Seeing Is Not Believing

<patient approacheth drop off window>

CP: Greetings. Are you dropping off today? 

Another Customer Exhibiting One's Failure Bout Appreciating Simple Signs: No. Picking up. 

CP: <looks up> Clearly. I shall help you down there. <points to pickup>

ACE OF BASS: Yeah. I saw the sign. 

CP: <looks up at Drop Off sign under which patient now stands> Did you though? Did it open up your eyes? When you saw the sign?

ACE OF BASS: Yes. I saw it. 

CP: But did you comprehend it? Life is demanding without understanding. 

ACE OF BASS: I saw the sign.

CP: No one's gonna drag you up to get into the light where you belong, but where do you belong?

ACE OF BASS: At pickup?

CP: Precisely. 

 

UT: How do you know so many song lyrics? 

CP: It's a gift. 

UT: Seriously though. Everything I say or patients say at work somehow leads you to a song lyric right off the top of your head. 

CP: I think in movie quotes and song lyrics. 

UT: No one is going to believe you had this conversation with someone and knew these lyrics. 

CP: That's why you're here; my witness. 

UT: Now witness the firepower of this fully armed and operational battle station.

CP: Nice.

Not Your Messenger

CP: Thank you phor calling CP's Cellar of Physic. How may I assist thee?

Female Rapidly Using My Patience: Did my prescriber call in my refill yet?

CP: We are indeed in receipt of your medication. 120 tablets for 30 days. 

FRUMP: It's supposed to be 240 tablets. I take 2 tablets at a time. 

CP: They sent us 120 at 1 tablet per dose. Perhaps you should call them. 

FRUMP: I always take 2 tablets. I've been taking 2 tablets forever. 

CP: Apparently, your streak comes to an end today. If you're expecting something different, you should call. Maybe she is weaning you off the medication? Or making a change?

FRUMP: No. She didn't say anything to me. You need to get the correct prescription. 

Uber-Tech: Thoughts?

CP: Bets?

UT: Prescriber changed it?

CP: That's my guess. Let's call. 

Nurse On Phone Exasperated: Dr. Zoffis, How may I help you?

CP: CP phrom Cellar of Physic calling to verify an e-script I received phor a patient. 

NOPE: Sure. 

CP: It came across as "1 qid" but the patient states she was expecting it to be "2 qid" as she previously received. Did the prescriber change her dosing?

NOPE: Let me check <mumbles the notes as she reads> Yes. 

CP: Ok. That's what we thought. Can you call her and explain that to her? She's called thrice this morning and yelled at us that we aren't filling it correctly and somehow, we can't read it correctly or interpret it correctly and one should be two. 

UT: When two become one?

CP: "Come a little bit closer, baby, Get it on, get it on 'Cause tonight is the night when two become one."

NOPE: Huh. 

CP: Nothing. Can you call?

NOPE: Nope. She was notified 30 days ago at her appointment. 

CP: Well apparently it didn't sink in. Can you call her again so she stops harassing us?

NOPE: Phine. 

UT: Think it'll sink in this time?

CP: Nope. She won't be happy that two became one. 

UT: She'll probably still take two anyway.

This Is The Reason. . .

 . . . You Can't Just Write What You Want And The Pharmacist Won't Just Fill It

CP: How often have we said "If you're a prescriber and you don't know how to prescribe a medication, perhaps you shouldn't be prescribing it"?

CPP: in aeternum. I don't mind if they call for some help, but I also don't want to prescribe the medication for them.

CP: Yeah, we should get a consulting fee on some of these. I do appreciate them leveraging us but choosing the medication and telling them how to write it is a bit much. 

CPP: Especially when they send it to another pharmacy. Or completely ignore our advice.

CP: Exactly. 

CPP: What spurred this topic today?

CP: A recent conversation with a prescriber and his nurse.

CP: Hello, Nurse!

Nurse Obviously Clueless Like U Expect: Hey, CP. Did you receive the e-script we sent?

CP: I did. Except there's a problem; the Oxycontin isn't available as 50mg. 

NO CLUE: It's not? Doctor wasn't sure. He stepped the patient up from 20mg to 40mg and wanted to go to 50mg now. 

CP: The next increase is 60mg. 

NO CLUE: Well he wants 50mg.

CP: The only way to achieve that would be to prescribe 40mg plus 10mg (or 20mg plus 30mg) but I'd advise against it. It will be quite difficult to get both strengths approved. Especially with how quickly he moved the patient from 20mg to 40mg, I'd go with 60mg. I have 10, 20, 30, 40, 60 in stock. 

NO CLUE:  How about 25mg? 

CP: No. The only ones they make I am missing are 15mg and 80mg.

NO CLUE: So there's no other way to get 50mg?

CP: I'm still recommending against it based on the patient's history but no, there is not.  

NO CLUE: Okay. I'll check with him. 

 

<1 hour later>

CP: So I see we received Rx's for 10mg and 40mg Oxycontin.

NO CLUE: That's what he wanted.

CP: Ok. Did you start the prior auth?

NO CLUE: Yes. 

 

<3 days later>

CP: So I see we received a new prescription for 60mg Oxycontin. 

NO CLUE:  Yeah. The 50mg just wasn't enough and it was confusing for the patient to remember to take one of each twice a day. 

CP: You don't say. Did you start the prior auth yet?

NO CLUE: This needs one too? I thought you said it wouldn't?

CP: If you had prescribed that first, it wouldn't have. Now that the patient has all kinds of tablets hanging around, the insurance needs an explanation. 

 

CPP: I like being asked how to make my job easier, then being ignored, then being provided the exact opposite then being forced to explain how to fix the problem I tried talking them out of making which makes more work for me because I have time to fix mistakes I preemptively fixed in the first place. 

CP: You can give a man an education but you can't make him take it. 

It Seems So Obvious, But. . .

ME: Hey CP, what's our topic today?

CP: Same topic we have every night, Pinky. Stupidity. 

MICE ELF: Egad Brain! Sounds incredible.

ME: Okay. But what specifically? What differentiates today's stupid? What sets is apart?

CP: Drug ads on TV and how, if you ask "how stupid can people be" long enough, eventually someone will fall forward and declare himself your champion. 

MICE ELF: What about the drug ads troubles you?

CP: Besides the fact they exist? I specifically phind phault with the legally required line "do not take this medication if you are allergic to this medication". 

ME: Sounds okay to me. 

MICE ELF: Yeah. Makes sense. 

CP: Except it's a brand new medication; being advertised as a new drug. How can you know if you're allergic if you've never taken it before?

ME: That'd be like saying you're allergic to foods or detergents or people and having never been introduced to them. 

MICE ELF: Exactly. You can't know you're allergic to bees until after you get stung. 

CP: It's just really stupid to watch these commercials in the first place then to be subjected to "don't take if allergic to it" makes it more insulting. It makes me wonder who out there is really thinking "I want to take this. I'm not sure if I'm allergic. How do I know? I know! I'll call my pharmacist and ask her if I'm allergic. She should have all my allergies on file. I bet this new drug that is like nothing else will be on my list and if it's not, I can yell at her for not knowing. I haven't yelled at anyone at the pharmacy today. I've just been watching Olympics all day while she is slapping labels on stuff. She'll be happy to hear from me 5 minutes before close."

ME: Yo. Bring it back. 

MICE ELF: How does this connect to a real world situation?

ME: Yeah. You were saying?

CP: Right. Besides that, I had this conversation last week.

CP: Make sure you do not take this medication with any Ibuprofen.

I Doubt It's Obviously That: Oh. I can't take Ibuprofen anyway.

CP: Why not?

IDIOT: I'm allergic.

CP: Oh? What happens?

IDIOT: I don't know. 

CP: What? Why?

IDIOT: I never took them.

CP: Then how are you allergic?

IDIOT: I don't know. 

ME: And now he's going to be allergic to all the drugs on TV. 

MICE ELF: Probably not all of them. He'll just randomly select a few.

CP: But he'll give one list to his prescribers and a different list to us.

I Don't Wanna Hold Your Hand II

CPP: I enjoyed yesterday's post. 

CP: It's amazing how much hand holding we have to do today. 

CPP: I have one phor you. 

CP: Let's have it. 

CPP: You know how we know people who don't understand checking accounts?

CP: Like the one woman who believed, as long as she had checks in the checkbook, she could keep writing checks, regardless of if there actually was money in the account?

CPP: Yes. You'll enjoy this one. 

Dependent On Insulin: Why am I out of insulin?

CPP: You used it all. 

DOI: But I still have tips left. 

CPP: Okay. The tips are used to administer the insulin. They are the tube that gets it from the insulin pen into your skin. 

DOI: That's not how it works. 

CPP: Yes. It most certainly is. 

DOI: No. The insulin is in the tip. It's always been in the tip. 

CPP: Then why do you keep the insulin box in the fridge and the box of tips on the counter?

DOI: I use the PODS now. 

CPP: Okay. The PODS. You mean the ones that you inject your insulin into prior to sticking the PODS on your skin?

DOI: Yes. 

CPP: Okay. Depending on how much insulin you calculate you need, PODS and the insulin may not finish together. 

CP: Just like most couples. 

CPP: <shh>

DOI: I still have PODS left but no insulin! You shorted me somewhere. Where is my insulin?

CPP: In the box. If you've been using insulin pens this many years, and now switched to the PODS, how did you think the insulin was in the pen tips and not the box labeled insulin?

DOI: That's the part that goes into my skin. The pen doesn't go into my skin. 

CPP: The ink of a pen is not in the tip either. It is literally "just the tip". 

DOI: That makes no sense.

CP: I can explain it to you, but I can't understand it phor you. 

CPP: That's like explaining how a straw works. 

CP: Yeah. The glass is just there for visual aesthetics. The milkshake is in the straw.

I Don't Wanna Hold Your Hand

Upcoming Pharmacy Student: School is hard. 

CP: But worth it. 

UPS (Pronounced OOPS): What's harder?

CP: Adulting. 

UPS: I can only imagine. 

CP: Can you order a pizza? 

UPS: Pshaw. Duh. 

CP: Can you pick it up?

UPS: Natch. 

CP: Can you brush your teeth and make yourself study and pay your bills and set an alarm to get to class and work on time? 

UPS: Uh-huh. Why the interrogation? 

CP: Adulting is hard. 

UPS: How do you mean?

CP: I've been at this a while and I don't believe I have had to hold patients' hands to the extent now required of me. 

CPP: This is where CP pulls out a vignette, a tale phrom recent history to show you how this relates. A little Aesop-esque without the phulphilling phable phinish. 

UPS: Oh. A lesson.

CP: I'll take it phrom here. 

 

Rude Ass Bitch Is Demeaning: I need my medications. 

CP: Doesn't everybody? 

RABID: I'm more important. 

CP: Of course you are. They are out for delivery. 

RABID: They were supposed to be here yesterday. 

CP: There was this huge storm? Maybe you heard about it on the news? Or felt it in the air? Or saw it with your eyes as you passed a window?

RABID: Yeah? So?

CP: So we couldn't deliver anything yesterday. In fact, we only had half staff to phill prescriptions yesterday as well. 

RABID: I need my stuff. 

CP: We have been trying to catch up on yesterday's deliveries as well as making today's. Our drivers have the deliveries, it's just taking them longer. They will be there. 

RABID: That's not my problem. 

CP: It appears that it is. Our drivers can only deliver as quickly as the roads allow them. 

RABID: I need my medications. 

CP: So does everyone else. Despite what your momma told you, you're not special. You're unique, just like everyone else though. If you'd like to help, you are always welcome to receive your prescriptions the old fashioned way. 

RABID: How's that? 

CP: Drive to the pharmacy and pick them up yourself. 

RABID: I can't drive. The roads are too bad. 

CPP: I remember the good old days. Back in the late teens. 

UPS: 19-teens?

CPP: Smart ass. Twenty-teens. Way back then, there was no curbside service and limited delivery. People had to get in their cars and drive to leave their houses. They had to forage the aisles and restaurants for their own groceries and meals. 

UPS: The horror. The horror!

CP: Now they can request grocery deliveries, meal deliveries, and pet food and prescription deliveries from their couches. With all of life's current conveniences, the only thing they can't get delivered is something to complain about. 

CPP: So they call everyone to bitch their conveniences aren't convenient enough. 

UPS: She really bitched that much? 

CP: She called every 42 minutes for nearly 7 hours until, we assume, she either received her delivery, her phone died because no one was available to plug it in phor her, or she died. 

CPP: Either way, everyone was satisfied. 

Stupid Is. . .

CPP What's one of our favourite sayings about people?

CPP: Never ask "How dumb can people be? They'll take it as a challenge". 

CP: Right.  

CPP: Why do you ask? 

CP: I have a new loathing for insurance companies. 

CPP: Do we need another reason to abhor, detest, execrate, despise them?

CP: Very vehemently vilified, verily. And yes. Yes we do. 

CPP: What did they do now?
CP: Ask us to commit insurance fraud. 

CPP: The insurance company?

CP: Yes. 

CPP: ASKED us to commit insurance fraud?

CP: Yes. 

CPP: However did this take place? 

CP: CP's Paradise where we'll do anything phor prescriptions but we won't do that. How may I help you?

Actively Seeking Insurance Fraud: I have a mutual patient of ours on the line who would like to get credit for his prescription. 

CP: You don't have to say "of ours". 

AS IF: What?

CP: You don't have to say "of ours" as in "mutual patient OF OURS". That's redundant. Like 6am in the morning. 

AS IF: Um. He'd like credit on his prescription. 

CP: Ok. Which involves what on my end?

AS IF: We need you to rerun his claim. It wasn't covered and he paid cash for it. We have since approved the claim so you need to reverse it and run it for a paid claim. 

CP: That all sounds like a good plan. When did he pay cash?

AS IF: Last Friday.

CP: Uh-huh. And when did you approve the prior authorisation? 

AS IF: Today. 

CP: Today being Thursday, 6 days later?

AS IF: Correct. 

CP: And, just to satisfy my own curiosity and perform my own due diligence, did you happen to backdate the claim to last Friday? The day he actually received the medication?

AS IF: No. 

CP: I see. Can you do that?

AS IF: No. The prior auth was approved today. 

CP: But you're the insurance company. You're supposed to do insurance-y things. I only do pharmacy-y things on my end. 

AS IF: No. We just need you to reverse it and rebill it so he can get a refund. 

CP: I cannot. I filled it on Friday. Today is Thursday. 

AS IF: You could change the date to today?

CP: I CAN!!!!???? Wow. Why didn't I think of that first!?

AS IF: I know. It's pretty easy. Happy to help.

CP: Except that's insurance fraud which legal people define as: "... any duplicitous act performed with the intent to obtain an improper payment from an insurer." You're asking me to change a fill date to satisfy your obligation to your patient. Since you, the insurance, wrote the contract, and determined this medication needed prior auth and have the power you granted yourself to change the fill date (called backdating), would it not be in your patient's best interest to do all of this yourself? And then, maybe, cut your own beneficiary a check directly from your own company? I'm sure the patient would appreciate this approach without unnecessarily involving other parties who, let's face it, don't really need to be part of addressing the problem you created. In fact, I don't think you need me anymore. I can give you the phone number to the patient's insurance for you to call for help if you like.

AS IF: No. I think I have it. 

CP: Good. Hope it works. If not, it's on the back of the patient's card. Good luck and go fraud yourself!

CPP: Damn. 

CP: Right? They wanted me to go fraud myself! 

CPP: To which you said Fraud That!

CP: Fraud off!

CPP: That's enough. People will question our sanity. 

Relax, Don't Do It

ME: People need to learn self-control. 

MICE ELF: Like people taking too many selfies? 

ME: Or finishing off the cheesecake?

MICE ELF: Shut it. 

CP: How about NOT calling the pharmacy?

ME: Like ever? 

CP: It would be a good start. I mentioned the other week about how we need to limit the number of calls a person's phone can make to a business; or how many our phone can accept from a number. 

MICE ELF: Like The Boy Who Cried Wolf?

CP: Sure. If the Phable Phits, Pharmacise it. 

ME: Enlighten us with your real world example, O Wise One. 

MICE ELF: Cuz we both know you have one. 

ME: You are never short on stories. 

MICE ELF: Short . . . stories?  

ME: <shrugs>

CP: Once upon a midnight dreary. 

CPP: It was day. 

CP: Phine. Day. 

 

Uber-Tech: CP's Paradise Lost Pharmacy, How may I help you?

Overly Harassing Everyone Like Literally No One's Safe: When will my medication be delivered? 

UT: Later today. Sometime between noon and 6pm.  

O HELL NO's: Can you be more specific?

UT: No.

 

<1 hr later>

Poor Intern: CP's Lost Paradise Pill Parade. How may I help you?

O HELL NO's: I need my medication. When will it be delivered?

PI: Still sometime between noon and 6pm.

O HELL NO's: Can you do better than that? 

PI: 3:14. 

O HELL NO's: Really?

PI: No. But it could be, seeing as how that is between noon and 6pm. We are short a driver and the storms have backed us up this week.

O HELL NO's: Well that's not my phault. 

PI: Whose fault? Whose but his own?

<Later> 

CPP: CP's Lost. May I help you?

O HELL NO's: When will my prescriptions be delivered?

CPP: Later. 

O HELL NO's: How much later?

CPP: Well my tech told you between noon and 6pm as did my Intern. I'm going to have to reiterate what they said. 

O HELL NO's: Not good enough!

<More Latererer>

CP: CP's <checks caller ID> Hell, How may I help you?

O HELL NO's: When will you deliver?

CP: We cannot provide exact times. 

O HELL NO's: Well I need it. 

CP: You don't want it? You just need it? To breathe, to feel, to know you're alive?

O HELL NO's: Yes!

CP: You could just <plays triangle> COME AND GET IT! 

O HELL NO's: It's snowing! I can't come out in this!

CP: Think of my drivers. Now I need you to stop harassing us.  

O HELL NO's: I'm not! I need my medication!

CP: Let me ask you this: Do you use the online tracking for FedEx, UPS, or the USPS? 

O HELL NO's: Yes!

CP: What does the tracking show?

O HELL NO's: Where it was last scanned. 

CP: Anything else? 

O HELL NO's: No. 

CP: Your prescription was last scanned here. It's on a truck, en route to your house. Once your Amazon package is on the truck do you call the shipper to ask for an exact delivery time? Do you call the warehouse every hour to harass them? All they did was ship it. Once it leaves the facility the shipper has no control over the route or time to destination. Stop. Calling. Us! 

O HELL NO's: Well this is ridiculous. 

CP: I could not agree more. Imagine the work all of us could have completed if you had listened to us the first time and NOT called us repeatedly. Sometimes, NOT calling is the best solution, like alcohol.

O HELL NO's: You are going to hell.

CP: “Better to reign in Hell, than to serve in Heaven.”

#Milton

#InHellIllBeInGoodCompany

#EndTelephonicHarassment

#JustBecauseYouCanCallDoesNotMeanYouShould

#WeHaveMorePatientsThanYou