The Pharmacy Chick

Flying the coup in retail

The weeds in my life. A non pharmacy post

Filed under: Uncategorized — pharmacychick at 8:13 pm on Saturday, June 27, 2009

By all accounts, it is the most perfect afternoon.  Imagine:  The sun has crested for the day and its late afternoon,  about 75 degrees, and a gentle breeze is wafting in the air.  There is not a cloud in the sky.  Every fiber of my being is saying “You’re off duty now, grab a cold drink, put your feet in the wading pool, and enjoy the afternoon.”  But there is also another voice to be heard. “Weed me”. 

If you have ever owned a home (with a yard) you know what I mean.  Despite our most heroic efforts of landscaping and design,  our beautiful gardens and yards demand attention on a regular basis.  Bushes need pruning, flowers need to be dead-headed, and weeds need to be pulled.  Its an arduous job, sometimes on hands and knees.  Occasionally we have to reach into dark corners to reach the reclusive weeds,  while other times they masquerade as flowers and we have to separate the desired from the undesired.  And even with our best efforts to protect ourselves, sometimes weeding is painful when thistles and thorns pierce our heavily gloved hands. Often after working hard, we feel the pain the next day with slivers and sore muscles.

As I complied with that latter voice I began to think about this weeding process and how it related to my life.  Our lives are much like our yards.  We like to have a beautiful yard and likewise we like to have a beautiful life.  But like our yards, our lives need pruning and weeding also.  The Lord is a master gardener but like any gardener knows, the best plants are made with proper pruning.

I began to think about the weeds in my own life and how I have to deal with them on a daily basis.  If I ignore the weeds in my yard, they’ll never go away.  They only get bigger and harder to deal with. So it is with my life-weeds.  They too are sometimes hard to reach and hide stealthly in my dark corners.  So also can they be painful to remove, but like real weeds, if they aren’t completely removed, they will surely come back. And sometimes, like real weeds, they also masquerade as flowers and attempt to compete with the good things in my life, all the while insidiously choking them out.

These life-weeds are sin.  Plain and simple,  these weeds need to be removed on a regular basis and no matter how often I weed my life, they keep creeping back in.  While some weeds are extracated forever, there always seem to be another to replace it.  Many are hard to recognize and all are hard to deal with.  Callous thoughts and comments at work are a persistent one for the Chick.  Its hard sometimes to find a nice thought to say about certain customers and I am working hard to just stifle what I am thinking instead of making it known.  Enjoying the temporary while neglecting the eternal is another weed I have to pull. There ARE more, but listing my personal failures and flaws isn’t necessary,  I know what they are.

The Lord has made it known that I am to be holy like He is holy.  Its an impossible task, but one that I work on every day.  By resisting the unholy, I will pull my life weeds out one by one, getting them all the way down to the roots. I don’t have to do it alone and I am grateful for God’s help. He doesn’t only weed  my life, but he also provides the nourishment I need to grow.  All food but no weeding would make a jungle like mess of a life.  I think we have all seen the disasterous collapses of lives of certain celebrities in Hollywood that reek  of “all-food-no-weeding”.

Weeding and pruning are seldom fun, but they are always necessary.  The next time you grab a bucket and your gloves, I encourage you to contemplate about your own life-weeds, as I thought about mine today.

Peace!

Which eyes will see, which ears will hear?

Filed under: Uncategorized — pharmacychick at 8:42 am on Friday, June 26, 2009

Pharmacy chick was reading yet another (?!?) article about somebody’s laptop being stolen with private health information on it.  Without getting into too much detail,  there was chart info, and billing information for a lot of patients at some HMO on a laptop stolen from somebody’s truck. 

Aside from the obvious (like, what in the sam hell was this information on a laptop anyway?), who leaves computers in cars anyway?  You are just begging for somebody to steal it.  But lets lets address the first issue.  This kind of stuff shouldn’t be leaving the office in the first place.  If my personal information is on some main frame computer in a dr’s office then THAT is where it belongs.  It shouldn’t be riding around in somebody’s truck.  I dont take patient’s profiles home on my computer.  In fact, I have no access to downloading any kind of information off my store computer.  Why would I want it anyway?  To work at home? Screw that.

Privacy is a joke. We all know it.  Lots of eyes see private information.  Lets just look at one thing: credit card numbers.  Everytime I pay my credit card, I write a check.  Some minimum-wage data entry person in a huge building will rip open my bill and input into a computer that I paid my bill, and what I paid.  This person has my credit card number, my checking account number, my name, address, phone, and my signature. Tell me that doesn’t freak you out a bit.  I have had this account for 15 years.  I doubt that Mr/Mrs Data entry is the same person every month so hundreds of entry people have had access to my stuff. I hope they have good hiring skills and security.

Go to PC pharmacy.  I have a counselling window, a drop off window and a pick up window.  To be honest, if I want privacy, I’d have to take the customer to the bathroom.  My counselling window opens up into my wait room.  My pick up window is at the checkstand.  You can pick which ears will hear your conversation: either the people picking up their rx or the people still waiting in the wait room.  If I try to speak low, then I usually hear “huh?”. I carefully pick words as to not reveal too much information for sensitive issues.  Its a no win situation.

Recently we updated our life insurances to replace some policies ready to expire.  We had to sign a tome worth of papers, essentially opening our life up for view by somebody in a cubicle to decide if we are deserving of more term insurance.  We literally signed away all of our privacy rights on one page.  They can see and ask for everything.  Clearly, if you want life insurance, you have no right to privacy either.

And, as I wrote before, try ordering a pizza.  the guy on the other end has your name and phone number already…on caller ID.

I went to get a hair cut last week at one of these big chain quick cutting places.  They wanted my name/address/phone “for their records”.  “What for?” asked I.  “for our records…again…and to send you coupons…”  So what?  you are gonna clip some hairs off my head and I am going to pay you cash, and I do not need any coupons.  They make me feel like a dolt for not wanting to fork over all my info.

Security cameras are everywhere.  I cannot imagine how many times I have my picture recorded in a given day. 

Too many eyes will eventually see and too many ears will eventually hear.

And, don’t kid yourself into thinking otherwise….

Games people play.

Filed under: Uncategorized — pharmacychick at 7:18 pm on Sunday, June 21, 2009

I should have handed him a deck of cards and said “if you are gonna play games with me, I’d rather you use these”.   He had about 5 teeth missing and near as I could tell, had never been a patient at Chick pharmacy.  Mr Dental Disaster had brought in a bottle of insulin and said he wanted to “exchange” it. “Exchange  it for what?” I asked.  “Another bottle, this one leaked out.” He claimed he had JUST bought it and all of the insulin leaked out. He also claimed he had called somebody here and they told him to bring it back.  There were several things wrong with this scenario:  1) nobody sold anybody any insulin that day. 2) any returns need to be discussed with the Chick and nobody called me about any insulin return, 3)  I have NEVER seen any bottle of insulin “leak” and 4) the rubber stopper looked dirty as if it had been entered several times with a needle.  He had a receipt in the bag he brought it but it was for $4.95.  (clearly not for the insulin purchase)and he “couldn’t find” the insulin box.

I declined to exchange it.

A few days prior a lady brought in a bottle of tylenol chewables. SHE wanted to exchange it also.  Her claim was that she JUST bought it and it was nothing but powder.  I opened it up and it certainly was powder.  BUT again, there were a few inconsistencies with this story.  1)  the bottle looked as though it had been in somebody’s purse for a LONG time. The cap was dirty and the label was worn. 2) the exp date on the container was 5-2010.  In theory, if she “just” bought it, the exp dates would be similar.  Our shelf product was already into 2011, and lastly,  she had no box (for somebody who “just” bought it).  Again, I declined to exchange the product, but since it was an OTC item, I deferred to the store manager.  Since he didn’t come back and ask about it, I can only assume he declined also.

Do I look gullible and stupid?  Do I appear to have the IQ of a stone?  Come on people.  I can see right thru these scams.  You  bring me dirty worn out product and try to tell me its new but defective, I am gonna call you on it.  I realize there are some businesses that will take back anything no questions asked.  There is a legendary story that one major luxury clothing store refunded some person for some tire chains.  (they dont carry tire chains).  While I doubt the validity of that story, it does serve to remind us that if you give somebody an inch they will a mile…with a smile.

Pharmacy chick’s company isn’t quite that gullible, and in recent days had become a little more conservative about their returns.  I understand that we need to be accountable for what we sell.  We do NOT need to have blind eyes to getting ripped off.

And, I didn’t.

Telepathic pharmacy.

Filed under: Uncategorized — pharmacychick at 9:42 pm on Friday, June 19, 2009

On a similar vein as dearest Dr Grumpy, here is my own entry for wishing I would read minds.

Yesterday morning we got an e-script for one of our customers.  It was Macrobid 100, #14, 1 bid.  I went to fill this rx and noted a warning for allergy to nitrofuran derivatives.  Its not a common allergy so it was duly noted.  I quit filling the prescription and called the office.  I got the nurse right away.  What she said stunned me.

PC: “Hi, PC here, we got a allergy notation on this patient about nitrofuran antibiotics and you have prescribed these for Mrs Ima Hogg.”

Nurse:  “yes, I realized that after I had transmitted it, you can cancel it”.

PC:  “Um,were you going to call us about that mistake? and do you want to give something else?”

Nurse:” we are talking to the dr. we will call you later”.

They never called us that day.  And, if you noticed…they didnt’ answer my first question.

Most meaningless endorsement of the week award.

Filed under: Uncategorized — pharmacychick at 9:24 pm on Friday, June 19, 2009

Perusing a trade magazine, I came upon an ad for a blood pressure monitor, Kinetik.  It bragged that it is the “first in the WORLD to be tested and approved by the British Hypertension Society’s validation service.”

eeeeew.  Now thats really something….

Seen and heard at the Dr’s office today.

Filed under: Uncategorized — pharmacychick at 5:10 pm on Tuesday, June 16, 2009

About 3 years ago my OB GYN guy retired.  PC was bummed because he was a great physician and I was not looking to find a new MD for my darkest most parts.  Time being what it is, I finally broke down and went to see the Doc my records were sent to.  For the record, he was great.  I was in and out of there (no pun intended) in less than 30 minutes. My kind of dr visit.

Before going in however, I got to fill out the battery of forms for insurance, health history and what not.  I was alone in the wait room and their phone rang.  I couldn’t NOT overhear, and it was an interesting conversation.  No HIPAA violations were noted.  It was a man calling on behalf of his wife (WHY??) who had received a positive pregnancy test.  They wanted to see the dr…a specific female dr that was of their same descent.  All I heard was this lady’s first name which was definitely not main stream American. 

 I could hear the secretary (can you call them secretaries??) offer up two dates:  June 20 for initial consultation with NO ultrasound available that day OR July 6 with consultation AND ultrasound. NOW, have you ever noticed that when some people are offered their choices (whatever they may be in life) that they will always want an option NOT offered to them??  This is one of those guys.  He wanted a June date with ultrasound.  Let.me.speak.slower…There was NO June date with ultrasound….

I am trying to focus on my form…”Have you ever had nonconsenual sex”…..does that include my creepy boyfriend from high school?…probably not.  check NO.  No, sir, we do not have June availability with an ultrasound,  Dr  Schmitza is  booked until July 6.  Yes, sir that is the earliest she can see your wife, unless you would like a different Dr.  Yes Sir, I understand you want to see Dr Schmitza.  “Was your last sexual partner male or female…..(whoa times HAVE changed,  that question wasn’t on my forms 20 years ago…) check MALE.  Yes sir, you are responsible for all charges not covered by your insurance and maternity charges must be paid before the birth. 

She really went on and on with this guy.  I am just giving you the condensed version.  She must have offered up those same two dates 5 or six times before he settled on one of them.  AND the entire billing process was spelled out multiple times.  He was not getting it.  I think he wanted everything free because he had insurance.   Even I had a firm grasp on it and I am not pregnant and heard only one side of the conversation.   I finally completed my last few questions “do you have multiple sex partners”…check NO  (if you sleep with a schizophrenic with multiple personalities, would that be considered multiple sex partners??…nah probably not).

Over hearing this conversation just reminded me that these circular and seemingly never ending conversations are not limited to the pharmacy.  This same guy is probably the dude who will bug you for non drowsy Benadryl and will dog you until you die of exhaustion or you give it to him, or the one who insists that Lipitor has a generic because its written Atorvastatin.  He will require you explain simple concepts to him over and over and then HE will repeat it back to you…incorrectly. He will want to schedule his flu shot before work…at 8 am and won’t take no for an answer even tho you are CLOSED at 8 am!  He will demand an indepth consultation over which stool softener works better.  DSS or Docusate Calcium.  He is the one who thinks that “covered” means “free”and thinks you are ripping him off for the copay, and he is also the guy who thinks that if he gets only 2 weeks of Nexium instead of a  month, that his copay should be half…and on and on.

The good news is, I am out of there until next year  but I have to have a mammogram (frozen glass torture device).  The better news is,  I am not that guys wife!

Ask for X, get Y.

Filed under: Uncategorized — pharmacychick at 8:21 pm on Sunday, June 14, 2009

You know its happened to you. You fax a refill request for A to a doctor’s office and they send back something different than what you asked for….and no explanatory note.  Then  the guessing game begins. 

This has become especially prevalent once the e-prescribing started.

 Did the Dr intend to change the prescription?  Did we fill it wrong to begin with? (pull the hard copy…check…whew, we did it right). Whether its asking for L-thyroxine 0.1mg and they fax back 0.125, or asking for Trivora and they send back Tri-nessa, its frustrating.  Would it kill them to include a note?  What if we didnt’ notice the change and just forwarded the previous rx with new number?  It’s happened before when we didn’t catch the change…we asked for X , expected X, refilled X and didn’t notice the change…a change that was supposed to be made.  After all, not ALL of them are mistakes.

Almost without exception, it requires a call back to clarify.  If there is one thing that the Chick does not like to do is GUESS on  the intent of a prescription.  I like to know without any doubt what the Dr wants. Sometimes it defies reason.

We sent a refill to a Dr for syringes for Mr K.  We have to have a signed RX because its Medicare-D.  A day later we get a fax from his Dr’s office for (and I kid you not)  “undetermined drug” 1 po qd.”  At the bottom it said Cinnamon capsules 200mg”.  First of all, cinnamon is an otc supplement.  We aren’t filling a prescription for it. Second we asked for syringes and got no response. and 3rd, the Cinnamon was unsolicited; we didn’t ask for it and as far as I know, the Mr K didn’t ask any member of the pharmacy for it.

I gave the project to the intern.  “Get an ok for this (handing him the refill request for the needles) and find out if he is supposed to get the cinnamon or not.”  He called the office and got the syringes ok’d (ok, thats half the battle) but hung up confused about the cinnamon and asked me for advice.  I told him ” Call them back..Its your job as the pharmacist  to not hang up from a conversation until you have the answers you need or are assured of what you are supposed to give the patient. If the nurse isn’t sure, ask her to check”. (sorry interns, but sometimes you guys can drive us nuts…)

Communication is a major component of what we have to do to provide health care to patients.  It really annoys me when I ask for specific information in a clear and concise format and I either get no reply or something completely different than what I asked.

For example: I sent a prior auth request for a patient prescribed Lipitor and it wasn’t covered.  3 faxes and 2 weeks later, I get a human on the phone and they said “oh, we gave her a prescription for Simvastatin…” (That the patient didn’t fill at my pharmacy….) yea thanks for letting me know…NOT.

or: I sent a refill request for Lantus and got  a rx back for Humulin 70/30.  I called the patient. “No, we haven’t changed anything…I need Lantus” Back to square 1…send the refill back to the office with notes that we do not want Humulin.

Almost missed this one:  We requested Fluoxetine 20mg refill.  The rx came back paroxetine 20mg.  since all these are electronic/faxed hardcopies sent instead of signing off on OUR refill request, the tech had just written the old rx number on this fax and I reassigned it.  It was finished and filled as fluoxetine before I noticed Paroxetine.  I called the office “Oops!,  sorry pharmacy, my bad, refill fluoxetine as before…”

These are like the equivalent of a prescription booby trap.   Ask for X, get Y back and hope you notice there is a problem, when there is a severe lack of notes.

I am just saying that if you are a prescriber and you are responding to a refill with something DIFFERENT than what we asked for, include a note: “new strength” “changed med” “dc old rx, fill new drug”, ANYTHING…

Please?

Why do we care about these people??

Filed under: Uncategorized — pharmacychick at 4:23 pm on Friday, June 12, 2009

Pharmacy Chick was in the checkout line purchasing her daily supply of carbonated caffeine.  I must have it or there will be a crabby Chick at around 10 am daily.  As I was waiting to check out my eyes turned to all the tabloids for the week.  If we were to believe that the tabloids print only those things we care about, then apparently Brad Pitt and Angelina Jolie, and John and Kate (and their brood) are the hottest topics around.  Without exception, one or both of these subjects graced the cover of every single one. 

I say ” who the (insert your expletive of choice) cares?”  I dont know them personally, and they don’t know me.  I don’t care who is fighting with who, who is having an affair, and I also don’t care what countries they are jetting off to to adopt children.

Enough already!  A show of hands of who agrees with me???

BUT, if you come up with a diet where I can lose weight while eating chocolate pudding and powdered donut holes, then I’ll buy it…

Must I multitask everything?

Filed under: Uncategorized — pharmacychick at 8:53 am on Thursday, June 11, 2009

If one does not multi task in the pharmacy well, that “one” will drown in a sea of work.  Obviously I have taken this artform home:

This morning, I decided to feed the dogs. I put some water in the microwave to heat for MY oatmeal,  and while I grabbed the dog bowls from the kitchen, I noticed the recycle needed to be taken out so I grabbed that too.  When I got to the garage, I sat the bowls down and took the recycle out to the can. I then remembered that the next day was garbage day so I decided to roll the garbage and recycle carts out to the curb. At the curb I noticed a few weeds, so I pulled the few weeds and put them in the yard debris container, and then rolled out the garbage cart. Then I finally returned to the garage, filled the dogs bowls with food and returned to the kitchen where the microwave just beeped with my hot water for my oatmeal.

This is just like work: A typical moment:  I decide to file my reports, As I head to the file cabinet I see a customer looking lost so I ask them if they need help.  As I dispense my wise advice, somebody else interrupts and wants to know where the motor oil is.  I tell him that the auto parts store is at the next light up 1/2 mile, and return to the pharmacy where 3 waiters await my final check and a phone call beckons.  I retireve the phone call, and check the rx’s and note that the light on the message phone is blinking so I pull the message denying a prescription (and asking ME to contact the patient for them..WUSSY DOCTOR), so before I forget, I pull the refill notice, and thankfully get only a recorder at the patients home, so I leave my own message…WHEN the store manager comes up with a pile of papers he says I have to sign before the end of the day so he can fax the office…and behind him is 2 ladies in purple hats who want a shingles shot since their good friend just got shingles and “we don’t wanna get it”.  Somewhere in this mess I put down my reports and as God is my witness, I can’t find them.

At least the Dogs got fed.

Creative Inventory Management? Start a rumor…heh heh

Filed under: Uncategorized — pharmacychick at 9:36 pm on Wednesday, June 10, 2009

I was scanning my shelves today and noted I had 16 boxes of Tamiflu.  I had tried to send 14 of them back to the wholesaler last week but was DENIED.   No.Way.  Do not pass Go, Do not collect $200. No Deposit, No return..shoot.

I was mumbling under my breath about the injustice of it all when Tech Extraordinare (without even looking up from her work) said “What we need is a good old fashioned swine flu scare again”…

Oh yea….

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