her it would be ready and she complained. I was already warned of her history so I was prepared. She kindly explained how she went out of her way to bring it in early, how we're her only pharmacy, but she's considering changing after this, blah, blah, blah. I offered her an apology and a $5 Gift Card for the inconvenience of having to wait an extra 10 minutes-though she was early. She ignored that and told me how, every time the other 3 pharmacies she uses make a mistake, they give her something without her even asking. How they buy her off just to shut her up, apparently. Not backing down, I apologized again. Now, 19 minutes into this conversation I had had enough. I interrupted her and asked "What do you want?" Taken aback, she said "Excuse me?" I told her "Listen. You have had me on the phone for 20 minutes now. I offered an apology and $5. You are not happy with that. In my experience there are only 2 types of people who call 1-800 numbers:         1.) Those who like a place and want it to improve and found something a little off during a recent visit.  2.) Those who want something.  This is you. Now. What. Do. You. Want? She told me she wanted a gift card. I told her I already offered that and she could pick up with her next refill, but not to yell at me or my staff again.  She has been back a number of times and no longer strikes fear in the hearts of my staff.  All it took was someone to stand up to her and call her out on her attitude.

Grouchy Guy refused to give my tech his wife's date of birth. He threw the Rx at her and told to fill it, he'd be around. I paged him back to the pharmacy and asked him why he was so mean. He said my job was just to fill it and he walked away. I shouted back to him to come back here, stuck out my arm with his script and said "Here. Take this. We're not filling this for you. There are plenty of pharmacies around and I don't need your business if you're going to treat my staff that way." Dumbfounded, he took it back and left. The funny follow-up is that his wife brought it back later and ignored the issue from earlier. Her husband has been back a few times and is always a model customer. Why did it take all of that to arrive at an amicable situation?

Why do we let customers abuse us? I love my technicians, for without them, I am nothing. At all of my stores, I have taken it upon myself to run interference between them and problem customers. My reasoning is simple and I have told many techs and customers this: They have a job to do. They don't get paid enough to get yelled at by you. Neither do I, but I can refuse to fill your prescription if I choose.  The only person who can yell at my techs is me.  I don't understand why other pharmacists won't stand up for their techs and themselves in these situations. We are still a profession. Doctors can discharge patients with a letter if they don't want them anymore. We have to do it face-to-face. What other profession gets yelled at as much as we do? What other profession rewards customers with the opportunity to call a 1-800 number for feedback that could impact that professional's career?
I elect to take a stand. I have a job to do. It does not involve getting yelled at for things that are way beyond my control. If you want to treat me that way, expect me to think that's how you prefer to be handled and I'll give it right back.

Monday, September 24, 2012

I believe...

This is the post where I lay it all out there.  It is titled "I Believe...A Cynical Pharmacist's Manifesto".

I Believe...

  • in no more 3-day holdover supplies for patients.  You knew your bottle was getting empty. Learn some responsibility. If you filled a 30-day supply more than 30 days ago, too bad. Your car tells you when it's almost out of gas and you listen. Your bottle says "only 1 tablet left" so listen. 
  • the State Board of Pharmacy should serve their pharmacists, not the public. They should not be out to get us, but should listen to our input.
  • if you ever use more than one transfer coupon, you give up all right to sue if an error is made. Period.
  • retail pharmacies need to get rid of 1-800 customer service numbers.  If I can't complain about a bad doctor or horrible patients, they can't complain about me and impact my bonus for doing my job.
  • we need 1-800 customer service numbers to complain about doctors and patients.
  • if doctors expect us to do their jobs (fax refill requests, look up profiles, run narcotic usage reports, remind patients of their appointments) then I should be able to bill the office and get paid as their employee.
  • if doctors are going to tell patients how much something costs in my pharmacy, they should pay the difference every time they are wrong.
  • if the FDA is truly worried about Acetaminophen toxicity and overdose, they would immediately stop all production of combination OTC products. (not change the packaging on Children's and Infant's Tylenol.)
  • if look-alike, sound-alike names are so error-prone, the FDA would NOT allow generic names to be so similar, differentiated only by salt form (metoprolol, anyone?). They also would come to some agreement on the stupid letters: CD, LA, SR, XL, ER. (How am I supposed to fill this Rx, again "Buproprion 150mg 1qd"?  or Bupropion XR 150mg? 
  • Pharmacy is way under-represented in our legislature. We cannot have a health care conversation without pharmacy.  The AMA and PBMs carry more weight than we do and dictate what we do. This should not be so. 
  • the 6-month exclusivity on new generics is OK, as long as we call it what it really is: Patent Extension. The brand company owns the generic that gets those rights (i.e. Actos) and they don't even change the tablets.  It saves customers money, but it's a lie.
  • the "customer is always right" is a terrible philosophy in pharmacy.  It would be akin to arguing a diagnosis with your doctor.
  • awesome technicians make pharmacists awesome. Without them, we are nothing.
  • manufacturer copay coupons are misprinted lies! They are more work for my techs, and misleading for customers who will immediately yell at us, not the manufacturer.
  • with a new diet pill on the horizon, that trying to lose weight by taking a pill is like trying to get pregnant by just watching porn.
  • in pharmacists as immunizers. But I also believe in at-will participation.
  • if my Medicaid customer comes to my drive-thru with a better car, or to my counter on an iPhone, smokes, or appears to have more money than I do, she should be arrested, forced to hand over those possessions, and immediately removed from the welfare rolls, along with anyone who shares her blood.
  • all Medicaid prescriptions should have copays. 
  • the children are our future.  Teach them well and let them lead the way.

Tuesday, September 4, 2012

Predictive Refill Programs

I have never been a fan of the predictive refill programs that have taken over our profession.  Correction: The original concept was nice, but we have, as always, let the programs run away from us and now have to fight to get it right.  My problems are these: No one is happy even if they voluntarily enroll in the program and no one program is perfect.

If we call patients to tell them their refills are ready, they are bothered because they are not out of medication yet.  If we do not call a patient, they are bothered because they ran out and no one told them they were going to run out.

I believe the best fix for these programs is to employ the early refill narcotic patients as mentors.  These patients know the exact hour we can fill each of their narcotic prescriptions and usually call us daily and hourly for weeks up to the due date.  If we could simply embed a narcotic taker with a blood pressure taker, then everyone would know precisely when to pick up their prescriptions.  In fact, I would be willing to bet that the diabetics would become even more compliant with their own daily regimens and actually take/use their medications correctly.

No longer would we have to suffer the ignoramus who comes to our counter after 6pm on Friday and complains that his bottles of insulin are empty and he's been without it for 3 days and he's going to die if we don't just give him Lantus and Humalog right now.  Sorry.  If you're willing to bet your life on the first 3 days, I'm willing to bet your life over the weekend.  Let me introduce you to Mr. Percocets.  He's always prompt when his medication runs out.  He's your new flatmate until you can learn to accept personal responsibility for your own health and wellness.

The other issue with these programs is the amount of work involved. I actually believe we had fewer customer complaints prior to implementing these programs.  Under the early refill system, we fill prescriptions we're not even sure they're still taking.  Not only that, but the entire concept is based on strict patient compliance.  It assumes they are taking the medication exactly as prescribed, not missing doses, and keeping appointments.  We all know what happens next: Our computer calls the patient on days 3, 5, 7, 9, 11 (or according to some patients, never) and they don't come in for it.  On the 13th day, per insurance regulations, we put the medication back in stock.  Now we have to label this bottle with a lot # and expiration date because the State Board says we can't dump it back in the stock bottle and then we have to hope we can use it in the next 90 days (Ohio's law).  Then, on day 14 (or mere hours after we pulled the bag, reversed the claim, and returned it to stock) the patient comes in and wants to know why it isn't ready and why they have to wait another 20 minutes when it should have been done last week.  This is usually followed with "I got a call that said I had until yesterday to pick it up. Why isn't it done?"  I guess you ignored the first 4 phone calls you got, huh?  Now we have to put them back in line, pushing back the other people whose prescriptions we should be filling, and do everything for them a second time.  This one person made us do triple work, but we only get paid once.  Never mind the other costs that go into filling the script.  How is this more efficient?

What about the automatic doctor refill requests? Wasn't that part of the original plan too? The refills would pop into our system early, see the patient was out of refills, fax the doctor, the doctor would get back to us, the refill would be filled, the patient would come in having no idea all the work that went on behind the scenes, and walk out, happy and ignorant as a clam. Brilliant! Except it never works that way. The patient wanted it somewhere else, switched to mail order, hasn't been to the doctor in over two years so they deny the refill, then the patient's phone number is disconnected.

(Full disclosure: The only reason I have to favor the refill system is for out-of-stock or special order drugs.  I don't have to keep these items in stock or I get at least a day's notice I need to order extra of something just for you.)

It's become a stupid, busywork generating system that promised to save us time but seems to only create  more work. We even have to dedicate 1-2 tech hours a day solely on dealing with these old refills. I understand the need to generate more prescriptions as much as any pharmacist today, however, how much time are we really saving?

Tuesday, August 28, 2012

And The People's Choice Winner Is...

"Of all the gin joints, in all the towns, in all the world, she walks into mine."

When your doctor asks (and on electronic prescriptions, it says) "Patient's Pharmacy of Choice", remember that YOU picked me.  It says Patient's Choice.  I did not force you to come to my pharmacy. It's not like a dinner choice.  Hey, I'm in the mood for Thai tonight. Your selection, and repeat business, is not just a whim.

With that in mind, I am done with you.  If you are unhappy, leave. When people threaten to go somewhere else, I'll tell them "Go Ahead".  I will even ask where they want me to transfer their profile so it's waiting for them when they get there.

A fine gentleman was leaving for vacation.  Of course, his refills were too early but he neglected to provide us with this information when he left them.  As I was going to explain this, he said he'd just transfer pharmacies if it was going to be a hassle.
Nope.  No hassle. If you leave, no hassle at all.  So go.  Now! See ya.

I'm tired of being held hostage by people who don't understand and refuse to understand how the whole refill/insurance/plan ahead thing works.  I'm tired of people thinking they can get something by complaining simply because of their own stupidity.

I am taking the Twitter approach to dealing with these people.  Ricky Gervais is wonderful to follow.  Twitter is about choice.  You actually have to choose to follow someone.  If you do not like what they have say, you have the simple choice to "unfollow".  I'd like people to apply that to pharmacy choice as well.  I only wish we could "block" people too.


Following someone on Twitter and complaining about what they tweet about is like phoning someone to tell them you don't want to talk to them


http://twitter.com/rickygervais

Friday, August 24, 2012

Customer Complaints=Money!

Why do people always act as if they are entitled to something?  Why do people always feel wronged and that they should be compensated for it? Is it the 1-800-WE-SUE-YOU ads on TV? Here are my favourite, recurring issues concerning customer service.
Only in Retail Pharmacy could we allow a profession to be subject to 1-800 complaint calls.  We can't complain about doctors or lawyers or accountants or other real professionals when they make us mad.  Ever had to wait more than a couple hours to see a doctor? Can't complain to anyone.  Had to wait more than 15 minutes for your prescription? Here's a free coffee, a $20 gift card, and the pharmacist won't get a bonus and will personally kiss your ass on the counter next time you're in.

Customer #1: Called to complain that she graciously gave us a full day to fill her prescriptions (dropped them off last night, but doctor wrote "do not fill until today" on them) and they weren't ready.  I apologized, explained we were busy, that we try to have them all done by 11 am, etc, etc.  She interrupted me and politely pointed out that when she goes to ABC Drugs, they always give her a gift card.  I apologized again and she said that XYZ Pharmacy always gives her free stuff when they are wrong too.  Aha!  I figured her out and proceeded to call her on it.
     ME: Okay.  Again, I am sorry.  In my career in retail, I have realized there are two types of people who call 1-800 complaint lines: those who are looking to continue coming to your establishment and have always had a great time and want just this one little problem fixed so they can continue to happily enjoy your services.
     LADY: Yes, That's me!
     ME: And the other type would be those who are looking for a handout.  Those who want something for some perceived slight against them. Those who figure they can bully a company or a manager into giving them a gift card or free crap to make them shut up and go away.  Every time you interrupted me, you mentioned the word "compensated".  That means you are looking to get something from me and all the other places you do business.  What will it take to make you go away?
     LADY: What?
     ME: I already offered an apology and a $5 gift card and you have kept me on the phone for over 20 minutes now, talking about compensation and how ABC and XYZ are so much better at handouts.  What will it take to make you go away?
     LADY: What?
     ME: I will have a $5 gift card waiting for you when you next come in for a refill.  Anything else?
     LADY: No.

I have heard nothing from her since.  Apparently, she was notorious for customer complaints prior to my arrival and no one stood up to her.  But why do we let people take advantage of our profession like this?

Customer #2: Comes back through the drive-thru and just now presents his insurance card. As we explain that he will have to come back after we rebill his prescriptions, his automatic response is :"Are you going to pay for my gas?"
     ME: No.  Why would I?
     HERR DOUCHE: Because I have to come back.
     ME: It's not my fault you didn't have your insurance card the first time. Or that you're 30 minutes earlier than we told you to come back. Or that your doctor didn't send the e-Rx over yet.
    HD: But I should be compensated for you wasting my gas.
     ME: Why? Does Best Buy pay you for gas when they issue a raincheck for the 72" TV they're out of? Does McDonald's give you a gas card when they make you pull up and wait for the fresh, hot fries they just dropped? Here's an idea. Park your car and walk your lazy butt into my store.  Shop around a bit.  It'll take you so long to get back here, since your only exercise is 12-ounce curls, that I can have it gift wrapped for you.  Pay for your gas?!

Since when did anyone deserve to be so entitled? These people are the product of parents who held their hand and did everything for them.  They were continually told they were better than everyone else and they didn't have to take it anymore.  It's a culture that retail pharmacy has not only encouraged, but strongly embraced.  Our bonus is tied to great customer service.  How about we focus on the professional aspects of our jobs, the reason we went to school.  We just need someone to tell these people "being a customer does not entitle you to anything. We appreciate your business, but I am not going to pay you for the privilege of shopping here."

Tuesday, August 21, 2012

I am NOT Your Doctor's Bitch

I know I have said this before (see Pharmacist vs. Doctor) but it bears repeating after this week's phone call.
I retrieved my voicemail to hear the following message from a doctor's representative:
"This is Dr. Zoffis calling.  We received a call from patient Lazy Ass.  He told us he was out of refills.  Dr. Zoffis requires that all requests be faxed from your pharmacy so we can give them to him when he has time and then send them back to you. Please make note of our fax number in your system so you can fax us on all refill requests.  The patient needs a refill on his HCTZ so fax it so we can get his refill back to you."

Wow.  What a bitch.  Is it just me or could this long-winded soliloquy not have been shortened to:
"Please refill Lazy Ass' HCTZ 3 times.  Thanks"???

Assuming we had actually faxed you correctly in the first place, I am certain we would have had either (or both) of the following outcomes:
     1. My doctor demands you fax him and he says you didn't yet and now I've been out of meds for over a week!
     2. My doctor said he faxed your refill request back on Monday, Tuesday, Wednesday, and twice on Thursday but you didn't fill it.  You lost it and now I've been out of meds for over a week.

Seriously?  Let me see if I understand this.  In the really old days, your doctor would write a prescription and you'd hand-deliver it to me.  In the olden days, a speedy-tongued girl would directly deliver a verbal order.  If she forgot to call or you forgot to give it to me, not my fault.  If you took it to the wrong pharmacy or she called it there, not my fault.  Now the onus is on us for every possible thing that could go wrong?  If they don't get the refill request? My fault.  If they forget to send it? Send it to the wrong pharmacy? My fault and my fault? If the e-script service verifies it was delivered but I can't find it? My fault?
I am sorry, but my obligation ends when I hit "SEND" on the refill request.  I cannot fill prescriptions I do not have and I only get paid for prescriptions I fill.  Therefore it is in my best interest to fill your prescription and not waste time tracking down a lost-in-transit, phantom script.

Obviously, there is a breakdown somewhere.  Why though, is the blame falling squarely on the pharmacist? The patients accept zero personal responsibility for their own healthcare.  They expect us to fill the refill before it's due, call them when it's filled, remind later in the week it's still here, call the doctor when the refills expire, then refill it when it's due; lather rinse repeat.  The only service we are not providing is actually going to the doctor for them.  Wait for it.  I'm sure some corporate pharmacy suit is crunching those numbers and figuring out the logistics of where to incorporate that between flu shots, MTM, and actual filling of prescriptions.

Everyone expects us to do everything for them.  I think I'll try the "my fax machine can only receive" trick and see what the offices' responses are.  Why, too, do doctors argue and scoff when you ask them to resend a script or to authorize a verbal order? Really? Just read it to me, like you used to do. Oh well, it's not like they're telling patients my pharmacy has a certain drug in generic or that they're free or $4, right?  They'd never do that.


Tuesday, August 14, 2012

How to Sound Stupid to your Pharmacist

Overheard recently (daily) at your local RxDrug Counter:

"I needs my Percs filled. Are they ready?"
"I forgot when my husband could get his Ativans. They due yet?"
"You got any OC's in stock?"
"I want the old Opanas.  You all have them?"

Rule #1: Do not pluralize your drugs.  It makes you sound stupid and an awful lot like a stereotype.  Therefore, I shall henceforth treat you as such.

Rule #2: Be careful of the stories you tell because I will talk to my techs and your doctor.  If your stuff was stolen, file a police report and we'll talk.  However, the important thing to remember is to tell the officer WHAT was stolen so he can list it on the line that says "Items Missing..." If you tell me someone entered your house while you were gone and they took your "Vikes", okay.  However, if the police report you handed me reads "Items Missing...Not sure. Man says someone entered his house, went through his drawers and didn't notice anything missing but would call if he did", THEN I'm not going to believe you even a little bit.  Especially if the doctor calls in to approve the early refill and I ask them what story they got and they tell me: "his wife called and said he got the crap beat out of him and they took all his Vicodins".  Strange because the report says windows were broken and you weren't home.  And don't pluralize your drugs.

Rule #3: Don't give me the stolen Rx story today then the "left them on vacation" story the next month, especially if you already used the "going on vacation" story in between.  No way did you leave them in the hotel.  You would have driven back and slapped the manager around to get back in there if it's possible you even let them out of your sight for even a shower.

Rule #4: Do not call me more than once a day.  Do not call me again once I have given you a date when your RX may be filled.  If I tell you the 13th, it will not change between now and the 13th.  Buy a calendar and put a shiny red heart on it so you know it's "Drug Day"!  Then call me on the 13th.  But only once. After 10am.

Rule #5: If for some reason I say "NO" to your narcotic refill request, you may ask for an explanation.  There may be a very legitimate reason you cannot get it and you may be a legitimate person asking for it legitimately.  For the rest of you, do not scream, curse, throw a temper tantrum, mumble things about sex with dead animals, or otherwise "lose it" in any theatrical way in front of my pharmacy.  You look like the stereotype mentioned in #1.

I do not assume everyone abuses their prescription medication. I do not stereotype based on looks or the Rx presented to me.  I do, however, have a job to do that while performing may lead to unexpected questions being raised.  It is these good people that are the recipients of my humble rants and raves here.

The truth is easy to remember; the lie is easy to forget.