The Pharmacy Chick

Flying the coup in retail

E-prescribing screw up of the day:

Filed under: Uncategorized — pharmacychick at 9:29 pm on Thursday, August 19, 2010

Actual Script e-sent to us…

Loestrin 1.5/30

#100

One teaspoonful once daily.

does ANYBODY look at these things before they sent them?  ( but if I layer them really carefully I may get about 15 tabs in one level teaspoonful)

puhleeze….

Who’s on first?…..Overheard at the Rx counter today..

Filed under: Uncategorized — pharmacychick at 10:05 pm on Tuesday, August 17, 2010

“Do you have a prescription for Brown?”

(look on shelf…no Brown)  “no, dont have a prescription for any “brown” family today”

” ARE YOU SURE?”  ( oh my favorite line)  “They said they called it in”. (of course they did)

I go to the computer…”and what is the first name?” and he gives me his first name…we dont have him in the computer at all. 

“ok, John Brown”. I dont have you in my computer and I haven’t received any phone call, fax or escript for you at all today.

“Oh, its not for me…its for my dog.”

(do a quick check of fax pile and see a vet rx for a Sally the dog Johnson)  “The only vet rx I have is for the last name Johnson”.

“Oh, thats me.  See? they did call it in”  (restraining the Dilbert fist of death).

(cant resist)  “So how was I supposed to get Brown out of Johnson?”

“Its actually my girlfriend’s dog”.

Girlfriend…do us all a favor..dont breed with this one.

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“Hey, can I get a flu shot today?”

“Sure” (and I give him proper instructions to fill out form…etc)…which he does…

He hands me the form and his insurance which is not accepted yet.  Most contracts havent’ been finalized..after all, it is FRIGGIN AUGUST and its 97 degrees out side.

“Sir, your insurance won’t pay for a flu shot yet, it hasn’t signed contracts for billing yet..check with me after Sept 1″.

He launches into a diatribe ” Yada…I am high risk, and must have a flu shot” (its August..and still 97 degrees out side) “I cant believe they won’t pay for my shot..they did last year” ( yes they did..in October)..stammered on…and on…

I offered him the shot for the usual $28 if he HAD to have it today. 

I guess keeping his $28 was more important. 

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“your insurance is terminated”…..”NO, THIS IS MY NEW CARD”.  “Yes, I see that, but its marked as terminated. I have all the right numbers”  “HERE, LOOK AT MY OLD CARD”. (matches new card except for color) ”  I agree with you sir, it should work, but it doesn’t and I can’t fix that”  “GIVE ME MY PAPERS BACK”  “Ok, here you are sir,  good luck”. 

 I would love to be a fly on the wall at the pharmacy down the street when he hands these same rx’s to some pharmacist…who looks at my half peeled of labels and wonders why he is there…but will find out soon enough..”coverage not active on date of service”.

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If I have a prescription for Dog food, can I bill it to my insurance?

no, we cannot bill dog food to your health insurance.

“But its PRESCRIPTION dog food”.

no can do…not even if you are eating it yourself.

Secundum Artem Quitum?

Filed under: Uncategorized — pharmacychick at 8:54 pm on Tuesday, August 10, 2010

“Hey Intern, will you please compound this cream?”   It was a pretty simple Salicylic Acid Aquaphor and steroid mix.    She looked at me like I had spoken a foreign language.  whoa…code red…

“Have you had your compounding class yet?” I asked.  “No, we dont have that class.  but we watched a video”…….A VIDEO… “But we made some lip balm and some sun screen last year”.  oh thats useful..who is ever gonna need to make lip balm or sunscreen?

She had never heard of the word triturate….she had never used a torsion balance.  She had no idea the difference between a balance and a scale. She didnt know what a eutectic mixture was.  I showed her a glass pill tile and asked her “Do you know what this is?”..she shook her head “no”.

Compounding class was the most fun class I took.  It was where I felt I was learning a secret skill.  I made rectal rockets, rolled pills (yes, rolled PILLS), made calamine lotion from scratch,  prepared a bunch of different ointments, creams, emulsions, etc…and had an all around good time.  We learned how to properly fill ointment TUBES and JARS ( do NOT let the cream stick to the lid students…an automatic F)  We made capsules and filled powder papers. I watched what happened if you put camphor and menthol crystals together…  Of al the classes I took,  compounding was the one I looked forward to the most and wished I could take over again.

Rewind 22 years.. The class before me was the last class offered Pharmacognosy…the study of drugs of plant origins.  We weren’t even offered it as an elective..it was discontinued.  I really felt I missed out on that one.

Is compounding  a class discontinued in pharmacy schools today?  How sad if its true.  Its our gift…Its our heritage…its OURS!

When Pharmacy Chick was working at an independent pharmacy, we had a contract with a pharmaceutical supply house.  I had access to any compounding supply I needed.  while I didn’t need to make a whole lot of stuff, I got to make stuff a lot more often than I do now.

Pharmacy Chick Pharmacy is a conglomerate.  No contracts with supply houses..Im lucky to be able to buy sulfur powder.  When my glass graduate broke, my wholesaler didnt’ even have one.  I found it on ebay! In fact, when I opened my store, I was given NO compounding supplies.  I imported them from the store we had purchased.  One of my graduated cylinders has actual etched glass. Truly an antique.

I showed my intern how to make this cream…Step by step.  And in one day she learned all of the answers to the questions she couldn’t answer earlier in the day.  And I think she really enjoyed it.

Wrong Number…REALLY wrong number

Filed under: Uncategorized — pharmacychick at 10:20 pm on Friday, August 6, 2010

As is customary in the pharmacy, we have to call GIANT PBM help desks ( the ultimate oxy moron if I have ever heard one) to get overrides for the most mundane of reasons.  Vacations, dosage changes, lost meds, this that….

So on this day it was Aetna’s turn..beep beep beep boop boop boop…ring ring.

Some dude from someplace off the shore answered the phone and I’m thinking..”Great, some guy from Manilla who isn’t going to understand anything I want” so I launch into my spiel.  “Hello, this is Pharmacy Chick from Pharmacy CHick Pharmacy and I need a dosage change override for one of your clients.”

I hear a pause and he says, “Do you have your account number?”

and I reply,  “dont you mean the patients ID number?..I dont know what my Aetna account number is.. but I need a dosage change override for a patient please..”

And he says:  “Ma’am this is technical support for an Adults only website, so unless you have your account number or visa on file with us, I dont think I can help you”.

and I say..”YOU ARE CERTAINLY RIGHT!”  “Never mind…”  click.

I checked my number dialed.. it  missed one digit.

and it was a doozy!  LOL.  Years ago, I was trying to dial McKesson by memory and got a phone s*x service…long before the days of 1-900 numbers..whodda thought there was technical support for such a website?  and who would call anyway???  ” UM, hello, my videos wont play…”

Puhleeze..

Some daily weirdness

Filed under: Uncategorized — pharmacychick at 9:08 pm on Monday, August 2, 2010

Every day brings its own  interesting quirks and quibbles.  Some are head-shakers, and others just make you wish certain customers would crawl back under the rock they emerged from.

1. Script from ER>  Symbicort 250/50.  From the get go, somebody has no clue.  I call the Urgent Care clinic and actually get Dr on the phone.  Apparently he knew nothing of what he was prescribing because ” Thats what she said she was on”.    He said to have patient  figure out what she was on, give her that, and let him know. She swears its Symbicort.. We finally had to resort to “what color is the box you used?”  She said red… I said, “thats not one of the options… Blue or Green?   blank stare…

2.  customer calls us and wants us to fill some simvastatin for her.  We discover she had never had it here.   She said she got it mail order and wants to know if we can fill it.  We say sure, we can transfer it from mail order…but NO, she doesn’t want us to transfer it….just fill it.  Must be the slow class..  We think we are moving in the right direction when things get weirder.. ” Can you check my chart to see if I am supposed to be on simvastatin anymore?”  Um, we dont have your chart records Ma’am.  This is the pharmacy. Call your physician..” Do you have his phone number?” Sure, what is his name?  “I dont know, dont you have it on your chart?”

moving on…

We get a script for Suboxone.  12mg for 1 week, 16mg the next then back to 12mg.. (!?!)  We call for clarification and the nurse says “we wondered if we would get a question about that”.  yea well thanks for helping the pharmacy out by NOT clarifiying anything, thereby making us call.  Turns out the patient is having some procedure that week and may need MORE suboxone.  How about not getting hooked on narcotics in the first place.?

” Do you deliver?”  No we dont have a delivery service   “well do you suppose one of your underlings would like to make a quick $20 by delivering my prescriptions?”  um, not likely and I am sure they appreciated being thought of as “underlings”.(thought but not said)

RING RING…   ” do you have 480 OxyContin 80mg?”  Not in a million years.

“What do you mean I have to take Generic Effexor now??”  State welfare doesnt’ pay for brand anymore now that there is a generic. “what a ripoff”..  (free is free, I fail to feel a lot of compassion right now)

But the winner of the day goes to :

“Do you have Lovenox 150″  (we affirm that we do).  ” OMG! you do??? I have called every pharmacy in town and nobody has it and I gotta have it today! wow!.  can’t believe my luck…(we fill the rx..and ring it up…cash rx)  “Oh thats too much money…do you price match?” 

I need a beverage…