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Friday, January 24, 2020

But, But, It's Not Wrong

CP: CP's Phactory of Phun. How are you going to amuse me today?
I Don't Understand My Business Software: I need to clarify a prescription we sent for a patient.
CP: Did we call you? Did you just send it?
IDUMBS: No. We sent it the other day.
CP: I see one for Azithromycin 1 gram packets.
IDUMBS: That's it.
CP: You mean the prescription she already picked up 4 days ago?
IDUMBS: Yes. We sent the wrong one.
CP: I don't believe your opening statement of "I need to clarify a prescription" is accurate; nay, it is misleading and erroneous.
IDUMBS: She was supposed to get a Z-Pak instead.
CP: Okay. Well since she picked it up, I can't edit or clarify anything. I will have to take it and fill it as a new prescription.
IDUMBS: She can't stand the liquid. Why didn't you call us? "You People" usually call us when we make mistakes like this.
CP: I'm sorry. What?
IDUMBS: Our system won't let us type Zith. . . so we have to type AZIT. . . and the first option is the 1g packets. You people usually call us on these.
CP: Wait a minute. You'e relying on the pharmacists to call on perfectly good, valid prescriptions because "YOU PEOPLE" can't figure out how to use YOUR software? Am I hearing that correctly?
IDUMBS: Yes. We never use the 1g packets.
CP: But we dispense them nearly every day. We have boxes of them. Why would I question a valid prescription? There was nothing wrong with it. It's a common STD treatment and we dispense it frequently.
IDUMBS: Well she doesn't have an STD. It's for an URI.
CP: Which I know now. However, it doesn't explain or justify your reliance on me to phix what is ultimately YOUR problem. Am I supposed to call on HCTZ 12.5 caps because I should know the patient gets tablets and your office always chooses the capsules because they are listed alphabetically first? Where do you draw the line? I have an idea for you. Have your office manager contact your software vendor and ask them for a demonstration on how to use your software. Better yet, just ask them how Z-Pak is supposed to be entered in order to prescribe a Z-Pak. I find it troubling that you have had this many issues that your expectations are for the pharmacists to call to bail you out and you have done nothing proactively to phix YOUR problem. Maybe a little morning pep rally would be in order.
What do we write? Z-Paks!
How do we write them? Type "azithromycin and look for 250mg pack"?
NO! Type something, hope the pharmacist calls, and pray for the best outcome!
Yay Prescribers!
IDUMBS: I can suggest that.
CP: Good. Because the scenario I just outlined is pretty spot on and simultaneously idiotic. But at least I have a post for next week!

UT: You know people are going to comment that "a good patient counsel would have cleared this up before the patient left".
CP: I know. Which is great if the patient picked it up herself. That also shifts the argument from "THE PRESCRIBER'S OFFICE IS TRYING TO BLAME US FOR THEIR CONTINUED IGNORANCE" to "well, had you talked to her, it could have been fixed". When the patient says "no, I know how to use it", and is in a hurry to leave or acts embarrassed, or isn't even present, that ends the counsel. My issue is that this happens with such frequency and the office KNOWS it, they don't try to phix in on their end AND they try to blame us. One of these days their reliance on us phixing their mistakes is going to cost a patient more than an inconvenient dosing method.

Wednesday, January 22, 2020

Listen, Process, Act Accordingly

CP: Thank you phor calling CP's Pill Palace. This is CP, Head Pill Pauper. How may I help you? 
Ignores Me And Then Wastes All Time: My patient called and said her insurance didn't cover her eye drops.
CP: Correct. 
IMATWAT: Is there a generic you can give? 
CP: That is the generic.
IMATWAT: Is there a coupon or GoodRx card you can use? 
CP: We tried a couple of the cards we had on hand and that was the best price. 
IMATWAT: Can you try a generic or a coupon? 
CP: Again, we did. How do you think we do our jobs here? That is what we do. You write it. We fill it in generic if one is available. The insurance pays, or they don't. We try a discount card and tell the patient the price. They either pay it, or they don't. 
IMATWAT: Is there anything else you can do? 
CP: What about what you can do? You can change the drug.
IMATWAT: But is there anything else you can do to help her? 
CP: Like what? I can't make the patient pay for it but YOU can change the drug. We have exhausted all of our options. The only thing keeping the patient from receiving this is the $50.00 cash price.
IMATWAT: Well the doctor says she has to have this one. Is there a coupon?
CP: Now you're just being ignorant. You keep saying that like I'm a phucking phairy and I can just wave my sparkle-shooting spatula across the computer and make it affordable for the patient. She has Medicaid so any amount greater than $0.00 is going to be too much for her. How about you turn around and treat the doctor like you're treating me? Say something like: "can't you change it? isn't there an alternative? can you give 2 separate drops instead? can you check the formulary? can YOU find her a coupon? can you just pay for them for her?". 
IMATWAT: Well he said she has to have these. 
CP: Then we are at an impasse and your prescriber is a tool. Not sure why she NEEDS tobradex but I can tell you what is going to happen. If he doesn't change the prescription, the patient won't pay the $50.00 and she won't receive or use the drops the doctor deemed she MUST have! In that case, the consequences of his inaction will be HIS fault alone. I did what I could for her and I can't make her pay me the $50.00. The ball is back in his court but do not try to blame me or act as if I am not trying to take care of my patient. 
IMATWAT Fine. I'll talk to him. 

Uber-Tech: Well done. 
CP: Really? It still feels as if she was trying to blame me for not helping. 
UT: How many times did she tell you to "just GoodRx it"? 
CP: Enough that I was afraid she wasn't listening or she has a comprehension defect.
UT: Remind me never to go to that office. 


Monday, January 20, 2020

Losing Phaith

UT: There's a pharmacist on the other line for you.
CP: Oh joy! I love speaking with other colleagues. Idle banter between professionals really breaks up the day. 
Other Professional Pharmacist: I'm getting a refill too soon message and the insurance is telling me you filled it? 
CP: I shall check. Name and DOB? 
OPP: Douche Baggins, 5/5/75. 
CP: I don't have anything filled. In fact, the last thing for her was in November. 
OPP: It's for her HCTZ 25mg. 
CP: We filled it on 11/30/19 for 90 days. 
OPP: Can you reverse it? 
CP: She got it. Picked it up on 11/30/19. 
OPP: Then why is it showing you filled it? The insurance won't let me process it. 
CP: Um. . . She received a 90 days supply. Approximately 45 days ago. She's not due until. . . 
OPP: I don't understand why they won't fill it. 
CP: I realise the groundhog isn't due yet, but even he would say that maybe it's because she has roughly 6 weeks of medication remaining? 
OPP: But they said you filled it. 
CP: I'm not sure where we go from here. Can you put someone else on the phone? Please? Perhaps my Uber-Tech can explain it better than I? I mean, she has the medication. 90 days.
OPP: Oh. So it's a refill too soon?
CP: Still once a day?
OPP: Yes.
CP: Then yes.
OPP: Sorry to bother you.
CP: No worries. I at least now have a post for tomorrow.
UT: Ouch. That was rough.
CP: Like a kiss on the lips from a sticky-side-up pad. 

Friday, January 17, 2020

Negotiations Were Short

Badgering And Raising Temper Ensures Refusal: I need to drop these off to be filled.
UT: Okay. When would you like to return for them?
BARTER: As soon as they can be filled.
UT: Of course, M'lady. It appears as if that will be Tuesday, per the "do not dispense until" date the prescriber scritched on here.
BARTER: We are hoping to leave town Monday.
UT: Don't let me stop you. Have fun.
BARTER: With the prescriptions.
UT: Then you shouldn't give them to me. I won't be able to fill them until Tuesday.
BARTER: How early?
UT: Well, we open at 8am. We usually tell people 2 hours after that time, so I'm going to go with 10am but let me check with my pharmacist. Hey, CP. How early on Tuesday? They are fleeing town.
CP: Give me 8:32am.
BARTER: Can it be any sooner?
CP: It's not a negotiation.
BARTER: How about Monday night?
CP: Again. . . It's not a negotiation. We are not dickering here. And how do you counter with a day earlier?
BARTER: My doctor said some pharmacists will do them the night before.
CP: Not sure how he came by this made-up sounding bit but, last I checked, he doesn't work here. In fact, I've never met him. Huh. Seems like a knowledgeable fellow though. Also not sure how I can legally fill and bill a prescription for one date if I fill it the day BEFORE that date happens. Perhaps I should give this smart prescriber guy a call for advice.
BARTER: So that's the best you can do?
CP: Attorney?
BARTER: No. Nurse.
CP: Huh. That was my second guess. Would've sworn. . . Anyway, ask me again and it will be 8:57.
BARTER: See you Tuesday.
CP: Bring coffee.
UT: You were right about one thing Master. Negotiations were short.
CP: Not short enough. Remember the one guy who asked me when are we least busy?
UT: Yeah. You replied "when we are closed".
CP: Right. Because we aren't doing any work.

Wednesday, January 8, 2020

New Year = Full Circle

ME: Happy New Year!
MYSELF: How can you tell it's Happy?
CP: Congratulations on spinning around the sun again?
ME: Well, when you look at it like that. . .
MYSELF: Technically, every day is a celebration of a new year. A year ago we were in this same spot in space. Hooray!
CP: Agreed. Circles are round. You will eventually come back to where it all started before being flung into the unknown, yet familiar void of the future.
MYSELF: Deja vu all over again.
ME: Can't I at least have a moment to share my post before you both circumambulate me with your circumscription?
MYSELF: Carry on.
CP: Is this about the Circle of Life discussion we had last week?
ME: It is. We were complaining about the complaint we received.
MYSELF: It really seems as if the only purpose complaints serve is to irritate those who receive them as they are often powerless to effect the change necessary to remedy the situation.
ME: Nice circumlocution.
CP: Moving on. The complaint stated the pharmacy was too busy, there were not enough employees to staff it properly, and the wait times were horrible.
MYSELF: Sounds logical.
ME: But the fact that our DM forwarded the complaint to the store with her own addendum of "please respond to the complaint and contact me with the resolution" was the coup de grace; the egg wash on the complaint pastry.
CP: <snickers>
MYSELF: What's so funny? What did I miss?
ME: The conference call.
CP: Mademoiselle DM led the conference call with a call to action. She said "we are going to start this year off right! I want absolutely NO EXCUSES! from anyone. Short-staffing is NOT an excuse and I won't tolerate it anymore!'.
MYSELF: Wow. Was she the ball that dropped in Times Square?
ME: Right? How did you respond?
CP: I replied to her that, since the patient's complaint mentioned we were understaffed and over busy, and that you (she) said those weren't excuses and excuses were not allowed, I told the patient everything was fine.
     Dear patient: Hope all is well. I spoke with my boss who invalidated your concerns by saying that, because short-staffing isn't "a thing" and therefore can't be used as an excuse, and she doesn't like excuses, your complaint is irrelevant. Please continue to use our pharmacy but change your opinion of us from one of dislike to tolerant. Better yet, like closing time at the bar, you need to lower your expectations. Once you do that you will see that we aren't so bad and maybe you'll take us home.
ME: How'd she take that?
CP: Pretty sure she still had her Flavor-Aid filled Rose-coloured VR goggles on when she read it. It appears as if she may have circumnavigated my reply.
MYSELF: My head hurts again. Maybe she realised that if short-staffing is not an excuse and she wants no excuses, then short-staffing is an acceptable answer and her brain collapsed in on itself.
ME: This whole thing gave me an aneurysm.
CP: But you still have to come in to work.

"It's okay
Had a bad day
Hands are bruised from breaking rocks all day.
Drained and blue
I bleed for you
You think it's funny, well
You're drowning in it too."

Monday, January 6, 2020

Now You See It. . . Or Not

Uber-Tech: You seem to be the type of person who enjoys playing fetch with dogs.
CP: I don't.
UT: You didn't let me finish. I was going to say, you seem to be the type of individual who would fake throwing the stick to the dog simply to derive pleasure from its confusion.
CP: Ah. Yes. That's more like me. Why the peculiar setup for this next post?
UT: It felt necessary; better than a cold opening.
CP: We could have simply put <fade in> or other screenplay-type directions.

<an average pharmacy in an average town; a lady approaches>

<the bell above the door rings as she enters>

CP: Welcome to Pill Pauper's Paradise. How may I help you today?
Comprehension Is An Obstacle: I am here to pick up my prescriptions.
CP: Glory be! We are happy to be your pharmacy of choice.
CIAO: I didn't have much say.
CP: In that case, we are happy to be your pharmacy of obligation! What is your name?
CIAO: Bella.
CP: Of course it is. I do have 2 prescriptions here for you.
CIAO: My doctor sent 3. Where is the other one?
CP: I do not know. I do know that I have 2 for you.
CIAO: Which one is missing?
CP: The 3rd one.
CIAO: Well he sent it, so I don't see the problem.
CP: Well I didn't receive it. Since my business is filling prescriptions I receive and not NOT filling prescriptions, I'm going to posit that I did not receive it, else I would have filled it.
CIAO: Well he sent it.
CP: Yet here we are. I have an idea.
CIAO: Okay.
CP: Let's play catch.
CIAO: I'm not sure what this has to do with my missing prescription.
CP: Step back.
CIAO: <steps back>
CP: <winds up and lobs a handful of air towards CIAO> Did you catch it?
CIAO: <flinching> What? No? You didn't throw anything!
CP: I did. Your 3rd prescription. Either you missed it, you dropped it, it was intercepted by gnomes, or I threw it somewhere else.
CIAO: What is your problem?
CP: So many answers to this. Yet germane to this conversation is the following: I don't have your prescription any more than you have something I threw at you. If I had actually thrown something, you'd have it. Yet you do not. Now, you can either accept that I do not in fact have your prescription and that your prescriber failed to send it, or you can continue helplessly volleying air with me.
CIAO: <to UT> You must hate working here.
UT: I find it rather enjoyable and amusing actually. You can give people answers but just because they don't like them does not make them any less true. These helpful analogies may seem petulant, but are quite illustrative. Sometimes the light clicks while other times, the bulb needs changed.

<2 hours later>
CIAO: Turns out my doctor only wanted me to have two prescriptions. He didn't send the 3rd one.
CP: Peculiar, innit? At least we had a rollicking good back and forth earlier.
CIAO: Indeed.
CP: Can you throw back your 3rd prescription I tossed to you? I'm going to need it for someone else.
CIAO: Sure.
CP: Sometimes, when "no" or a simple explanation seem to not suffice, a more orchestrated, demonstrative answer seems to be in order.