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Thursday, March 14, 2019

Pete and Repeat Are in a Boat. . .

CP: CP, Master Pill Pauper. How may I help you? 
Pt: I am here to pick up my prescription. 
CP: Name?
PT: Barf. 
CP: Your full name? 
Pt: Barfolomew!
CP: Date of Birth? 
Pt: 5/5/75. 
CP: I do not have anything ready for you. 
Pt: My doctor was supposed to send it. 
CP: Today? 
Pt: Yes. 
CP: I checked my will call section. I checked my e-scripts. I checked my faxes, my voicemail, my drone deliveries and the old paper airplane landing strip and we haven't anything for you. 
Pt: He was supposed to send it. 
CP: Nothing here. 
Pt: Nothing from my doctor? 
CP: Nothing here. 
Pt: From Dr. Acula? 
CP: Nothing here. 
Pt: It's for my blood thinner. 
CP: Nothing here. 
Pt: I take it every day. 
CP: Nothing here. 
Pt: He said I need to take it every day. 
CP: Nothing here. 
Pt: Are you sure he didn't send it? 
CP: Nichts hier. 
Pt: I was just at the office. 
CP: Nimic Aici. 
Pt: It's the weekend and they're closed. 
CP: Nothing. Here! Do I really need to be here for this or are you just having a conversation with yourself? 
Pt: I just need to make sure he didn't send it. I need it. 
CP: Yes. You made that quite clear. However, as much as you made clear you need it, I made twice as clear I don't have it. There is nothing here. I can keep explaining it to you, but I can't understand it for you. If you'll excuse me, I have a spot on the wall calling my name and a forehead that needs a solid knocking. 
Pt: Ok. What shall I do? 
CP: Call the office? Or keep talking to yourself? But I'm pretty sure I don't need to be here for either so, good day. 
Pt: Real quick? 
CP: Yes? 
Pt: Can you check again?
CP: <runs to wall, beats head, smiles again>


Tuesday, March 12, 2019


CP: I don't mind helping. I simply ask that you help me to help you help me.
ME: You really need a new partner at work.
MYSELF: We're tired of being your go-to phriends for these conversations.
CP: No one understands me like you do. Besides, you offer good counterpoints from time to time so I can see both sides.
ME: Right. Which, as we've discussed recently, too few people are willing to do.
MYSELF: If you are able to see what the other side is going to argue, it will either reinforce your beliefs or allow you to change them in light of new evidence.
ME: Now that everyone is asleep, can we progress to today's lesson?
MYSELF: <yawns> Please?
CP: I love thinking for myself, but I don't like having to think for others as well.
ME: Yes you do.
MYSELF: What happened?

<fades into a recent conversation, phone rings, 4pm>
CP: Happy Phriday! CP, Pauper of Pills, How may I assist thee today?
Nurse At Pain Management In Need of Defending Early Refill: Yes, I'd like to let you know we approved an early fill.
CP: Thanks. I didn't ask for your approval, not that I need it of course, but. . .
NAPMINDER: For your patient.
CP: Well that's different. Why did you approve it?
NAPMINDER: He is taking a vacation.
CP: Nice. When is he leaving?
NAPMINDER: Tomorrow morning.
CP: Wow. Excellent. Thanks for giving me lots of time to get the okay from his insurance since they're likely to be the ones to put the kibosh on the early fill.
NAPMINDER: The prescriber just okayed it and the patient only just called this morning.
CP: Right. They planned for a vacation, bought tickets months ago yet somehow it sneaked up on them and they remembered the medication they take 4 times a day is the last thing on their minds. Got it. Quick question for you.
CP: When do they return?
NAPMINDER: I don't know. I didn't ask.
CP: You should have. It's a rather important question, don't you think?
CP: The patient called and said he is going on vacation and needs an early refill and you approved it without asking when he'd return?
NAPMINDER: Yes. That's how we always do it.
CP: What if he's coming back Monday? Or Tuesday? Or, I don't know, any day before his medication would run out?
NAPMINDER: I don't know.
CP: Then you'd be giving him a month supply of medication when he really doesn't need it yet. Or maybe he only needs a day or two.

<patient calls 5 minutes later; or maybe he was already on hold while I was finishing>
Needs Early Refill for Vacation Outside United States: Did my prescriber approve my vacation override?
CP: Yep.
NERVOUS: Great! When can I come down for it?
CP: When are you leaving?
NERVOUS: Tomorrow. We have an early flight.
CP: And when do you return?
NERVOUS: We come back next Saturday.
CP: Okay. I will have your prescription ready for you next Sunday.
NERVOUS: But my doctor approved it.
CP: And I filled it for you 21 days ago, which was a day early. If you started taking them on the day you picked them up from me (which you should not have done since that fill was one day early) you would have enough medication to last you through next Sunday, the day after you return.
NERVOUS: But they said it's okay.
CP: Unfortunately, they do not get final say. Since I would have to call your insurance and explain the reason for the early refill, I will have to answer these questions and plead your case. Since you will not only NOT run out of medication but will have enough for a day after your return, I cannot defend the early refill.
NERVOUS: But. . .
CP: Have a nice trip. Relax. Take your prn meds as needed and we will see you in a week.

ME: What if they were diabetes or BP meds? 
CP: Wouldn't matter. 
ME: Why?
MYSELF: Because he had enough to last? 
CP: Yes. That and I don't have to report those fills to a PDMP. Also, there are laws regarding early fills on controls that don't exist for other medications. 
ME: Perhaps they're planning on losing some.
MYSELF: Let it go.
CP: Wouldn't you rather they lost the last day or 2 of medication than their new supply for the next month? Try explaining that one.
ME: So you're not being a giant douche, flexing your muscle and keeping people in pain?
MYSELF: Sadistic little. . . 
CP: No. I have a job to do. While people may not, or choose not to understand, or may not like or agree with my responsibilities, it does not change the fact that I still have a professional obligation to meet. 

Tuesday, March 5, 2019

Sometimes They Say "No"

CP: No.
ME: What's with the foreign language lesson, CP?
CP: Just curious if people will recognize the sound of "No" in other languages as easily as English.
MYSELF: I feel a post coming.
CP: Have you ever noticed how patients don't seem to understand this word? It's practically the first word we teach our children. It's also one of the first words they mimic back to us when we ask them to do something.
ME: Right. And?
CP: It's a simple, yet effective word. However, people seem to have a difficult time understanding its meaning.
MYSELF: No means No. Right?
CP: Yes.
ME: Okay. I'll bite. What was the impetus for this?
CP: Metrics.
CP: Yes.
ME: Explain.
CP: It started with a recent conversation with my boss. She popped by to discuss our performance on all the metrics we have to meet.
ME: And?
CP: I told her I wasn't trying.
MYSELF: What? How are you still employed?
CP: I wasn't trying to convince people to change their minds.
MYSELF: I bet that went over well.
ME: Like tofu at a steak dinner.
MYSELF: What, exactly, did you tell her?

Boss Lady: You need to sign people up for all of our programs.
CP: I cannot.
BL: Sure you can. I have phaith in you.
CP: I am an awesome pharmacist, but a lousy pitch bitch.
BL: It's all in how you ask.
CP: No it isn't. You know why? Sometimes people say 'NO'. Just like that. They say "no". I can ask politely; I can try to sweet-talk them; I can try to bribe them; I can even berate and belittle them for not saying "yes", but sometimes, people say "no".
BL: It's all in the ask.
CP: That's a corporate slogan. Like thinking outside the box. Jargon.
BL: You have to believe in it to sell it.
CP: Again. I'm not the one who needs convincing. I bet there were a lot of unsuccessful door-to-door vacuum and encyclopedia salesmen over the years who were fed the same lines of BS and felt bad about themselves for failures that were out of their control. I shall not feel bad because people say "no".
BL: Explain why these programs are so good, so helpful for them.
CP: You don't like to hear "no" either, do you? If they tell me "no", I'm going to tell you "no". Simple. No. If I'm not in the market for fresh salmon at the local monger, I'm not going to buy it. I'm looking for scallops tonight.
BL: Huh?
CP: If I am successful on 23% of my opportunities, that means that 23% of the respondents were willing to say "yes" and 77% said "no". I can't change their minds. It's also not my job to sell them. That's why we have marketing departments, print ads, radio ads, etc.
BL: Well you have to meet these numbers on all of our promotions or you won't get a good score.
CP: After all these years together, do you really believe I'm driven by who signs up for our app? Or our courtesy refill reminders? Or our sync program? You're still arguing with me as if you don't believe people ever say "no". Trying to get people to donate to our charity-cause-of-the-month? I always say "no" because I choose my charities on a personal basis. I say "no" to just about everything I am asked at a store: credit card? loyalty card? survey? free candy? And I know plenty of people like that.
BL: Well, you could at least try a little.
CP: I ask. They say "no". End of conversation. Next patient. If you want someone to strong arm them, hire me a cashier with a history in the mob. I'll hit 100% in about a week.

ME: Seriously. Why does your boss even like you?
CP: I'm honest. I hit my sales and Rx goals. I can think for myself. She doesn't have to worry about me and only visits when she wants to pull out some hair.
MYSELF: Next time, you need to sing to her.
CP: I thought about it. . .
"My name is "No"
My sign is "No"
My number is "No"
You need to let it go"