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Monday, November 27, 2017

We Take All Complaints Seriously. . . Except

Mistakes happen. Depending on your source, they either happen more frequently or less frequently than reported.
Sometimes it's a simple mistake.
Sometimes it's an error so egregious, lives are at risk.
Over-reacting helps no one.
Please do not overreact.
"Happy, smile. Sad, frown. Use the corresponding face with the corresponding emotion."

OverReacting Woman Expecting Lots of Love: I am calling to complain.
CP: <checks caller ID> What seems to be the trouble today?
ORWELL: You shorted my husband 1 tablet on his medication.
CP: My apologies.
ORWELL: What are you going to do about it?
CP: Nothing.
ORWELL: What!? This is his life-saving blood pressure medication. He needs it.
CP: And he has it.
ORWELL: I think someone down there is stealing his medication.
CP: That's quite a leap.
ORWELL: You did this to us last time. He always gets a 90-day supply and we noticed he was 1 tablet short last month. Now you owe us 2 tablets.
CP: I don't owe you anything.
ORWELL: He could die without it.
CP: He could. But he's not going to miss any of it. Perhaps, as you say, he was short 1 tablet.
ORWELL: We sat together and very carefully counted his pills and we only got 179.
CP: Must have been a phun Saturday night at the ORWELL household. Let me audit my inventory.
<checks on-hand quantity, dispensings, who counted their prescriptions>
My inventory is spot on.
ORWELL: So. What does that mean?
CP: You are the only person to have received this particular NDC of this medication in the last 6 months. Twice we filled 180 tablets for you. We had 400 tablets to start. We counted to 180 each time. I currently have exactly 40 tablets on my shelf. I am not over, nor am I short.
ORWELL: Well where is his extra tablet?
CP: How do you know we shorted him last month?
ORWELL: He takes it twice a day and he only had enough for his morning dose on the last day.
CP: I see. Thereby proving, beyond a shadow of a doubt, that we shorted you 1 tablet. Not only that, but that one of my employees is stealing it. Case closed.
ORWELL: Right.
CP: Could it not also be possible that your husband missed even 1 dose throughout the last 90 days?
ORWELL: No. He is very religious about taking these. He knows he can't miss a dose.
CP: He also could have dropped one.
ORWELL: I doubt it.
CP: As much as I doubt we are to blame. I do have a solution for you.
ORWELL: Which is?
CP: Next time you are down here, I will give you a counting tray and a spatula and have you count the medication in front of me before you leave the pharmacy. If you are short, I will give you one. If you are over, you owe me one. If your count is correct, you can go home happy and continue playing checkers on the kitchen counter with your prescriptions.

I know what everyone is going to say, "why not just give her 1 tablet and be done with it? Why continue to argue to prove a point; to prove you're an asshole?". First, my inventory would be off by 1 tablet. I hate that more than anything. Second, the patient would expect it and I'd set a precedent. (I have given a single tablet to patients in cases like these where warranted. Not in cases where patients accused my staff of stealing a single ACEI.) Third, these "kindnesses" would become expectations along with faxing prescribers for refills, automatic refills, and loaning "just a few" to get through the weekend. Fourth, I had a woman argue with me every month that I shorted her. I added an extra tablet to her bottle, thereby giving her an odd number, and waited for the phone call. When she complained about the odd number, I told her to examine her bottle where I initialed the quantity. I told her I added an extra tablet and was not putting up with her phone calls anymore. She never complained again.

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