Dear Board Of Pharmacy

I have a question for my BOP.
Perhaps you too will share this question.
CP: Dear BOP, do you have to approve pharmacist license applications?
BOP: Yes.
CP: Do you have to approve companies that do business with the State BOP?
BOP: Yes.
CP: Do you have to certify e-script providers and other vendors that do business with the State BOP?
BOP: Yes.
CP: Okay. Do you suspend licenses of pharmacists in the State?
BOP: Yes.
CP: If a pharmacist was asked to complete something as part of her registration, and told you "NO", could you revoke their license?
BOP: Yes.
CP: If a vendor said "NO", could you do the same thing?
BOP: Nope.
CP: Why not? You know that you have approved over 200 e-rx systems in the State. You know that one of the providers has refused to fix a known issue with their software.

(Here's the background. If an e-rx is sent by a prescriber, it passes from the office system to another processor who passes it on to Emdeon. They in turn pass it to a switch who is responsible for passing it to the pharmacy. IF, at any point it does not make it to Emdeon, whether due to a system outage or a "glitch", the e-rx is routed directly to my fax machine. This comes complete with no signature by the prescriber. My state has mandated that these Rx's are, in fact, not legal. We are required by the State BOP to call on each of these Rx's. They even have a disclaimer at the top that reads "Warning. This is not a valid Rx until called to verify by the pharmacist." What's even better is, we then have to transcribe it as a verbal order instead of an e-rx, thereby circumventing the intent of the e-rx in the first place.)
Still with me? Good. Now, despite repeated conversations between the company and the BOP, the company has refused to take the action that the other two big e-rx players have and that is to change their software to allow signatures to be printed on the faxes. They also contain a disclaimer that essentially reads "this started as an e-rx but due to a system error or glitch, got routed to your fax instead. It is totally valid so feel free to dispense it. Approved per State BOP", or something to the effect.
BOP: What's your question again?
CP: Why can't you just revoke their approval? Like you would a license?
BOP: Because.
CP: Oh. Okay. What do you suggest?
BOP: Call the offices that use this software and speak to their office managers. Explain the situation and why you have to call all the time, even though they get frustrated with you, and have them complain to their software vendor. Maybe, once enough offices complain about all the phone calls, the company will relent.
CP: Or you could just give them 90 days to be in compliance or threaten them with the loss of their license.
BOP: The Board of Medicine wouldn't go for that. Too many doctors would complain.
CP: Gotcha. So you approved a system that basically tells all the pharmacists to piss off, makes more work for us, then you tell us it is OUR responsibility to call on something you could fix, because you, the Board of Phrickin Pharmacy, are afraid of what a group of prescribers will do?
BOP: Yes. Pharmacists have no backbone and won't stand up to us. We only approve the systems.
CP: I got nothing. I need to relocate.

O Seltamivir (O Tannenbaum)

Pronounced: O SELT um a VEER

O Seltamivir, O Seltamivir
My how you help my symptoms
O Seltamivir, O Seltamivir
My how you help my symptoms
Your price is high but that's okay
You really don't work anyway
O Seltamivir, O Selatamivir
Nah you don't help my symptoms

O Seltamivir, O Seltamivir

Why are you never in stock

O Seltamivir, O Seltamivir

Why are you never in stock

The same time each and every year

The flu like clock-work reappears

O Seltamivir, O Seltamivir

Why are you never in stock

O Seltamivir, O Seltamivir

It's time to be backordered

O Seltamivir, O Seltamivir

It's time to be backordered

Xofluza's new, competes with you

Though it's not cheap, one dose will do

O Seltamivir, O Seltamivir

It's time to be backordered

O Seltamivir, O Seltamivir

You let us know, flu is near

O Seltamivir, O Seltamivir

You let us know, flu is near

So many scripts, we do receive

Yet out of stock, we can't believe

O Seltamivir, O Seltamivir

You're such a disappointment.

Words

CPP: Why are you laughing so hard? 

CP: Words. 

CPP: The building blocks of communication?

CP: How the wrong word at the right moment is hysterical.

CPP: Puns and double-entendres, and innuendo, oh my?

CP: Precisely. Some words cannot be interchanged in all situations. 

CPP: Like all squares are rectangles, but not all rectangles are squares?

CP: Yes. And how, sometimes, NOT saying anything to acknowledge the error allows the situation to build. Allow me to revisit my recent conversation. 

 

CP: Happy Friday! How may I help you?

Nurse On Phone Explaining: I was calling to check if you received an e-script we sent for our patient. 

CP: I know she called earlier and we had not received it. 

NOPE: Well it looks like the provider sent it, but it got rejected. 

CP: Bummer. I guess that explains it. Do you wish to resend?

NOPE: She left the office already. 

CP: Oh. 

NOPE: Can I give it to you orally?

CP: <crickets>

NOPE: <crickets>

CP: uhm

NOPE: VERBALLY! VERBALLY! Can I give it to you VERBALLY?

CP: That's probably a better idea. A lot easier, faster, and with fewer permissions required. 

NOPE: <laughs maniacally> Now I'm embarrassed.

CP: Happy Friday!

NOPE: Thanks. You too.

CPP: Orally: "by means of or through the mouth"

         Verbally: "by means of words; spoken"

CP: Some words when spoken, can't be taken back. 

New Advice/Reply

CP: From now on, whenever someone doesn't like my answer, I have a new reply. Try it with me. 

CPP: Can I drink with this? 

CP: No. 

CPP: That's not new. 

CP: Keep going. 

CPP: Can you just give me some for a few days?

CP: No. 

CPP: I don't like your answers. You don't want to help me. 

CP: My answer will not change. You don't have to like it, you do have to accept it.

CPP: Very nice. It reminds me of those televised trial circuses of government employees or mafia members. "I do not recall" and "My attorney has instructed me I don't have to answer that". 

CP: Or Shaggy: "It wasn't me". 

CPP: Good one. The questions may change but the answer does not. 

CP: You don't have to like it, but you do have to accept it. 

CPP: The sooner you accept it, the sooner we can move on. 

Aesop

CP: Welcome. 

Demands A Miracle Now: I need the Heavy Duty Flu Shot. 

CP: I can use an 18g needle to administer it but that's as heavy duty as we get here. 

DAMN: No. I need the high dose flu shot. 

CP: Oh. In that case, we are out of stock. 

DAMN: When will you get more?

CP: I have no idea. 

DAMN: You suck. 

CP: Well, it is the middle third of November; the month after the unofficial month for flu shots. 

DAMN: This is ridiculous!

CP: Did you learn a lesson today?

DAMN: Yeah. Not to get my shot here. 

CP: Wrong lesson. How about "Premature Inoculation"?

DAMN: What? I don't have that. 

CP: No. Premature Inoculation; getting your shot earlier in the season, say September, when most pharmacies still have the shot in stock.

DAMN: I don't want it too early. It needs to last all year. 

CP: Any time during peak shot months (September or October) is perfect; though I would encourage late September. And that's like knowing your grandkids want the new, hottest toy-of-the-year and waiting until Christmas Eve to buy it. Tis the season. Or using a condom after you're pregnant. Or turning on your turn signal halfway into the turn.

DAMN: I'm never getting my shot here again!

CP: If you didn't actually get one today, is that really a threat? I wonder how many places you visited who gave you the same answer. 

DAMN: This is my 4th pharmacy today that doesn't have it!

CP: Here endeth the lesson.*

*If you choose to wait, it may be too late.

Empty Returns

How do you return something to stock if you don't physically have the product? I had a tech who, when she couldn't find the prescription to return, would just delete it. Worse, she would cancel a prescription without pulling it from the will call bin. I have seen this happen at every pharmacy where I have worked.
Occasionally the misfiled bag will be discovered hiding in another bin weeks or months later but ofttimes it has been sold.
I'm going to try that at Best Buy and Target.
CP: I am here to return my purchase.
Blue Shirt: Okay. Was there a problem?
CP: This 70" TV I purchased was too small. It didn't fill the space.
BS: Okay. Um, where is the TV?
CP: Right here <sweeps arm around>
BS: I don't see a TV.
CP: It's okay. You can just return it and give me back my money.
BS: Do you have the receipt?
CP: No. Can't you just look it up?
BS: Do you have your rewards card?
CP: No.
BS: Oh. Okay then. Here's $800.00 cash. Have a good day.

Essentially, that IS what we are doing.

Sometimes, The Truth Hurts (If The Real World Worked. . . )

Uber-Tech: Why don't people want us to do our jobs? 

CP: Oh, they want us to do our jobs. They just expect us to do them while altering the laws of time and physics. 

UT: I'll rephrase. Why don't people want to give us the necessary time to perform our jobs? 

CP: Your example, please? 

 

One Needing Expedient Rush Of Usual Service: I just left the office. How long?

UT: Okay. They just sent it. That'll be about 20 minutes. 

ONEROUS: What? Really?

UT: Yes. Really, really. 

ONEROUS: I waited there for hours and now I have to wait here?

UT: You waited as long as was necessary for them to do their job, correct?

ONEROUS: Yes.

UT: Well, I am sure they appreciated that. Your prescriber and office had time and did their job. Now I need time to do mine. 

CP: Nice example. 

UT: Thanks. I get it from working with you. 

CP: I can imagine this another way as well. In a checkout line at a local retailer, you see lots of people in front of you. Pharmacy patients would be expecting to just walk to the front and check out. 

UT: The difference is, in this scenario, those in the standing queue can see the "work" waiting in front of them. 

CP: Whereas in the pharmacy, they can't see the queue in our computer. Nice. 

UT: I got that from our Disney discussions. 

CP: Speaking of, have you read about how they innovated the switchback queue and different staging areas to distract crowds from the boredom of standing in line?

UT: I think we need those in the pharmacy. We could start them outside. 

CP: As long as we get the time to do our jobs. I'm going to have to use that next time. "Your office was allowed time to do their jobs, now allow me the time necessary to do mine."

#IfTheRealWorldWorkedTheWayPharmacyDoes

#TheTruthHurts

Least Busy

CP: Ah, fall. The end of flu shot season Part I, and a pause in the number of times we are asked "when are you least busy"?

Uber-Tech: Now what? 

CP: The mad rush through the holidays and end of the year. . . and a surge in "are you going to be busy when I get there" questions. 

UT: Right. How are we going to know? 

CP: I've been answering "we are least busy when we are closed" and thought I'd pay homage to a great book.

UT: Which likely means you have something prepared for us today. 

CP: Halloween is not the only time for playacting. Let us begin. 

CP: From now on, I don't want anyone to come in and see me or call or me while I'm in the pharmacy. Is that clear?

UT: Yes, CP. What do I say to people who want to come in and see you or call for you while you're in the pharmacy?

CP: Tell them I'm in and ask them to wait. 

UT: For how long?

CP: Until I've left. 

UT: And then what do I do with them?

CP: I don't care.  

<patient approaches>

Pt: Is CP in?

UT: Yes. 

Pt: About how long will I have to wait before I get to see CP?

UT: Just until we close. Then you can go right in. 

Pt: But CP won't be here then, right?

UT: No, ma'am. CP won't be back in the pharmacy until we reopen tomorrow. 

Pt: Okay. Will I be able to see CP in the morning when you open?

UT: CP never sees anyone in the pharmacy while CP is in the pharmacy. 

Pt: What did you just say? 

UT: I said that CP never sees anyone in the pharmacy while CP is in the pharmacy. 

Pt: Are you trying to make a fool of me? 

UT: No, ma'am. Those are my orders. You can ask when you see CP. 

Pt: That's what I'm trying to do! When can I see CP!?

UT: Never. 

<patient leaves>

UT: That's quite some catch, that Catch-22. 

CP: The best there is

 

#PharmacyPhun

#Catch22

#MajorMajor