Va-Giant!

I received the following prescription, along with the accompanying old joke, from a pharmacist last week.



I got a kick out of this Rx yesterday. One gallon?? What is that, 128 tubes?? Kind of reminds me of the old joke where the patient is having an exam by her GYN. Patient: How does it look Doc? GYN: WOW, that is the largest vagina I have ever seen,,,WOW, that is the largest vagina I have ever seen,,, Patient: Well, you did not have to say it twice. GYN: I didn't.

As a phan of alliteration, I felt it was up to me and L'Intern d'Grande to develop new euphemisms for the vagina that could hold a gallon.

We started with the obvious: Cavernous Choach, Gargantuan Garage, Conception Canyon, and Voluminous Vagina but decided that 3 words might best fit the task at hand. And it got worse...
Behemoth Baby Baker?
Humungous Human Heaver?
Spacious Sapiens Shooter?

Stupid is as Stupid Does

Ever have one of those coworkers that just couldn't figure out how wrong they were? Even when you showed them they were making mistakes, they refused to believe you? I don't tolerate stupidity very well, especially when I have to do more work to correct you.

CP: You forgot to do this. Again.

Twit Of The Day: "Well, if you're not making mistakes, you're not learning anything."

CP: Then you should be the smartest person in the pharmacy.

Corporate Is Smarter Than You!

A(nother) Conversation With Myself...

CP: Hello? Self?
SELF: Yes. It is I. What troubles you?
CP: It's been...many years since I last sought your counsel.
SELF: I know. Get on with it. People are waiting to see if this will be phunny or not.
CP: Got it. We need to stock more Epipens.
SELF: Why?
CP: It is peak season.
SELF: I see. End of summer combined with back-to-school.
CP: Exactly. So you understand my phrustration?
SELF: Not exactly. Corporate says "no". When corporate wisdom says "no" they are to be obeyed for their omniscience shall ne'er be question'd.
CP: Why does corporate say "nae"?
SELF: The very complex computer algorithm thingy shows a history of using only 2 packs per week.
CP: But it's peak time. The averages don't work now.
SELF: That's just what they tell us.
CP: But we need them, just in case.
SELF: But, according to corporate, you probably won't use them.
CP: Kinda like the patient, amiright?
SELF: Now you're catching on.
CP: I'm glad you're willing to take the risk for the patient. We wouldn't want them to pay for something that has become prohibitively expensive that they're just not going to use anyway.

CP: But seriously. Why does corporate insist on using rolling 13 week averages (just one of many options they have for programming their inventory control) to select inventory? The gas company anticipates I shall use an amount of gas similar to last September during this September. My June demand will not be the same as my February or my October demand. Antibiotics and lice treatments will be all the rage here in one to two weeks while ear drops and allergy medications will have to wait until their numbers are called again next May to enjoy prominence on our shelves. I know this. You know this. The public knows this (for they tell us all the time when we are out of stock) but corporate does not.

The next time your pharmacy is out of Medrol Dose Paks, Ciprodex Ear Drops, Epipens, it's not (always) their phault. You know those items that the big retailers advertise in their weekly sale ads? Very popular that week and likely to sell through.

What (Not) To Say During Flu Shot Season

1. CP: How'd it go? 

    CPP: I boned the flu shot lady. 

    CP: You did what? 

    CPP: That sounded bad. I hit bone.

2. Don't tense up while I pull out. 

3. I didn't expect to get so deep. 

4. Just relax, it goes in easy. 

5. Oh God! Is it in? 

6. Pt: Well that was quick. I didn't feel a thing. 

    CP: That's what she always says. 

7. Time to play a little of the in-out, in-out.  

8. CP: Ok. You're going to feel a little prick. 

    Pt: That's what my last boyfriend said too. 

9. Just stick around for about 15 minutes ... I'll make you breakfast. 

Euphemism

A mild or indirect word or expression substituted for one considered to be too harsh or blunt when referring to something unpleasant or embarrassing:

CP: How may I help you today, kind sir?
Creepy Old Dude Giving Ejaculatory Responses: I need your help.
CP: In what capacity?
CODGER: I need a little pick-me-up.
CP: You're depressed?
CODGER: No.
CP: Narcoleptic? Always dozing at the bingo hall?
CODGER: No. I need a lift.
CP: You...want me to call a cab?
CODGER: No. It's not hard!
CP: Actually it is. You could just come right out with it.
CODGER: That's the problem. It won't come out.
CP: What?
CODGER: My pencil.
CP: And you're at the pharmacy for...?
CODGER: I need lead in my pencil.
CP: Oh. Okay. I think I got it now. Follow me.
<walks out to the back-to-school section>
Here you go.
CODGER: What's this?
CP: Lead. For your mechanical pencil. Do you need the 0.5mm or the 0.7mm?
CODGER: I need an erection.
CP: Oh. Why didn't you just say so? Here.
CODGER: What's this, now?
CP: Since we're in the school aisle, I thought it convenient to hand you duct tape and some tongue depressors. Think splint. Anything else I can help you find?
CODGER: Headache medicine.
CP: Isn't your wife supposed to give you that excuse?

But...how?

Drop-off window.
A patient.

A prescription. 

A basket. 

A question.

Prioritization is key. Some people excel at it. Others, not so much. (Think about dropping off your prescription BEFORE putting ice cream in your cart. Just saying.)

Basket Lady Presenting Rx: I am here to drop off this prescription. 

CP: Swell. Would you like us to fill it too? 

BLPR: That would be most ideal. 

CP: Will you be waiting for us to fill it? I noticed you have a basket and it is empty. 

BLPR: As it is empty, your observation is most correct for I do intend to shop while you prepare it. 

CP: Lovely. 

BLPR: For my reference, how long will it take? 

CP: Approximately 11 minutes. 

BLPR: Delightful. 

CP: Oh. While we were talking, it appears they have already managed to bill your insurance for it. 

BLPR: Oh my. That was fast. 

CP: <That's what she said> Yes. We are on the ball today. It will be yours for the low low price of two whole dollars!

BLPR: Oh. Really? 

CP: Yes. I can make it more if you like. 

BLPR: No. It's not that. I will have to come back. I don't have $2.00. 

CP: But you're going shopping. You have a basket. It is empty. You said you were going to buy stuff. You're not on Medicaid so you can't be using a SNAP card. How, pray tell, do you intend to pay for the sundries?
BLPR: Never you mind. Just know I shall return.
CP: Of that I have no doubt. 

A Little Pharmacy Phun

Guy In Search Of Memory: Do you have Prevagen?

CP: I do not believe we carry that. Let me check. 

GISOM: It's for memory. 

CP: Oh. We do not carry it. 

GISOM: You don't? 

CP: I told you once. 

GISOM: No you didn't. 

CP: I most certainly did...
GISOM: But you didn't even check.
CP: I did.
GISOM: Didn't.
CP: Did.
GISOM: You did?
CP: I did.
GISOM: Wow. I really need to find that.

Pharmacy Phantasy

It's that time of year, the time when everyone starts researching players for their Fantasy Football Drafts. As I prepare my own teams, it occurred to me that we are missing an in-store opportunity here.

What about Phantasy Pharmacy? 

What about drafting patients? 

Each store would be its own league made up of pharmacists, interns, and technicians. 

Points would be awarded in the following categories: 

1. Phone Calls  = 1

2. In-Store Visits  = 2

3. New Prescriptions Filled
    1 Rx = 1
    2 Rx = 2
    3 Rx = 3
    4 Rx = 4
    5 Rx = 5
    6 Rx = 7
    +2 for each Rx filled thereafter

4. Prescriptions Refilled = 1

5. Prescriptions Returned to Stock = -1 / Rx up to 5 then points reduced per New Rx Filled scale

6. Personal Calls (from patients requesting a specific employee) = 2

7. Complaints to the 1-800# (negative points) = -3

8. Compliments to the 1-800# (positive points) = 3

9. Insurance Changes = 2

10. Manufacturer/Discount Cards presented = 2

     (positive for presentation at drop-off, negative for presentation at pick up)

11. Vaccines Received (bonus points if more than 2 administered in one visit)

     Flu=1, Pneumo=1, Shingles=2, Hep A or B=3, TDaP=3, MMR=4, Meningococcal=5, HPV=5

12. Enrolled in your Med Sync Program = 10
13. Removed from your Med Sync Program = -10 

14. Transfers In = 1.5 / Rx
15. Transfers Out = -1.5 / Rx

Obviously, some weeks you would do better with certain patients. The first of the month is a good time for the high volume refillers. A month with 5 Mondays or Fridays or weekends would help in some categories as well. 

We could play the game head-to-head one week at a time for a full season or we could draft every month or two and have a winner-take-all at the end of the year. 

We would make available each patient's statistics and post them to the mock draft board. 

Jane Smith leads the store in phone calls per day while only filling two prescriptions regularly. However, she is seeing a new prescriber. 

John Smith is never happy when he visits and he only calls when he needs his Viagra refilled. However, he must have found a new girlfriend because he is in our store 3 times a week buying one tablet at a time and he always calls first. 

Jacqueline Smith leads the store in 1-800# complaints and gift cards received. She also finished last season third in the company and is seeking to move up to a CC1 (Chief Complainer #1). 

(Un)Educated Question

We deal with many questions. Patients want to know about their diagnosis, their treatment, where to find batteries, what their rash is, etc. It's no surprise we have to answer so many, what we consider to be, "weird ones" with the ordinary. I impress upon my students that to the inquirer, their question is important to them...
...unless, of course, the asker prefaces it with "I know this is stupid, but..." then it is okay to mock them later.

<Phone rings>
CP: Allo? CP's Emporium of Drugs.
Overly Dramatic Dame: I know this is stupid, but I have a question for you.
CP: It's not stupid to have a question. Lots of people have questions.
ODD: Good point. Let me try again. I have, what I perceive to be, a stupid question.
CP: There are no stupid questions, only stupid people.
ODD: Right. Um...
CP: That's why I like working retail. You never know what you're going to hear on the other end of the phone.
ODD: Good way to look at it.
CP: Ask away!
ODD: Oh. Right. So I was just there buying ice cream.
CP: Oxygen Potassium...
ODD: And the lady in front of me was buying stuff for lice.
CP: Uh-huh. So you two bought L-ICE Cream together?  How Cute.
ODD: Well, she told the cashier she had head lice. "Did I get it?"
CP: Lice?
ODD: Yes.
CP: Did you hug her?
ODD: No.
CP: Did you have a sleepover with her?
ODD: Odd question, but, no.
CP: Did you slow dance together in line? Cheek to cheek? Put your head on my shoulder kind of 60's groove?
ODD: Um. No.
CP: Okay. Then you should be in the clear.
ODD: Really? I wasn't sure.
CP: Which is why you asked. I appreciate that. Note that I used levity to ease your mind, not make you feel too stupid about your question, and still answer in a way that left you wanting more from me.
ODD: That's great. I feel so smart now.
CP: Want another simile?
ODD: Sure! Your writing and true, daily conversations are so invigorating and honest. I can't get enough.
CP: Thinking you can get lice by standing in line behind someone at the grocer is like thinking you may have become pregnant by standing in line behind the guy buying condoms because, to your knowledge, he wasn't wearing one at the time.
ODD: You have a rather warped brain.
CP: I know. My staff tell me that all the time.

Counseling and Labeling 101

Okay: Take this medication as directed prior to colonoscopy.
Not Okay: Juice the sluice and let 'er loose.

Patient Logic

Patient and, for that matter, general public logic seem rather irrational. There is no way to explain what happens inside the brain of an individual patient or an hysterical group of fanatics (see the people who managed to get Trump AND Clinton to the POTUS Finals...)
But I digress.

CP: Welcome to Pee Wee's Playhouse. How may we help you today?
Always Complaining Never Ebullient: I need to know if you have this medication in stock.
CP: I am certain we do but shall check it doubly.
ACNE: Mmm-hmm.
CP: My brain, like the North, remembers. We do have it.
ACNE: Good. I shall wait for it.
CP: Okay. It'll be about 7 to 11 minutes.
ACNE: Wow. That quick?
CP: We are quite efficient here.
ACNE: I was just at your other location. I don't know why I keep going there. This is the seventh month in a row they haven't had my medication in stock. And they told me it'd be 45 minutes to get it ready. When I got back up to the counter, they told me they didn't even have it.
CP: Which brings you here. Welcome! We always stock this particular medication and strength for we have many people on it.
ACNE: They said it wasn't that common.
CP: Well it isn't if you don't stock it. We happen to always have it which may be why it is more common to us. Though it is surprising with them only 6 minutes down yonder to not see it nearly as frequently. Have you considered transferring here?
ACNE: What? No. I live halfway between the stores but they're so much more convenient.
CP: Uh-huh. I don't follow.
ACNE: They have a drive-thru so I can drop off without putting on pants to go inside.
CP: Lucky ladies.
ACNE: Then I can swing back by and pick it up without getting out of my car.
CP: Very convenient.
ACNE: Plus their pharmacy is on the side and not in the back so when I do decide to go inside, I don't have to walk as far.
CP: With pants...Sounds like a well-planned location. Everything seems perfect and convenient except one thing.
ACNE: What's that?
CP: They don't ever have your medication in stock. You have to drive to that pharmacy, drop off your prescription, then discover they are out of it. THEN you leave there, drive past your house in the opposite direction "to the Chelsea drug store to get your prescription filled" because we do have it. Sound about right?
ACNE: Yes. But I don't like coming here.
CP: Praytell...
ACNE: You're not convenient.
CP: You keep using that word. I do not think it means what you think it means. Try this definition: "Fitting in well with a person's needs, activities, and plans".
ACNE: See, right there, this is why I don't come here.
CP: Other than every month to get this prescription only we carry.
ACNE: Right. What?
CP: Don't let your incredulity keep you from calling our 1-800# and telling them how awesome we are. In-stock issues are actually a measurable metric for our bonuses. But make sure you tell them the other store is always out of stock.
ACNE: Nah. I don't call on those. Unless they give me something, I'd rather complain to you about it.
CP: I see. Yet here we are, just a boy, staring at a pharmacist, hoping to get the other store to like him and carry what he needs.
ACNE: You're weird and I couldn't even keep up with your references today.
CP: Thanks. But your prescription is now ready. See you next month.

Patient Logic

Patient and, for that matter, general public logic seem rather irrational. There is no way to explain what happens inside the brain of an individual patient or an hysterical group of fanatics (see the people who managed to get Trump AND Clinton to the POTUS Finals...)
But I digress.

CP: Welcome to Pee Wee's Playhouse. How may we help you today?
Always Complaining Never Ebullient: I need to know if you have this medication in stock.
CP: I am certain we do but shall check it doubly.
ACNE: Mmm-hmm.
CP: My brain, like the North, remembers. We do have it.
ACNE: Good. I shall wait for it.
CP: Okay. It'll be about 7 to 11 minutes.
ACNE: Wow. That quick?
CP: We are quite efficient here.
ACNE: I was just at your other location. I don't know why I keep going there. This is the seventh month in a row they haven't had my medication in stock. And they told me it'd be 45 minutes to get it ready. When I got back up to the counter, they told me they didn't even have it.
CP: Which brings you here. Welcome! We always stock this particular medication and strength for we have many people on it.
ACNE: They said it wasn't that common.
CP: Well it isn't if you don't stock it. We happen to always have it which may be why it is more common to us. Though it is surprising with them only 6 minutes down yonder to not see it nearly as frequently. Have you considered transferring here?
ACNE: What? No. I live halfway between the stores but they're so much more convenient.
CP: Uh-huh. I don't follow.
ACNE: They have a drive-thru so I can drop off without putting on pants to go inside.
CP: Lucky ladies.
ACNE: Then I can swing back by and pick it up without getting out of my car.
CP: Very convenient.
ACNE: Plus their pharmacy is on the side and not in the back so when I do decide to go inside, I don't have to walk as far.
CP: With pants...Sounds like a well-planned location. Everything seems perfect and convenient except one thing.
ACNE: What's that?
CP: They don't ever have your medication in stock. You have to drive to that pharmacy, drop off your prescription, then discover they are out of it. THEN you leave there, drive past your house in the opposite direction "to the Chelsea drug store to get your prescription filled" because we do have it. Sound about right?
ACNE: Yes. But I don't like coming here.
CP: Praytell...
ACNE: You're not convenient.
CP: You keep using that word. I do not think it means what you think it means. Try this definition: "Fitting in well with a person's needs, activities, and plans".
ACNE: See, right there, this is why I don't come here.
CP: Other than every month to get this prescription only we carry.
ACNE: Right. What?
CP: Don't let your incredulity keep you from calling our 1-800# and telling them how awesome we are. In-stock issues are actually a measurable metric for our bonuses. But make sure you tell them the other store is always out of stock.
ACNE: Nah. I don't call on those. Unless they give me something, I'd rather complain to you about it.
CP: I see. Yet here we are, just a boy, staring at a pharmacist, hoping to get the other store to like him and carry what he needs.
ACNE: You're weird and I couldn't even keep up with your references today.
CP: Thanks. But your prescription is now ready. See you next month.