Lots of thought.
Or no thought.
As parents, there is an obligation on you when naming your child.
Make sure he/she is not going to have to deal with a life of misfortune thanks to your decision. (Marlana backwards? Anyone?)
(And let us keep in mind the poor souls with longer-and-more-complicated-than-necessary spellings who are forced to complete bubble tests. While they are still bubbling in their names, half the class have completed the exam.)
For those of you with cute, peculiar names or with atypical spellings, keep one thing in mind: In life, there is no one who is responsible for your name except your parent(s). Especially not the pharmacy staff.
Hate your name? Change it.
Hate the spelling? Change it.
Hate having to explain to everyone with whom you interact how to spell or pronounce your name? Change it.
Or, better yet, embrace it. It's beautiful. Just like you.
We know it's not your fault, but it IS your name. It's not my name.
If you know you have a unique spelling, please accept the fact and help us.
(Yes, there are lots of photos of Starbucks cups with beautiful attempts at names but I'd rather put it in to the computer correctly and be able to find you when needed.)
If you are a Thom instead of a Tom, tell us.
Same goes for Theresa or Teresa.
Alyx and Alex and Alixx?
Allison, Alison, Alyson.
Larry or Lawrence or Laurence?
Geri or Gerri or Jeri or Jerri or any of those with a "y"?
Don't even get me started on the K v C names-
Kathy/Cathy, Katherine, Kathryn, Katharyn, et al. (Same goes for Kaitlynn)
Kris, Chris, Criss, Khris?
Cindi, Cindy, Cyndy?
Caryn, Carin? Karen?
Seriously. I could do this all day. You get it. And I know people will add some of their favourites. Or favorites.
The point is, make life easier on everyone.
When picking up at the pharmacy, or anywhere you need to give your name, just tell us "it's-Jon-with-no-H". Save us all some grief and especially that awkward moment where we have to stare at you because we can't seem to locate you in the system. I can't possibly process all the permutations of Kaitie, or Caitie, Katey, or Caity, or . . . ad infinitum.
If you have to tell me how to spell your name, this is not the first time you have encountered this.
Be polite.
"Erik with a K" is nice.
(Also, please pick one name and stick with it. "The doctor has me as Taylor but I go by Lyn with one N here at the pharmacy but my real name is TaQLynn with 2 N's and a silent Q. It's pronounced TAY LIN.")
Again, don't get mad because we do not know how to spell or pronounce your name. Take a second, spell it, pronounce it and we may remember it.
Yes, you are unique, just like everyone else.
You live with your name and I with mine.
Our interactions are limited to minutes per month and the name exchange is but seconds of this time. It is ephemeral and quickly forgotten, as when you provide your date of birth.
#BePolite
#HelpUsToHelpYou
Wednesday, May 8, 2019
Monday, May 6, 2019
Good Rx - Good Phor Patients, Bad Phor Pharmacists
I was on a Netflix or Hulu binge recently and saw a GoodRx ad. Normally my blood pressure elevates only slightly during these ads but this one made my blood boil.
Phine. GoodRx helps patients save money. Not against that.
Phine. If pharmacies want insurance contracts we have to accept GoodRx. K.
My issue with this particular ad was in the way the actualisation of the savings was portrayed. People believe what they see with their eyes, not what knowledgeable, credible, professional people tell them. This means that after watching this ad, patients will make the assumption that the scenario portrayed in the ad is a mirror of real world practises.
It's not.
Phar phrom it.
What happened in the ad to ruffle your feathers, CP?
The patient approached the pharmacy counter and was told/shown a price by the pharmacist of $67.00. As the patient's look of shock took root, she realised she had a phone which she pulled out, found a price on GoodRx, then showed it to the pharmacist. The pharmacist, at the register, waved the phone in front of the register and the price on the screen magically dropped to $8.90.
Did you see it?
It instantly changed from $67.00 to $8.90. . . AT. THE. REGISTER!
Instantly.
(Yes. I realise it is a 30 second commercial. This does, however, reinforce the false belief that changing a copay and getting the discount is like handing a cashier a coupon at the grocery.) #ThatsNotHowItWorks!
Why is this bad, CP?
First, it trivialises what we do.
Second, it encourages bad behaviour in patients when it doesn't work exactly as shown in the commercial.
GoodRx is NOT a credit card.
GoodRx is NOT a register coupon.
In order to use the GoodRx discount (or any other pharmacy discount card, including manufacturer coupons) we have to change how we billed the prescription. This means we must edit the prescription and either add the new coupon or reverse the claim to your insurance and bill only the GoodRx plan. This is completed in the data entry system, not the register.
Once completed, the pharmacist must then reverify all of the information, including checking the prescription and the medication dispensed. (Sometimes the GoodRx coupons are for different quantities and now we must change what we dispensed.)
How does it work in reality, CP?
Patients can expect a wait.
Can I redo the prescription in 5 minutes? Sure.
Should they expect it each time? No.
Are they the only person who needs something done right now? Definitely not.
Their prescription gets put in line along with everyone else's.
How can they expedite the process?
Call ahead.
Call for the price BEFORE coming to the pharmacy.
When you check GoodRx online, call back with the billing information BEFORE coming to my counter.
This will allow me to process it when I can and run a smoother workflow in my store.
It's also not fair to other patients waiting on prescriptions for you to expect yours to be redone ahead of theirs. Sure it was finished, but you changed the completed order. (Imagine finishing placing your order at Arby's, sliding on down to the pickup window then deciding to change your order. You can't just sidle on back to the order window, cut in front of the line, and expect the staff to redo your order ahead of those waiting to place orders. Or maybe you do expect that which is why you suck.)
Either way, please complain to GoodRx that even though they have cheapened prescriptions for patients, they don't need to cheapen our profession along with it. We can handle that quite well on our own, TYVM.
Phine. GoodRx helps patients save money. Not against that.
Phine. If pharmacies want insurance contracts we have to accept GoodRx. K.
My issue with this particular ad was in the way the actualisation of the savings was portrayed. People believe what they see with their eyes, not what knowledgeable, credible, professional people tell them. This means that after watching this ad, patients will make the assumption that the scenario portrayed in the ad is a mirror of real world practises.
It's not.
Phar phrom it.
What happened in the ad to ruffle your feathers, CP?
The patient approached the pharmacy counter and was told/shown a price by the pharmacist of $67.00. As the patient's look of shock took root, she realised she had a phone which she pulled out, found a price on GoodRx, then showed it to the pharmacist. The pharmacist, at the register, waved the phone in front of the register and the price on the screen magically dropped to $8.90.
Did you see it?
It instantly changed from $67.00 to $8.90. . . AT. THE. REGISTER!
Instantly.
(Yes. I realise it is a 30 second commercial. This does, however, reinforce the false belief that changing a copay and getting the discount is like handing a cashier a coupon at the grocery.) #ThatsNotHowItWorks!
Why is this bad, CP?
First, it trivialises what we do.
Second, it encourages bad behaviour in patients when it doesn't work exactly as shown in the commercial.
GoodRx is NOT a credit card.
GoodRx is NOT a register coupon.
In order to use the GoodRx discount (or any other pharmacy discount card, including manufacturer coupons) we have to change how we billed the prescription. This means we must edit the prescription and either add the new coupon or reverse the claim to your insurance and bill only the GoodRx plan. This is completed in the data entry system, not the register.
Once completed, the pharmacist must then reverify all of the information, including checking the prescription and the medication dispensed. (Sometimes the GoodRx coupons are for different quantities and now we must change what we dispensed.)
How does it work in reality, CP?
Patients can expect a wait.
Can I redo the prescription in 5 minutes? Sure.
Should they expect it each time? No.
Are they the only person who needs something done right now? Definitely not.
Their prescription gets put in line along with everyone else's.
How can they expedite the process?
Call ahead.
Call for the price BEFORE coming to the pharmacy.
When you check GoodRx online, call back with the billing information BEFORE coming to my counter.
This will allow me to process it when I can and run a smoother workflow in my store.
It's also not fair to other patients waiting on prescriptions for you to expect yours to be redone ahead of theirs. Sure it was finished, but you changed the completed order. (Imagine finishing placing your order at Arby's, sliding on down to the pickup window then deciding to change your order. You can't just sidle on back to the order window, cut in front of the line, and expect the staff to redo your order ahead of those waiting to place orders. Or maybe you do expect that which is why you suck.)
Either way, please complain to GoodRx that even though they have cheapened prescriptions for patients, they don't need to cheapen our profession along with it. We can handle that quite well on our own, TYVM.
Tuesday, April 23, 2019
A(nother Holi)Day In The Life
CP: Thanks for calling CP's Pill Palace. This is CP, Paladin of Pills, how may I help you?
Worker Of Miracles Anxiously Needy: I need a dose of my Xarelto.
CP: I see you are out of refills. I can fax your doctor.
WOMAN: I'm out! Don't you know I have afib?
CP: Yes. Yes, I can infer such a diagnosis from the medication. And?
WOMAN: Well I need it.
CP: Were it so important to you, this afib diagnosis, you would have been more proactive, right?
WOMAN: I'm going to die.
CP: Eventually, yes. But, in the words of Syrio Forel, "not today". If you are that concerned, call your office. Or go to the ER.
WOMAN: It's Easter!
CP: Didn't stop you from calling me. Besides, your refill expired in December. We last refilled it in October for 3 months. How did you make a 3 month supply last 6 months?
WOMAN: I just took my last one last night.
CP: He is Indeed Risen! It's an Easter miracle. You made a 3 month supply last 6 months. Impressive. Do it again and you'll have enough for the weekend.
WOMAN: Well why didn't you call me?
CP: And say what?
WOMAN: To refill it.
CP: We probably did. Last year. When it was due. If you have a surplus of medication, I can't see that.
WOMAN: Well something's wrong here. What are you going to do?
CP: Repeat my earlier comment, a little firmer this time: Call your prescriber. They have answering services and on call prescribers for a reason.
<2 hours later>
CP: We just received your prescription. You may come to retrieve it at your earliest convenience. We are here until 3pm today.
<WOMAN comes in to pick up>
WOMAN: Am I on that courtesy refill thingy?
CP: Yes.
WOMAN: I still don't understand why you let me run out of medication.
CP: Well, simply put, we call when it's due. Which is usually about 10 days early on a 90 days supply. If you don't want it, don't need it, or don't pick it up, it goes back in stock and we wait to hear from you.
WOMAN: Well something is wrong here. I'm very scared.
CP: I'm sorry. What? You're scared? Of what?
WOMAN: That your system let me run out of medication.
CP: How is it that you made it to 75 years old? What did you do before pharmacies did everything except actually take your medications for you? Or anything else for that matter. Your car must constantly run out of gas and your refrigerator must always be empty since no one is there to tell you they need refilled.
WOMAN: I guess I'll have to go home and figure out what to do now.
CP: You do that. But make an appointment with the prescriber. They only approved a one month supply. Happy Easter!
Worker Of Miracles Anxiously Needy: I need a dose of my Xarelto.
CP: I see you are out of refills. I can fax your doctor.
WOMAN: I'm out! Don't you know I have afib?
CP: Yes. Yes, I can infer such a diagnosis from the medication. And?
WOMAN: Well I need it.
CP: Were it so important to you, this afib diagnosis, you would have been more proactive, right?
WOMAN: I'm going to die.
CP: Eventually, yes. But, in the words of Syrio Forel, "not today". If you are that concerned, call your office. Or go to the ER.
WOMAN: It's Easter!
CP: Didn't stop you from calling me. Besides, your refill expired in December. We last refilled it in October for 3 months. How did you make a 3 month supply last 6 months?
WOMAN: I just took my last one last night.
CP: He is Indeed Risen! It's an Easter miracle. You made a 3 month supply last 6 months. Impressive. Do it again and you'll have enough for the weekend.
WOMAN: Well why didn't you call me?
CP: And say what?
WOMAN: To refill it.
CP: We probably did. Last year. When it was due. If you have a surplus of medication, I can't see that.
WOMAN: Well something's wrong here. What are you going to do?
CP: Repeat my earlier comment, a little firmer this time: Call your prescriber. They have answering services and on call prescribers for a reason.
<2 hours later>
CP: We just received your prescription. You may come to retrieve it at your earliest convenience. We are here until 3pm today.
<WOMAN comes in to pick up>
WOMAN: Am I on that courtesy refill thingy?
CP: Yes.
WOMAN: I still don't understand why you let me run out of medication.
CP: Well, simply put, we call when it's due. Which is usually about 10 days early on a 90 days supply. If you don't want it, don't need it, or don't pick it up, it goes back in stock and we wait to hear from you.
WOMAN: Well something is wrong here. I'm very scared.
CP: I'm sorry. What? You're scared? Of what?
WOMAN: That your system let me run out of medication.
CP: How is it that you made it to 75 years old? What did you do before pharmacies did everything except actually take your medications for you? Or anything else for that matter. Your car must constantly run out of gas and your refrigerator must always be empty since no one is there to tell you they need refilled.
WOMAN: I guess I'll have to go home and figure out what to do now.
CP: You do that. But make an appointment with the prescriber. They only approved a one month supply. Happy Easter!
A (Holi)Day In The Life
Weekends at the pharmacy are their own strange little days but holidays on weekends are even more anomalous. Something happens to people to the point where their brains must shut down and enter power saving mode. It's the only explanation for some of the interactions I've had.
CP: This is CP, Pill Pauper Extraordinaire, how may I help you?
Won't Hear Any Thing: I am out of medication. Can you give me some?
CP: Whoa. Right to the chase. Unfortunately, I cannot.
WHAT: What? Why?
CP: Did you call your doctor?
WHAT: It's Saturday.
CP: Yes. And? Many offices have after hours services. You should try them.
WHAT: I'm suffering.
CP: Then you should call the office sooner rather than later.
<2 hours later>
CP: CP's Palace of Pills. How may I help you?
Wilful Husband Of WHAT: My wife is out and needs some medication.
CP: I believe I spoke with WHAT earlier. Did she call the office as I suggested?
WHO,WHAT: No. She's in a lot of pain and going through withdrawal.
CP: Better call the office now then.
WHO,WHAT: She took her last one last night.
CP: Okay. And we filled it 45 days ago. For a 30 days supply. She has missed more than one day in the last month. I'm pretty sure she will make it to Monday.
WHO,WHAT: So you won't help me?
CP: If it's that severe, call the office.
WHO,WHAT: But it's Saturday.
CP: Why do you keep saying that? Phones work on the weekends. Prescribers are on call. With e-scripts now many respond to refill requests to ease the Monday work burden. Call them.
<2 hours later>
CP: How may I. . .
WHO: Can I please have some medication?
CP: No. Did you call your office?
WHO: I called them during the week and my doctor is on vacation and no one would call in a refill for me.
CP: Okay. And what about today? Did you call like I advised you and your husband earlier?
WHO: No. It's Saturday.
CP: Call them.
<1 hour later>
CP: Hello? Is it me you're looking for?
Nice Prescriber: Calling a refill for a patient. Apparently her office didn't call in her refill this week so I wanted to give her a week's worth.
CP: You're so kind. I'm glad she called you. I've been advising her to call all day.
NP: You're welcome.
<15 minutes later>
CP: Calling to let you know your office called in a short-term supply for you. In the immortal words of Rod Roddy, "come on down!".
WHO,WHAT: Here to pick up for WHAT.
CP: Have a nice day!
WHO,WHAT: <storms off>
CP: You're welcome! <hums "Closing Time" while shutting down computer, sees an e-script for a 90 days supply from patient's prescriber; closes head in door while exiting>
CP: This is CP, Pill Pauper Extraordinaire, how may I help you?
Won't Hear Any Thing: I am out of medication. Can you give me some?
CP: Whoa. Right to the chase. Unfortunately, I cannot.
WHAT: What? Why?
CP: Did you call your doctor?
WHAT: It's Saturday.
CP: Yes. And? Many offices have after hours services. You should try them.
WHAT: I'm suffering.
CP: Then you should call the office sooner rather than later.
<2 hours later>
CP: CP's Palace of Pills. How may I help you?
Wilful Husband Of WHAT: My wife is out and needs some medication.
CP: I believe I spoke with WHAT earlier. Did she call the office as I suggested?
WHO,WHAT: No. She's in a lot of pain and going through withdrawal.
CP: Better call the office now then.
WHO,WHAT: She took her last one last night.
CP: Okay. And we filled it 45 days ago. For a 30 days supply. She has missed more than one day in the last month. I'm pretty sure she will make it to Monday.
WHO,WHAT: So you won't help me?
CP: If it's that severe, call the office.
WHO,WHAT: But it's Saturday.
CP: Why do you keep saying that? Phones work on the weekends. Prescribers are on call. With e-scripts now many respond to refill requests to ease the Monday work burden. Call them.
<2 hours later>
CP: How may I. . .
WHO: Can I please have some medication?
CP: No. Did you call your office?
WHO: I called them during the week and my doctor is on vacation and no one would call in a refill for me.
CP: Okay. And what about today? Did you call like I advised you and your husband earlier?
WHO: No. It's Saturday.
CP: Call them.
<1 hour later>
CP: Hello? Is it me you're looking for?
Nice Prescriber: Calling a refill for a patient. Apparently her office didn't call in her refill this week so I wanted to give her a week's worth.
CP: You're so kind. I'm glad she called you. I've been advising her to call all day.
NP: You're welcome.
<15 minutes later>
CP: Calling to let you know your office called in a short-term supply for you. In the immortal words of Rod Roddy, "come on down!".
WHO,WHAT: Here to pick up for WHAT.
CP: Have a nice day!
WHO,WHAT: <storms off>
CP: You're welcome! <hums "Closing Time" while shutting down computer, sees an e-script for a 90 days supply from patient's prescriber; closes head in door while exiting>
Tuesday, April 16, 2019
Vaccines
CP: Are you ready for a new installment of "Me, Myself, and I"?
ME: No.
MYSELF: <yawns> Again?
CP: This will promise to be doozy.
ME: What can you possibly debate with us that will cause people to become irrationally irritated and divisive?
MYSELF: Yeah. It's not like you're going to attempt to tackle vaccines with logic or anything, right?
ME: Right?
MYSELF: Um. . . you're not, are you?
CP: Did you ever notice how people like to argue that they are better and no longer need their medication?
ME: Yeah. Like blood pressure medication because they don't feel any different and cholesterol because they can't feel it working.
MYSELF: They don't see or feel the effects directly so they're cured.
CP: Right.
ME: And since the numbers on their labs/tests come back WNL, they must be cured and no longer have HBP or cholesterol.
MYSELF: Except. . .
CP: Except the reason they are better is because they are taking the medications.
ME: I see where you're going with this.
MYSELF: Of course you do. We are of the same mind. Literally.
CP: It's like vaccines: there are no cases of diseases any more so we can stop getting the vaccines for them. WRONG! There are no cases BECAUSE we have been immunizing.
ME: Let's not forget that people travel and tend to carry disease with them.
MYSELF: Yes. Unlike HBP or cholesterol, these conditions are contagious.
CP: And deadly. But let's continue the game of "if I don't see it, it must not be there".
ME: Reminds me of the old contagion and miasma theories. Until germ theory was postulated in the second half of the 19th century (fun fact, by John Snow), people, including leading science and medical experts, believed diseases were spread by "bad air". (We could have a discourse on this about how they weren't necessarily wrong; as you removed what held the bacteria, you improved the air, but that's a far over-simplification of the theories. Besides, the prescribed treatments for miasma didn't work for cholera.)
MYSELF: We are seeing the rise of measles because people refuse vaccinations because they believe the disease no longer exists?
CP: Partially. In 2000 the United States declared measles eliminated from the country. Great. Except other countries' vaccination rates were less than ideal. When our rates slipped due to anti-vaxx movements, the door was opened for outbreaks and a resurgence in the US.
ME: What you're saying is that, with all of the medical advances and scientific knowledge we have gained over the last ~170 years, we are regressing?
MYSELF: As we've said before a little knowledge can be a bad thing.
CP: The point of this exercise is to show people that just because it's not staring at us every day in the mirror or on our social media alerts, it does not mean it's not really happening. I came up with this thought to leave with you:
"I suppose the real question we need to be asking these parents is: are you making the correct, most-informed decision for your child and her health or are you putting a higher value on your own personal beliefs at the risk of your child's health?"
Great Books if you wish to read more:
1. Pox Americana
2. The Ghost Map
3. The Butchering Art
4. Quackery
ME: No.
MYSELF: <yawns> Again?
CP: This will promise to be doozy.
ME: What can you possibly debate with us that will cause people to become irrationally irritated and divisive?
MYSELF: Yeah. It's not like you're going to attempt to tackle vaccines with logic or anything, right?
ME: Right?
MYSELF: Um. . . you're not, are you?
CP: Did you ever notice how people like to argue that they are better and no longer need their medication?
ME: Yeah. Like blood pressure medication because they don't feel any different and cholesterol because they can't feel it working.
MYSELF: They don't see or feel the effects directly so they're cured.
CP: Right.
ME: And since the numbers on their labs/tests come back WNL, they must be cured and no longer have HBP or cholesterol.
MYSELF: Except. . .
CP: Except the reason they are better is because they are taking the medications.
ME: I see where you're going with this.
MYSELF: Of course you do. We are of the same mind. Literally.
CP: It's like vaccines: there are no cases of diseases any more so we can stop getting the vaccines for them. WRONG! There are no cases BECAUSE we have been immunizing.
ME: Let's not forget that people travel and tend to carry disease with them.
MYSELF: Yes. Unlike HBP or cholesterol, these conditions are contagious.
CP: And deadly. But let's continue the game of "if I don't see it, it must not be there".
ME: Reminds me of the old contagion and miasma theories. Until germ theory was postulated in the second half of the 19th century (fun fact, by John Snow), people, including leading science and medical experts, believed diseases were spread by "bad air". (We could have a discourse on this about how they weren't necessarily wrong; as you removed what held the bacteria, you improved the air, but that's a far over-simplification of the theories. Besides, the prescribed treatments for miasma didn't work for cholera.)
MYSELF: We are seeing the rise of measles because people refuse vaccinations because they believe the disease no longer exists?
CP: Partially. In 2000 the United States declared measles eliminated from the country. Great. Except other countries' vaccination rates were less than ideal. When our rates slipped due to anti-vaxx movements, the door was opened for outbreaks and a resurgence in the US.
ME: What you're saying is that, with all of the medical advances and scientific knowledge we have gained over the last ~170 years, we are regressing?
MYSELF: As we've said before a little knowledge can be a bad thing.
CP: The point of this exercise is to show people that just because it's not staring at us every day in the mirror or on our social media alerts, it does not mean it's not really happening. I came up with this thought to leave with you:
"I suppose the real question we need to be asking these parents is: are you making the correct, most-informed decision for your child and her health or are you putting a higher value on your own personal beliefs at the risk of your child's health?"
Great Books if you wish to read more:
1. Pox Americana
2. The Ghost Map
3. The Butchering Art
4. Quackery
Thursday, March 14, 2019
Pete and Repeat Are in a Boat. . .
CP: CP, Master Pill Pauper. How may I help you?
Pt: I am here to pick up my prescription.
CP: Name?
PT: Barf.
CP: Your full name?
Pt: Barfolomew!
CP: Date of Birth?
Pt: 5/5/75.
CP: I do not have anything ready for you.
Pt: My doctor was supposed to send it.
CP: Today?
Pt: Yes.
CP: I checked my will call section. I checked my e-scripts. I checked my faxes, my voicemail, my drone deliveries and the old paper airplane landing strip and we haven't anything for you.
Pt: He was supposed to send it.
CP: Nothing here.
Pt: Nothing from my doctor?
CP: Nothing here.
Pt: From Dr. Acula?
CP: Nothing here.
Pt: It's for my blood thinner.
CP: Nothing here.
Pt: I take it every day.
CP: Nothing here.
Pt: He said I need to take it every day.
CP: Nothing here.
Pt: Are you sure he didn't send it?
CP: Nichts hier.
Pt: I was just at the office.
CP: Nimic Aici.
Pt: It's the weekend and they're closed.
CP: Nothing. Here! Do I really need to be here for this or are you just having a conversation with yourself?
Pt: I just need to make sure he didn't send it. I need it.
CP: Yes. You made that quite clear. However, as much as you made clear you need it, I made twice as clear I don't have it. There is nothing here. I can keep explaining it to you, but I can't understand it for you. If you'll excuse me, I have a spot on the wall calling my name and a forehead that needs a solid knocking.
Pt: Ok. What shall I do?
CP: Call the office? Or keep talking to yourself? But I'm pretty sure I don't need to be here for either so, good day.
Pt: Real quick?
CP: Yes?
Pt: Can you check again?
CP: <runs to wall, beats head, smiles again>
#EveryDayIsExactlyTheSame
Tuesday, March 12, 2019
Blind
CP: I don't mind helping. I simply ask that you help me to help you help me.
ME: You really need a new partner at work.
MYSELF: We're tired of being your go-to phriends for these conversations.
CP: No one understands me like you do. Besides, you offer good counterpoints from time to time so I can see both sides.
ME: Right. Which, as we've discussed recently, too few people are willing to do.
MYSELF: If you are able to see what the other side is going to argue, it will either reinforce your beliefs or allow you to change them in light of new evidence.
ME: Now that everyone is asleep, can we progress to today's lesson?
MYSELF: <yawns> Please?
CP: I love thinking for myself, but I don't like having to think for others as well.
ME: Yes you do.
MYSELF: What happened?
<fades into a recent conversation, phone rings, 4pm>
CP: Happy Phriday! CP, Pauper of Pills, How may I assist thee today?
Nurse At Pain Management In Need of Defending Early Refill: Yes, I'd like to let you know we approved an early fill.
CP: Thanks. I didn't ask for your approval, not that I need it of course, but. . .
NAPMINDER: For your patient.
CP: Well that's different. Why did you approve it?
NAPMINDER: He is taking a vacation.
CP: Nice. When is he leaving?
NAPMINDER: Tomorrow morning.
CP: Wow. Excellent. Thanks for giving me lots of time to get the okay from his insurance since they're likely to be the ones to put the kibosh on the early fill.
NAPMINDER: The prescriber just okayed it and the patient only just called this morning.
CP: Right. They planned for a vacation, bought tickets months ago yet somehow it sneaked up on them and they remembered the medication they take 4 times a day is the last thing on their minds. Got it. Quick question for you.
NAPMINDER: Yes?
CP: When do they return?
NAPMINDER: I don't know. I didn't ask.
CP: You should have. It's a rather important question, don't you think?
NAPMINDER: No. Why?
CP: The patient called and said he is going on vacation and needs an early refill and you approved it without asking when he'd return?
NAPMINDER: Yes. That's how we always do it.
CP: What if he's coming back Monday? Or Tuesday? Or, I don't know, any day before his medication would run out?
NAPMINDER: I don't know.
CP: Then you'd be giving him a month supply of medication when he really doesn't need it yet. Or maybe he only needs a day or two.
<patient calls 5 minutes later; or maybe he was already on hold while I was finishing>
Needs Early Refill for Vacation Outside United States: Did my prescriber approve my vacation override?
CP: Yep.
NERVOUS: Great! When can I come down for it?
CP: When are you leaving?
NERVOUS: Tomorrow. We have an early flight.
CP: And when do you return?
NERVOUS: We come back next Saturday.
CP: Okay. I will have your prescription ready for you next Sunday.
NERVOUS: But my doctor approved it.
CP: And I filled it for you 21 days ago, which was a day early. If you started taking them on the day you picked them up from me (which you should not have done since that fill was one day early) you would have enough medication to last you through next Sunday, the day after you return.
NERVOUS: But they said it's okay.
CP: Unfortunately, they do not get final say. Since I would have to call your insurance and explain the reason for the early refill, I will have to answer these questions and plead your case. Since you will not only NOT run out of medication but will have enough for a day after your return, I cannot defend the early refill.
NERVOUS: But. . .
CP: Have a nice trip. Relax. Take your prn meds as needed and we will see you in a week.
ME: What if they were diabetes or BP meds?
CP: Wouldn't matter.
ME: Why?
MYSELF: Because he had enough to last?
CP: Yes. That and I don't have to report those fills to a PDMP. Also, there are laws regarding early fills on controls that don't exist for other medications.
ME: So you're not being a giant douche, flexing your muscle and keeping people in pain?
MYSELF: Sadistic little. . .
CP: No. I have a job to do. While people may not, or choose not to understand, or may not like or agree with my responsibilities, it does not change the fact that I still have a professional obligation to meet.
ME: You really need a new partner at work.
MYSELF: We're tired of being your go-to phriends for these conversations.
CP: No one understands me like you do. Besides, you offer good counterpoints from time to time so I can see both sides.
ME: Right. Which, as we've discussed recently, too few people are willing to do.
MYSELF: If you are able to see what the other side is going to argue, it will either reinforce your beliefs or allow you to change them in light of new evidence.
ME: Now that everyone is asleep, can we progress to today's lesson?
MYSELF: <yawns> Please?
CP: I love thinking for myself, but I don't like having to think for others as well.
ME: Yes you do.
MYSELF: What happened?
<fades into a recent conversation, phone rings, 4pm>
CP: Happy Phriday! CP, Pauper of Pills, How may I assist thee today?
Nurse At Pain Management In Need of Defending Early Refill: Yes, I'd like to let you know we approved an early fill.
CP: Thanks. I didn't ask for your approval, not that I need it of course, but. . .
NAPMINDER: For your patient.
CP: Well that's different. Why did you approve it?
NAPMINDER: He is taking a vacation.
CP: Nice. When is he leaving?
NAPMINDER: Tomorrow morning.
CP: Wow. Excellent. Thanks for giving me lots of time to get the okay from his insurance since they're likely to be the ones to put the kibosh on the early fill.
NAPMINDER: The prescriber just okayed it and the patient only just called this morning.
CP: Right. They planned for a vacation, bought tickets months ago yet somehow it sneaked up on them and they remembered the medication they take 4 times a day is the last thing on their minds. Got it. Quick question for you.
NAPMINDER: Yes?
CP: When do they return?
NAPMINDER: I don't know. I didn't ask.
CP: You should have. It's a rather important question, don't you think?
NAPMINDER: No. Why?
CP: The patient called and said he is going on vacation and needs an early refill and you approved it without asking when he'd return?
NAPMINDER: Yes. That's how we always do it.
CP: What if he's coming back Monday? Or Tuesday? Or, I don't know, any day before his medication would run out?
NAPMINDER: I don't know.
CP: Then you'd be giving him a month supply of medication when he really doesn't need it yet. Or maybe he only needs a day or two.
<patient calls 5 minutes later; or maybe he was already on hold while I was finishing>
Needs Early Refill for Vacation Outside United States: Did my prescriber approve my vacation override?
CP: Yep.
NERVOUS: Great! When can I come down for it?
CP: When are you leaving?
NERVOUS: Tomorrow. We have an early flight.
CP: And when do you return?
NERVOUS: We come back next Saturday.
CP: Okay. I will have your prescription ready for you next Sunday.
NERVOUS: But my doctor approved it.
CP: And I filled it for you 21 days ago, which was a day early. If you started taking them on the day you picked them up from me (which you should not have done since that fill was one day early) you would have enough medication to last you through next Sunday, the day after you return.
NERVOUS: But they said it's okay.
CP: Unfortunately, they do not get final say. Since I would have to call your insurance and explain the reason for the early refill, I will have to answer these questions and plead your case. Since you will not only NOT run out of medication but will have enough for a day after your return, I cannot defend the early refill.
NERVOUS: But. . .
CP: Have a nice trip. Relax. Take your prn meds as needed and we will see you in a week.
ME: What if they were diabetes or BP meds?
CP: Wouldn't matter.
ME: Why?
MYSELF: Because he had enough to last?
CP: Yes. That and I don't have to report those fills to a PDMP. Also, there are laws regarding early fills on controls that don't exist for other medications.
ME: Perhaps they're planning on losing some.
MYSELF: Let it go.
CP: Wouldn't you rather they lost the last day or 2 of medication than their new supply for the next month? Try explaining that one.
MYSELF: Sadistic little. . .
CP: No. I have a job to do. While people may not, or choose not to understand, or may not like or agree with my responsibilities, it does not change the fact that I still have a professional obligation to meet.
Tuesday, March 5, 2019
Sometimes They Say "No"
CP: No.
Nyet.
Nein.
Nu.
Non.
Nee.
Voch.
ME: What's with the foreign language lesson, CP?
CP: Just curious if people will recognize the sound of "No" in other languages as easily as English.
MYSELF: I feel a post coming.
CP: Have you ever noticed how patients don't seem to understand this word? It's practically the first word we teach our children. It's also one of the first words they mimic back to us when we ask them to do something.
ME: Right. And?
CP: It's a simple, yet effective word. However, people seem to have a difficult time understanding its meaning.
MYSELF: No means No. Right?
CP: Yes.
ME: Okay. I'll bite. What was the impetus for this?
CP: Metrics.
MYSELF: No.
CP: Yes.
ME: Explain.
CP: It started with a recent conversation with my boss. She popped by to discuss our performance on all the metrics we have to meet.
ME: And?
CP: I told her I wasn't trying.
MYSELF: What? How are you still employed?
CP: I wasn't trying to convince people to change their minds.
MYSELF: I bet that went over well.
ME: Like tofu at a steak dinner.
MYSELF: What, exactly, did you tell her?
Boss Lady: You need to sign people up for all of our programs.
CP: I cannot.
BL: Sure you can. I have phaith in you.
CP: I am an awesome pharmacist, but a lousy pitch bitch.
BL: It's all in how you ask.
CP: No it isn't. You know why? Sometimes people say 'NO'. Just like that. They say "no". I can ask politely; I can try to sweet-talk them; I can try to bribe them; I can even berate and belittle them for not saying "yes", but sometimes, people say "no".
BL: It's all in the ask.
CP: That's a corporate slogan. Like thinking outside the box. Jargon.
BL: You have to believe in it to sell it.
CP: Again. I'm not the one who needs convincing. I bet there were a lot of unsuccessful door-to-door vacuum and encyclopedia salesmen over the years who were fed the same lines of BS and felt bad about themselves for failures that were out of their control. I shall not feel bad because people say "no".
BL: Explain why these programs are so good, so helpful for them.
CP: You don't like to hear "no" either, do you? If they tell me "no", I'm going to tell you "no". Simple. No. If I'm not in the market for fresh salmon at the local monger, I'm not going to buy it. I'm looking for scallops tonight.
BL: Huh?
CP: If I am successful on 23% of my opportunities, that means that 23% of the respondents were willing to say "yes" and 77% said "no". I can't change their minds. It's also not my job to sell them. That's why we have marketing departments, print ads, radio ads, etc.
BL: Well you have to meet these numbers on all of our promotions or you won't get a good score.
CP: After all these years together, do you really believe I'm driven by who signs up for our app? Or our courtesy refill reminders? Or our sync program? You're still arguing with me as if you don't believe people ever say "no". Trying to get people to donate to our charity-cause-of-the-month? I always say "no" because I choose my charities on a personal basis. I say "no" to just about everything I am asked at a store: credit card? loyalty card? survey? free candy? And I know plenty of people like that.
BL: Well, you could at least try a little.
CP: I ask. They say "no". End of conversation. Next patient. If you want someone to strong arm them, hire me a cashier with a history in the mob. I'll hit 100% in about a week.
ME: Seriously. Why does your boss even like you?
CP: I'm honest. I hit my sales and Rx goals. I can think for myself. She doesn't have to worry about me and only visits when she wants to pull out some hair.
MYSELF: Next time, you need to sing to her.
CP: I thought about it. . .
"My name is "No"
My sign is "No"
My number is "No"
You need to let it go"
Nyet.
Nein.
Nu.
Non.
Nee.
Voch.
ME: What's with the foreign language lesson, CP?
CP: Just curious if people will recognize the sound of "No" in other languages as easily as English.
MYSELF: I feel a post coming.
CP: Have you ever noticed how patients don't seem to understand this word? It's practically the first word we teach our children. It's also one of the first words they mimic back to us when we ask them to do something.
ME: Right. And?
CP: It's a simple, yet effective word. However, people seem to have a difficult time understanding its meaning.
MYSELF: No means No. Right?
CP: Yes.
ME: Okay. I'll bite. What was the impetus for this?
CP: Metrics.
MYSELF: No.
CP: Yes.
ME: Explain.
CP: It started with a recent conversation with my boss. She popped by to discuss our performance on all the metrics we have to meet.
ME: And?
CP: I told her I wasn't trying.
MYSELF: What? How are you still employed?
CP: I wasn't trying to convince people to change their minds.
MYSELF: I bet that went over well.
ME: Like tofu at a steak dinner.
MYSELF: What, exactly, did you tell her?
Boss Lady: You need to sign people up for all of our programs.
CP: I cannot.
BL: Sure you can. I have phaith in you.
CP: I am an awesome pharmacist, but a lousy pitch bitch.
BL: It's all in how you ask.
CP: No it isn't. You know why? Sometimes people say 'NO'. Just like that. They say "no". I can ask politely; I can try to sweet-talk them; I can try to bribe them; I can even berate and belittle them for not saying "yes", but sometimes, people say "no".
BL: It's all in the ask.
CP: That's a corporate slogan. Like thinking outside the box. Jargon.
BL: You have to believe in it to sell it.
CP: Again. I'm not the one who needs convincing. I bet there were a lot of unsuccessful door-to-door vacuum and encyclopedia salesmen over the years who were fed the same lines of BS and felt bad about themselves for failures that were out of their control. I shall not feel bad because people say "no".
BL: Explain why these programs are so good, so helpful for them.
CP: You don't like to hear "no" either, do you? If they tell me "no", I'm going to tell you "no". Simple. No. If I'm not in the market for fresh salmon at the local monger, I'm not going to buy it. I'm looking for scallops tonight.
BL: Huh?
CP: If I am successful on 23% of my opportunities, that means that 23% of the respondents were willing to say "yes" and 77% said "no". I can't change their minds. It's also not my job to sell them. That's why we have marketing departments, print ads, radio ads, etc.
BL: Well you have to meet these numbers on all of our promotions or you won't get a good score.
CP: After all these years together, do you really believe I'm driven by who signs up for our app? Or our courtesy refill reminders? Or our sync program? You're still arguing with me as if you don't believe people ever say "no". Trying to get people to donate to our charity-cause-of-the-month? I always say "no" because I choose my charities on a personal basis. I say "no" to just about everything I am asked at a store: credit card? loyalty card? survey? free candy? And I know plenty of people like that.
BL: Well, you could at least try a little.
CP: I ask. They say "no". End of conversation. Next patient. If you want someone to strong arm them, hire me a cashier with a history in the mob. I'll hit 100% in about a week.
ME: Seriously. Why does your boss even like you?
CP: I'm honest. I hit my sales and Rx goals. I can think for myself. She doesn't have to worry about me and only visits when she wants to pull out some hair.
MYSELF: Next time, you need to sing to her.
CP: I thought about it. . .
"My name is "No"
My sign is "No"
My number is "No"
You need to let it go"
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