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Tuesday, September 26, 2023

Dumb Things People Say

CPP: What's an embarrassing guilty pleasure of yours?
CP: I enjoy reading the little gossip news posts about people having a bad day, or crazy texts from parents to their kids, or entitled asses. 
CPP: Schadenfreude mein freund? 
CP: Precisely. A little joy at the misfortune of others. But I also find the entitlement and peculiar things people say fun to observe as well. It lets me know they are not like this solely at our establishment; they behave poorly and stupidly everywhere. 
CPP: Hence you "If the real world worked the way people believe pharmacy does" series. 
CP: I really need to make that into a book. 
CPP: Yes, but how are you going to segue this into a story? 
CP: Just dumb things people say. 
CPP: Have at it. 

CP: Top O' The Mornin' To Ya. Welcome to the House of Pain. . . Pills. How may I help you?
UT: What's the hassle, man?
CP: shhhh
Do You Know Who It Called: I think I am here to pick up my husband's prescriptions. 
CP: You think that's the reason? 
DYK WIC: Well I don't know. 
CP: Are we supposed to have something for him?
DYK WIC: Well he was expecting something, but I never got the call. 
CP: I see we filled two Rx's phor him 16 days ago; they were put back as they had been filled for 13 days and on the 14th day, PharmaGods said it must be returneth. 
DYK WIC: Well I didn't get any calls or texts; you people call or text me when my stuff is ready. 
CP: I'm sure our system deliberately singled you out as the one omission it was going to make in the notifications every other day for exactly two weeks; making that a total of roughly 7 missed calls/messages. 
DYK WIC: I didn't receive them. 
CP: I shall get them ready but, just because I already know the answer and want to hear you say it, what phone number should we have on file for your husband's prescriptions?
DYK WIC: 867-5309. 
CP: And who, Jenny, has the number 867-5308?
DYK WIC: My husband. 
CP: The person under whose name the prescriptions were filled?
DYK WIC: Yes. 
CP: The person for whom the prescriptions were filled is the person receiving the calls and texts. 
DYK WIC: Ok. And? I didn't get them. 
CP: But your husband did. They are his. YOU wouldn't get a phone call since you just confirmed they are his prescriptions. 
DYK WIC: Well he didn't tell me. 
CP: And that, alas, is something with which I cannot help. But I do appreciate you not understanding how phones and profiles and HIPAA all work and phor wasting my time today. 

Thursday, September 21, 2023

My Job Is Not Me Doing Your Job

CP: Thank you phor calling CP's Pill-adium. How may I help you?
Nurse At Her Big Rad Office: I have a client who needs refills. 
CP: A Client? Not a patient? Is that code phor something? 
UT: wink wink, nudge nudge
NAH BRO: Um, no. Just a patient. 
CP: Then say patient when you mean patient. We are medical professionals. 
NAH BRO: Our patient has been there before and needs these refills. 
CP: I'm going to guess you are calling in new phills phor his pills, else you'd be planning on giving me Rx numbers?
NAH BRO: Correct. But he's had them before. 
CP: Or else they wouldn't be refills, huh?
NAH BRO: Sure. 
CP: Any time you're ready. 
NAH BRO: He needs Latanoprost drops, you should have the strength on file and same directions. 
CP: Ok. How many bottles?
NAH BRO: Three. 
CP: And refills?
NAH BRO: Let's go with two. 
CP: Sure. Let's. 
NAH BRO: Then we have Brimonidine, same directions. 
CP: Strength?
NAH BRO: I don't know. He didn't write it for me. But you should have it. 
CP: And so should you. Next one?
NAH BRO: Timolor? I think. I can't read it but it's the same directions. 
CP: Strength? 
NAH BRO: 0.05? Maybe?
CP: <squeezes bridge of nose> OK. Here's what's going to happen. If you choose to phone in a prescription and you are from Dr. Zoffis, and you elect to not use the e-scripts, then you need to have everything ready for me. You are calling me. You are giving me information. No, I am not going to look it up or trust that it is the same as last time. You're harshing my mellow. 
UT: You didn't just say that to her. 
CP: <shrugs> I'm ornery. 
NAH BRO: What do I need?
CP: <winces, sighs> When phoning in a prescription, you are required to provide me the name of each drug, the strength, the proper directions, the quantity you want the patient to receive, the number of refills to determine how long therapy will last. Since you work in the office and have ready access to the actual provider, this should all be readily retrievable. I am not going to do your job phor you. Just because the patient has had them before, regardless of if I even philled them, does not absolve you of doing your job properly. Now do yours so I can do mine. 

<1 hour later>
UT: NAH BRO calling back. 
CP: I'll get her after I give these shots. 
<15 minutes later>
CP: Thanks for your patience. Shall we proceed? 
NAH BRO: <provides all information with a smile that I can hear through the phone>
CP: Thank you phor choosing CP's Pill-adium. Have a wonderful day. 


Wednesday, September 20, 2023

That's Not How It Works - Never Has

ME: Are we doing another PSA series? 
MICE ELF: I hope not. 
CP: Just a refresher course. 
ME & MICE ELF: Oh dear. What is it?
CP: <clears throat> ahem. Let it be known that today, I am announcing, again, for those who may be caught unawares, the following about the Patient-Prescriber-Pharmacist Healthcare Triangle:
Doctors and all Prescribers, it is not necessary for the pharmacy to contact you or your office to request refills or any prescriptions for our patients. 
ME: But. . . 
CP: You do not need to hear from the pharmacy to send a new prescription. 
Do not tell your patients it is our responsibility; it is not. 
MICE ELF: But. . . 
CP: You say you didn't receive our request? You. Don't. Need. It. 
You are fully capable of submitting a new Rx without our intervention. 
ME & MICE ELF: But why do they keep telling people that?
CP: <shrugs> I have no idea. They'll reject the refill request anyway before submitting a new Rx in its place which causes more work than me being able to match the Rx's together and fill the new one. 
ME: But what about the ones who claim it's "their policy"?
CP: My policy is to not accept this as reality. Will I send a request? Yes. Once. After that, if you have had your office on the line and they insist they need to hear from me, politely explain how this is a lie. Here's how it has always worked: Patient becomes unwell, goes to their provider. Provider performs magical dances and spells and diagnoses a problem that the medication I govern can treat. Said provider then provides a prescription indicating which of these you need and which I am to dispense. Prescription arrives at my pharmacy, whether by land, sea, or air and, after performing my due diligence, it is filled properly, patient retrieves it and, presumably, begins to get better. No steps are to be skipped. At the end of the initial treatment, their provider will indicate if they need more. If none indicated, treatment is complete and you shall go on your merry way. However, a follow up visit may also be indicated. Notice how none of this involves the pharmacy?
ME: Yeah, not the initial visit, the follow up visit, the diagnosis, whether the patient still needs it. 
MICE ELF: Yeah, we really don't need to be tracking down the refills of all thousand of our patients. 
CP: When they have only their own to worry about. Last week, a patient called and reminded us of his provider's "policy" and I reminded him of mine. It had been 11 days since we first contacted the office. I went back and pulled the successful confirmations, all four of them, circled them, and sent them along with yet another request; a request which also contained the following note, written with "Dr. Zoffis Sharpie", that said: If it is your policy to have the pharmacy request refills, then do not ignore and stop telling your patients you didn't receive them. As you can clearly see, we faxed this successfully four times. I shall remind you of this one more time: YOU. DO. NOT. NEED. THE. PHARMACY. TO. REQUEST. REFILLS. Stop telling patients this when you have them on the phone."
ME: Did it work?
CP: Three days later we received the refills. 
MICE ELF: Unbelievable. 
CP: From now on, I tell patients I will send it once. Here endeth my obligation. If your office can't figure out a way to refill your prescription without my intervention, then again, even WITH my intervention, there is nothing for me to do. But I have way too many patients to play this game. Find a new Dr. Zoffis or track it down yourself. 
ME and MICE ELF: Amen. 

Thursday, September 7, 2023

It's Not Rocket Surgery

CPP: <aside> why are you using me as the setup person in this?
CP: <whispers> because I need a cold intro since no one else has heard of this. 
CPP: you're saying we are old?
CP: -er, old-er. 
CPP: Phine. What is the best migraine relief medication you have used that you can't get anymore?
CP: Wow. That's really out of left field. Let me think. Sprix. 
CPP: That was a good one. Why did you have me ask you about it?
CP: It's gone rogue, off the grid, escaped the tethers of reality. 
CPP: Do tell. 
CP: We were able to order it, briefly, over a decade ago. Then it became a special order from the manufacturer. 
CPP: And now?
CP: Now the prescriber has to order it online through the company. 
CPP: And the story phor today involves this, somehow?
CP: It does. 

UT: What the hell is this?
CP: Sprix! I haven't seen a prescription for this since Moby Dick was a minnow. 
UT: You're old. 
CP: Only in pharmacy years. I didn't think you could find this anymore. 
UT: You can't. I checked all suppliers. 
CP: Let's ask da google. hmmm, curious. 
UT: What have you found?
CP: It is only available online, through the manufacturer. I''ll call the office and let them know. 
Little Office Lady: What is your question?
CP: The doctor prescribed Sprix nasal spray. If they want the patient to have this, they have to go online and have the prescription sent to the company. 
LOL: Ok. Well I'll send them a message and see what he wants to do and call you back. 
CP: No. No "see". They have no other option. If he wants the patient to have it, they send it online. You don't need to involve me in this matter any further. I shall even ring the patient myself and provide them the same information. You two can hash it out between yourselves. 
LOL: Okay. Someone will get back to you. 
CP: I often wonder if we speak the same language. 
UT: People would be so much better if they weren't so people-y. 


Wednesday, September 6, 2023

Not On Me

Pick A Pharmacy That Executes Special Tasks: Did my doctor call in my prescription?
CP: Yes. It's ready to pick up. 
PAPTEST: Is it ready?
CP: Asked and answered. Next question. 
PAPTEST: Do you deliver?
CP: Alas, we do not. 
PAPTEST: Now how am I supposed to get my medication?
CP: <shrugs>  Not my problem. That's not up to me. 
PAPTEST: I really need it. 
CP: I don't doubt that. Needing it is not the issue here. What you really needED to do, was choose a pharmacy that offers the services you so desperately require. If you cannot pick up your prescriptions between 8-6 M-F, then skip the independent that is closed nights and weekends. You choose a restaurant based on what they DO offer, not what they don't. Besides, McDonald's doesn't tell you how to eat your food if you're NPO or can't chew and you just ordered a Filet-O-Fish and fries.
PAPTEST: I just live down the street. 
CP: That's not going to change my inability to deliver. 
PAPTEST: Can you walk it to the curb?
CP: I am by myself and cannot leave the pharmacy. How do you get other things? Groceries and other sundries?
PAPTEST: Someone picks them up for me. 
CP: So. . . ?
PAPTEST: I guess I'll call them. 

ME: But they've been here before. 
MICE ELF: And they know we have neither a drive-thru nor delivery on our menu of options. 
CP: Apparently we need to change how we operate our business for one put-out patient. 
ME: Yeah, like Chik-Fil-A will open on Sundays for me. 
MICE ELF: I do miss the days when most businesses were closed every holiday and Sundays. 
CP: Somehow we all managed to survive the cold, cruel world of the 70's. 
ME: Imagine if it had been the 40's and there was rationing with a war. 
MICE ELF: It's too difficult. 
CP: Now I'm hungry. 
ME: Door Dash us some Chik-Fil-A. 


Monday, September 4, 2023

Insurance Stupidity Knows No Bounds

UT: You'll never believe this one. 
CP: Oooh. That's a challenge I'll accept. Proceed. 

<UT on phone with long-time patient>
UT: Your insurance won't pay for your NP Throid; it requires a prior authorisation.
Patient On Phone: I know. And I can't afford over $100 per month for it. 
UT: They want you to try and fail both BRAND Synthroid AND BRAND Levoxyl before they will cover the NP Throid. 
POP: Can you tell me what the cost of those will be?
UT: Sure. Well that's interesting. 
POP: I assume that is "not interesting"?
UT: If I run through Brand Synthroid, the insurance requires a prior authorisation. Same with Brand Levoxyl. Unless. . . 
POP: What?
UT: Unless the doctor writes DAW1 on the prescription, the insurance requires prior auth. 

CP: Wait. So the insurance requires these brands be tried and failed. 
UT: Yes. 
CP: But they won't pay for them unless it's with a DAW1?
UT: Yes. 
CP: So we now have to call the office and have them send another Rx to prevent prior auth?
UT: Yes. 
CP: That's not THAT surprising. 
UT: But they set the rules and changed them midgame, it seems. 
CP: You mean "why couldn't they just say that in the first place?' instead of sending us a prior auth request for brand Synthroid and Levoxyl when it was their idea? 
UT: Right. Why do they need a p/a on what they prefer? It seems stupid to require brand only to THEN require it be DAW1. Brand is Brand. It shouldn't matter. 
CP: And they're delaying for months therapy that has worked for this patient for years. 
UT: Insurance rules don't matter. It's like they're playing a different game than we are and when we discover the playbook, they change the game. 
CP: Monopoly versus Australian Rules Football. 
UT: Well said.