The Pharmacy Chick

Flying the coup in retail

More issues than Sports Illustrated.

Filed under: Uncategorized — pharmacychick at 4:08 pm on Saturday, January 28, 2012

Some days run as fast and as smooth as a Ferrari.  Other days run like a used Yugo.  Friday was Yugo day….broken down YUGO day…for example:

For starters,  I am so sick of transfers I could just puke.  Walgreens made a real statement by dumping Express Scripts, a decision I admire.  Its rare that a pharmacy stands up to a PBM.  In their eyes Express Scripts is a bucket of crap.  If thats the case, why are the rest of us all fighting over who gets to pick up this bucket of crap?  We have received all kinds of communication from  suits at corporate encouraging us to welcome  this bucket of crap insurance and offering the holder of this crappy insurance transfer coupons, gift cards, welcome gifts, etc.  Let me share 2 problems with this:  1)  lots of extra work and no extra labor.  I’m piling up 25-30 transfers a day. 2)  a lot of these offers aren’t valid for the majority of these customers who get frickin pissed when they dont get the gift card/welcome gifts/coupons.  Tricare is express scripts…one of our major welfare plans is express scripts and several Medicare D plans are Express scripts…none of which are eligible for the incentives….and none of which bother to read the fine print on the offer…leaving us to deliver the dirty news.  So fun.

Friday was also ” brainless customer day”.  I dont need much from a customer to process their prescriptions.  Really, I dont.  All I need is information…information that THEY alone possess, and they either have stored in their heads or on one small plastic card.  I’ve written about this before, but a good rant  is in order.  Because we have had a huge influx of new customers, I’ve endured the frustration of their uncanny inability to process even the simplest requests: Tell me specifically what you want transferred  ” all of them” ( bang head on counter)  and bring me your current insurance information.” Cant you get it from walgreens?”. No, I am using their online tool and that doesnt’ come with the prescription and Wag’s is pretty busy right now.  Cant you get it off their computer? seriously?  do you think that  PC pharmacy can “dial in” to a competitor’s data base and garnish data?  How painful is it to bring out a small piece of plastic and hand it over ?  you’d think I was asking for a pound of flesh.

Jon Doe came to the counter Friday also.  I just knew this was going to be a painful process when he announced ” I am from out of town and I need these workman’s comp rx’s filled”.  I was right…in spades.  For starters he had insufficient INFORMATION.  Handing me only a data sheet from the doctor’s office I asked him for the prescription billing info and he looked at me like I was speaking a foreign language. Knowing THIS was going nowhere I asked him where ELSE he got his WC rx’s filled and he told me Joe’s drugs in ShadyNook.  I looked them up and they hadn’t seen him in 3 years.  Calling him back I relayed this info…and he said ( get this) ” OMG did I say SHADY NOOK?  wow I must have had a brain fart..I moved from there a few years ago..I live in Sunnynook now and go to Sam’s drug there. “So I call Sunnynook and get the billing info..( one hour later and I still have no progress on these 3 rx’s)  I finally process all three…and all 3 reject  ” please call 866-123-3333 for confirmation”  Since NOTHING has gone right from 9 am on today, its not surprising to me that THIS isn’t going well either.  I call the number and the lady ” logs into the payors website” and agrees to pay for the 2 morphine rx’s and denies the concerta rx..claiming that drug is not consistent with his diagnosis.  I guess I can’t argue with that, since I have NO history on this gentleman, and NO idea what his injury was.

I got the pleasure to relay THAT information back to Jon Doe who went about as ballistic as one human go to..I was grateful it was a PHONE conversation and not one at my counter. I was also grateful that his anger was directed at his comp and not at me.  Suffice to say that a 3 hour investment of my time paid off with exactly nothing, other than he paid cash for a 3 day supply of his Concerta and he would “address this issue with my attorney on Monday because my injury is catastrophic and everything should be paid for”.  I typed up some notes of what I had attempted and left it wrapped up in the rx..one copy for file and one copy for him.  I decided I dont want to be on the receiving end of any angry calls from Mr. Doe….or his attorney.

Then I got Mr Chavez.  Nice man actually..and another out of town transfer with NO refills.  Faxing Dr ABC’s office from the info on the transfer slip I get a fax back saying ” wrong doc”..call Dr XYZ.  Well XYZ was in the same clinic at the same fax number ( ?!?!) so I crossed out ABC, wrote in XYZ and faxed it back…to which I got a return note 3 hours later: ” patient not at this clinic”.  Getting Mr Chavez on the phone I relayed this series of events and he said ” Dr ABC covered for Dr DEF..DEF is my current dr..Ive never seen Dr XYZ……”.  Well Dr. DEF practices out of a satellite office…and different fax number. Fax number 3 goes out to DEF… and it is returned just after 5 pm signed by none other than Dr GHI covering for DEF, that Mr Chavez has never heard of…again. I filled the prescription with the caveat for Mr Chavez ” you might just expect this to happen next month..since Dr GHI is on the rx and you haven’t seen him..God only knows where he normally practices…”.

Mrs Browbeat transfers 2 Rx’s to my pharmacy.  Written for 90 days, her plan only covers 30 days at the retail setting.  She wants 90.  She claims she got a letter saying she can get 90. ( and I agree..but probably only mail order).  I show her the rejection that she disses immediately. I want to see this letter she has so I can read it myself, but she wont provide it, insisting she KNOWS she can get 90 days. wash, rinse, repeat…here we go again. I show her the rejection..she leaves mad and its ALL MY FAULT.

Ms OnaleeBrandWillDo is ticked because her Medicare D plan made her take generic Lipitor last month.  She is convinced it doesn’t work despite the fact I show her that its the very same tablets…from the same manufacturer…only tons of $$ less to her…  As far as she is concerned, I filled the bottle with dirty gravel I guess…and its ALL MY FAULT

Dr. Picky writes a renewal script for sertraline for a newer patient of mine who has been getting it filled here for 2 months.  We carry Northstar Sertraline.  He wants Greenstone..of course I know why..its same as Zoloft..  Problem is that I can’t get that one.  We purchase on contract..we get whatever vendor our company has agreed to purchase from. I tried to order Greenstone..they shipped the contracted item.  I really dont care to deviate from the company policy. If they remain competitive in the marketplace by purchasing by contract, I will support that. The special request process is slow and results in higher drug costs because its NOT a contracted item.  The customer didn’t care what she took…but HE did so he made her find a pharmacy that could buy Greenstone and fill it there.  Whatever…

One after another..issue after issue…It was painful to get a simple prescription from hard copy to the cash register without going thru some kind of  suffering.  Loyalty cards that didn’t work.  Medicare D patients insisting they had NO changes in 2012 ( they did).   I even had to listen to squabbling among patients who were arguing who got to the counter first…really? must I listen to this? by the time you fight this out BOTH of you could have been gone..in restrospect I should have offered to flip a coin..

I was so ready to go home. I had to make one delivery to a disabled guy on my way home. Hoping to just drop it off and fly, he wanted to engage in a conversation about his favorite new tv show…for 45 minutes.  My phone was buzzing non stop..Mr chick was freaking out..it was nearly 10 oclock before I hit the garage door.

I’m ready for a Ferrari kind of day.

11 Comments »

Comment by mdb

January 28, 2012 @ 4:54 pm

There is a pair of customers in one of the store I float in that usually never fail to piss me off. They want brand everything, the female of the pair got pissed and called our DM when both I and the pharmacy mananger refused to order a bottle of brand bactrim DS (which only comes in 500ct when we checked as the smallest bottle). She didn’t even have a script for it but wanted us to order it because “I usually get one or two scripts for it a year”, working about 10-14 tabs a script, let alone the insurance copays and not covering meds. And the fact she and her hubby are snowbirds means the pharmacy is not ordering in a med we won’t ever use to dispense at most maybe 50 tabs in the years until the bottle expires to for a maybe get an rx a year. I could just see the money flying out the door. Of course I also wanted to scream when she wanted us to order brand amoxil for her hubby when he goes to the dentist and brand penicillin also as a just incase. Last I knew, there was no brand pen VK made anymore.

Comment by Pharmaciststeve

January 28, 2012 @ 9:39 pm

apparently your company is working under the old business philosophy of no matter how little we make or lose on a product.. we will make it up WITH VOLUME… How have we let or why have we let it happen that the safety net that we provide has been allowed to expand to such a size that it could cover a FOOTBALL FIELD.
Go into the doctor’s office the first time and you are presented with several pages of info that they require. Even when you are a repeat visit.. the first thing is .. give me your insurance card and pay your copay.. then go sit down…but .. they are healthcare professionals … providing a service.
I am one of those ESI pts that got caught in the ESI/Walgreens squabble… can’t fill my Rxs at the LTCP that I temp at… the tech where I ended up going almost had a shocked look on her face.. I brought in a Walgreen’s computer printout from their website.. highlighted the ones I wanted transferred … copy of my insurance card… she said.. almost as if apologizing that it “normally takes 24 hrs”… and my reply was …I will be back in a few days…
I would seem like to me that most/all of these issues are self-inflicted or we have encouraged to build up.Most of these issues ARE self inflicted..we place ads in the store that say ” Fill rx’s while you shop”…” Transferring is easy! we do it for you”. We over promise and then are doomed to failure because the company fails to give us the tools to succeed. Patients no longer see us as health care professionals because the companies we work for dont treat us as such. We are crammed between the bakery and the meat departments…we get quotas on how much we have to fill each hour or warnings pop up. We have to stuff food into our faces between rx’s. and I have to empty the garbage and clean the bathroom..then hope the person we failed to say hello to was not the proverbial mystery shopper who will REALLY ruin our day with a poor report. Then the final indignity is when we try to out-advertise each other by bribing customers with coupons and gift cards. When was the last time you saw a doctor office offer gift cards for each patient who transfers HIS file? Get an X-box with every vasectomy? A play station with every ACL repair?…arrrrgh

Comment by Pharmaciststeve

January 29, 2012 @ 9:51 am

@Chick… there was a story on the TV last night .. where a dentist made a offer on GROUPON or one of those type sites and got 1300 new patients. Of course there are dental offices showing up on nearly every corner.. locally we have a “dental chain” that claims to have 26 locations. The dentist that I have went to for 35 yrs… his son .. is now also a dentist and had to go to work for one of these “dental chains”… his father is very ethical… and his son first practiced in his practice… the stories of “gray ethics” that his son has to put up with being an employee are similar to some of ours issues.

Comment by Ramblings of a Pharmacist

January 29, 2012 @ 11:52 am

I hate Yugo days with a passion. What makes it worse sometimes are all elderly patients who can’t hear and/or have no clue about what you have been saying for past 10 minutes. It is very sad, because some of them have no one to help them (small town and children moved to big city or the like), and even though we want to help, we often can’t make them hear or understand what it is that we need. 2012 medicare part D was a mess.
And then some well-abled young female damages our drive-through with her car because State Welfare will not pay for her headache medicine and the cost is whopping $20!
Stay strong, Chick. Pharmacy would be in much worse shape if people like you weren’t behind the counter!

Comment by bcmigal

January 30, 2012 @ 12:45 am

Nicely said, Pharmacy Chick. I have this fantasy that one day I will gather every transfer coupon I can find and burn them in a bonfire in the parking lot. Just think, the company spends a dollar a minute to make 40 cents on a prescription. Whoopee!

Comment by Pharmacist too

January 30, 2012 @ 7:38 am

Friday was that kind of a day for me also. I am so sick of hearing all of these complaints about stuff over which I have no control. The customers then complain to the NON pharmacist store manager who has no idea about the legal and other constraints we have. I have to have a sit down with him tomorrow to make sure that I and my staff understand his expectations about customer service. By the way, our numbers show a 40% increase over last year in a very competitive market. I think we understand customer service.

Comment by Frantic Pharmacist

January 30, 2012 @ 8:48 am

OMG, I hear that. Some days you are just overwhelmed when you think of all the stuff we do that has NOTHING to do with being a pharmacist. And people wonder why it takes so long to just ‘put some pills in a bottle.’ I have also had it up to here with people whose responsibility it is to SUPPLY ME with their information— ALL of it — and somehow because of ‘customer service’ it becomes my responsibility to hunt it all down for them. Absolutely makes me crazy.

Comment by Pharmaciststeve

January 31, 2012 @ 8:24 pm

What I think that we are describing is a “informationally deficient patient”.. is this a congential defect or socially acquire trait?

Comment by The Cynical Pharmacist

February 5, 2012 @ 10:45 pm

I was so ready to go home. I had to make one delivery to a disabled guy on my way home. Hoping to just drop it off and fly, he wanted to engage in a conversation about his favorite new tv show…for 45 minutes.

Yep, I know what you mean.

Comment by christine

February 6, 2012 @ 1:51 pm

wow, i think it’s great that you stayed to talk to the disabled guy. i’m shocked that no one else commented on that!

Comment by Kerri

February 12, 2012 @ 11:26 pm

My pharmacy has been hell on wheels since the ESI nightmare. Our area is also heavy Tri-care, Med-D, and our Medicaid plans are also ESI. Very heavy Medicaid area. We were getting 100-200 (no lie) tx requests PER DAY. My pharm is within 2 miles of 3 high volume Walgreens. These people don’t understand only ask to transfer rxs YOU ACTUALLY TAKE. I’m not going to waste my time transferring a rx for promethazine that you haven’t filled since last May.
My pharmacy has turned into a broken down Yugo with slashed tires.

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