What Separates us from Street Dealers (If the real world worked...)

Random thoughts that enter my head get turned over, chewed up, then spit out here for your amusement. Or derision. Let's go with amusement.
I do not like plastic bags for prescriptions. I wrote a post about this before. I tell my techs that street drugs come in plastic baggies, not prescriptions.

Building upon that, I had another thought yesterday. We received a few patients yesterday that had not filled with us in some time. Whether for insurance issues, relocation issues, or spite, they left us. Now they had returned. Companies want us to be jealous. They want us to compete for the affections (and money) and loyalty of every living, breathing human on the planet. Which led to me pondering if the local street dealers go out of their way to be jealous.

SD: So...where ya been? Haven't seen you around lately.
Local User: <looking down, shuffling feet> Had to transfer corners, man. Not allowed to cross the street anymore.
SD: Still got your stuff. I'm offering a coupon to all my regulars who return.
LU: Really? Is it good on anything?
SD: Yep.
LU: I changed my regular order while I was gone. The other guy was using some other supplier and his stuff wasn't as good as yours. I needed to change it up a bit.
SD: Well I got just what you need. Transfer all your orders to me and we can set you up with reminder texts, phone calls to get your next order placed, discount cards from my suppliers on their products, and we can even give you Naloxone in case you OD.
LU: Really? No one else offers that.
SD: It is incumbent upon me to satisfy the needs of my customers. I'm in the business of making money. Dead clients don't pay.
LU: What?
SD: I mean, it's business. The more I can get you to come to me to buy, the more money I can make. The more money I can make, the less the other guy makes. Eventually I can buy out his corner too.
LU: Thanks. I'm glad I came back. I didn't realise you offered all those services. You're such a caring dealer. You really care about my high and...
SD: Yeah yeah yeah. NEXT!

PayDay Med Advance

(Another in the series of "If the real world worked the way people believe Pharmacy does".)

My next business model for the phuture of pharmacy is to incorporate a Cash Advance system into our stores. If a person goes to a bank and whines that they are out of money until payday or they will die without $10.00 to get them through the weekend, the bank does not provide them a handout. The bank does not say "we will take it out when you come back with your check on Monday". This led to the proliferation of the Payday Loan establishments.

Initially, our model would open up inside a pharmacy. It would be an adjoining window, like a walk-up teller or ticket booth. Since we would have access to the patients' files, we could provide instant access to their medications. Eventually, and herein lies the beauty of the system, once pharmacists receive their limited prescribing status, our established business model would allow for freestanding stores to be built. Instead of being attached to a pharmacy, we could build on an outparcel in front of the pharmacy. We would be cash only of course.
While I'm shooting for the stars, let's assume we are able to get contracts with the major pharmacies in town to access their software. This way, we could operate one mini-PayDay Med Advance pharmacy in a town with a CVS, Walmart and Walgreen's.

Mr. No Refill Guy: I'm out of refills and I'm going to die.
CP: CP to the rescue. I can write you a prescription for enough medication to last until your appointment next week.
MNRG: Gosh. That'd be swell.
CP: Please see our rates on the board behind me.

Requires CP to write a prescription: $25.00 each
Filling of prescription: $15.00 (this is the dispensing fee w/o medication)
Medication: Cost of med (acquisition cost) plus 20% plus $10.00

MNRG: It's going to cost me $50.00 for this?
CP: Yes. And that is before I put any medication in your bottle.
MNRG: That's ridiculous.
CP: Perhaps. But I don't want you to die.
MNRG: Can you bill my insurance?
CP: For the medication I can. The $50.00 in fees still applies and is cash only.
MNRG: I think I'll just die.
CP: At that point it would be your choice. Keep in mind, as I'm sure we've reminded you in the past, the ER is always an option for those who don't want to die. This is a simpler, faster, cheaper alternative.
<waves bottle of medication in front of patient's face; gives them a taunting shake>
MNRG: Fine. I'll take them.
CP: Good. See you next month.

Because...Beer Remembers

Why is American Beer like making love in a canoe?

They're both fucking close to water. 

#montypython

I developed this business idea. My goal is to start small, then grow the business in every Pharmacy College town...and towns that have liquor establishments. Here's the idea:

After the weekend parties, I will have college students collect all the empty beer bottles and cans from all the fraternities and sororities on campus. They will bring them to my labrewery. 

Each bottle will be filled with water. 

Each bottle will be emptied into a large vat. 

Each bottle will again be filled. Then dumped. 

This will occur 11 times. 

After the vat has been filled, the contents will be slowly swirled. 

The next step in the process will be packaging. 

The vat will be emptied into individual bottles for distribution and sale. 

Initially I expect to use 30 ml bottles with droppers. 

The bottles will then be labeled and priced for retail sale at our store/pharmacy and on campuses and in bars across the country. 

Directions for use will appear on the label as follows:

"For prevention of intoxication, place 1 dropperful (1ml) under tongue once a day."

"Additionally, to prevent hangover from a night of binge drinking, take 5ml (5 droppers full) at least 2 hours before imbibing."

How it works...

Beer Homeopathy works as follows: Water has a memory. Beer is made of water. Therefore, beer has memory. By introducing minute, infinitesimally small, untraceable, immeasurable amounts of beer to your system on a daily basis, you can prevent hangovers and drunkenness from ruining your next party. 

It's Just a Word

Some words become overused to the point where people do not understand their definition anymore. A few that fall into this category, from strictly a speaking standpoint, would be "so", "like", and "literally".
"So" has become an introductory pause, effectively updating "um".
The abuse of "like" can be heard from any teenager, but is best exemplified by watching "The Valley Girls". Like, totally...
It "Literally" makes me want to gag myself with a spoon. Not!

Okay. Why the stupid lesson with words you use more smarterer than us?
Phunny, and it would be "words you use better than we..."
I just wanted to add one more word to the list.
It's just a little word.
We hear it at work every day.
It's directed towards us to oversimplify what we do.
Just.

According to definition #4 of the Oxford Dictionary, "Just" is defined as: "Simply; only; no more than."

As in:
It's just a refill.
It's just a box.
You just have to slap a label on it.
Why is it so expensive? It's just an antibiotic.
Why so much? It's just an eye drop.
Why is it taking so long? It's just one tablet.
I just have a question.

Unfortunately, we are often guilty of committing this error. How often does a person bring a bottle to the counter and our initial response is: "You just have a refill"?
Or we have to add insurance or a discount card when the patient is at pickup and our techs tell them "It'll just be a minute".

Everything takes time.
Give people a realistic expectation.
Maybe they'll learn.
If not we can stab them with our finely sharpened Spatula Kitanas and tell them it's just a flesh wound...

Is That Long For Something?

Names. I've done rants before about names and how they affect profiles. 

Hyphenated names? Hate them. 

Father-Son with the same name? Expect problems. 

Mother-Daughter with the same name? Ditto. 

Twins named Lynn and Lyn? #STFU

Triplets named Sean, Shaun, and Shawn? #GTFO

As complicated as the patients like to make our lives, and thereby their own, sometimes you just can't help some people. The following example will illustrate how it's not always the phault of the patients. 

Fade In. Monday. Bright Pharmacy Lights. (Imagine the sound of Law & Order with a Dunh-Dunh.)

The set up: Pharmacy sends refill request to prescriber. 

Prescriber returns faxed request with the following note: 

"Not. Our. Patient."

CP: Hello? Mr. Guy? 

LTCG: Yes. Speaking. 

CP: I am calling today to notify you that your prescriber denied your refill request. 

LTCG: What? Why? 

CP: Well, someone at the office scrawled across the top: "Not our patient". 

LTCG: What? I've been a patient there since they opened that office. Are you calling the correct place? 

CP: Yes. Perhaps you should call them. 

LTCG: I will. <click> 

Tuesday. (Dunh-Dunh)

LTCG: I spoke with the office. They said they haven't received anything from you. 

CP: Phunny. 

LTCG: They gave me another phax number to try. 

CP: Okay. Let's have it. I shall try this one. Did you ask them to take the refill request over the phone? 

LTCG: They said they require a phax. 

CP: If I am to understand, you had the office on the phone. To refill a prescription. That is yours. With them. We are too incompetent to send a phax correctly, yet they and you are dependent upon me to accomplish this? 

LTCG: Essentially. 

Wednesday. (Dunh-Dunh)

A new phax arrives: "NOT. OUR. PATIENT"

CP: Guess what? 

LTCG: What? 

CP: Chicken Butt. 

LTCG: Again? 

CP: Yep. 

LTCG: You need to call them. 

CP: I will. If for no reason other than I cannot wait to see how this one ends. 

Thursday (DUNH-DUNH!)

Dr. Zoffis: Allo?

CP: Hi. We have been trying to get a refill authorization from your office for our mutual patient. We have sent phaxes to you on Monday, Tuesday, and Wednesday, per your requirement. To his credit, Mr. LTCG has phoned your office on these days as well. Each of our requests has been returned with the following note: Not Our Patient. Can you explain how this could be? 

DZ: Yes. (and I quote) "You sent us a refill request for a Lawrence The Cable Guy, DOB 2/17/63. We have a LARRY The Cable Guy, DOB 2/17/63 but NOT a Lawrence." 

CP: Okay. Can you hold while I slam the phone into my phorehead a few times before returning to make phun of you and your staff? 

DZ: Sure. 

<CP slams phone into phorehead>

CP: Do you have any Tom's or Tommy's there? Perhaps a Thomas? Joe? Joseph? Joey? Jen or Jennifer or Jenny? Mike or Michael? Ooh Ooh..How about a Jon or John or Johnathan? You had the patient's name. The DOB. The address. The phone number. They all matched. You have officially lowered the bar on stupidity's expectations. No. You grabbed the bar, dug a hole, threw the bar into the hole, then jumped on it. Criminals taking selfies at the crime scene then posting them on social media are laughing at you right now. 

You Misunderstand My Business

We are in the business of making money. Yes, it's healthcare. However, if you're not making money, you're not surviving. With that in mind, I sometimes, okay, daily, wonder what people think our job actually is.

Accuses Me Of Essentially Being A Liar: I'm here to pick up my prescription.
CP: Let me check to make sure we have it.
AMOEBAL: You should. (This is followed by any or all of the following):
1. I watched him send it.
2. I just left the office.
3. "They" called me and told me it was here.
4. "Someone" called and said "they" sent it.
CP: Unfortunately, whoever "they" are were mistaken. We do not have any prescriptions for you.
AMOEBAL: I know it's here.
CP: I don't know who your inside source is, but you have received bad intel. We do not have any prescriptions for you.
AMOEBAL: You're lying to me!
CP: Okay. Let's examine this for a minute. I get paid to FILL prescriptions; not to NOT fill them. Therefore it is in my best interest to fill as many as I can. The more I fill, the more money I make. Get it? It's not as if there's some little 20's mobster with a Tommy Gun, or Henry Hill himself, standing in front of my pharmacy counter handing out $100s to throw away your prescription. "Psst. Don't fill the next prescription you get." Capisce? Now our friend, Luca Brasi, will escort you to your car.

#WakeUpYouNeedToMakeMoney

The Truth Shall Set You Free

I do not suffer ignorance gladly at my pharmacy. This is especially true when the ignorance of others is directed towards me or my staff. Just because you're an intolerable git does not mean I have to listen to you abuse my staff. This person learned that lesson. 

Intern Extraordinaire: I just need to put your new information in the computer. 

Patient Lacking Usual Manners Probably: All I want is a price. 

IE: Today is the first of the month and the first of the year. Our system is running a little slow. 

PLUMP: <sighs loudly> 

...meanwhile, 2 feet away, CP is entering new information for another regular ole patient.

ROP: Busy today, I see. 

CP: Got that. Worst time of year for pharmacy. 

ROP: No worries. I know how busy you guys are. 

CP: Thanks. The computers are a little slow with all the changes and updates. 

ROP: Take your time. 

IE: Sorry. The computers are giving me a hard time. They're a little slow. 

<IE walks away to the printer at which time I hear...>

PLUMP: Or it could be user error. 

Uh-oh.  Oh. No. You. Didn't!

Time to intervene. 

CP: Excuse me? I'm sorry, but did you just say "it could be user error"? She just told you the computers are running slow. You also just heard me say the same thing to this gentleman right here. It's the first of the month, the first of the year, the weekend, and it's 10am. Everyone's insurances have changed and the companies are processing their updates on the weekend. She has apologised for the wait a few times and you have the balls to say "it might be user error!"? 

PLUMP: Sorry. I just figured maybe it was a training issue. 

CP: Seriously!? So now you not only have the stones to call IE incompetent, but you have the audacity to insult me and how I train my staff? You have quite the nerve. I'm so sorry we let you down with our incompetence. You are quite welcome to go to another store that has well-trained, competent staff who may more readily meet your needs and demands. 

PLUMP: Uh...

CP: Sorry for that rude interruption. 

ROP: Not a problem. I know how it is here. You guys are always so nice and helpful and patient with me. I really appreciate it. 

CP: Aw...<blushes>

PLUMP: <quietly waves IE over and whispers> may I have my prescription back? I want to see something on it. 

IE: <unaware of my conversation with PLUMP> Sure. Here you go. Thank you. 

<PLUMP fakes a cell call, walks to the end of the aisle, and slinks away.>

CP: Well that was phun. 

ROP: What. A. Bitch! I couldn't stop staring at her. I figured this bitch can't be for real. 

CP: She was. Unfortunately we have phar too many people like her today. 

ROP: You handled her well.

CP: Rule Number One in my pharmacy is you don't phuck with my staff. 

We Need to Break Up

Every day we deal with patients threatening to leave us. Whether it's customer service related, belief insurance prices will be lower, or some other perceived slight, we hear this frequently. The phunny thing is, as we all know too well, the patients who do leave manage to boomerang back to us in a month or so.
People like to believe the grass is greener on the other side. When you turn grass over, it's dirt.

After dealing with far too many patients this week insulting my staff, I finally realised what made this scene all too familiar: Patients are like your ex-significant other.

They pick fights with you.
They tell you you're no good for them.
They tell you they can do better.
They threaten to walk out.
They constantly complain about you to others.
They eat up all your time and energy.
They make you do all the work for them.
They do nothing for you.
Then they leave...

...which is good...

Until...they want to come back and...
They complain about the new person.
New Place didn't treat them the way you did.
New Place didn't know them like you did.
New Place didn't do that special thing they liked.
They didn't know they had it so good with you.

Are we really that desperate? Really?
Do we really need/want this person back?
Wasn't there a reason we were glad to see them go in the first place?
Didn't we have a Bye, Felicia Party the day they transferred?
Isn't the annoying little rash that keeps coming back enough of a reminder of the failed relationship from the first go-round?

#SorryNotSorry. You broke up with me. I've moved on. There are still a few other pharmacies for you to try.
#SellCrazySomePlaceElse