Brand/Generic

Doctors are dumb.
The only problem is they don't know it.
The problem with doctors, and the ever-growing number of others with prescriptive authority who aren't pharmacists is they think they know everything about everything. This includes how a pharmacy works and everything about medications.
Never mind they tell patients how my pharmacy operates when most of them have never spoken with a pharmacist let alone stepped foot inside one.

A new twist on the all-knowing prescriber overstepping his knowledge:

CP: How may I help you?
Patient of Silly Doctor: I need this filled.
CP: Fabulous. We are in the script-filling business after all.
POSD: Can I get that in brand?
CP: Most definitely. However, I must warn you that the cost could be exorbitant if your insurance chooses to be quite the prick.
POSD: I have to have it though.
CP: May I ask why the brand is so important with this particular medication? (No, it is not a NTI drug and it is a new prescription for this patient.)
POSD: "My doctor told me to get the brand because the generic will give me side effects." (Yep, actual quote.)
CP: Ok. I'll let that one go for a minute but she actually needs to tell me that since, you know, I am the one actually filling it. A DAW from a doctor could mean the difference between a small copay and the debt of Detroit.
POSD: Okay, I'll speak with her. Why would she say that?
CP: No clue. It's like someone telling me Motrin works better than Advil. If you've never tried this, how can you know the generic will cause side effects? It is a rather asinine comment and I will add the doctor to my Do-Not-See-If-My-Life-Depended-On-It List.

It's Too Soon

It is a complicated issue to explain. Insurances rule everything. So do those pesky state and federal laws. It should be simple, really: Your bottle is empty, therefore you get more medication. (Just like if your refrigerator is devoid of milk, you buy more to put in there.) Only prescriptions are a different issue. If you are out because you took too many, your doctor told you to take more, you lost them or you had them stolen, then we cannot simply hand you more. Our job is to know why you need them and make sure you are taking them correctly. Simple? Yes, except when it's not.

Restless Patient: Did my doctor call in my refill?
CP: Yes. However it is too soon to fill.
RP: But my kid dumped them.
CP: Okay. I am truly sorry you let your young child play with your Ambien bottle and they got dumped but it is still too soon to fill.
RP: But my doctor called in a new prescription.
CP: Indeed he did. But he didn't change anything.
RP: But it's new.
CP: Only its origination. He could call in the same prescription every single day promptly at 11:38 am. Unless directions or strength changed, directing me towards the conclusion you should have these early, I am unable to fill this for you today.
RP: What if my doctor tells you he's okay with the early refill?
CP: That would be different. Or you can call your insurance and ask if they allow for a lost/stolen override. I shall wait to hear from either you or your doctor.
RP: Meanie.
CP: Nope. Parent. Give your kid a fork. Let him put it in the electrical outlet.
RP: Oh. My. GOD! That is so cruel.
CP: Yes. But he won't do it again. Lesson learned. Just like letting him play with your prescription bottle. You're just lucky he didn't take any. Why couldn't you pick them up and put them back in the bottle?
RP: Ew. They fell on the floor.
CP: Right. How silly of me. Again, lesson learned. And unless your insurance and doctor allow for the early refill, an expensive, restless one too.

Help Me to Help You

I want to purchase something. 

I wish to know how much it is. 

Generally, I have an idea of the product I seek. 

A TV, car, US Soccer Jersey, whatever. 

I like to know what I am going to spend before I buy. 

I comparison shop. 

Seems rational. 

Except in this case...

Long Time Listener, First Time Caller: I'm calling to get a price. 

CP: Ok. Do you have insurance or will this be straight cash?

LTLFTC: Cash. I have no insurance. 

CP: Okay. For what prescription do you seek a price?

LTLFTC: I don't know. 

CP: You don't know?

LTLFTC: No. I haven't seen my doctor yet. I don't have a prescription. 

CP: Okay. Makes my job a little difficult. What's wrong with you? Why are you going to the doctor?

LTLFTC: I don't feel well. Can't you give me a price on something for that?

CP: Did he give you any indication what he may prescribe?

LTLFTC: No. 

CP: Drug name? Strength? Quantity? 

LTLFTC: No. Why can't you just give me a price?

CP: Okay. I can give you a range since I don't have any specifics. 

LTLFTC: Okay. 

CP: It will be more that $1, but less than $1,000. How's that?

That would be like calling Best Buy for a price on something in their store but not knowing whether it was a TV, washer, Blu-Ray, PS3, iMac, or that new-release DVD that just came out sometime in the last month. 

Employee Surveys

How many of us have been asked over our careers to complete Employee Satisfaction Surveys?
I'd much prefer them if they were called "What You Really Think About Corporate" Surveys.
Whether you're in the hospital or retail setting, does anyone believe management is looking to make changes based solely on employees filling out biased surveys? Shouldn't they have something to do with, oh I don't know, The Practice of Pharmacy?
They tell you your responses are anonymous. They expect you'll be honest.

Anonymous? Honest? Does any employee really believe that?
Why don't they ask the questions you want to answer? They only ask questions that have answers they want to hear.
Opinions? The free space for Comments?

I believe we should be able to submit them online.
We could leave comments as if we are reviewing a recent Amazon purchase:

Two Stars
"My problem is that The Company continues to see our patrons as Customers instead of Patients. This basic philosophy is misguided and will only continue to propagate a disconnect between employees and those we are trying to serve."
(There is currently a lawsuit involving Rite Aid and this very verbiage.)

One Star (Because I couldn't give Zero)
"You cannot continue to require employees to perform more tasks, more time-consuming tasks, while also whittling away their hours of help. Increasing hours allows for shorter wait times, quicker turnarounds, more time spent on each task, a reduction in errors, happier customers, improved Patient Satisfaction Scores, and increased profitability for the store. It is quite obvious that your method of reducing hours while asking us to accomplish all of this is not working."

Now What?

"Who are you? Where do you come from? What do you wanna do with your life?"

Congratulations! You made it. You graduated. Cram for those boards and your license is on its way. 
You earned it. You worked hard and you deserve this.
That was the easy part. 

Now you're going to work even harder and the sense of accomplishment will not be quite as satisfying. 
College was great. The Real World has something else in store for you. 
I ask: What are YOU going to do about it?

To all the new grads: Do you think RPh's, interns, and techs work hard? Do you think we deserve breaks and lunches at appropriate times? Are you tired of corporate pushing and pushing? Now that YOU are the actual RPh, what are you going to do about it? What can we all do about it? I have seen several RPhs go into the management sector because they were tired of how hard they had to work, yet they kept up the "same-old same-old". It seems that chain pharmacies have become the "new WalMart", and the only thing that will change this attitude is a big lawsuit. What can we all do to change the way we work? What about what you've seen on rotation in hospitals? 

Will you join the rank-and-file who continue to let other groups tell us what to do? 
Will you speak up and be heard? Or will you keep your head down because you have loans to repay?
Will you be The One who takes all of the splinter Pharmacy Groups and unites them under one banner, championing our professional cause? 

"We're not going to take it. No! We aren't going to take it. We're not going to take it, anymore!"

Its' Not Supposed to Be Like This

I received a complaint. Let me explain. No. It is too long. Let me sum up...

Lady presents a prescription for Vicodin 5/500. (Hasn't been made for 5 months. Memos went out in November 2012 about the withdrawal of this product.)

Very Patient Lady: I know this is wrong but here's what happened. My husband had this same Rx last month. I told my doctor as she was writing this that is was wrong. I told her it needed fixed. I told her they don't make it anymore. Do you know what she said?
CP: I am curious.
VPL: "That's okay. The pharmacist will call."
CP: Curious, indeed. She's right. I am going to call.

Office Nurse: How may I help you?
CP: I need to talk to Prescriber Person about an incorrect prescription.
ON: I am sorry, PP is out of the office today.
CP: Of course she is. It is Monday at 9:15am. Can no one else help me?
ON: Her assistant is out on vacation too.
CP: Okay. I wish to register a complaint. (I explained the circumstances surrounding my call.) It is not my job to call on this. The prescriber has had ample time to get with the program. The patient even brought it to her attention. Instead, here is where we are. You have to take a message. I have been timing the amount of my time and your time being wasted because your physician said "the pharmacist will call". So far we are at 5 minutes. You just told me PP is out of the office. Her assistant is out too. This means my patient won't get her medication until tomorrow. Why? All because PP was too lazy to learn her job and fix the problem immediately. It would have taken 4-7 seconds to scribble out the "500" and replace it with "300" and scrawl her initials on it. That is lazy, ignorant, and unprofessional.
I wish for someone to call me back regarding my complaint.

(In all fairness, this assistant knew the rules and we never have issues with her or her physician.)

Instead of getting an apology, I got a complaint. Pharmacists can complain to an office manager and what happens? Nothing. The prescriber likely doesn't see it or they laugh about it. If an office chooses to complain about a pharmacist, we get written up, we get dinged on "customer satisfaction surveys" even though they aren't even customers, we get a target on our backs from the powers-that-be.

This is a situation no other profession has to face. Worst of all, we have to face it from OTHER PROFESSIONALS!

It's time to put a stop to this disparity.

#IWantMyProfessionBack
#WhyYourPharmacistHatesYourDoctor
#IAmNotYourBitch

Unforgettable

...that's what you are...

I try to stay off naughty lists, especially Santa's and Corporate's. Every business, office, pharmacy has one though it may not exist in print. I hope I am never a customer who makes another company's list. I don't aspire to be memorable in a negative way. When we think of names throughout history, the first thing that comes to mind is their lasting impact; their contributions to history whether good or bad.

Our list usually involves our MOPs (Most Offensive Patients). Why do they seek to make a name for themselves in this way? The sight of their names on our computer screen is often enough to send employees into panic attacks. Cue eye-rolling as soon as their voice is heard on the other end of the call.

With these patients, you know you're in for a rollicking good time...and a trip to the liquor store on your way out the door.

I understand people are sick. I understand they have health issues. I understand they had to wait for hours at the prescriber's office or the ER.
What I do not understand is the need to be a belligerent Ass Baggins to those who are trying to help you. There is no reason for it. There is nothing you could have done in your life that gives you license to be an Ass Baggins (aka Kanye West). You are no more important than anyone else. Get in line, wait your turn, and come back when we tell you...and quit calling to complain every 15 minutes. The same staff are here and we all know how many times you've called today.

If nothing else, retail pharmacy really opens your eyes to how people treat other people. When I am a customer at any other retail business, it is sometimes painful to watch how the employees are treated.
In other countries, they have a mandatory military requirement. I believe we should have a mandatory retail requirement. Everyone, in order to graduate high school or enter college, should be required to work retail for 2 years.

New Pharmacy Ideas

I was walking through the hospital today and my mind jumped a bit when I noticed the lovely drop-off window. It was the only indicator that a pharmacy was hidden behind the dull, art-covered walls. I like this idea. I think all retail outlets should adopt this. But as you know, they won't. I have room to improve the idea.

I picture a movie theatre ticket window. The ones that have the little speaker cut right in the middle of it. We'd have a prescription booth out front. Patients would walk up to the window, say "two please" and slide their prescriptions under the glass. The "prescription taker" would then verify your information, scan in your insurance card, and send the prescriptions to the pharmacists in the back via pneumatic tube.

While you are waiting, you could visit the lobby.
Even better idea? Put a pharmacy IN a movie theatre! Drop off your prescriptions, get movie tickets, enjoy a show, pick them up as you exit through the gift shop which we will put in to market movie tie-ins and drugs! Brilliant!

We'd have to work on the concession stand though. No traditional movie fare to be found here. We can't be irresponsible and offer candy and popcorn and nachos and pop/soda. (That'd be like chain pharmacies selling cigarettes and having a candy section in front of the pharmacy. Wait. They do that?)