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Friday, September 21, 2018

Yes, This Is The Recommendation You Are Looking For

There's a difference between ignoring the advice you sought and arguing with the source.
Angry Little Elf Seeking The One Remedy Miracle: I need your advice. I come here all the time.
CP: What seems to be the trouble?
ALESTORM: I scraped my arm on a screw and now I have this inch wide scrape and I need to know what to do.
CP: Have you had a tetanus shot?
ALESTORM: Why? That's for rusty nails. I put peroxide on it.
CP: Ok. Maybe not the best choice.
ALESTORM: But it fizzed.
CP: Yes. That's the murder of millions of your cells, all screaming in their death throes. Did you try a bandage?
ALESTORM: Yes. But it kept sucking the blood out of me.
CP: Vampire bandage? Made by Lestat?
ALESTORM: What do I do? I'm not going to the ER, my doctor won't call me back, and I need your advice.
CP: Promise to take it?
ALESTORM: Nope. But I'll argue with you if you don't tell me what I don't know I want.
CP: Sounds right. Wash it with water. Pat dry. Place Neosporin Cream on it. Cover it with a bandage.
ALESTORM: But I don't want the bandage to suck out my fluids.
CP: Your wound is weeping. It will weep whether there is a bandage on there or not. This keeps you from moisturizing everything you touch with your flesh wound. Please cover it.
ALESTORM: Do I need waterproof or regular?
CP: Regular is what I handed you.
ALESTORM: But should I get waterproof?
CP: Planning on swimming soon? Getting a fish mani-pedi?
ALESTORM: No. But I'm washing my hair.
CP: Since this is on your forearm, I'd hate to see how you wash your hair if you're going to get this sopping wet.
ALESTORM: I'll take both. You don't know what you're talking about. I don't know what I want and I came here for help and you're not helping me.
CP: My apologies. Please allow me to reiterate and I will be blunt, so there can be no misunderstanding. Go home. Wash your wound. Apply Neosporin. Cover it with a bandage of your choosing.
ALESTORM: What about this other stuff?
CP: Tegaderm? No.
CP: Hydrocortisone? No.
CP: That's the ointment of the Neosporin I gave you.
ALESTORM: It costs more so it must be better.
CP: Yes. At occluding your weeping wound, trapping bacteria, and hastening your demise. Stick with the cream.
ALESTORM: You haven't helped me one bit. I don't know why I come here.
CP: Because your life sucks, you're bored, and you like to annoy and intimidate people so you feel better about yourself for a minute or two?
ALESTORM: How often do I change the bandage?
CP: You've never used a bandage before?
ALESTORM: Not these.
CP: When they are dirty. If they fall off. If they're wet. If you no longer like the appearance of them.
ALESTORM: I'm just taking what you gave me and going home. This was a waste of time.
CP: You can say that again. But at least you got what you didn't know you needed and I got a headache.

Thursday, September 20, 2018

Your Doctor Is A Dick

As a Pharmacist, I have a job to do.
As a Doctor, you have a job to do.
Collectively, our jobs are about Patient Healthcare.
Everything else is about ego and pride.
CMS requires both of us to work together for the betterment of the patient.
(They're called Outcomes.)
Based on your diagnosis, a treatment is selected.
Maybe you missed something.
Maybe you forgot about the use a class of medication in patients with certain conditions.
Maybe you deemed it not therapeutically appropriate in this patient.
I don't have access to your notes, but I have a diagnosis, a patient history, and am currently speaking with our patient right now.
See, it's my job to make sure that what you write is appropriate.
Is complete.
Is effective.
Is actually correct.
You don't have to follow my suggestion(s) any more than I have to fill your prescriptions.
But you don't have to be a dick.
So here's what I'd send back:

You know what they call the person who graduated last in his class at Med School? Doctor.
Well I'm both a Pharmacist AND a Doctor so what's your superpower?
Care to follow the CMS recommendations now?
Do you need a second opinion?
As a Pharmacist AND a Doctor, I am fully licensed to provide you with one.
Oh, one more thing. If you were such a good doctor, wouldn't you already have known about this recommendation and put your patient on it?

(Yes. As I mentioned earlier, it may not be therapeutically appropriate for this particular patient. Maybe she tried and failed; had reactions; can't afford it. Whatever. As happens all too often with prescribers, they don't like being told what to do. Fortunately I've seen a shift over the last few years and love when all types of prescribers call to discuss treatments with me.)

Reminder: #DontBeADick

Monday, September 17, 2018

More Shot Thoughts

Random Thought Phor The Day. . .
CP: I need your help.
ME: What's up?
Myself: What do you need?
CP: A lead-in to my thought.
Me: What is it?
CP: <whispers to Me and Myself>
ME: Got it. Hey, what types of marketing do companies do for flu shots?
Myself: Let's see, there's TV, radio, internet, mobile apps, print in newspapers, circulars, signs in stores on the windows and counters, buttons on staff members, coupons, banners in front of stores, billboards, digital signs, some random dude dressed like a syringe standing out front jumping up and down.
ME: Oh yeah, the currently-out-of-work Liberty tax guy!
CP: Thanks. I'll take it from here.
Myself: It's your show.
CP: If you are a multi-billion dollar company and you spend millions of dollars on print advertising, digital advertising, TV advertising, multimedia advertising, and you STILL want your staff to ask "You want a flu shot with that", perhaps your marketing isn't worth it.
Save the money, give me more tech help and THAT in itself will generate more flu shots and mo money, mo money, mo money.
ME: Right on! Seriously, at this point, who doesn't know we offer flu shots?
Myself: Or that McDonald's has fries?

People will eventually not notice it thanks to #TheBlindnessOfUbiquity