The Pharmacy Chick

Every year Pharmacy Chick’s church group (none of whom knows of her alter ego) gets together for some Holiday cheer.  This year, because of some horrible weather, its going to fall on New Years Eve.  AND, every year I include a gift bag with some small offering.  Usually its some cookies and a home crafted gift made by yours truly.  One year it was  little doilies, and last year it was crocheted kitchen towels.  Because our group spans the socio-economic specrum, its always low on the dollar scale and never anything that would make anybody feel bad. 

This year I decided to make everybody a pot holder. I found this delightful little pattern that was made with flannel, cut in several layers, sewed then washed.  the cut portions would fray and make cool designs. It was designed as “easy” and “quick to make”  So. It. Said. 

What it failed to mention that this “easy” and “quick to make” project would best be suited if the sewing machine used for it was designed for such things as LEATHER PURSES OR SADDLERY!  Lets just say by the time I can actually completed the 5 potholders I had succumbed to many unholy thoughts, not to mention sacrificed 3 needles and all of my patience. Try sewing binding on 7 layers of flannel.

Oh, they turned out fine, especially after washing, when their imperfections were hidden under all that frayed beauty. AND since the original distribution of these gift bags was supposed to be mid December instead of NYE, my friends are getting 2 week old cookies and potholders I sinned mightily while making. 

I hope my friends still like me.

Call it and end of year miracle, or whatever.  I got that Prior Auth I needed about 4 pm in the afternoon.

It took 19 days and who knows how many phone calls but its done and there is one mighty happy customer this evening….not to mention his pharmacist.

Done.

Tomorrow is the end of the year.  Wrong, you say? its only December 29?. HA!  I spit on your shoes!

Ok, I wouldn’t actually spit on your shoes, but after my shift ends tomorrow, I will not unlock the pharmacy doors again until Jan 2.  (of course, the New Year invites its own problems, but I’ll not think about that now).  The Pharmacy Chick got the store duty the days before Christmas, so my man Friday gets the duty the days before New Year.   I got the snow storm and the frantic wait-til-the-last-minute travelers.  He gets the wait-til-the-last-minute end-of-year people.  You know who I am talking about. “I want everything I can fill filled before the end of the year.  My deductible is met”.  

Some people want junk filled they don’t even need just because it will be cheap (or free).   PC tries to be forward thinking.  I look out for my people who are out of their donut hole.  I’ll call some key customers up and remind them that their 2009 deductible will start over on Jan 1 and if they need ANYTHING, now (not later) is the best time to call me.  I’ll obtain permission from their physicans to dispense a 90 days supply if its covered. Still, despite all my efforts its still a nightmare the last few days of the year. 

I have one Prior Auth in my box I have been fussing with since Dec 10th.  It ticks me off because the insurance company ok’s it every time but they always make the dr jump thru a hundred hoops. In the mean time this guy suffers with open sores on this body.  I’ll bet if the CEO of the PBM had open sores all over HIS body he’d get his cream in less than 20 days. If I can’t fix it tomorrow, I doubt it will get done.

Nevertheless, time will tick away and at shifts end tomorrow, I say goodbye to 2008.  I will leave specific instructions for my techs to work the refill box like its the most important thing in the world. I’d love to see it empty at the close of business Dec 31, but thats likely a pipe dream.

And speaking of dreams: I have my own wishlist for 2009. Feel free to add your own:

1. Gift cards for transfers?  BANNED, for all time

2. No more split bills.  I hate loyalty cards, especially the ones that require I remember a monthly split bill. How presumptuous of any manufacturer to expect me to do that.

3. A universal prescription card…with everything required for transmit…and all members listed on one card including Processor name, BIN, PCN, ID, Group, Person Codes and a phone number. IN A FONT THAT IS FREAKING READABLE!

4. Ban direct to consumer ads for prescription products. 

5. The Hotel hosting the national convention of PBM and Medicare auditors would catch fire and everybody would perish inside. Chick just got done faxing over 30 pages of documents to support one prescription of test strips. She is a tiny bit bitter.

6. A requirement that if you are a help desk agent you speak fluent (not merely functional) English AND be located in North America. No more India, no more Phillipines.

7. Every manufacturer who has a recall be fined seriously big bucks which would be paid out to pharmacies who bought their junk, since we are the ones who have to clean up their messes.

8. My corporate office would have the same hours they make ME have. I probably had a dozen tech no-shows over the year that happened on the weekend. Guess what?  Tough noogies.  We worked alone because everybody in the office were snug at home.

and lastly…9.  That all of you would have a prosperous and happy 2009.  I’ve been doing this for just about 10 months now. Who’d think that anybody would have been interested in the ramblings of one retail pharmacist? THANKS!

God Bless you all!

“I’m here to pick up my prescriptions, I have two” I see only one on the shelf and tell the patient so. ‘ I called the refill in yesterday on your recorder” (to complicate matters,the patient is also the physician).  I apologize and tell the dr/patient I will get it ready as soon as possible. The claim rejects: refill too soon…filled yesterday…someplace e.l.s.e. I ask the pt/dr if he possibly could have called some other pharmacy. “No, I took YOUR phone number off the bottle”. Tech extraordinare calls the help line to ascertain WHO filled the rx yesterday cuz it certainly wasn’t us.  After much handwringing (the doofus at the PBM didn’t seem to want to tell us that info) it was determined it was filled at same chain different locale (about 5 miles from here). “Is there a chance you could have called our 5th and main store? it was filled and is ready there.” “Yes I suppose I could have…..”

“Hi, I am Leslie Wizzenburgenstein, here to pick up my rx.”  I have never heard the name,  nor do I have Leslie in my computer. I relay that information to Ms Wizzenburgenstein “you guys just called me to to tell me my rx was here.”  Again, my suspicion is that Ms Wizz is at the wrong store.   I call the pharmacy where she “transferred” it from.  Its already transferred to Johnson street store. Time to call Johnson street, and yup its there and yup, they called to tell her it was ready..because she asked us to.  Sheesh, buy yourself a clue and figure out where you transfer your stuff.

“$60? I only paid $30 last time”  These comments sound like fingernails on chalkboard to The Chick. So it was. He paid $30 in September…SEPTEMBER. It is December.  Previously these eye drops had been billed as a 30 days supply.  I couldn’t get away with that. “It lasted you 70 days, I cannot tell your insurance its a 30 days supply if it lasts you 70.” The patient tells me he had samples. Allright, I’ll buy that and try to bill for a 30 day supply.  I get trumped by the insurance, a Medicare D plan, when it rejects for days-supply.  They have gotten into the business of regulating eye drops down to the minutae.  No less than 60 days will be accepted by this plan.  He pays $60.

“Pharmacy Chick Pharmacy, can I help you?” “Can I have the front desk?” “Sure, I will transfer you, but their direct line is 555-1212 for future reference.” beep beep beep, and she is transferred.  About an hour later, same woman, same request.  Then AGAIN.  WHAT.THE.HELL?  Finally she calls back later in the day with the same request.  This time I lie..”That line is busy, I am unable to transfer, please call 555-1212 directly to get in the que. Thank you very much..goodbye.

***ring-ring***”Do you sell gift cards?” “yes we do” ..“Which ones?”  “Let me transfer you to customer service”  I suspect they will hate me after this call. We sell hundreds of them.

I checked the calendar..the moon wasn’t full..but it might as well have been.

Its monday afternoon and the phone rings at Chick Pharmacy.  Who knows how he picked my pharmacy out of the thousand in the city (thanks Dex), but courtesy of Trusty Airlines Inc, he had been separated from his luggage (and therefore his prescription medication). 

This brain trust of a Y chromosome PACKED his prescription medication, that which “keeps me alive”, he tossed into a suitcase and trusted that it would arrive at the same time (and city) that he did.  Well, it did not.  According to this gentleman, He is in PC’s city and his luggage is somewhere in Missouri.  He wanted to know if he could just “buy” a few days worth of his pills.  Sure buddy, just give me a list.

I just politely but firmly informed him that option was not available BUT heres our phone number, have your doctor call us with what you need.  A couple of hours later, sure enough,  Dr Wunderbar called with a 3 days supply of 5 medications including:  Lipitor (yup cannot live without that one for 3 days), Omeprazole (hmmm otc?), Baby aspirin( what?!?), Plavix,  and timolol tabs.  TIMOLOL tabs?  who the heck has timolol tabs?  I told the nurse that we dont have timolol tabs lets try door number two: atenolol/metoprolol/or even pindolol..

She opted for the metoprolol.  

The guy showed up an hour or so later.  Nice enough guy, almost hated to take his $55.  An expensive lesson:  Do NOT pack prescription medication.  If you cannot afford to miss it, then take it with you.

So you don’t think that PC is completely cynical and heartless, that very evening she bundled up and made a delivery in a snow storm to a little old lady in a wheelchair whose insulin bottle was sucked dry that day.  She can’t drive and her family couldn’t get out.  I guess 20 inches of snow in 48 hours can do that to a mountainous community like ours.

Praise God for tire chains.

And, I hope Y got his luggage back.

Pharmacy chick got an odd one today, for diltiazem ointment.  My first thought was electronic rx goof up. However after doing a bit of research I see Dr’s are using this product to help healing of anal fissures. I would have to wonder ….Who’d have thought to try THIS for THAT? 

Regardless, my internet search for a formula came up empty handed.  Are any of you compounders?  Have you made this?  What base?  just grind up tablets?  I am looking for 2% ointment.

I beseech thee for help!

WHUMP!

Startled enough to look up from my quilt pattern making, I asked “What was that?!”  Looking up from his sudoku my brother in law said “I think something hit the window!”  After 10 hours of snow and 3 hours of freezing rain,  the city we live in was basically motionless, and certainly nobody was at our back door. We had been housebound for 2 days. I got up from the table and looked outside.  On the snow covered ground was a tiny bird, smaller than a sparrow.

Sitting upright, it was clear he wasn’t dead, but he most assuredly just had his little bell rung by hitting my window. The dogs weren’t aware of the happening so I stepped outside and put my finger down on the ground. Expecting him to take off, the little bird just climbed right on.  I stood outside with my little friend til I was too cold to continue.  Birdy was not taking flight, just sitting there on my finger.  I didn’t think it was a good idea to just sit him outside so I instructed Mr Chick to grab a shoe box or something for me to put the bird in til he warmed up.  He grabbed a bucket and my skillet splatter screen as a makeshift cover.  He took a warm towel from the dryer and we put the bird in the warm bucket to gather his wits about him.

I was amazed.  This was a wild bird.  I cannot imagine any circumstance where I could walk up to a bird, reach down and pick it up, pet it like a parakeet without it freaking out or taking off like it was shot out of a cannon, yet this is exactly what happened. 

I knew that once it gathered it self, it would flutter like mad to get out and about 15 minutes after it smacked into the window, it started to get restless.  I took it out to my front porch. I took off the splatter screen, and it popped onto the edge of the bucket.  It took one look at me (honestly) and flew away.

It was one of the coolest moments I have had in a long time.

Someday when the world is made right, I think it will be very cool when I can walk in the meadows with the lions and play with the birds.

Merry Christmas to everybody and Happy Birthday, Jesus!

Ok, We all have had them and now its time to fess up. Baking disasters 101.  Unfortunately I have had more than my share.  Lets just say I am a much better pharmacist than I am a cook.  I’ll never give Rachel Ray or Emeril a run for their money. Once I made pink macaroni and cheese. I’ll tell you about that later.  I do keep trying and occasionally I’ll whip up with something really special and complicated..like Rice Krispie Bars.

No, actually I can do better than Rice Krispie bars.  Sometimes however, it takes practice. 

My mother, God bless her, was a wonderful cook.  She had to be. Not only were things rather lean at our home, but Dad wouldn’t have taken us out to dinner anway. He hated to eat out. She could do amazing things with food. I loved her tuna casserole and hated her stuffed green peppers.  To this day I cannot duplicate her french onion chicken and I miss it terribly. 

I didn’t inherit her cooking skill, but to her credit, she did try to teach me. I give myself a C+.

This one earned me a F.  I decided to try my hand at candy making.  I had my mothers candy thermometer, my heavy pan and my directions.  I had to melt sugar into a caramely syrup.  The instructions said to constantly stir, so I did.  I stirred….and stirred….and stirred.  It started to liquefy and turn a nice caramel color but there was this small bit of off white that I couldn’t seem to get into solution.  So I kept stirring.  The more I stirred the more this white stringy stuff seemed to appear. I wondered if the sugar was crystalizing back out, but it couldn’t be, it was too hot.   I  just kept stirring and this white junk just kept appearing.  I had enough. This stuff wasn’t going right at all.  I pulled out the spatula and sat it on the spoon rest. OH MY,  there was about 2 inches less of my spatula than I had started!  I was dissolving my rubber spatula in the hot sugar.  Apparently “heat resistant” doesn’t mean “heat proof”.   Whups.  That ended my candy making evening..and the useful life of a spatula.

THEN, once I decided to make shortbread for a function I was attending.  I had made shortbread before, and in fact, I make really good shortbread, rich enough to clog your arteries right on the spot.  I had always used a brownie pan for making my shortbread but a friend of mine had gifted me with some new cookie sheets, the insulated Air-Bake kind.  Niiiice.  She said they make perfect shortbread.  I went thru all the preparatory machinations getting my shortbread ready for cooking, the whole batch fitting on one sheet, and put them in the oven. After 20 minutes or so they were done and I grabbed the cookie sheet and pulled it out.  I lifted on edge slightly higher than the other.  Before I could react, the entire batch slid off the cookie sheet and landed in a steaming heap on the bottom of the oven.  I never had completely flat cookie sheets before and I had never had ones so slippery.  What a mess. The whole thing was a loss, an hour of my time and a pound of butter wasted. 

Next time:  Pink Mac and Cheese and my Banana soup disaster.

I pass my melted spatula onto you–what have you ruined?

One of the things that Pharmacy chick wishes was different about herself is that she wishes she was an avid reader.  I don’t know if pharmacy school beat that out of me, but once I was out of school, I didn’t want to pick up another book for a good long time. 

My cousins are another story.  They love books.  To call them readers would be akin to describing the Pope as “a bit religious”. They are nuts. They would categorize their books, keep lists of “wants” and “haves” and would trade with each other as one would finish off a book the other wanted. Their childhood home’s basement was packed with a thousand books.  

 I, however, never developed this love of books.  I only barely got thru the books I had to read thru high school.  Once I finished Sylvia Plath’s “The Bell Jar” I remember thinking What a pathetic depressing piece of work.. Perhaps if they picked more interesting literature, I’d have been more inclined to love reading…who knows.  I remember getting The Hobbit for a gift once, and made it thru halfway before abandoning it. Same with Narnia, also donated back to Goodwill.   I guess fiction is not my forte.

Therefore when the Harry Potter phenomena started a decade ago, I never jumped on the bandwagon. It was a kids book, and the idea of having to wait 2 years before the “next” book came out didn’t appeal to me. I had already wandered into that waiting nightmare with the series “Left Behind”.  By the time a book finally appeared, I’d have to re read the previous book to catch up with the new one.  I did manage to get thru something like all 12 of them. 

Then HP-7 came out.  One of Mr Chicks employees was a nut about all things Potter.  Being a little cheeky, Mr Chick picked up the book she had brought in, and having read nothing of 1-6, proceeded to read the last two chapters of book 7.  The next think I knew there was a copy of Book 1 sitting at home.  Mr chick had read a good part of it during a slow day at work. I guess those 2 chapters of book 7 needed some explanation, hence book 1.  All of a sudden there were new words being spoken in the house, words like Muggles and Hogwarts,  Dumbledore and Draco.  He tried give me a condensed version of what he was reading but it wasn’t working.  Soon there were two bookmarks in this borrowed copy: one for Mr Chicks reading and one for my own. 

I was hooked.  At least I wasn’t going to have to spend a decade waiting to read the story.  I had access to all seven books, thanks to a handy bookstore in my local mall.  Soon, I was on my way to joining the ranks of Pottermania.  I blew thru all 7 books before Mr Chick did.  I learned a whole new verbiage, of wands and wizards, and of a world that would be pretty fun to be a part of, Voldemort nonwithstanding, of course.

I was committed that I would not view the movies until I had read all the books, and I did that.  I didn’t quite avoid the waiting game altogether.

There are still 3 more movies to come out.  

I don’t think I’d be inclined to do battle with dark wizards if I was lucky enough to be blessed with magic, but I’d love to have my own wand and house elf Dobby.

Yea,  that would be seriously cool. Alas, I am just a muggle pharmacist.

I’m not sure what brought this story to my mind, maybe JP’s DAW discussion and its fraudulent use in patients to get brand name for a lesser price.  Regardless, its a story worth telling.

A few years ago, I had this patient who’s doggie had heart issues.  His vet prescribed Benicar ( trying nothing else first that I know of).  For several months he picked it up and whined about the price every time.  He asked me once if his insurance would pay for it.  “Not for a dog it won’t”.

This man himself had nothing of consequence on file for himself, save a rx for Prilosec and some thyroid med, and occasional antiobiotics, junk like that.

One day I was working and the light came on my message machine for new prescriptions.  A dr was leaving a prescription….for THIS man….for Benicar.  It just happened to be the same strength, and directions that his dog used.  My baloney-0-meter was registering a new high and I decided to dip a toe into this murky water.

I called the Dr back, and actually got him on the phone.  ” Would you mind if I asked you please, is this prescription for Mr Smith? or is it for Mr Smith’s Dog? I didn’t want to be accusatory, so I added “Because I want to be sure I have the right patient–His dog takes Benicar, and Mr Smith doesn’t.”  There was a very pregnant pause on the other end. 

“Its for his dog”, he replied.  “Are you a vet?” I asked.  “No, I am actually his neighbor” The physician replied. He said he wasn’t sure if was he was doing was right, but he wanted to help out his buddy.

I wanted to remind the physician that the only thing he was helping his buddy do was fraud his insurance, but I just said, “I think you can only prescribe for your own species”, “I’ll contact the patient if you’d like”.

They both were so busted.  I called the patient and remained as noncommital as possible and explained that only a veterinarian could prescribe for animals.  He knew I knew and that was enough. 

He never filled anything at my store again.  I’d say he was either embarrassed enough to leave or he got his flaky Dr neighbor to call a pharmacy who didn’t know better. 

 Honestly I don’t care.