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Tuesday, September 14, 2021

Get Out Of The Line

CP: I always greet patients as they enter the store or approach the pharmacy. 
ME: Me too. 
MICE ELF: It's a good way to let them know they have been seen. 
CP: It also cuts down on complaints about them standing around without us acknowledging their presence. 
ME: Do you want a pat on the back or something?
MICE ELF: Yeah. That's what you're supposed to do. You can't take credit for things you're supposed to do.
CP: My issue is with those patients who do not acknowledge they have been acknowledged. 
ME: Like when you say "Hi. We will be right with you" and they do not respond?
MICE ELF: Or when you say "Welcome! Are you dropping off or picking up?" and they proceed to just stare blankly as if they just woke up in their body and have no idea who or where they are?
CP: Right. It's not your first time here. Or being in public. There is an order to social interactions; a procedure to follow, if you will. I say "hi" then you say "hi".
ME: Pleasantries exchanged! 
MICE ELF: Now we can conduct business. 
CP: Is it worse to ignore the first step? or just jump ahead to "stating your business" unbidden? 
ME: Like when people walk in, you say "Guten Morgen" and they say "Jones. Pick up. 7/7/77." and they haven't even fully entered the building yet?
MICE ELF: Right? Like let's just blow past first base and jump to dry fingering. 
ME: Something is very wrong with you.
MICE ELF: Well that's how it feels. I didn't even have the chance to look up or put on my fake smile and we're already blasting away. 
ME: It still amazes me how people can be clueless.
CP: Like the people who look confused as to where to stand. There are signs: "Drop off", "Pick Up", "Consultation", "Vaccine", but "Stand Here With Dumb Look On Face" is not among them.
ME: Precisely. 
MICE ELF: Remember John Pinette? 
MICE ELF: He had a comedy bit called "lines drive me crazy" about his experiences waiting behind people to order food at fast food restaurants. 
CP: I always think of this when I'm in line. Or when people are in my line. 
ME: Walk up. Get acknowledged (so you know I'm paying attention). Announce your intention(s). Wait for my response. Follow orders. Move along. 
MICE ELF: Move along. 


Thursday, September 9, 2021

Please Contact YOUR Patient

CPP: What is the most annoying change to happen to us (seemingly overnight) over the last decade or so? 
CP: I am most annoyed by doctors' offices that have outgoing messages on their phone trees that state: "If you are calling for a refill request, please contact your pharmacy and have them send us a request electronically". 
CPP: Yeah. Especially not helpful if you are calling to request a NEW prescription that the patient has never filled at your pharmacy before; they recently transferred from another pharmacy or state or provider and you need to get them a fill. You can't refill it if you haven't filled it. 
CP: I've decided to phlip the script on these offices. 
CPP: How's that?
CP: After each attempt at a refill, I will leave a voicemail message or note on the e-request that states: "Should you or your staff choose not to approve this medication request, it is incumbent upon you to call your patient and explain to them why you denied the fill/refill. We told the patient we would submit the request but that we did not have to power to approve or send the approval to the pharmacy. Patients have been instructed to follow up with you on all denials/non-responses after 48-72 hours.
CPP: You should also have a message on our phone tree specifically for the patients. 
CP: It just so happens I do: 
"It is up to the doctor to explain why they denied your request(s). If you do not hear from the pharmacy stating your refill has been approved, please contact your office until you get an answer. We can ask for a refill, but we can't make them review it, approve it, or send it back. We are busy giving shots and testing for COVID and not filling prescriptions or answering phones. Call your doctor until you get a response."
CPP: Nice. 
CP: Well, two can play at the game. Now if we could just use call forwarding to send them directly to Dr. Zoffis. Hmmmm. 
CPP: Can we include "we will no longer accept handwritten or phoned in prescriptions"? 
CP: I'll allow it. 
CPP: This reminds me of the time we talked about scheduling patients' office visits. Sort of.
CP: When we got tired of offices including those little notes on e-scripts and phone calls? 
CPP: Right. That, and when offices told us we should just have it ready when they get here. 
CP: Oh yeah! We just started telling patients they had appointments or they could just waltz into the office and they'd be seen immediately. 
CPP: Change the expectations. 
CP: Change the world!

Tuesday, September 7, 2021

Conflict of Messaging

CP: What are among the first things you do whenever you change your name, change your address, or change any personal information? 
CPP: I let everyone know. Family, businesses, banks, etc. 
CP: Right. Good. Makes sense. 
CPP: Are you moving? 
CP: No. I just wanted to make sure it wasn't me. 
CPP: What wasn't you? 
CP: There once was a lady with prescriptions
In desperate need of decryption
We called with no luck
She said what the phuck
And thus ended her conniption. 
CPP: Cute. You just made that up for this post? 
CP: #LamePharmacyJokes phor the win!
CPP: What's the point of telling people you've changed your bio?
CP: Seriously. This lady with prescriptions. We had a note in her profile from two years ago. "Patient transferred out to Long Dick's Drugs. ANY prescriptions sent to us will have occurred in error and should never be filled, but forwarded to LDD." 
CPP: Okay. Phairly straightforward. 
CP: Until we received prescriptions which needed decrypted. We called the doctor. He said she uses the other pharmacy so we filed them. 
CPP: Again. So phar so good. 
CP: Until the patient calls the next day asking why we didn't fill her prescriptions. 
CPP: And you explained the note. 
CP: At which time I explained the note. She said she decided to come back to us for convenience and we are again, her new pharmacy. 
CPP: But not before she got mad at you for not filling prescriptions she told you not to fill? 
CP: I'm pretty sure if I were to start doing business with a company, I'd tell them before I start having things sent to them on my behalf.
CPP: Like that scene in Notting Hill where Honey tells the friends she met someone, looks at Spike and mouths "it's you"?
CP: Exactly. You can't get mad at me for doing what you asked me to do even though you now changed your mind and didn't tell me to no longer do that thing and to do something else without telling me to now do the something else instead. 
CPP: Not a lady. Definitely a woman. 

Wednesday, August 25, 2021

Things That Make My Brain Hurt

ME: What's today's puzzling, makes-my-brain-hurt conversation?
CP: It's a good one. Makes me question my sanity. 
MICE ELF: You have some left?
ME: Please continue. 

<Scene: Friday, 16:42>
Lady On Some Therapy: I need a refill. 
CP: I see you have a refill available but we do not have the medication in stock. 
LOST: I am lost without it. 
CP: You are lost with it. 
LOST: I'm going to die without it. 
CP: You are going to die with it. 
LOST: I need it.
CP: It's Friday evening and we do not receive orders on Saturdays. I can order it for Monday or I ca. . .
LOST:  Can you transfer it?
CP: . . .or I can phone the pharmacy of your choosing and transfer it to them. 
LOST: Transfer it to Other Pharmacy People so I can get it this weekend. 

MICE ELF: There's nothing wrong with that. 
ME: Yeah. That scenario repeats itself all day every day in every pharmacy. 
CP: Fast forward to Monday morning. 

<Scene: Monday Morning, 10:10>
Dr. Jack Shephard: My patient called and said she needs a refill. 
CP: You mean LOST? 
DJS: Yes. 
CP: She has a refill. We were out of stock. It's a special order item due to cost. As it was Friday night, she opted to transfer it to OPP. 
DJS: She called and said she needed a refill. 
CP: Nope. 

MICE ELF: Again, not weird. 
ME: I'm bored. 
MICE ELF: Get to the denouement already. 

<Scene: Monday morning, 10:42>
LOST: Did my doctor call in my refill?
CP: You don't need a refill. You transferred you medication to OPP on Friday. 
LOST: Yeah. But I didn't want to go out over the weekend. 
CP: Wait. You had us transfer your prescription to OPP because you were going to die if you had to wait until Monday and now you tell me you didn't feel like going out to retrieve it Friday night, all day Saturday and all day Sunday? And they're a 24 hour store!
LOST: That's why I called my doctor. 
CP: Your doctor doesn't enter into this. He is irrelevant to the current situation. 
LOST: Well I want you to refill my medication today because I don't want to go there.
CP: Well I cannot. 
LOST: Why not?
CP: As you were told on Friday, we order this only for you. Since you elected to transfer it to OPP, we had no reason to order it for today so we did not order it for today. 
LOST: Well what am I supposed to do now?
CP: Um. You could, um, oh I don't know, uh, go to OPP where your prescription is currently filled and, like a puppy in a shelter, waiting to find a home?
LOST: Why don't you keep it in stock?
CP: Because it costs a lot. You're the only patient on it. Despite repeated pleas from us to sign up for automatic refills and alerts, you continue to refuse. Perhaps you will change your mind now. Or not. 
LOST: Well transfer it back and order it for tomorrow in case I don't get over there. 
CP: Huh? I am not going to hedge your bets for you. I can't transfer if you ARE going there because they will have to cancel it. 
LOST: Well if I don't get it, you'll need to order it. 
CP: I'll just don my wizard hat and crystals and scry to know if you're going to pick it up and, while I'm at it, divine your intentions to refill future prescriptions. 
LOST: I don't know what that means. 
CP: And I'll sign you up for automatic refills and texts.

ME: Wow. That took a turn. 
MICE ELF: I'm surprised she called you on Monday.
ME: Yeah. Wasn't she supposed to be dead?
CP: Alas, no. One of these days someone is going to actually keep the promises they make to pharmacies.

Friday, August 20, 2021

Booster Shots

With the announcement that pharmacies (and everyone else) will be administering COVID booster shots soon. . . 

Kick 'em when they're up
Kick 'em when they're down

The Giant Deuce salivating and rubbing their hands (read:genitals) over this news.
Number 1: How do we stretch our staff even further and put patients' lives at risk under the guise of "helping patients live better lives"?
Number 2: Decrease staffing as we enter Pharmacy Winter.
Number 1: Always.
Number 2: Push flu shots at the expense of workflow and safety precautions.
Number 1: Duh.
Number 2: Announce that we will be administering more COVID vaccines and we will be adding staff to help?
Number 1: Huh?
Number 2: Just checking if you're awake. Further decrease staff, add daily conference calls to distract pharmacists and staff about the need to push flu and COVID shots, give them a goal or slogan of "FLU PLUS 2!"
Number 1: Catchy. How about "COVID and Flu and Shingrix, oh my!"? Also, can we work them until they have panic attacks and die behind the counter?
Number 2: That's next on the list.
Number 1: Think anyone will notice?
Number 2: Nope. Pharmacy staff are the worker bees. They die for us to survive.
Number 1: And make bank!
Number 2: No one cares about the profession. Nurses got all the press in 2020. Newspapers tried to bring attention to Pharmacies before we quashed the shit out of those reports.
Number 1: Give them pizza!

Oh. Yeah. Boosters. Good idea.
They work for all types of vaccines that mutate or whose effects wane over time.
Good idea, this. 
But if we know it's coming, why aren't we staffing NOW!
I say the day they announce as the first date shots are available, we all walk out. 
No shots. 
No shifts. 
No shit. 
Someone has to pay attention to us then.

Wednesday, August 18, 2021


CP: What if everyone adopted metrics? 
ME: You mean there are people NOT on metrics? 
MICE ELF: How do they function? 
ME: Yeah. How do they even know what to do next?
CP: Metrics make me nostalgic for the days of 5S. 
ME: Like when we had to label our staplers and spatulas and where we filed our prescriptions. 
MICE ELF: It was better than phorcing pharmacy to adopt Six Sigma. 
CP: They weren't inherently bad, but pharmacy workflow has too many variables and not enough help to allow it to work. 
ME: Glad we have those metrics though. 
CP: As I began, what if everyone adopted metrics and phorced their employees to attain them to the detriment of their other work? 
MICE ELF: Examples, s'il vous plait? 
CP: Dear OB/GYN Kenobis, you have not met your quota for baby deliveries this month. Don't drop the ball.
Dear Hospice, not enough people are dying to work with you this week. Start killing it. 
ME: Well, with hospice metrics, they'd call it something like "graduating to the mortician" or something more catchy and less somber.
MICE ELF: Can you imagine the action plans for OBs to make more deliveries? 
CP: I have a long-term plan, but it's going to take about 9 months, a lot of sperm bank withdrawals, and some open-minded volunteers. 
ME: And about those morticians, are there quotas for funerals in a week? Or cremations? Or alternative burials? 
MICE ELF: Probably alternative burials; like pushing HPV shots during a certain month. I know you had your heart set on this beautiful casket and plot with a tree but, can we interest you in tree burial? Where we hang him in the tree? It's our special this month. Next month is Sky Burial month. Half off if you book one for yourself too!
CP: I thought I was the oddball of the three of us. 
ME: You are. We try to keep up. 
CP: Speaking of the stupidity of pushing shots during random months and speed over accuracy, we sound like the police. 
MICE ELF: Holidays, tickets, and speed traps, oh my!
ME: Talk about filling quotas. 
CP: Metrics aren't inherently bad, it's simply that pharmacy uses them to measure the wrong things at the wrong times and worse, don't use the data to make informed business decisions. 
ME: They use them to punish us. 
MICE ELF: Like Mistress May?
ME: There's another business without metrics. 
MICE ELF: Not enough punishment delivered?
CP: I have such sights to show you. 
ME: You know you mixed your genres there at the end, right? 
CP: They'll get it.

Thursday, August 12, 2021

Pharmacy Label Phlair

CP: Our labels need updated. 
ME: Why? 
CP: They're not exciting enough. 
MICE ELF: They're supposed to convey important instructions to the patient so she knows how to correctly take her medication. 
CP: But they could be improved. They're boring. 
ME: Boring is good. Succinct. To the point. No misunderstanding. 
CP: That ship sailed a long time ago when e-scripts joined the scene. If there is one truth about e-scripts and directions, it's that they're even more difficult to understand now. 
MICE ELF: What do you have in mind? 
CP: Same message, more elegance; or eloquence. 
ME: What prompted this? 
CP: Remember yesterday's post? Under My Tongue?
ME and MICE ELF: We do.
ME: Yeah. What prompted that?
CP: One of my techs was fixing her sig code in the computer and wrote "under the tongue, dissolve one tablet" and thought that was a much more fluid way to write the directions. Then I took it to the next level and asked us, what if we applied that to ALL directions and labels?
ME: Oh dear. And you came up with?
CP: Diagramming sentences. We just move the parts around. 
1. Under the tongue shalt thou dissolve a single tablet. 
2. Via the Vagina shall ye insert one applicator of thine cream.
3. By mouth, thy shall swallow two capsules (place a pair in there)
4. Regarding the rectum, remove from foil one rocket and ram it home. 
5. Between the lips place the inhaler and proceed to breathe deep, puff. . . puff . . . hold. . . hold. . . hold. . . exhale through nose, pass. 
MICE ELF: Wait. What was that last one? 
CP: Huh? Nothing. Thinking ahead. We have pharmacy phriends in other states too, don't forget. 
ME: This was lame, even phor you. 
CP: It's been a slow week. But I made ME laugh.

Wednesday, August 11, 2021

Under My Tongue

Under my tongue
Dissolve a tab for your ills
Under my tongue
Dissolve the films or even pills
Sublingual those
Convenience of the dose you chose
Ease of use, dissolving's fun
It's under my tongue
And ain't this the best way? 

Under my tongue
Can't resist when you can't swallow today
Under my tongue
There is just no easier way 

Goes down easy, yes it does
No need to drink just swallow now goes down easy 
My meds are phun
It's under my tongue 
I, I, say that's the way

Under my tongue
A delicious taste of a pill 
Under my tongue
It's the sweetest, yeah, dose it's a thrill

Goes down easy
The way it melts in your mouth it so 
Goes down easy, my dose is phun
It's under my tongue
I'll take the easy way
Goes down easy, oh yeah
No way I swallow the tabs no more
Down easy, that way is dumb
It's under my tongue
Yeah, just let it melt

Under my tongue
Won't choke on solid dosage phorms
Under my tongue, and I 
I can see why this dose was born

Goes down easy, yeah, that's she said 
The way it melts like it's s'posed to do 
Down easy, this dose is phun
It's under my tongue.