Trying not to hate on the Stupid patients...

But some days it is really, really hard not to.  It's almost as if there is an invisible "Stupid" energy force in the universe, and it's like it has its own gravitational pull that starts in the pharmacy and pulls them in...like a pharmacy black hole, sucking in all the Stupid it can find.  Once it starts in a day, it keeps rolling downhill, picking up speed, rolling up everything Stupid in its path like a Stupid Snowball from Hell.

Don't get me wrong, I have lots of patients that I just love, and I have been able to train most of my patients to call their refills in early, bring their bottles with them "just in case," etc.  I've even had a few of them stop by this morning. 

But, unfortunately, Stupid has reared its ugly head - a patient and an insurance rejection, I'm a tech down, I have a mild stomach bug, which is trying to trigger a migraine, I'm afraid it's going to be a struggle against Stupid all day, and my patience is non-existent already.  I'm only an hour and a half into my day.  I just hope I can hang on to what's left of the patience with what's left of my fingernails, not alienate anyone today, and not verbally pop off and actually call someone an idiot to their face.

Have you noticed that Stupid also goes hand-in-hand with supreme neediness?  The energy-sucking, needy, time-wasting idiots that must speak to the pharmacist and then proceed to ask what isle something is on?  That just openly revel in your attention, and ask all kinds of Stupid questions (and yes, there is such a thing, sorry to inform you!) just to keep you out front fawning over them?  Almost like a very sick, Stupid pharmacist stalker?  When I first got out of school, I thought it was kinda nice, until you learn that you are actually enabling a sick addiction.

Don't get me wrong, again.  I love to answer questions and share my knowledge with patients.  Patients who want to learn and do something better with their lives.  Not people who pull up to the pharmacy and sit in their cars until they think of something clever to ask the pharmacist, just so they can feel important.  I know it sounds mean and elitist and snotty, but I'm not here to make someone feel important.

I also understand the impact we as pharmacists can have on people's lives, so I don't mean to downplay patient interaction.  I also don't mean to downplay the compassionate side of things - I know that many of these people who are chronically ill and older may only interact with people of the health-care profession.  Many, many times we are their only social contact with the world.  So I do see that side, and have great empathy and compassion for people in that situation - I've been in that situation myself and it's a horrible place to be.

So, that would be the reason I don't call people idiots to their face and physically toss them out of the store, and spend the time out front with them, with a smile on my face and invite them back or to call with any additional questions, knowing I'll be on the phone within five minutes of their getting home, answering yet another Stupid question they thought of on the way.

But by the same token, especially when it is really Stupid, Stupid takes my valuable time away from my patients who really have a legitimate medical question and need.  Stupid also takes my time away from doing Stupid paperwork and Stupid governmental regulation-type tasks.

Most days I handle Stupid quite well.  But it's days like today when events conspire, Jupiter aligns with Mars, and the swirling pharmacy black-hole pulls Stupid into my orbit that I just hate having to be at work.

Wish me luck!  Share your Stupid stories below, so we know we're not alone, and so we can have a laugh!  I know I certainly need it!

     --T.Ph.RPh.

We Are NOT A Bank....

SERIOUSLY.  I am SERIOUSLY sick of people asking if they can make payments.  Don't get me wrong.  I understand how expensive medication is.  But we aren't allowed to make payments when we purchase from our wholesalers, and if everyone made payments (like that would happen consistently - otherwise you wouldn't have to ask if you could make payments...but I digress), what would I use to purchase the drugs you need?  Why on earth would you think you can make payments?  Does the grocery store let you make payments on that steak you want to grill this weekend?  Would you even dare to walk into WalMart or Walgreens and ask that question?

So, the fourth person today just walked in and asked if I could hold a ticket.  The first two actually did walk in and ask if they could "make payments."  The last two asked if I could hold a ticket.  While I have put a stop to new charge accounts (see the title of the post), these last two were DENIED a charge account because they bounced checks.  And still they have the fucking nerve to ask.

Do any perishable-goods merchants allow you to make payments?  NO.

If you have to make payments, get a credit card.  Get a bank loan.

I am not a used car salesman.  I am not a bank.  Pharmacy may be a multi-million dollar business, but the pharmacy no longer "rakes it in" like most people think they do.  Pharmacies barely survive.  Yes, mind-boggling amounts of money flow through here, but unfortunately, the buck doesn't stop in my pocket.

So no, YOU CANNOT FUCKING MAKE PAYMENTS.

Not My Problem, Mr. "I'm Important"

I'm just sitting here (yes, sitting - for all my complaining, I do realize I have a job that comparatively, is like a working vacation) contemplating my latest, heart-warming, life-saving, professional interaction that I had trained for and spent six years in school for....(dream sequence, wavy lines, fading into the beginning of my reminiscing of the lovely encounter that typifies my "normal" day as a deeply satisfied health-care professional on the front lines...)

Mr. I-Have-An-Important-Last-Name-In-This-Town-So-You-Must-Drop-Whatever-You-Are-Doing-And-Do-My-Bidding comes in the door. Usually he is boisterous, sexist ("Hey, pretty brown-eyed thang" to my married techs), condescending, and somewhat amusing (he thinks he is God's gift) and I can come away from our interactions with at least a smile on my face. He's also a big man - a very tall, wide man. He is also flabby fat - on the edge of morbidly obese. With diabetes (surprise!). Should pick up four bottles of Lantus a month. But of course, putting down the fork and walking away, nay, walking at all, except back to the refrigerator, is out of the question. But I digress.

I'm sitting at my desk, working on the mounds of paperwork (I am one of the few independent pharmacists I know who manages to keep the top of their desk somewhat organized and cleared - I have a wonderful job) this "profession" creates. I hear Mr. Important's booming voice greeting my tech. She tells him his insulin prescription only has a quantity of two bottles left, and we would have to call the prescriber.

"Well, what's the number out there? I'll just call 'em" says Mr. Important, whipping out his cell phone.
Ms. Tech: "Well, sir, they prefer we fax the refills to them."
Mr. Important: "What's the number?"
Ms. Tech: "We will just fax the request over to them."
Mr. Important: "What's the number? I'll call 'em right now."
Ms. Tech: Gives him the number. Repeats the fax preference.

So Mr. Important gets the receptionist, trying to charm her into telling him the refills are ok (like that makes everything ok), then blows up at her, shouting into the phone, "WELL! I SHOULDN'T NEED AN APPOINTMENT OR BLOODWORK!!! I JUST HAD THAT DONE TWO OR THREE MONTHS AGO!! I'M HERE AT THIS PHARMACY, RIGHT HERE, RIGHT NOW!!"

Of course, as we all know, two or three months in patient-speak means about a year or more ago...

Mr. Important: "Who is in there with ya? Where's that nurse?"
(Receptionist obviously asks him which nurse.)
"You know, the one that was so-and-so's kid."
(She changed jobs about a month and a half ago)
"Ok, well, what about the other one?"
(Apparently receptionist has received our fax request and given it to the prescriber, and tells him they will call it in.)
Mr. Important hangs up.

By this time I've dragged my ass out to the filling line, charming, professional smile plastered on, but mentally I am gritting my teeth and shooting daggers into the blubber that surrounds Mr. Important like a shroud. Pleasantries are exchanged. Then the uncomfortable waiting begins. He stares holes into our foreheads, expectant. We fill prescriptions - not his, yet.

I know this self-importance attitude is as despised by our NP as it is by myself. I have a quite a few pet peeves, but self-importance because you have a certain last name is probably up in my top three. So I know that the refill authorization won't be coming any time soon.

Mr. Important begins to realize this as well. Gets his big feelings hurt and decides to run some other errands. Huffs and puffs and waddles out the door.

Being a small clinic and a small pharmacy, by the time he returns, all is well with his prescription. So he's all happy now...until he gets to the cash register. I hear commotion, but I ignore it. The clerk points him back to the pharmacy. He needs the exercise, so I let him waddle back to the filling line before I look up. Apparently instead of paying $39 like last month, for a prescription that cash price runs around $500.00 give or take, his insurance returned a copay of $162. Still sounds pretty fair to me...so I ask if he is in his donut hole. "I DON'T KNOW!! There's no way I can be in my donut hole!! I've only filled my insulin twice." Hmm, really compliant. If you are unwilling to put down the fork, exercise, and take your medication on time, why do you even bother? Oh, wait, it's only been $39 to this point...

It's obvious he expects me to call his insurance. I no longer call insurance companies, haven't for years. Not my responsibility, not my problem. (I don't know why we, as a profession, started calling insurance companies, or even taking assignment. Yes, customer service, and customer retention. BUT IT IS NOT OUR RESPONSIBILITY - we already baby the patient almost to the point of taking their medications for them. Yet, again I digress...oh, but trust me. There will be a post about patient responsibility and how we have, inadvertently perhaps, turned our patients into blubbering, inconsiderate idiots.)

Back to Mr. Blubber, er, I mean, Mr. Important. I sweetly tell him (daggers, daggers, daggers) that with this third fill, his Lantus alone (he does take other medications - surprise again!) has cost his insurance company well over $1500, and did he know when his donut hole started?

Exasperated, he spits out "No, I have no idea!!" So I told him to contact his insurance company and find out why the copay changed so drastically, and if there were some miscommunication, we could rebill it and give him a credit. He stands there (obviously not the answer he wanted), then stomps to the cash register and says "I'll just pay it all!!"

This is just what I went to pharmacy school for - and slaved, and studied, and sacrificed. So I can get yelled at by a fat, self-important man who cares absolutely nothing for his health or himself, and who knows more about the engine in his car than the intricacies of his health insurance policy, yet he will have spent more on his health insurance policy that his car within a few years. I guess I don't understand people.

My job satisfaction is OFF THE CHARTS!! I am making a difference!

I'd better get back to it...saving lives and making a difference, one patient at a time!

-T.Ph.RPh.

The Patient's Guide to Pharmacy Etiquette

A Patient’s Guide to Pharmacy Etiquette:

1. Be sure to stare at the pharmacist while your prescriptions are being filled. Staring makes them work faster.

2. Never remember the name of the medication you want filled. By calling it “the little white pill” you are sure to receive the correct medication.

3. When calling in 8 or more prescriptions, always arrive at the pharmacy to pick them up within 10 minutes. It is ok to hurry the pharmacist. If they make a mistake, it won’t kill you or anything. It is strongly encouraged to call them in on your cell phone while waiting in the drive through.

4. Instead of calling your insurance company, who sets the price, feel free to ask for the exact price of your prescription before it is filled. After all, the staff should know the copay of every drug, for every person’s individual plan.

5. Always ask how long it will take to be filled. If you’re lucky, you will get it free if it is not ready in 15 minutes or less. Also, be sure to ask if the prescription is ready every 5 minutes, because the pharmacist often keeps them after they are ready just to piss you off.

6. Be sure to complain about the copay. The copay is set on the whim of the pharmacist and has nothing to do with the insurance company you chose.

7. It is not necessary to present your insurance card or even know the name of the company. Pharmacists are psychic and know everyone’s insurance.

8. Upon requesting a refill for a maintenance medication with no refills, always question why the doctor has to be called when you’ve taken the same medication for years. It is only a myth that prescription medications have to be ordered by a physician. The pharmacist usually doesn’t fill prescriptions just to piss you off. NOT filling prescriptions is good for business, after all.

9. Always question why the insurance company is so concerned with you getting your medication ten days too soon. After all, you’re only paying $5.00 for it and that’s all it costs.