The Pharmacy Chick

Flying the coup in retail

I’ve turned into a major homebody

Filed under: Uncategorized — pharmacychick at 9:05 pm on Sunday, September 28, 2008

Pharmacy Chick has 3 major social outings:  Work, church, and my sport activity of choice.  My chosen church is a larger church and has opportunities for many after-service social functions.  The women’s ministry is very active with all sorts of luncheons, retreats, meetings, speakers, culture nights, craft nights, card nights, you-name-it-nights.  And, for 99% of them, I stay home.  Not that they are bad,  they aren’t. In fact they are wonderful.  I get invitations for all of them by my friends from church.  “you’ll have FUN, come on!”  The largest majority of these events I have an automatic “out” because they happen to be scheduled when I am working.  However most of these invites are from my stay-at-home mom friends.  I have a lot of them.

I respect (and am envious to some degree) that they can stay at home and I believe their children will be better for it.  I think kids are better off if they are raised by full time parents instead of spending 40 hours a week in day care. ( no hate mail from working parents–I understand why you have to work too OK???) BUT where I am going with this post is this: to me, these social outings are like being at work, and I am at work too much already.  Stay with me here.

When I am at work, I am in a very noisy public setting, being at the beckon call of patients, their family and caregivers, doctors, nurses, drug reps, and fellow employees. Every one of them wants a piece of the Chick and I have little say as to how my pieces are doled out. I cannot control when the phone rings,  or when I am summoned for a counsel. I put out a hundred fires a day all on somebody elses time table. I eat between prescriptions and when a patient  interrupts me with an insincere “sorry to interrupt your meal BUT….”  I want to scream “SO DON’T OK?” 

I have gotten to the point where my FREE TIME is not free..its very valuable to me.  It is my most valued non-tangible posession, and I like to be in control of how (and with whom) I spend my free time.  The last thing I want to be doing in my free time is spending it in more noisy public situations, where I have to make small talk with people I don’t know very well.  Once somebody finds out what I do for a living, the inevitable questions start next and BAM, I am at work again.

Its not that I am antisocial,  I love to hang out with my friends.  I do however, love my quiet time at home with just Mr. Chick and myself.  Home is a special place for me. Caller ID determines if I am going to answer the phone, and when I see “800-service” on the screen, I ignore it.  I can see who is at my door with out being seen and if I see a stranger, I may not answer it. I’ve picked up a few hobbies I can pursue at home and it feels good to be able to do them.

I feel this is a casualty of the exposure overload I get all day at work. Maybe if I worked at a desk all day or if I was a stay-at-home-mom, I’d appreciate the social stimulation.  For now, give me some yarn and  a crochet hook, turn off the TV and leave me in peace.

The Price Override: biting the hand that feeds you.

Filed under: Uncategorized — pharmacychick at 10:38 pm on Friday, September 26, 2008

Pharmacy Chick would like to believe that the prices that the pharmacy charges to cash payers have been researched by a department of very smart people who have devised complicated formulas for each drug to remain competitve in every market.  Either that or its a random collection of prices set by a bunch of drunk executives trying to justify their existence.  Lately I am leaning towards the “drunk executives”.

When some poor (literally) soul without insurance comes in with a clindamycin 150 #56 2 TID,  my cost is something like $4-6 dollars.  The price to the customer comes out at $70+.  I suspect this goes back to the pricing schedule based on a percentage of the brand.  Brand Cleocin would be at least twice that, so $70 is still a great savings over the brand.  Regardless, if you dont have any money, $70 is as out of reach as that Astin Martin I saw in the parking lot.

I usually try to encourage the uninsured to at least obtain some kind of discount plan, preferably a free one. (why should a PBM make money for nothing?) Not all do and Pharmacy Chick gets to make a decision: Charge the full price and hope they dont balk and leave, or sell it competitively to keep the sale.

Therefore, I will occasionally give somebody a break on these one-timers.  I try not to override prices on monthly rx’s because it means somebody has to remember to do it every month, and invariably it will get forgotten.  Then something weird happens:  the customer who was oh-so-grateful for Chick’s price reduction, now considers it an entitlement and gets indignant and pissy when this price reduction is accidentally forgotten.  It happened enough times that I have decided its not an exception.  By bad luck or fate, these special cases always seem to show up when relief pharmacists or techs or on duty.  They either don’t notice or don’t care that the price is different.

I had one today but it wasn’t my own price override.  I had a transfer from within our own company.  The retail price was $21.  It was a non-covered item. She bristled at the counter when the tech rang her up. Apparently the pharmacist at the original store sold it to her for $10 and neglected to tell us that when we did the transfer.  Her pissy attitude put me off right away.  “He apparently gave you some kind of special deal, because this is the standard retail price.” I told her and offered to call to find out what he had been doing.  We obtained the information, decided to grant her the same offer and redid the rx.  The ungrateful wench grabbed her bag and walked off muttering something about getting ripped off.

The Tech was pissed because she was the one who did all the work.  “You’d think she might be grateful we agreed to charge the same price…we didn’t have to.” she said.  I agreed with her on that one. I just told her that some people look their gift horses in the mouth.

Thought for the day:  No good deed goes unpunished.

The Crystal Ball is foggy today.

Filed under: Uncategorized — pharmacychick at 4:53 pm on Wednesday, September 24, 2008

One of my regulars came in to pick up her regular pile of pills, none of which was ready.  “Did you phone them in?” we asked her.  She said she faxed in her list from work.  We apparently did not receive the list or we would have filled them. Its a small department- the fax is right next to the computer–we dont just “lose” faxes, and nobody else handles them. We offered to fill them as soon as possible but it would take around an hour as she had about a dozen. “That is not acceptable!” she spewed.  “I faxed them in 2 days ago”.  We asked her if she had verified that we had received her fax. “THATS your job” she spat back, then stomped off.

So, lets review.  I am supposed to verify that I did not receive a fax that I didn’t know I was going to get.

I WISH I was that good…I’d play the lottery.

Style or Stupid, you decide

Filed under: Uncategorized — pharmacychick at 3:35 pm on Tuesday, September 23, 2008

Pharmacy Chick had the day off, so she did exactly as she usually does and stayed as far away from Chick pharmacy as she could.  She did however need some groceries so she went to her friendly neighborhood grocery store and produce stand and loaded up on all sorts of healthy food she will attempt to feed Mr Chick tonight.

As I was leaving the store I happened upon a young man walking out ahead of me.  I understand the current style for hip young men is to take their pants and yank them down so their butts are hanging out showing their tidy whities ( or their colorful boxers).. This young man had taken this to a new low (literally).  His jeans were completely off his butt and were around his thighs only. What made this so humorous to me was that in order to keep his pants where they were, he had to walk like he had just crapped himself, otherwise these gravity defying pantaloons would go south quickly.  its a good thing ( I suppose) that he had an oversize shirt because if the back of his pants were so low, the front had to have been also and frankly,  thats a visual I didn’t need to conceive.

If somebody wants to make some money, I’d suggest patenting buttless pants:  2 legs and a waistband.  I am thinking this kid would be first in line.

I want an endorsement contract.

Filed under: Uncategorized — pharmacychick at 8:35 pm on Monday, September 22, 2008

I was watching TV the other day and somehow wandered thru some post event interview with a race car driver.  The guy had patches from head to toe from companies who pay him to wear them: you know what I mean… endorsement contracts.  A million dollars to wear Viagra on his hat,  Valvoline on his sleeve, firestone on his other sleeve, and so on.  I’ll bet he doesn’t even know what the generic name is for Viagra and couldn’t tell you anything about the drug itself.

It got me thinking:  Why can’t I have endorsement contracts?  People come to me every day begging for recomendations for this and that and I dont get one plug nickel for any of them.  It would seem I would be the  perfect person for endorsements.  First off, I have this great white jacket with nothing on it but a name tag.  It could use some color and I have lots of room on it.  Second of all, I would actually know something about the products I am endorsing. Thirdly,  there is hardly a new or innovative item over the counter so with a few well placed endorsements, I could advise (and get paid for) some great recommendations. 

 I could have a Delsym contract, a Sudafed contract, and a Nature Made contract for all those vitamins I am asked about.  Nyquil and Sudafed could go to war over me getting the best patch placement on my jacket.  I could get a Tylenol, Aleve AND Motrin contract and Advil will get aced out because they didn’t bid high enough for the placket of my coat.

My own company would have to pay me big time to recommend the store brands ($ka-ching$) because we all know store brands are junk… until the endorsement comes in…

Honestly, I’d be picky so I wouldn’t cheat my consumers by recommending items I really don’t believe in, unless the bidding got really high.  I could find SOMETHING good in Harry’s Hangover Remedy if he paid me ten million dollars.  (sheesh, for 10 mil, I’d TATTOO Harry on my forehead!)

They could even put me on TV, which would be great because I wouldn’t have to say ” I am not a doctor but I play one on TV”  (like that lends credibility to the commercial?)  I could say “Hey I am a real pharmacist and this stuff is great!” “Buy it now!  I know what I am talking about”

I think I am on to something.

Redneck laptop repair

Filed under: Uncategorized — pharmacychick at 8:17 pm on Saturday, September 20, 2008

As you all have read, Pharmacy Chick is not a technophile.  I love my computer…when it works…perfectly.  My first computer was God’s own lemon but since I went with another manufacturer, I have had much better luck.  At work, all I have to do is call the I.T dept and Hunky Steve comes running with his truck full of all kinds of gadgets.  Poor Steve, when he comes running for some repair, I usually have a honey-do list of “while-you-are-at-it” when he arrives.  I need my own personal “Steve”….

Over the last few months however, my way-out-of-warranty laptop has been doing some goofy things, all associated with RAM apparently (after an exaustive internet search of symptoms).  A few things I have learned:

1.  The manufacturer web site sucks.  Honestly I have no idea why they even have a technical support page. Searching their knowledge base is a waste of time and I have never found my problems there.

2.There is no phone support unless you take out your credit card, and when I had free support, I would be on the phone for an hour or more, so why would I hand them my credit card and pay by the hour to talk to some dude in India who I cannot understand??

3. User/technophile web pages and forums are the biggest help of all.  If you have a problem, look there and likely you will find not only the problem described but several solutions as well.

So, I have a known problem and the manufacturer (rhymes with Hell) will not do anything about it and their fix for everything is either reformat my hard drive or replace the motherboard, neither of which I am going to do. When I turn on my computer, only 2 out of 3 lights come on, the hard drive light blinks a few times and then goes out.

It turns out I have the most iron clad form of security measures on my laptop, for (thru trial and error) I learned I have to squeeze certain areas of my laptop BEFORE pushing the power button or it wont boot.   Basically its a 5 lb anchor unless you perform these machinations.  I have however, gotten tired of having to massage my laptop every day–its gets better massages than I do and I am getting bitter and resentful about that.  Therefore, I decided I was going to fix this wagon…er…laptop. 

I deduced that my memory cards aren’t seating properly and squeezing my laptop must be seating it so it will boot. Being the great brain trust that I am, I  figured I could either keep squeezing my computer or have something squeeze it for me.  I chose the second option and took some card stock, folded it into fourths and opened my memory slots. I just laid the card stock on top of the module, closed it up so it applied gentle pressure from the cover. 

BADA BING, we have success!  Dang, I am good.

Now, the only one who will be getting massages to get turned on..is Chick.  Oh, Steve???  Just Kidding…Mr Chick reads this….

I’ve been sayin…

Filed under: Uncategorized — pharmacychick at 7:36 pm on Thursday, September 18, 2008

From the FDA on Sept 16 2008

http://www.fda.gov/bbs/topics/NEWS/2008/NEW01886.html

The letter about Ranbaxy manufacturing problems in India. 

 I have been a long-time opponent of importation of pharmaceuticals from certain foreign entities. My pharmacy is packed with drugs from India, and none of them is there because I chose them.  My company chooses what we carry and ships what is on their preferred drug list. I have tons of Apotex, Aurobindo, Dr Reddy’s, NorthStar, Ranbaxy and others.  Let’s just say, I am not their biggest fan.

Tip of the iceberg?

Generic Substitution 101

Filed under: Uncategorized — pharmacychick at 7:20 pm on Thursday, September 18, 2008

Rule for the day. If you are going to diss generics, at least be somewhat informed about what you are trashing.

Miss Cosmo-girl calls up and wants a refill on her birth control.  She gets Yasmin, which as you all know came out generic a few months ago under the name of Ocella.  AND…as you all know they did the same trick as Protonix did and packaged THE SAME TABLETS UNDER A DIFFERENT NAME.  They didn’t even have the dignity to change the markings on the tablets.   In other words (can you say redundancy) its the same medicine, by the same manufacturer, in virtually the same packaging, for less money.

Last month, we used Ocella and it saved her $40.00.  Her $50 copay became $10.  She called me up last weekend to refill her pills and said ” I want the brand name this month, the generic didn’t work as well”.  Pharmacy Chick learned a long time ago that arguing with patients about brand/generic was a huge waste of time, so I let the issue drop and filled it for Yasmin and its corresponding $50 copay.

When she came to pick it up, I casually said “So, you didn’t like the generic?” She slopped her designer back on my counter and launched into an Oscar winning drama queen routine “OH, I had the MOST Miiiiiserable month of my LIFE! I was moody and tired and I had cramps so bad I couldn’t hardly stand it”.  “I guess the generic just won’t work for me”.

I decided to spare her the embarrassment of showing her they were the SAME med by the same manufacturer, made in the same place. 

She balked at the price. Seems that her selective memory “forgot” that she paid $50 for her pills only 2 months ago. I wasn’t budging, so she paid her copay and teetered out on her black stilettos.

The human mind is amazing.  If you think its great, its great.  If you think its sh*t, then its sh*t.

 

.

Dumb prescriptions of the day

Filed under: Uncategorized — pharmacychick at 9:28 pm on Wednesday, September 17, 2008

Occasionally we get prescriptions that need “clarification”.  Its just part of the job.  Whether its imaginary dosages doctors invent, or drug interactions that would kill a patient,  its prudent practice to make sure every duck is in its row before a pharmacist releases a prescription to a patient.

These two came in after the office closed for the day.  They were for the same patient.  My reaction to the first was WHAT?!? and my reaction to the second was “you have to be kidding me….both rx’s are going back to the office”.  Below is each rx copied exactly as its written and my comments on both.

Rx number 1.  Pramipexole (MIRAPEX) 1mg oral tablet    SIG:  Take 3/4 tablet (1mg) my oral route 3 times daily  Dispense 45 with no refills.   ok,  first off 3/4 tablet is not 1mg  unless you are pointing out to me a second time that you want 3/4 of a 1mg tablet which is stupid because halving a tablet is hard enough but this poor guy has to quarter them and most patients are simply not smart enough to keep track of quarter tabs.  Back to the office with this suggestion  and question:  “you want a 0.75mg dose 3 times daily?”  How about 1.5mg  tab : 1/2 tab 3 times daily?”

Rx number 2 for same patient: Selegiline 5mg oral tablet  Sig Take 1 tablet (5mg) by oral route 1 times per day at breakfast and lunch.  Disp 15 with no refills.  Well at least this rx has got the dose right, one tab does equal 5mg but the last time I checked, taking something at breakfast AND lunch constitues taking something 2 times per day, but hey, maybe its just my math heh heh… Back to the office “so its 1 time daily af breakfast OR lunch or twice daily at breakfast AND lunch”

There is always something to keep it interesting at the pharmacy..

Did anybody watch the Red Sox game tonight?  Did ya hear that guy screaming all night?  Somebody should have taken about 6 inches of duct tape and strategically applied it across his loud mouth!

How does this add up to …”stay?”

Filed under: Uncategorized — pharmacychick at 9:04 pm on Monday, September 15, 2008

Ok, I have a non pharmacy rant today after I read this mornings paper. 

 So,here goes:  you have a storm coming that is as big as the state you live in (which happens to be the largest in the lower 48) PLUS you live on an island that happens to be directly in its path, PLUS you received mandatory (note: mandatory doesnt mean optional) orders to leave, PLUS the nightmare of Katrina is still being felt just a few hundred miles away..and yet 20,000+ people in Galveston and 100,000+ people in nearby towns STAYED to weather out IKE.   I do not get this. 

I am not denigrating the impact of this storm and I hope that the Plagakis family is safe and their home is intact, but thank God they had the wisdom to leave.  But what possessed some of these people to stay? Todays paper had a photo of a dazed woman being rescued from the floodwaters and her destroyed home.  Her husband was already in the boat.  There is no running water, hence nothing to drink and nothing to flush. There is no electricity so no refrigeration and food will spoil.   Its hot so it will spoil quicker.  Water outside is putrid and caskets are apparently bobbing to the surface and floating away.  Water is unsafe, full of snakes and insects abound.  There are no stores open so no food to buy.  Desperate people do desperate things.

Further down in the article a woman was quoted as saying “If they had told us what it would be like NOW, we would have left!”  Whoa, wait a minute…lets blame “they”?  Did this person live in a cave after Katrina? Had she not seen one single picture of post-Katrina mess?  Did the folks that stayed think that after a hurricane, everything would be back to normal monday morning? 

From what I understand Galveston is a pretty afluent area, unlike some of the areas in Louisana where abject poverty was the rule and evacuation might as well be as likely as sprouting wings and flying.  These people could have (and should have) left.

Help me here..anybody got a clue? Maybe Pharmacy chick is a big chicken, but if I was gonna experience a hurricane, I’d have said a prayer over my house, packed my car and gone before the sun was down on the first evacuation order. I would have driven as far north as I could get and waited it out.  Losing everything I own would suck and my heart goes out to everybody who lost their homes, but honestly, if you forced this choice:  “give me your house, PC, or give me your life.”  I’d give the house every time.   I hope I never have to make that choice.

The people who stayed behind could have lost them both. Some did, I am sure.

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