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Tuesday, October 27, 2015

Flu Shot Phun

1. Wear a Kevlar cutting glove on your non-shooting hand. Tell the patient it's to protect your hand because the last time someone came in with arms this small, you had a through-and-through and stabbed yourself. (Yes, I know you can stab through these. They won't know that.)

2. Tell your students, especially those who've not yet experienced hitting bone, that when they do, they need to request a curved needle so they can go around this weird obstruction they found. 

3. When you hit bone, pull out a little, redirect your aim, hit it again, then tell the patient: "There's something in here. I can't get the needle around it. What's wrong with your arm?"

4. Attach a mini laser pointer to your syringe. When the patient asks what it is, tell them it's your laser sight.

5. Attach dart flights to your syringes. Grab a red Sharpie and draw circles on the patient's arm. Have the patient stand against the wall. 

Monday, October 26, 2015


My brain works in mysterious ways. It works faster than the rest of me. It works on the next task before I've managed to get the prior one completed. It sees things differently. It tries to organise and find patterns. This is why I excel at Boggle, Scrabble, and Words With Friends and why people hate playing me. This is also how I came up with today's challenge.

We all know drug companies spend lots of money on research for marketable names and there is a science to it. This is why so many medications have Zs and Xs. Great words for the Scrabble board. Not so great to make other words.

Come up with your own Drug Name Anagrams.
Here are 6 to get you started:

Klonopin=Pink Loon
Xarelto=Tax Lore

Now if I could just get Zynga to create a Pharmacy WWF games...

Thursday, October 22, 2015

More Pharmacy Phun With Words

As I've oft written, I rarely miss an opportunity to have some phun with my staff, phamily, or patients. This is especially true with regards to questions and grammar. A previous lesson involved the questions of time.
Do you know what time it is? is a Yes/No question. Note, I did not ask for the time. I may have simply been nosy inquiring if you knew. I may also have espied you checking your watch and wanted to test your recall. Either way, the correct answer is either Yes or No.

For today's example, I draw upon the conversation I had earlier this week.
CP: Top O' the Morning to You!
Telephone Inquirer Making Exaggerated Requests: And Good Day to you.
CP: How may I help you on this brilliant day?
TIMER: I was hoping to get a phlu shot today.
CP: Most definitely. No better way to spend an autumn day than getting shot.
TIMER: That's what I was thinking.
CP: When would you like to visit our establishment?
TIMER: Well, that's the reason I am calling. I'd hate to be a bother during your busy day.
CP: No worries. We are always busy but we are also quite accommodating.
TIMER: "When are you the least busy?" (The real question)
CP: "When we are closed." (The real answer)
TIMER: Phunny.
CP: I thought so. Did you want to know times when we are less busy?
TIMER: I suppose that would make more sense. Rather difficult to get prescriptions and shots while you are closed, eh?
CP: Indeed.

Monday, October 19, 2015

Magic Mouthwash

Sounds more amazing than it is. In some pharmacies, this is the only item they will ever be asked to "compound" for patients. However, as straightforward as this prescription appears to be, there remains a great deal of ambiguity around its formula. The problem is, there really exists no single recipe for it. There are as many possible ways to assemble this as there are prescribers to write for it. Each believes his or her own to be the one true king. As a result, conversations like this will ensue:

Clueless Office Staff Person Lamely Answering You: Dr. Zoffis. How may I help you?
CP: I am CP.
COSPLAY: OMG! The great CP is calling my office? What did we do?
CP: Well, you are not a local office to my pharmacy. You're over an hour away and as such, I am unfamiliar with your local customs.
COSPLAY: Ok. What is it you need?
CP: Magic Mouthwash.
COSPLAY: Yes. She writes it all the time.
CP: Apparently the pharmacies near you are used to this from her. Round these parts, we ask our prescribers to write ingredients and directions on their prescriptions.
COSPLAY: She writes this all the time.
CP: I heard you. Now please extend the same courtesy and hear me. She simply wrote "Magic Mouthwash". There is no amount to dispense. There are no directions for mixing. There are no ingredients. Does she want a 1:1:1 ratio of Maalox, Benadryl, and Lidocaine? Does she like the fancier version with Nystatin? Or Dexamethasone? Or Doxycycline?
COSPLAY: I don't know that. She writes it all the time.
CP: Then you should know what she uses. Does she have a recipe somewhere in the office?
COSPLAY: I've never seen one.
CP: Would it be possible to trouble her for the answers I seek?
COSPLAY: She's in a procedure right now.
CP: Of course.
COSPLAY: Can't you just give her the usual?
CP: That's like me flying to Saskatchewan, walking into a random bar I've never visited and asking the bartender to give me "my usual".
COSPLAY: Well she writes it all the time.
CP: I'm guessing you were hired to answer phones and the only qualifications asked of you were: "can you say 'Hello?' in a sweet voice?" and "can you make appointments in the computer?".
COSPLAY: She writes it all the time. Just give her the usual.
CP: Okay. Here's what we're going to do. I'm going to tell you what I'm going to write on the prescription. I'm going to put your name on it as the person who approved it. Then I'm going to fill it and give it to the patient. Verstehen?
COSPLAY: Okay. I'm not going to end up on one of your posts...am I?
CP: Sorry. I'm mentally writing as we are concluding our business.

Wednesday, October 14, 2015

For What it's Worth

Everyone has a price point. There is a point at which the value of the item is exceeded by its cost. Some people spend an extraordinary amount of money on their pets. Fine. Good for them. Others spend money on baubles and trinkets and collectibles. To each his own and all that. At what point do you care less about your health than anything else?

Very Anxious Geriatric In Need of Application: Did my doctor call in my prescription? 
CP: Yes. Yes, she did. 
VAGINA: How much is it? 
CP: $286.57. 
VAGINA: Really? 
CP: Yes. 
VAGINA: Why so much? 
CP: You have $233.00 applied to your deductible. After that, your copay will be $53.57 henceforth. 
VAGINA: That's a lot for a cream. 
CP: Yes, ma'am. But if it works...
VAGINA: I've tried other things in the past but this is so expensive. What's this one called?
CP: Estrace. Vaginal Cream. 
VAGINA: Okay. Does it work? 
CP: Haven't tried it. 
VAGINA: And it's how much? 
CP: $286.57 today. $53.57 going forward now that your deductible has been reached. 
VAGINA: Okay. Let me think about it. I'll probably be down later. 

CP: (to uber-tech) How much is your vagina worth to you? 
UT: What? 
CP: Is it worth more than $200.00? 
UT: Yes. 
CP: Ok. Just checking. 
UT: I'm surprised you didn't ask her that. 
CP: Thought about it. Was afraid of the answer she'd give me. I didn't need to hear about The Tin Man and his Oil Can. 
UT: Ew. 

Tuesday, October 13, 2015

I'm on Vacation

I hear everything. I have to be on high alert. It's just how my brain works. It helps if I need to jump in on an interaction with a belligerent patient at pickup. It also helps when my technicians may be asked questions to which I know the answers, like if we have something in stock. Anyway, on this particular occasion, I was lurking behind the wall, cramming a donut into my maw while simultaneously thumbing through my fantasy football lineups. I overheard a patient, Runs-With-Scissors, asking my technician if we would sell syringes to her over the counter. I was obliged to help this poor, unfortunate soul until I rounded the corner and walked into the conversation.

RWS: I am trying to buy syringes for my insulin.
CP: Okay. What brings you here today?
RWS: I'm on vacation from Iowa.
CP: Uh-huh.
(aside to my tech: "she does realise we are currently in Iowa, right?")
Uber-Tech: (whispers to CP: "I don't think so.")
CP: Where do you usually fill your prescriptions?
RWS: Hometown Pharmacy.
CP: Which insulin do you use?
RWS: (smiling, like she was waiting for this question, she proudly answers) PORK!
CP: Okay. Well, they haven't made that insulin since 2006 but there is a Hometown Pharmacy just down the tracks a bit. Perhaps they could look up your information from your home in faraway Iowa. RWS: So you can't help me?
CP: No. I believe that to be an impossible task at the present time.

Monday, October 12, 2015


I was tooling around Costco the other day looking at all the mega-size bottles for sale and I had an epiphany. First I thought "who can use this much Honey?" when I saw a 3 pack of litre bottles shrink-wrapped together. Then it hit me. People take these big bottles and dump them into smaller bottles at home, just like we do with medications at the pharmacy. It was at this point that I started talking to myself. Hey, it happens. 

Myself: <laughing>
CP: What's so funny? 
Myself: Remember the post you did last week about the 3D printer? 
CP: Yeah. What about it? 
Myself: Remember how the one guy asked if he could just have the "ones you dump from the bigger bottles into the smaller ones"? 
CP: Of course. Where you going with this? 
Myself: I have an analogy for you. Since I know you love little literary devices. 
CP: Intrigued.  
Myself: You're always looking for a comeback or some way to put someone in his place for belittling you and your job. 
CP: Okay. 
Myself: This time it's waitresses. 
CP: Go on. 
Myself: Saying that all we do is pour pills from big bottles into little vials is like saying that all a waitress does is pour ketchup and salt & pepper from big bottles in the back into small bottles on your table. 
CP: No one's going to catch the similarity. 
Myself: Sure they will. They greet you when you sit at their table. They take an order from you. They hand the order off to be prepared and deliver it to your table. Afterward, they send you to the cash register where you are asked if everything with your meal was to your satisfaction. The only part you saw was when she refilled your drinks from the big pitcher, or your condiment containers from the big bottles, and when she took your order, then delivered it, along with the bill. You didn't see all the other work she did in the kitchen. You didn't see her waiting other tables in the other room or outside. You didn't see her ringing register while the hostess was on break. You didn't see her taking phone orders for curbside pickup. 
CP: So now you're saying we're just glorified waitresses? 
Myself: No. I'm saying we are kindred spirits. We are compadres. We are forced to smile at people while they denigrate us and our work to our faces while we are trying to do our job FOR them. 
CP: Got it. You're a strange little person. 
Myself: I know. 
CP: Deep Thoughts. 
Myself: Know what's phunny? 
CP: You changing all your "F's" to "PH's" in everything you write? 
Myself: Haha. No. This post was supposed to be one line, short enough for a twitter post. 
CP: Okay. Which line? 
Myself: I'd intended it to only be about where I said "saying pharmacists only put pills from big bottles into smaller ones is like telling a waitress her only job is filling ketchup, S&P, and drinks on your table from bigger vessels in the back". 
CP: Phunny. 
Myself. Don't you start...

Friday, October 9, 2015

How to be a Better Patient

How to be a Better Patient...
1. If your prescriber sends your prescriptions electronically, either
a. call before you come to the pharmacy to verify we received them and make sure we have your information, or
b. come to the drop off window to verify the same.
This way you won't have to wait in a long pickup line only to discover we've not yet received or even started filling your prescriptions. It helps us prioritize and helps you manage your time. 
2. Read Your Insurance's Explanation of Benefits. At least give it a cursory glance on the key points: copays, deductibles, preferred pharmacies, mail order requirements, and formulary restrictions. I'm like the general practitioner of insurance: I know a little about a lot. You are the specialist, the one who knows a lot about a little, when it comes to YOUR insurance. Help Me to Help You. 
3. Read Your Labels.
They tell you how and when to take your medication. If your prescriber changed anything, it will be on your newest label. Read it. Even if we counsel you on the changes, by the time you get home, it is difficult to remember everything you heard in a whirlwind morning of office and pharmacy visits. 
4. Refills. Now that you've read your labels, note the refills. Also, call them in 3 to 5 days early. This will ensure the prescription refills are valid and allow the pharmacy time to process any refill requests, insurance issues including prior authorizations, and order the medication if it is out of stock. You don't have to pick it up right away since you still have medication remaining so thank you in advance for giving us time to make sure everything is correct for you. 
5. Pick Up Your Prescriptions...Now!
I know. I just said call them in early and wait a couple days. This is for the patients who sign up for the refill service and, despite 3 phone calls, texts, emails, and skywriting campaigns, still do not pick up their medications within 13 days. It wastes our time to fill prescriptions you do not need. It wastes resources to keep them filled and continue trying to contact you. It phrustrates you when you come in, the day after we return them to stock, expecting them to be there and now we have to scramble to get them ready for you post haste. Please come get them. They are lonely without you. They miss you. Maybe we could send snapshots of unadopted prescriptions like the local pound does with puppies and kittens...
6. Know what you're taking and, more importantly, WHY! and Ask Questions!
After reading the labels, call us. Or review everything with us at pickup. We are not as imposing as your prescriber. We don't have other appointments that are running behind. We are here for you. The more medications you take the harder it can be to remember what you are treating. My favourite question people are reluctant to ask is: "Did my medication change? It looks different from last time". I love this and tell all my patients who ask the same thing. This. Is. Awesome. It means you are actually paying attention to what you are putting in your mouth. 
7. Your Pharmacist is a well-educated Professional. She is a valuable resource for health information. Just because her work environment may seem like Chuck E. Cheese's does not give you the right to yell and scream like a toddler when you don't get your way.
Your prescription is just as important to her as the one before it and the one after it. So is your time. Maybe this time you don't have a question. Maybe another patient does. Maybe next time that person will be you. 

8. Patients need Patience.
Prior Authorizations happen. Out-of-stocks happen. Wait Times happen. Phone Calls Happen. Consultations Happen. Why is the pharmacy busy? People like us. We're popular. Just like you, other people are unwell as well. Just like you're not alone in this world, you're not the only person who is sick today. Not surprisingly, you're not the only person who felt now was the perfect time to get a flu shot. You're not the only person who decided to go shopping the day after Thanksgiving either. As I've said in a previous post: If it is at all possible, avoid peak times at the pharmacy. This basically means all Mondays, Weekdays from 11-1 and 4-6, and days immediately before/after holidays. 

Wednesday, October 7, 2015

Silly Stuff People Say...

1. "They called and said my prescriptions are ready to pick up and I can't come in until tomorrow."
CP: Okay. And who might you be? Because you're our only patient. Anyway, I'm busy tomorrow. Can you make it the day after the day before tomorrow instead?

2. "I'm having a drug test tomorrow. I hope I pass."
CP: Did you study?
(This was from a person who had never used illicit substances but truly was afraid of not passing.)

3. "I'll be back sometime before you close."
CP: Good, because after we close makes no sense...unless you're planning on robbing us. That's a good time for that.

4. "I need a refill on my white capsule. It's 100 megatons."
CP: That's heavy, Doc.

Tuesday, October 6, 2015


Pharmacy Phun with Patients. The next time someone asks "what's taking so long?" or is dull enough to utter "all you do is put pills in a bottle", surprise them with this witty tete a tete.

Irascible Dude Getting All Fervid: What's taking so long?
CP: Your prescription.
CP: Printer Problems.
IDGAF: I don't care about that.
CP: Well, you did ask. I assumed you were being empathetic.
IDGAF: I watched my doctor send it over an hour ago.
CP: And?
IDGAF: I assumed when he hit "send" it just came out done.
CP: Oh. Like hitting "start" on your microwave instantly cooks your bag of popcorn?
IDGAF: Yeah. I mean, no. But I saw him send it.
CP: I'm sure you did. Ever send an email?
IDGAF: Of course.
CP: Ever see what happens to it after you hit "send"?
IDGAF. No. I'm not there.
CP: And neither were you here. As for our printer problem, more importantly the one that directly affects your prescription, it's a little slow. It's the newest printer you can get.
IDGAF: It should be faster then!
CP: Not exactly. It's a 3D printer. It prints out each individual dose, one-at-a-time. Your doctor ordered 180 capsules. It's going to be a while.
IDGAF: Can't I just get one of those you just slap a label on?
CP: Nope. Not what your doctor ordered. My technician is busy sitting in front of the printer, holding a vial, waiting for each capsule to be completed so she can grab it off the printer and place it in the vial. It's a very labor-intensive endeavour. Not sure how long it's going to take to even get to the label slapping part.
IDGAF: What about the ones where you just takes pills from a big bottle and put them in a smaller bottle?
CP: We're out of those.
IDGAF: What are all those bottles behind you?
CP: Antique displays.
IDGAF: What?
CP: Ever been in a pharmacy where they have cute little decorative urns and mortars and pestles, and glass bottles of many colours?
CP: Throwbacks to the days when we were apothecaries and actually made your medications. Now we use those as pharmacy decorations. Same with these stock bottles. We need something to take up all this shelf space. Wouldn't want patients thinking we didn't have anything in stock.
IDGAF: This is absurd.
CP: No. It's cynical. Now go sit down, pull out your phone, and play Candy Mania until we call you.
IDGAF: Fine.
CP: Wait. Almost forgot... (singing) Do you wanna get a flu shot? What else you gonna do? You have a lot of time to kill. It's such a thrill. Just let me please shoot you!

Thursday, October 1, 2015

Drug Combos

In an effort to fully embrace our fast food mentality and expedite workflow, we need to learn from the restaurant business. We need to have catchy names for some of the most common prescription combinations. This way our data entry technicians, or those in charge of the drop off window, can shout: "Ordering! One Whiz-Bang* and a Dental Double**" to the line cook, er, filling station technician.

*Whiz-Bang=Cipro 500 and Flagyl 500
**Dental Double=Amoxil 500 and Norco 5mg
Steeler Special=Macrobid and Pyridium
Johnny-on-the-pot=Golytely and Dulcolax
Jump Around=Z-Pak and Medrol Dosepak (pack it up, pack it in...)