Simpler Times

CPP: Did you go to the managers' meeting?

CP: Yes. It was even more pointless than the previous phew. 

CPP: Which you said were more pointless than a soccer ball. 

CP: This left me like a phlat soccer ball - deflated. 

CPP: How can you tie this in to a great story, O Wise One?

CP: Glad you asked. Phirst, I get a story at work. Then I decide which characters are necessary to phlesh out a solid intro and conclusion and we're off on an adventure. 

CPP: Thanks, Bilbo. As you were. 

CP: I miss the days when things were simpler; like that meeting?

CPP: Yeah?

CP: It should've been a memo. 

CPP: And today's story?

CP: Shouldn't've 'appened. 

CPP: That's a lot of apostrophes. Your story?

CP: An officer of Dr. Zoffis left me a voicemail. 

CPP: Nothing new there. 

CP: Officer said: "Stop sending refill requests. Patient must make appointment."

CPP: And therein lies the rub. 

CP: Indeed. Phirst, I cannot stop patients phrom calling in their Rx numbers on my phone/app/website requesting a refill phor which they have not received a new Rx as these are automatic and outside my control. Second, I called OUR patient and provided this information to them; even included the exact verbiage on their previous label of the 90 days supply you gave them as just-this-one-time-more. Third, and I know this is where I lose the officers, but STOP. CALLING. ME. 

CPP: <gasps, but with a cynical inspiration> Bite thy tongue! How darest thou insinuate it is incumbent upon the officers of Dr. Zoffis to ring their own patients. 

CP: I not only insinuate, I point blank call them out on it. Instead of calling me and, not only bypassing me where I can correct you to save us both some time by you calling the patient, leaving a message you chicken little, you could have called the patient, scheduled the appointment, and saved everyone trouble. Now, the patient will get a call phrom ME telling THEM their doctor called ME to tell THEM to call the OFFICE to schedule an appointment. WTF? Are we in grade school again? 

"Pssst. Kory told Leah to tell Kevin that Lindsay likes Brian and wants him to ask her out. Make sure Brian tells Andrew to tell Mike to tell Jen to tell me to talk to her first."

CPP: Your theory is revolutionary! If only there were a way to implement this. 

CP: <snaps phingers> Got it!

CPP: That was quick. 

CP: #TWSS! Remember the other day when I mentioned I would tell patients their doctor has "Magic Hours" from 8-10am with no appointment necessary; you can walk in any time and be seen immediately with half-off copays?

CPP: Yes. 

CP: I'm going to call these offices back, transfer to their voicemail, and tell them I scheduled their patients' appointments phor them. 

CPP: I like it. How's that work?

CP: "Hi. It's CP calling phrom Cynical Shenanigans Pharmacy. You left a voicemail telling me to call your patient to let them know they need an appointment. While I had them on the phone, I took the luxury of scheduling their appointment phor you so you would not be troubled phurther. Ana L. Fischer will be there Tuesday, 5/23 at 9:15. Should you have any questions, please phollow up directly with the patient as this is a non-callback number and messages left phor the pharmacy will not be returned but will result in phurther appointments being scheduled." 

CPP: I like this. We could see how many of these calls it takes before they "get" the message. I'd say, after the first voicemail, schedule one appointment, second voicemail, schedule another appointment, third voicemail, schedule two appointments, then schedule 3, then 5, then, 8 then 13. . . 

CP: Spiral out. 

Stay In Your Lane

<checking out at Dr. Zoffis, eavesdropping>

Nurse On Phone: Ok. Well I can check the price for you. It looks like it will be $26.42 if you use Wag's or $28.93 if you visit Chronic Vaginal Secretions. No. There's a coupon from their website. Yes. Ok. I'll send it there and you can tell the pharmacist it should be that price. 

CP: Excuse me. I couldn't help overhearing <since you talk really loud and we are inches apart>. How does that work exactly?

NOP: What?

CP: When you give them a price?

NOP: Oh, I look it up on the website. 

CP: Right. But where do you put the coupon info?

NOP: I don't know. I just click this box and hit "send". 

CP: Do you do this for most prescriptions?

NOP: Yes. I look them up on GoodRx. 

CP: That's a problem. 

NOP: <doe-eyes go dark, blinks> How so?

CP: Well, those coupons typically end up in the middle of the directions or just below. They appear on so many prescriptions that they become background noise we just ignore; they're not part of the actual prescription so we don't even look at them. No wonder patients get mad at us when they tell us "my doctor said it would be $xx". 

NOP: <shrugs> Oh. I just click this and send it. 

CP: Yes. That's the problem. Please don't quote prices to patients. You don't work in my pharmacy and those prices often don't reflect what we see. Second, my pharmacy doesn't take GoodRx, even though prices for my pharmacy are on their website. 

NOP: Why?

CP: Who knows. I can put anything I want on MY website. It doesn't have to be real. They can do the same. Also, if you insist on giving prices to patients AND you spoke with this patient and gave her a price, please put a note, either directly in the sig, or the "prescriber notes" section telling the pharmacy "Patient was quoted a price with GoodRx and opted to use that in lieu of her insurance". This way, I will more likely see the note, run her insurance, then run the coupon or my discount card to compare prices. But please stop telling patients "you will pay this". 

NOP: <stares blankly>

CP: Or I will instruct all your patients that I changed their appointment times and, that Dr. Zoffis said if you arrive before 10am, say 8-10am, you don't need an appointment, you can just walk right in and be seen and your copay is half during these premium hours. 

When Is My Job Finished?

CP: When are we actually done with our job?

ME: All of it? When the Rx is sold? 

MICE ELF: Once I sell it, our interaction is over. 

ME: Allowing for calls back with questions, etc. But I'm guessing that's not what you have in mind for us today? 

CP: Observant. It is not. I shall ask again, rewording this time. If you process a claim, and you are rewarded with a paid claim, is your job done?

ME: Of course. We bill the insurance as a courtesy to help finance the cost of the medication. 

MICE ELF: Yeah. Once the insurance replies with "yes, we accept the terms of our arrangement and hereby agree to pay our part (for now) as long as you charge the patient her $25.00 copay, our transaction can be considered concluded". 

CP: Verbosity. You definitely speak like an insurance company. But you are wrong.

ME and MICE ELF: WHAT?!

CP: Is there a cheaper manufacturer? A preferred NDC#? Just because you received a paid claim does not mean you get to celebrate yet.

ME: But that has always been the way. 

MICE ELF: Yeah. This is the way. 

CP: Alas, no longer. We have had multiple instances where we processed a claim, told the patient her copay and when she balked, instructed her to call the insurance. When she called us back, she bluntly explained we used the wrong manufacturer. 

ME: Wouldn't it make more sense for the insurance to simply deny the initial claim for "NDC not covered" than pay the claim at a higher copay? 

CP: One would think. But insurances are not in the business of making it easy for us or their patients. It's like finally getting the notification that the insurance company approved the provider's prior authorisation request, only to process the claim and discover there is a 90% copay for the patient now. Thanks for nothing. Now the patient is still mad at us because we are overcharging them. 

MICE ELF: And we continually get yelled at because we had a paid claim. How are we supposed to know which NDC is preferred? I miss the days when brand was no longer covered the day the generic entered the market. I miss all generic versions being covered by the insurance. 

CP: I miss the days when there were no insurances or PBMs and patients paid cash for everything. We need to move to the medical billing model. Patients pay an office copay before each visit. We accept their $25.00 copay up front and all of the billing takes place behind the scenes or after the fact. Pharmacies should have their own billing departments. 

ME: You are so wise.

CP: And don't get me started on "would it be cheaper with GoodRx or a discount card?". 

MICE ELF: It's not my job to figure out ways for me to lose money to you. 

ME: Could you imagine going to a business and telling them you don't like the price you are being charged and expecting THEM to help YOU pay for it? 

MICE ELF: Or to suggest a better, cheaper location. 

CP: You picked me. You don't have to come here, oh wait, damn PBMs. But once I get a paid claim, my work here is done. Transaction complete. Here's your receipt. 

Sam? Is That you?

(To Green Eggs And Ham)

I said no. I said no. No I said. 
That no-I-said! That no-I-said! I do not like that no-I-said

Is there a script ready for me?
There is no script that I can see

There is no script I have ready

Do you have one here or there?
I do not have one here or there

I do not have one anywhere

I do not have a script for you 

I do not like you, no-I-said

Did you get one on the phone?

Did you get one via drone?

I did not get one on the phone 

I did not get one via drone

I do not have one here or there

I do not have one anywhere

I do not have a script for you 

I do not like you, no-I-said

Mayhap received them on the fax?

Perhaps upon the telegraph?

Not on the fax, nor telegraph

Not on the phone, nor via drone

I do not have one here or there

I do not have one anywhere

I do not have a script for you 

I do not like you, no-I-said

Did you check the Code of Morse

Do check again, yes of course

Did check, no luck, Code of Morse

Oh do check them evermore, 

Maybe flags of semaphore?

They are not in a semaphore 

No Code of Morse no nevermore. 

I do not have them on the fax, 

I do not have on telegraph

I do not have them on the phone

I do not have them via drone

I do not have one here or there

I do not have one anywhere

I do not have a script for you 

I do not like you, no-I-said

E-Scripts! E-Scripts! E-Scripts! E-scripts!

Did you, would you, check e-scripts?

No E-scripts nor semaphore

No Code of Morse no nevermore

I do not have them on the fax, 

I do not have on telegraph

I do not have them on the phone

I do not have them via drone

I do not have one here or there

I do not have one anywhere

I do not have a script for you 

I do not like you, no-I-said

Eh? Voicemail? Yay voicemail?

Did you, could you, voicemail?

I did not could not, voicemail

Did you, could you, ASL?

I did not, could not, ASL

Not voicemail, not on e-scripts 

No Code of Morse no nevermore

Let me alone now, please, I implore

Not on the fax, nor telegraph

Not on the phone nor via drone

I do not have one here or there

I do not have one anywhere!

Have you checked the avian friends?

I have too checked them, no-I-said 

Maybe it was sent with raven

It was not sent with raven

Upon the leg of carry pigeon?

Not attached to carry pigeon

Did you, could you signal smoke?

Did not, could not signal smoke

Perhaps Pony Express's tote

No to Pony Express's tote, 

No to fire and signal smoke

I did not, could not, ASL

Not voicemail, not on e-scripts 

No Code of Morse, no nevermore

I do not have them on the fax

I do not have on telegraph

I do not have them on the phone

I do not have them via drone

I do not have one here or there

I do not have one anywhere!

There is no script that I can see

There is no script I have ready

You did not find them, so you say

Find them! Find them! yet you may

Please just check again, okay?

(checks again)

No. No script I that I can see

And still! I have no script ready

Not in Pony Express's tote

Nor in fire and signal smoke

And nothing signed with ASL

No voicemail  nor e-scripts

No Code of Morse no nevermore, 

I do not have them ask no more

I do not have them on the fax

I do not have on telegraph

I do not have them on the phone

I do not have them via drone

I do not have one here or there

I do not have one anywhere!

There's still no script that I can see

There's still no script I have ready

Can you check again?

Should I

CP: Welcome to CP's Palace of Potions. How may I help you?

Naturally Opining Makes Answers Subjective: I am here to pick up my prescription. 

CP: I have one prescription here for you. 

NO MAS: That is correct. 

CP: Treating a bird today, I see?

NO MAS: Huh?

CP: Thrush. 

NO MAS: Huh?

CP: Okay. That one missed. How about <sings horribly> "It's just, a little thrush?"

NO MAS: Yes. That's it. 

CP: Any questions today before I go over this with you?

NO MAS: Should I change my toothbrush?

CP: Great question. The answer is yes, and frequently until the infection clears, then you can continue with that one. 

NO MAS: But I don't want to replace it. 

CP: Ok. If it means that much to you, you can sterilize it. Either in mouthwash, or a baking soda or Hydrogen Peroxide solution. I'd do that until the infection clears, then replace it. 

NO MAS: I use expensive toothbrushes. 

CP: And how often do you change them?

NO MAS: Each season. So 3 times a year. 

CP: Which season do you skip? Do you change it every season, like winter, spring summer, or fall. . . 

UT: All you have to do is call. Sorry. 

CP: Or do you change it every 4 months?

NO MAS: I change it every 3 months. 

CP: When are you due to change it again? I change mine quarterly on the first of every third month so if you're like me. . . 

UT: I hope not. . . sorry. 

CP: . . . then you'd be due to change it now that it's almost April 1st. 

NO MAS: I'm supposed to change it this week. 

CP: Okay. You SHOULD change it. You CAN disinfect it. You are ABOUT to change it anyway. I'm not sure how much more I can help you. You either ARE going to change it; or you're not. You either need to, or you don't. 

NO MAS: <head starts twitching>

CP: Here's your troches. Slowly dissolve. Have a good day. <slowly backs from counter>

UT: Are you just going to leave her like that?

CP: Her head is twitching. She looks like a short-circuited fem-bot from Austin Powers. 

UT: Good thing you didn't ask her for her preferred pronunciation. 

CP: Tro-key. 

UT: I still think we should pronounce douche like that as well: Doo-Key. 

Still Need To Be Nice

CP: It's not their fault. 

ME: What isn't?

CP: That patients are forced to call pharmacies for Adderall and other backordered products. 

MICE ELF: Right. 

CP: But it hasn't stopped pharmacies from treating them with disdain and being rude about the calls. 

ME: Big Meanies!

MICE ELF: And let me guess, they're not only hostile about it, but they're not telling callers if they have it because "I'm afraid I'll get robbed"?

CP: Yes. Although Adderall has never really been atop the pharmacy theft list. 

MICE ELF: That's pretty lame. 

CP: I get it. Under normal circumstances, I rarely provide inventory information on most C-IIs. 

ME: But this isn't normal circumstances. 

MICE ELF: And we do get questions about the oddball medication from time to time. 

CP: Indeed. And if hospitals or offices call, I'm fine with telling them what I have. The problem with pharmacists refusing to tell callers if they have products in stock, and being rude about it, has nothing to do with concern about theft. Now, I have to deal with people calling saying "Hi. I'm an RN from a doctor and wanted to know. . . "

ME: No. No you're not. That's not how they speak. 

MICE ELF: You could at least try. Put some effort into your knavery. 

CP: All true. 

ME: What about "I'm keeping it in stock for my regular patients"? 

CP: I'm okay with that. But be honest about it and not rude. It's surprising to me how many fellow colleagues are rude. 

ME: But they're too busy to deal with all the phone calls all day long. <sighs>

MICE ELF: We all feel the same. But we aren't all shitty about it. 

CP: Which makes me look good when people call and I either have it in stock or I locate a product at another location. 

ME: And don't lie to people.

MICE ELF: Let me guess. You're slipping this post in between a couple of Don't Be A Dick posts on purpose, aren't you? Thinking no one will notice?

CP: Hey, it doesn't take much to be nice and answer the question. Again, it is not the fault of the patient they have to call. We cannot complain that we won't call other stores for patients, expecting them to call themselves, then, when they actually DO call themselves, we treat them with disrespect, are rude, and whine "I'm afraid of robberies". Then treat them like shite. 

ME: We can't have it both ways. 

MICE ELF: Before CP says it, Don't Be A Dick. 

CP: It's not their fault. Say "yes", say "no". But, yeah, what MICE ELF said. 

#ItsNotTheirFault 
#DontBeADick 

#ThisIsntGoingAwaySoon 

Dick And Jane Refreshed

Dick and Jane go to the pharmacy (in America). 

CP asks them for their dates of birth.

CP: Jane, what is your DOB? 

Jane: 3/6/79. 

CP: <types 03/06/1979> Danke! Here's your prescription.

Jane: Bitte 

CP: Same question, Dick. 

Dick: The eleventh of August, 1982. (Or however you know they respond that isn't mm/dd/yy.)

CP: Why are you the way you are?

Dick: I was in the military. 

CP: Does this look like a military installation to you? Did we salute when you entered? 

Dick: We are the only country that doesn't do it that way. Other countries say the day first. 

CP: I know. They're also all on the metric system. Shall I convert all your dosages? Do you request petrol in litres? I have plenty of military in my family. Never once did I go anywhere with my family and, when asked for dates of birth, did they respond with 5th of May, 1977. Never. They knew the person asking for the information was entering it the American way, not the military way, or the "everywhere else in the world" way. When you are asked to enter your DOB online in the MM/DD/YYYY format, do you adapt to this? Or do you try to force your birthdate in using your format? Do you ring customer service and complain "that's not how I was taught"? My foreign language in HS was German. They say their numbers as two-and-twenty for "22" (zwei und zwanzig). They'd be right at home singing "4 and twenty blackbirds baked in a pie". Mayhap I learned to count through that song. Yet I don't say my day of birth as three-and-twenty. The answer to "what is the meaning of life" is not "two and forty", but "42". Sure, you sound cool to yourself. But you're a dick to everyone else. 

Dick: We're the only ones who. . . 

CP: No. YOU'RE the only one who does this. I start typing "11" then have to back up and fix it all because you think you're being cute. <whiny voice "military does it like this. other countries do it like this, wahhh".> Are we on base?

Dick: No. 

CP: In a country outside the USA?

Dick: No. 

CP: Could you adapt to the current situation? Which I'm sure is part of your military training? Happy, smile. Sad, frown. Use the corresponding face with the corresponding emotion. Give the correct answer to the correct audience. 

Dick: Well, I. . . 

CP: Then don't be a dick. 

Reading

CPP: Good Morning, CP!

CP: And good morning to thee as well. 

CPP: What do you have phor us today?

CP: General phuckery. 

CPP: Perfect. Can you be more specific?

CP: People are stupid. 

CPP: Yes. And I reiterate my request to be more specific. 

CP: What do you think is worse: The lack of reading what is right in phront of you? or the lack of reading comprehension?

CPP: Tough one. I'd say it's a tie. As I believe I know what this is about, I'm going to say everyone is a loser. 

CP: Here we go. 

UT: I put a sign on our new SigCap device. 

CP: Is it remarkable?

UT: It is! It's on a large, pretty pink Post-It with fluorescent gel pen. In beautiful, printed handwriting, large letters and all, it says: "NO PEN. USE FINGER TO SIGN." I even added a few little flourishes to draw the eye. 

CP: Phool-Proof! 

UT & CP: hahahahahahahaha

CP: What about our vaccine sign? Did you phreshen that up a bit?

UT: I did. I placed it on the side we don't use at pick-up. It reads: "PLEASE STEP TO DROP OFF WINDOW FOR ALL VACCINES!"

CP: That should keep people away phrom pickup and help us run efficiently. 

UT: No one is going to believe you typed this all with a straight phace. 

CP: <shrugs> Reality Bites. 

CPP: Ok. I see the new signs. UT did a great job. 

UT: <bows> Danke. 

CPP: Back to the reading lesson, CP. What happened?

CP: No one reads the sign on the SigCap device. No one. They will look all around, grab the power cord and yank it, slap the counter in phrustration, and throw their hands in the air and wave them cuz I just don't care before I politely say "phinger" while pointing near the sign.

UT: But you always wait until you've had a good laugh. 

CP: Schadenfreude, baby. It's the little things that bring me joy in this world. 

CPP: And the other sign? 

CP: I love it when people head to drop off and this happens:

CP: "Dropping Off?" 

Didn't Understand My Board: "No. The sign said to come down here". 

CP: No it didn't. 

DUMB: Yes it did. 

CP: Go back and reread it. 

DUMB: <enunciating loudly and deliberately> STEP. TO. DROP. OFF. 

CP: Keep reading. 

DUMB: For. . . oh. 

CP: So, picking up then?

CPP: I see your point. 

CP: I've learned that people either don't read signs or, if they do, they don't comprehend what they read. 

CPP: Short attention spans. 

CP: You should read the book "Death At Yellowstone". There's a great section in there about signs and posters and warnings and people's ignorance of them. 

CPP: So which is worse? Not reading? or Not comprehending?

CP: Well if you don't read you can't mis-comprehend anything. 

CPP: Better to remain silent and be thought a phool than to speak and to remove all doubt. 

CP: Just goes to show, you can lead a man to an education but you can't make him think. 

Or should it be "You can give a man an education but you can't make him take it"?