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Tuesday, April 28, 2020

If The Real World Worked. . .

UT: I've realised during all of this COVID chaos that people's perceptions of pharmacy haven't changed.
CP: As have I. Their approach to a New World and its expectations has altered but they continue to treat pharmacy as they always have.
UT and CP: Poorly.
UT: Like a necessary evil with which they have to deal instead of the valuable service we provide.
CP: You're talking about the people from last week.
UT: Right. For some reason patients continue to have different expectations of us than they do of the rest of the world and it's rather consistent with multiple occurrences.
CP: Let's revisit.

<flashback scene>

CP: How may I help you?
Dude Asking For Things: I am here to pick up my prescriptions.
CP: I am sorry sir, but we have nothing for you.
DAFT: My doctor was supposed to call 2 hours ago when I spoke with him on a televisit.
CP: Apparently he did not as I have nothing in my pharmacy for you.
DAFT: Are you sure?
CP: <raises hands>
DAFT: What are you doing?
CP: The old Sure commercials. You know the jingle? "Raise your hands if you're Sure!"
DAFT: Can you call him?
CP: No.
DAFT: Why not?
CP: He's not my doctor. It's after 7pm and he's likely closed.
DAFT: But I need it.
CP: I guess he didn't think it was that important or he would have called. Maybe try his after hours number or his e-chart.

UT: Which would be like this scenario playing out in today's world:

<dream sequence>

UT: Hi! I'm here to pick up my curbside grocery order.
Grocery Store Worker: We have no order ready for you.
UT: My wife was supposed to call it in 3 hours ago.
GSW: Again, we have nothing here.
UT: Can you call her for it?
GSW: No.
UT: Why not?
GSW: She's your wife. That would be weird.
UT: It was worth a shot.
GSW: It really wasn't.
UT: It apparently works at my pharmacy.


Friday, April 24, 2020

In Case We Forgot

CP: Remember how before all this started we weren't respected?
CPP: Yes.
CP: And now we're respected less, to the point of invisibility?
CPP: Yes.
CP: I miss the good old days when it was just disrespect by prescribers and their offices.
CPP: What brought about this nostalgic stroll?
CP: I had to call an office and their phone prompt reminded me of our nonessential status with them.
CPP: Their phone tree had no option for "Pharmacist"?
CP: That and. . .

<phones office, presses "doctor line"
Office Of Pure Stupidity: Doctor's Line? Whassup?
CP: I have an important question about an urgent e-script one of your prescribers just submitted. Based on the medication and indication, it appears the patient needs it soon and I, unfortunately, do not carry this. Can I speak with the prescriber about options?
OOPS: This is the doctor line for urgent calls. Hold please.

*Thank you for calling OOPS refill line. Please call your pharmacy and have them send an electronic refill request. Leave your information for your refill. *BEEP*

CP: Hi. This is CP. I am Head Pill Pauper at Palace of Pills. I was calling because a new medication you prescribed is not available in my store, or locally. I have another strength we can substitute for the short-term until my order arrives if the patient really needs this tonight.

<4 hours later>

CP: Pill Paupers Paradise. How may I help you?
Prescriber at OOPS: I was calling about a prescription I sent earlier.
CP: Would this be the Rx for Ana L. Fischer?
POOPS: It would. I had a question about it.
CP: Would this be an answer to the voicemail I left?
POOPS: What voicemail?
CP: The one I was forced to leave this morning. The one I left immediately after receiving the prescription, typing it myself, calling around to other stores to see if anyone had it? The one I left explaining all of this after calling your prescriber line but the receptionist deemed my sense of urgency only required being turfed to the refill line?
POOPS: I never got your voicemail. I never knew you called.
CP: So now I need to revisit the entire conversation with you. Even though I left all this information and we could have resolved this earlier, my call wasn't deemed important enough to not only be pushed through, but to generate a memo that I called. Sweet. So why were you calling?
POOPS: I wanted to see if you had the Rx in stock.
CP: No.
POOPS: Do you know who may?
CP: No one.
POOPS: Can you order it?
CP: Had you taken my call this morning, I could have had it tomorrow. Now I can't get it in my store for 2 more days.
POOPS: Well we can call the patient. I think she can wait.
CP: Nice. I have some of a lower strength if you want to hold her over for a couple days.
POOPS: I'll call you back.

<2 hours later>
POOPS: She says she can wait a couple days. Go ahead and order it.
CP: Ok. I'd hate to be in her condition right now, but I will order it. Please add me to your list of local pharmacies that has this in stock since I am the only name on the list right now.
POOPS: Will do. Thanks for your help.
CP: It's what I do.

Thursday, April 23, 2020

Miracles!

CP's Partner: What are you ruminating about this fine morning?
CP: Miracle workers.
CPP: Anne Sullivan?
CP: More along the lines of the JCCP.
CPP: The JCCP?
CP: Yes. The Junior Christ Club of Pharmacy.
CPP: Oh. Explain.
CP: The JCCP is that group of miracle workers who have been turning 30 days supplies into 90 days, or greater, supplies, since at least Babylonian times.
CPP: You do know Ancient Babylon predates Jesus by. . .
CP: Shhh. You get the point. They changed names over the centuries.
CPP: What spurred this today?
CP: With the quarantine, people apparently had a lot of time on their hands and were digging deep into their medicine cabinets looking for medications to refill. Either that or they only now discovered that something they take every day was finally empty. That, and this conversation:

Man On Phone Yelling: I need this refill for my wife.
CP: She is out of refills.
MOPY: (shouting to Lady In Another Room) You're out of refills.
LIAR: (shouting back to MOPY) I can't be. I take it every day.
CP: We last filled it in September. . . of 2019 for a 30 days supply. She should have been out last October.
MOPY: (shouting) You filled it last September. You should have been out 6 months ago.
LIAR: (Shouting) I just took my last one!
MOPY: She says she just took her last one.
CP: I didn't realise she was a member of the JCCP. Unless she changed her dose to once week, that is the only way she could have made 30 tablets last 210 days, or 30 weeks, and to have taken the final dose yesterday.
MOPY: It says on here "March 17th, 2020".
CP: Right. That's when the refills expire. Check the fill date next to the Rx# on the right side.
MOPY: (mumbles) "9/19/19". (shouting) How the hell have you been taking these?!
LIAR: (shouting) Every Day!
CP: I faxed the prescriber for you. If she can't complete another miracle and turn the empty bottle into a full bottle, I suggest you also ring the refill line and request a renewal.
MOPY: Okay.
CP: I'd also suggest you retract her application for Sainthood.

CPP: I think the manufacturers should hire from within the JCCP. Imagine what they could do for our patients during all these manufacturer backorders.
CP: We never would have run out of Albuterol MDI or ARBs, or anything ever again!

#ThoughtsAndPrayers
#ThePowerOfChristCompelsYou

Wednesday, April 1, 2020

Zombie Apocalypse - COVID-19 Version

CP: I was going through the archives recently and guess what I found?
ME: Your dignity?
MICE ELF: A soul?
CP: Haha. Phunny. No. I found my Zombie Apocalypse post from 2013.
ME: Refresh our memory.
CP: "Pharmacy would be the worst place to be during the initial outbreak of a Zombie Apocalypse. Think about this...

Where is the first place people will go for advice for their initial symptoms?
Where else do people herd around each other in tight-knit groups to ensure complete lack of privacy?
Ever see Contagion? Rise of the Planet of the Apes? See how that spreads?

In World War Z, people were fighting over bottled water and canned goods. The pharmacist was dispensing...with a gun. No one was asking him for the 512's.

Since I do have the keys however, I could imagine being camped out in there for some time. Coping with it would be so much easier. I'm just not sure I want to be at work when it all starts. While we are quite savvy and resourceful, there is not much of a defense to be mounted with vials and counting trays. I'm not sure my sharpened spatula qualifies as a Katana."

MICE ELF: Wow. And that was 7 years ago?
CP: It was.
ME: Except it was hand sanitizer and toilet paper.
MICE ELF: Why did you dig this one out of the vault?
CP: My prediction was accurate. We were the first group of people to be visited. Everyone came to us for thermometers, TP, sanitizer, alcohol, aloe, masks, and gloves. They complained about a cough while getting in our faces. They touched everything in our stores. They bellied up to the 36" deep counter and leaned over it asking questions.
ME: And despite orders to the contrary, they continue to visit us in the same numbers.
CP: As I said then, "people herd around each other in tight-knit groups to ensure a complete lack of privacy". It took mandates of social-distancing (which should be termed "physical-distancing") to force people to provide space.
MICE ELF: Well, that and tape on the floors.
ME: What's your wish with this (re)post?
CP: That physical barriers will be erected to "close the pharmacy".
- That all negative customer service scores be immediately thrown out as it regards a pharmacist's bonus percentage.
- That, if corporations are going to continue to force us to work during this crisis, we should be protected and receiving their fullest support.
- That companies exploit their business as a critical, front-line healthcare job by promoting us as the critical service providers we are. (Instead of making the news for NOT providing basic protections for their employees.)
ME: It would be nice if the media opinion of the major pharmacies in this country was "US Pharmacists and Techs on the front-lines helping people get their medications as companies offer full support of curbside pickup, delivery and personal shopping amid concern for their employees' and patients' health and safety."
MICE ELF: How'd you type that without laughing.
CP: It doesn't hurt to dream.
ME: What's your next prediction?
CP: Barriers will be erected and my dream of "closing the pharmacy" will be nearly realised. (Except I know they won't completely cover the 40 linear feet of open airspace.)
ME: Yeah. It'll be the size of a police officer's riot shield.
CP: Like sticking a butterfly bandage on a severed limb.
MICE ELF: Buuuuuut?
CP: But we will have to take bets on how long after this crisis is over before these companies remove the barriers and put us back at risk.
ME: Instead of being prepared for the next outbreak or continuing to care about their employees' safety and welfare?
CP: "Despite all my rage. . . "

Wednesday, March 25, 2020

Satisfaction

I can't get no ther-mo-mete-rs
I can't get no ther-mo-mete-rs
You can try you can cry you can try you can cry
I can't get no, I can't get no

When I first get in to work
And a patient stops and follows me
He's askin' if I got more
Another case or six or seven
Like he's the only one to question

I ain't got no
No face masks no
Hey hey hey
That's what I say

I ain't got no ther-mo-mete-rs
I ain't got no ther-mo-mete-rs
You can try you can cry you can try you can cry
I ain't got no, still can't get no

My tech's trying to fill your scripts
And your girl comes up and asks her
Where is sanitizer
And I have to explain for the hundredth time
They used to be over there

We can't get no sanitizer
No face masks no
hey hey hey
That's what we say

We can't get no ther-mo-mete-rs
We ain't got no sanitizers
You can try you can cry you can try you can cry
We can't get no, We ain't got no

You keep driving in search of
What everyone else is looking for too
Yet you're askin' like I'll pull some
Outta my ass or from hiding somewhere in the back
Can't you see everyone is out too

I ain't got no
No face masks no
Hey hey hey
That's what I say

I ain't got no, I can't no
I can't get no ther-mo-mete-rs
No ther-mo-mete-rs, no sanitizer
No toilet paper, I can't get no.

Monday, March 23, 2020

Close The Pharmacy - Updated

You did not misread that. You misinterpreted it. Pharmacies used to be hidden. Pharmacists were accessible if they walked out to you. Which we often did. And we were more valued as a result. You could no more stare at us over the tops of the shelves than you could hear us whispering on the phone in a corner. Times have changed. While the whole open floor plan concept works great in building a house, it does not suit the pharmacy. I say close it.
We are truly a few metal bars and a coin-operated food dispenser away from being animals in a zoo. People stare at us. They yell at us from anywhere in the store. They throw stuff at us. They put their kids on our counters. I swear someone took my picture at my last store too. Seriously. What other profession allows its professionals to be treated as such?
I say close it. If the "centralized pharmacist" concept is going to work, make the rest of it happen behind the scenes. This way, when I have 3 techs each on a phone line and I am checking something, no one can smart off saying "there's 4 people back there not helping me". Piss off. Now you see me, now you don't.
I want the pharmacist to be the focal point. I want to perform my professional duties. You just don't need to know what else goes on. "Pay no attention to the man behind the curtain." I don't really want or need to see how my food is prepared in the kitchen (Hibachi is exempted from this) nor how my friends' colonoscopies are performed. I don't care. All I want is for my profession to be taken seriously again.
Close the pharmacy. Put up a wall. Slow down the whole process. Focus on the professional aspect of our jobs. Focus on our knowledge. Focus on why we spent so much time and money at school. If we stop trying to squeeze blood from a desiccated idea (profit margin on pills?) then we can look at new ways of highlighting our place in the health care world and getting paid for it.
Doctors live an insular experience, hiding behind layers of staff and walls. They visit with patients, one-on-one, privately going over medical history, diagnoses, and treatments. Pharmacy needs to examine this concept. I have an outline for this model.

ME: Feels as if this needs updated today.
MYSELF: Agreed.
CP: Has anyone attempted to close their pharmacy during this crisis?
ME: Yes. People have sent me pictures of their pharmacies with gates mostly closed, plastic sheeting on the backs of the gates or directly hanging in front of the counter. Some have cut out slots at the bottom through which they transfer the prescriptions.
MYSELF: I had someone send me a note that their staff brought masks from home and were told that they weren't necessary and they are for essential healthcare workers and pharmacy staff were not essential.
CP: Ouch. We have always been, and now it's more apparent that we are, considered the bastard stepchildren of healthcare.
ME: I'd say the Rodney Dangerfield of healthcare.
MYSELF: No respect.
CP: I wonder if doctors are getting yelled at as much as we are. We need to Close The Pharmacy and focus on staying healthy ourselves so we can continue to serve our patients with the least amount of direct contact possible.
ME: Imagine if people had listened to you 7 years ago when you first wrote this. We need isolation so we can focus on the important tasks without constant interruptions and distractions from patients yelling at us, multiple phone lines ringing, and just doing our jobs.
MYSELF: We would be better able now to close it had we taken these steps and removed the 40 linear feet of counter space open to the public.
CP: But at least we have a steel door with a window that'll keep out the robbers and the COVID.
ME: Yeah. I wonder whatever happened to our last boss who complained when we left the door ajar to help patients find items.
MYSELF: She's locked in an ivory tower now. Safer than we are.
CP: In case I wasn't clear enough earlier. Close. The. Damn. Pharmacy! Imagine the scientists working with this and other highly contagious diseases operating in a lab in the middle of a store with no PPE and only a rope line to keep them out of your airspace. They have precautions in place for a reason. We have that problem right now. Instead of worrying about patients' views/perceptions of us operating in a closed environment, let's make employee safety priority number one!
ME: Well said.
MYSELF: No one is listening.
CP: I know. But I feel better.

Friday, March 20, 2020

Pay Attention

UT: Why do we have to over explain everything to everybody?
CP: Better question; why do we have to explain it in the first place?
UT: People don't watch the news?
CP: Judging by the number and frequency of complaints we have received over the last week or so, people are pandiculating after a long wintry hibernation from all news and world events.
UT: There is a reason we have to put "unwrap and insert" on suppository labels.
CP: And "chew then swallow" on chewable medications. What advice are we dispensing today?
UT: In no particular order:
7. If you are being told not to touch ANYTHING, for the love of all that is Holy, PLEASE STOP bringing bottles in to the pharmacy for refills. Call me. Give me your name and medication. Hell, I'd even settle for "that little white one" at this point. But Stop Bringing In Bottles!
2. If you find it necessary to wear a mask in public (I will give you the benefit of the doubt you need it), then use my drive thru. Don't walk in my store. Businesses are closing and becoming drive-thru only. But a mask? Stay in the car.
4. IF you find it necessary to wear a mask (and I know you don't need one), WASH YOUR DAMN HANDS when you leave the bathroom. #TwatWallet
1. Take advantage of the services your pharmacy provides. Use the phone app. Use the refill line. If the pharmacy calls and asks if you want something refilled, tell them yes! If you get a text, call to verify the medication that is due, THEN come to get it. Save an unnecessary trip to the pharmacy. If they offer delivery, stay home.
5. You're going to have to sign for your prescription. Bring your own pen. Use your finger. If available, use the app so you can sign on your phone. Just stop phreaking out that we are asking you to do something you have always had to do.
3. Cover your mouth with your arm/sleeve. No brainer? Yes. Needs repeated? Ad nauseum.
6. When we walk out to help you find a product, stay away from us. It's great that you're a "close-talker" but now is not the time. #SocialDistancing applies here too.
8. Do not be that creeper who likes to touch my fingers as I hand you your prescription/OTC product. There's a reason I hand it to you the way I do.
CP: Wow. Great list. You'd like to think our phaith in humanity would be rewarded during times like these but it's rather diminished instead of late.
UT: Are you still tracking how many questions we receive each day?
CP: Of course. I need a distraction from all the extra inanity:
Do you have thermometers?
Do you have alcohol?
Do you have hand sanitizer?
Toilet paper?
Milk?
UT: Remember, you are unique, just like everyone else. And you are not any more special than anyone else. Have patience. Take a breath. Relax. The calmer everyone behaves, the smoother the lines will go and the sooner we will get through this together.
CP: Right. Acting like an ass only causes others to behave the same way.
UT: "Nothing attracts a crowd like a crowd."
CP: I really need to write that post.
UT: Play nice. Soon enough we in healthcare will be the only ones working face-to-face which puts our lives and the lives of our families at risk.
CP: I said it once before but it bears repeating, wash your hands! and the list. Reread the list.
UT: What does COVID-19 say?
CP: You can't stop me, you can only hope to contain me!

UT: You realise we rambled quite a bit on this post, right?
CP: I know. It's been a long stretch at work. My brain hasn't fully recovered. It's still mush from the last 6 days of chaos.
UT: Fortunately we have each other, and this page, for some commiseration and relief.
CP: Yes. We are all mad here.
UT: We really like to mix our quotes/phrases/lyrics on here, don't we?
CP: Out of chaos comes order.
UT: Please stop.

Friday, March 6, 2020

I Want. . .

CP: Thanks for calling CP's Playhouse. How may I go insane today?
Wants It Now, Early Refill: I am calling to ask how many prescriptions I have ready today.
CP: It appears I have one medication ready for pickup today.
WINER: Is there another one?
CP: If you ask how many, and I reply "one", what makes you think there would be another one ready? Like a mystery box under my counter is filled with prizes and if you know the secret and to ask me to check my special box o' Rx, you get the script of the day?
WINER: Well my other one is due next week.
CP: Oh. In that case, I have exactly one prescription waiting for you. Today. Call back next week and, depending on the day, I may have two.
WINER: Can you fill it so I don't have to come back and make another trip?
CP: Sure. Next week.
WINER: But I want to get them both together.
CP: It is 4 days too soon for me to fill it.
WINER: Can't you just fill it anyway?
CP: No.
WINER: But I only want to make one trip.
CP: Sometimes, perspective is narrow. If you choose to look at life in black and white, you miss all the colours around you.
WINER: What are you on about?
CP: Instead of thinking in terms of "I want both ready today so I may make one trip", you need to change your perception.
WINER: To what?
CP: If I wait until next week when my other prescription is due, I can save myself a trip by not going to the pharmacy today. You could wait and still accomplish your goal.
WINER: That makes no sense.
CP: Change your perception, change your reality.
WINER: I just don't want to have to make 2 trips.
CP: Do you have enough of the first medication to last you 4 days?
WINER: Yes.
CP: Just because we call to tell you an order is ready for pickup does not mean you have to get it today. Just like when you are at my pharmacy counter or drive thru and your phone rings does NOT mean you have to answer it right now. Silence it. Let it go to voicemail. The message will still be there when our transaction is completed in 42 seconds. Your prescription will still be here in 4 days when your other one is due.
WINER: If you say so.
CP: I do say so. That's me. Dispensing wisdom and prescriptions for a healthy mind and body.
WINER: So 4 days?
CP: <sighs> Yes. See you then.

Uber-Tech: If there are multiple ways to view something, perspective as you say, why are people so mired in their original beliefs?
CP: Close-mindedness. From something as simple as this transaction and looking at it a different way to a world view, people tend to believe theirs is the right way. It's why Americans have a such a negative stigma associated with us when we travel abroad.