The Pharmacy Chick

Flying the coup in retail

Listen to me!

Filed under: Uncategorized — pharmacychick at 11:34 pm on Tuesday, February 22, 2011

walk up to counsel a patient on an antibiotic…

Hello, I am pharmacy chick and Dr Wunderful has given you this antibiotic for an infection.  Is that what you are expecting today? (he nods) This medication should be taken twice a day,  one with breakfast and one with dinner.  Food is best because this medication can upset your stomach and cause diahrrea.  Be sure to finish all the prescription or it may not treat the infection. 

AND HE SAYS…I kid you not:

Is there anything SPECIAL I need to know about this med?   So I repeat what I said above….

AND HE SAYS:

is this gonna make me queasy or something?  do I need food?

(WTF dude,  were you not listening to even one word) Yes sir, take it with food, it can upset your stomach….

Is there anything ELSE I need to know?  (not that you are going to listen to)….No sir, I think you got it…

The All nighter…

Filed under: Uncategorized — pharmacychick at 8:09 am on Wednesday, February 16, 2011

I know every pharmacist has done it.  Epic Sucks..In fact, its the biggest pet peeve I have about pharmacy and it doesn’t even happen within its walls.

DREAM about work.  Last night I pulled the all nighter.  Usually these dreams follow one of two scenarios:

1.  I am trying to close and people just keep streaming INTO the pharmacy and I can’t get them out in order to leave the building…and

2. I spend all night working on one prescription because I can’t get it done for some reason..either I am missing equipment (no keyboard, no screen) or I can’t find the drugs.

Last night it was no.2.  All night long I tried to fill a rx for Percocet #85 for a long time customer of mine, Mr Smith…ON MY PHONE.  The damn touch screen wouldn’t work and I couldn’t do it!  It made me crazy.  For hours I fiddled with that thing, all the while they were getting more and more impatient as the hours passed.

Criminy..I woke up exhausted.  And I get to go to work now.

The weird side effect.

Filed under: Uncategorized — pharmacychick at 5:35 pm on Sunday, February 13, 2011

In late December, PC had quite enough of the tendonitis that had been plagueing  her for months and months.  I played an entire season of golf in pain and had finally reached a point where picking up a glass was getting painful.  I called up my friendly PCP and set up a time to get a cortisone shot. 

Well FOUR actually.  Two arms, two shots in each arm. It was the first time I have had a cortisone injection…and I have to say it worked like a charm.  I am completely pain free.  I did however develop an odd side effect to the injections:  a vitiligo type effect at the injection sites of each arm.  At this point I have 2 silverdollar sized spots above the injection site that are lilly white…and very unlike the medium tan skin that I posess on the rest of my body.  The ones under my elbows are also depigmented but they are not very noticeable.

I showed it to Mr Chick the other day and he asked if it bothered me.  Considering how good I feel since the injections, they could be GREEN and I wouldn’t care. Being the dead of winter, nobody sees my arms, but if it doesn’t change between now and summer, it may make interesting conversation!

Im trying to come up with a clever response to why I have the marks, but  can’t think of one yet…

One (or more) idiocies of autofill.

Filed under: Uncategorized — pharmacychick at 3:38 pm on Saturday, February 12, 2011

Anybody who works in pharmacy knows that  one sad part of what we do is that not every RX filled goes out the door.  We do a lot of unecessary work..filling a prescription (or dozen) only to have it languish on the shelf, ignored by its owner until we finally put it back.  To UNDO a prescription is nearly as much work as FILLING the prescription in the first place..and we get nothing out of it.   Personally, I’d love to have a Return To Stock fee added to scripts not picked up. If a doctor can charge you $200 for an appoinment you didn’t show up for ( or cancelled too late), then it would seem appropriate that I should be able to do the same..

Yesterday I looked at the daily RTS report and saw nearly 20 entries..a small day for us and nearly every one was auto fill.  We wait til the end of the day to do the returns just in case the person will actually come in….because NOTHING brings in a client faster than having JUST put it back.  Its really uncanny to be honest. Tech extraordinare put back about 15 of them yesterday with promises from 5 that they will come in THAT day..she called them to tell them their script was about to be returned…and these were some we really didnt’ want to return..expensive rx’s

However, nearly just as irritating as doing the RTS is having all these autofill patients strolling by and asking if they just happen to have anything ready.  We have to stop what we are doing to see if there is anything for them…finding nothing…then getting the NEXT inevitable question:  “Am I due for anything?..and if so Can I get it while I am here?”  Geez people….if you are going to sign up for Auto fill, why dont you just let the thing do what its supposed to?

First of all, every script (auto fill or not) that is ready will cause a generate a call to be delivered to the patient telling them it is ready.  Second of all,  when I “early fill” an auto fill rx, I have extra steps forced on me so the auto fill sequence is not permanently screwed up.  Auto fill is stupid…it does not know I have refilled the script early and re-set the date.  It keeps the date exactly as it was.  So, if the autofill date was (for instance) the 10th of the month, and I happen to fill it on the 7th, it will try AGAIN to fill it on the 10th.  Apparently this is one thing not very well thought out when the program was written.

Lastly, one unintended consequence of auto fill is that the patient has no idea how many prescriptions are waiting for them . Sample conversation:  “I am here to get John Smith’s prescriptions..we got a phone call”  Ok, how many scripts do you have..I see two  (we are supposed to ask how many they are here for) “um I dunno,  I just got a call, and Im on auto fill, they just DO them…”     Another big WTF moment for the company policy that demands we ask how many prescriptions he patient wants…whatever.  They (and we) never know..until they leave and the tech says  “Hey wasn’t John Smith just here?  we got one for his wife Jane too”..  sigh….

For somebody like myself, where organization is important, this makes me unhappy.  we aren’t allowed to bunch rx’s by address.  Jane and John smiths RX’s are not bagged or rubberbanded together.  Its not allowed.  Unless I know them REALLY well, I do not ask if they want the other rx too.  HIPAA and all that crap stopped that.

I can’t help but think that pharmacy (and patients) were better served a generation ago when the complications of certain technologies and regulation were absent…when the relationship with the patient, Dr and Pharmacist was uncumbered by the PBM,  and when the distance between hard copy and finished script was a much straighter line than the convoluted path it is now.

Stick THIS in your tank

Filed under: Uncategorized — pharmacychick at 11:20 pm on Friday, February 11, 2011

Boring Friday night:  punching in returns to the wholesaler….

I came across this little bottle of stuff called Bromday.  Little pissant bottle with 1.7 ml in it…and it costs about $127.oo

click click click on the calculator

That comes to …(drum roll)  over $ 280,000 per gallon

Fill er up??

Errors back in the news.

Filed under: Uncategorized — pharmacychick at 8:46 am on Thursday, February 10, 2011

I didn’t see the article, Mr Chick did.  “Hey, did you read this bit about the pharmacist in Colorado?”.  I replied that I didn’t and he gave me the lo down. 

Wow.  My first thought was Thank you God that it wasn’t me and my second thought was a prayer for both the pharmacist and the girl.  I feel bad for both.  The girl, tho she only took one tablet I understand, will have 8 and 1/2 months of waiting and wondering if she will have a healthy baby or not, and the Pharmacist is probably an emotional mess.

Mistakes happen, and we all have made them. But we also know that some are more important than others.  We have something like 4 Dr Dan Smith’s in our computer.  If you happen to put the wrong Dr on a label, the worst that is going to happen is at refill time, you’ll get a note from the Dr saying “not my patient” and you will have to go back and correct it.  If you put the wrong number of refills on the label, you will just have to pull hard copy and fix it.  If you mispell pain  with “apin” or take like “atke” you just look stupid…

All of those are “errors”.  But the mother of all errors is Wrong Drug or Wrong Patient.  Either way, somebody is getting a drug into their hands that is unintended. We have all kinds of safeguards in place….and it still happens.  Its something that seems to just happen. The “system” breaks down.  No matter what happens, when humans are part of the equation, either by design or necessity, unintended consequences can happen.

At my store we use “right patient” verification by  verifying their address/dob/etc.  Even then, some patients who aren’t paying attention will say yes to everything. Next we will ask them to answer a NON yes or no question.  Some get a little pissy with all of this verification.  They don’t understand. We aren’t being nosy. we are being careful

Right drug is tricky.  We have scanners to verify NDC, but we still have to pick the right drug.  The eye has to see the RX correctly.  It has to be read by a human. It has to be Re-read by a tech and finally checked by a pharmacist.  Recently we had a script e-scripted for Neupogen 300mcg/ml. give 0.5ml once daily.  The pharmacist selected the only Neupogen on our computer drug list in the 300mcg strength…Neupogen 300mg/0.5ml.  …give 0.5ml etc….  Do you see the error? 

Let this be a sobering reminder…I dont care if  patients are beating on the counter because they are in a hurry.  Check your work. Read the script…every letter and every word… Do the math.

Have a safe day today…so that license stays on the wall!

Spelling matters.

Filed under: Uncategorized — pharmacychick at 9:07 pm on Wednesday, February 9, 2011

I wrote recently about my trials with Verizon and getting my new smart phone.  All worked out finally, and I have been enjoying my new Droid X..for the most part.  I miss my REAL key pad and in retrospect might have enjoyed the Droid 2 instead of the X.  It is what it is, and there is no going back.

Smart phones have a curious feature called auto correct with regards to spelling.  Its the WORD equivalent to spell-check.  But it has a preverse sense of humor…that comes out at the most inappropriate times:  For example

PC  ” Thanks for helping me out yesterday, I sure appreciate it..I was so sick.  So what time did Sex leave?

TECH:  Um, about 25 years ago, when my divorce was final..

PC : “what?!?  Sh*t..stupid auto correct..I meant DEE, what time did DEE leave

TECH: Im laughing so hard I am going to pee!

Apparently this has happened to so many people that a website has been launched just for the sole purpose of posting screen-shots of auto-correct errors. I have it in my blog roll and enjoy reading it every day!

I nearly made a comment to a blog and signed it Pharmacy Dick…

May Sex only leave when it is supposed to and may Pharmacy Dick never rear his ugly head…NO PUN INTENDED!

Interesting, but confusing

Filed under: Uncategorized — pharmacychick at 8:25 pm on Tuesday, February 8, 2011

Recently, I have received several comments on a post of mine dating back to 2008.  I wrote a piece called Pet Peeves 101, which at the time (and still does) reflect some of my personal pet peeves of the pharmacy as it relates to the retail world. 

These comments you will not read because they were rude and vile.  These people do not agree with my position and that is fine, but clearly in my disclaimer I state that I do not post comments that are overtly rude.  These commenters only post to see their venom in print and the very least I can do is not oblige them. If somebody disagrees with a position and states it in an appropriate manner, then we will move forward and discuss it.  Flaming is not allowed on my site.

What I am confused about is….who sits and reads 3 year old posts?  I mean those things are WAY back in the archives…and that is literally hundreds of posts ago.  Somebody needs a hobby…because my writing is not so profound and spellbinding that it would cause somebody to sit and read 3 years of my postings. 

Go figure.  Am I going viral someplace in blogville that somebody is spreading this particular ancient post among pharmacy/pharmacist haters? 

whatever…

To the Rude-est pharmacist in the world.

Filed under: Uncategorized — pharmacychick at 3:19 pm on Tuesday, February 8, 2011

Dear “Steve”. 

I sure was not surprised to hear that Big Box had fired your butt several months ago.  You were a thorn in my side for years.  Working at my competitor nearby, I always dreaded calling you for a copy.  You’d leave me on hold for friggin ever then act as if you had never heard my voice before despite having spoken for years.  You, sir, are a twit.  I can only assume that if you treat your peers this bad that you had to treat your customers and your subordinates even worse.  I was never so glad to hear you were gone.  Never have I had to deal with a pharmacist so rude and indifferent in all my years. Your replacements have been delightful.

I was MOST surprised however to pick up the phone to call BIGGER Box pharmacy yesterday for a copy to be put back on hold for friggen ever ( an unusual occurrence) THEN have you answer the phone. I knew your voice immediately but had to confirm. “Is this STEVE?”.  My incredulity in my voice had to be obvious. BIGGER Box had to be desperate to hire you, either that or you put on one major act to get hired on.   No wonder I was left on hold forever. You are back to your old tricks.  No matter.

What I wanted to say to you STEVE, is Thanks…in advance that is.  You see, when you were at Big Box, you were a great source of income to me.  People hated you…and it was justified I might add.  I took a lot of copies from your store by people who had taken enough abuse from you and your condescending attitude.  Now that you are at Bigger Box, I can be rest assured that in short order, I will start getting bottles from YOUR store with people who have had enough of you.  For you see STEVE ,many of  these are the people who left Big Box because you suck.  Once they see you at Bigger, they are off to me.  Thats money in my pocket buddy and I just wanted to extend my thanks to you for that. 

Just in case you show any interest in Pharmacy Chick Pharmacy, I would like to let you know that you stand NO chance of ever getting hired. I personally will make sure of that, so once Bigger Box figures you out and cuts you loose,  don’t waste the ink filling out an app. 

So Good luck Steve.  I’ll be talking to you a lot I suspect.

PC

A good read from RedHead

Filed under: Uncategorized — pharmacychick at 12:37 pm on Tuesday, February 8, 2011

Red Head writes a great post on his take on the need for insurance overhaul. 

http://www.theredheadedpharmacist.com/?p=3044

Its well written and worthy of sharing.  After having had to become an insurance expert over the years, I can testify that what he says is valid and worthy.  The idea of standardization in pharmacy cards has been a hot issue for years, and to date, still not resolved.  Time and time again I am presented cards with sketchy information, missing data, EXTRA or useless data,  and poor layout.  Why, for instance, must I memorize that on XYZ plan with ID of  UAFR1190A3456  That I have to leave off the UAF and start the ID number with the R?  Can somebody explain THAT to me?  If I dont need the UAF, then why even put it on the card?

I also agree with the concept of simplification on what is covered and what is not.  The PA system has become so complicated that I get faxes from doctors now who wont even try.  ” We dont do Prior Auths, patient can pay or move to covered item”.  I can’t say that I blame them.  If  XYZ doesnt’ want to cover a drug then don’t.  If they are, then price it accordingly.   Send patients a COMPLETE list.  “This is what we cover and THIS is what you will pay…”  Personally, I like the percentage copay system.  It brings some accountability into the patients hands.  If they want Very Expensive Brand When A Similar Generic Is Avaliable, then they can pay an appropriate percentage of the price.  Personally, I like charging a 88 cent copay on  HCTZ and Lisinopril than $100 on Diovan…but thats just me.

I also would like to see a major player step up and say NO to unfair contracts, but it will never happen. Corporate Pharmacy has become a spinless industry.  We have rolled over and played dead so many times that we have actually died in the process.  Caremark , Medco, ESI….they own the industry.  Prove me wrong.

Thanks Red for writing an excellent post.

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