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Tuesday, July 26, 2011

Mail Order Bitches

I am your bitch.  Not only has my profession sold out with transfer coupons, free meds, 15-minute guarantees, and a lack of respect on Capitol Hill, we've given way too much power to mail order over the last 15 years that we're just their bitch as retail pharmacists.
It began inauspiciously enough.  They were a bastard stepchild of retail pharmacy.  When Rite Aid acquired PCS insurance in 1998, the entire industry was in an uproar that it would stifle competition and force customers to only utilize Rite Aid pharmacies.  Under a lot of pressure and SEC issues, the partnership was dissolved.  Around the same time, Merck bought Medco.  No one batted an eye at this collaboration.  Suddenly, employers forced their employees to use mail order and Merck brands were preferred everywhere.  Surprising, no?  What happened next was a way for mail order to not only push us down, but to kick us in the head, piss on our faces, and ask us to smile about it all at the same time; it was called the 14-day mail order override.  Instead of us just billing a prescription and getting a receipt, we needed to process it, get the rejection from the insurance, call the insurance, wait for the override, reprocess it, then finish the prescription.  In other words, it took at least double the work for half a prescription.  Until Walgreen's stood up and said "NO!", we continued to take it.
A side effect of all of this was customers came to us for their non-maintenance meds, but continued to ask questions about their mail order stuff.  Great, that's my job.  However, it has evolved to where we field questions such as "my mail order sent me something different than what you gave me.  What is it?  Is it the same thing?".  My recent interaction went like this: "I used to get this prescription, but they sent me this instead.  I went to my doctor who sent the prescription to mail order and he said he can't help and that I should come here".  Awesome!  So your doctor who wrote your prescription wouldn't help you?  So he sent you to me, a pharmacist, at a store where you do not do business?  And somehow, with only the fact that you are standing in front of me as proof that this is real, I am supposed to answer a question about a new med your doctor wrote and you had filled at not only another pharmacy, but a mail order pharmacy?  Great, could you give me less to go on?
Yes, this is no different than if you went to a competitor across the street, except that they are just as accessible as I am.  In fact, I can call them myself.  Mail order has traditionally not had that easy connection with its customers.  I will pick up my phone when someone calls and asks for a pharmacist, usually within a minute.  It's like buying produce at one grocery store and complaining to the other grocery store about the first's selection.  Even better, it's like ordering books from Amazon.com, then walking into Barnes and Noble without the book and asking why the cover is different, it has fewer pages, and it costs more here.  If they're where you do business, call them.
I realize pharmacy options have grown, but if I don't have your information on file, I can't give you the best, correct answer.  I am sorry you chose them over me for whatever reason is personal to you.  I don't really care what the reasons are.  It's akin to transferring your prescriptions to an independent that delivers, but is closed after 5 pm and on weekends and you expect me to bail you out.  You decided to use their services, now you have to learn to operate within them.  I am tired of being your bitch just because you like some of their services better than what I have to offer.

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