The Pharmacy Chick

Flying the coup in retail

“Underwater”–a non pharmacy post

Filed under: Uncategorized — pharmacychick at 6:53 pm on Wednesday, February 29, 2012

The new catch phrase for this tanked economy is ” underwater”.  By the definition given by the housing market, a homeowner is “underwater” if they owe more money than the house is worth.  I can see that..and it sucks.  Maybe I am confused.  Maybe I am ignorant.  So I am asking for a reader education.   I’ll speak my peace and you answer me if I am right, wrong, misinformed, or right on the button.

When I was a kid, the best lesson my parents ever gave me was money managment 101: live on less than you make and  borrow only what you can pay back.  Its a pretty simple concept and one that I have based my life on.  I have ONE and ONLY ONE loan right now: my home.  I bought my home 15 years ago.  I have seen its value go UP, go DOWN, stay stagnant.  I put 20% down, and faithfully make my payments ( and then some) each and every month.  If all goes to plan, I own my home in about 4 more years.  I have no intention of ever buying another primary residence again.

In my home state, 1 in 4 owners are ” underwater” : they owe more than the home is worth.  OK that sucks. So why are they being foreclosed?  BECAUSE THEY AREN’T PAYING THEIR LOAN, THATS WHY.   You can owe more than the home is worth simply by taking out loans against your home( and its value tanks), but if you pay back your loan, you can stay in your house.    Put simply, if you buy a house for $300k and you have a $2000 monthly house payment…and you keep making your housepayment, it doesn’t really matter if your house is only worth $100k..you can stay in the house.  If you quit paying your mortgage, the bank wants their house back..and frankly, that is fair.  After all, when you signed that 4 inch stack of papers buying that house, you agreed to such.  I am quite sure somewhere in there is the phrase   ” I agree to pay…..”

The term “underwater” confuses me a bit.  With the exception of HOUSES..nearly everything we buy goes “underwater” as soon as we take possession of it…think about it.  You go to the car lot and buy a brand new car for $40k…you agree to pay $40k for the car and you sign the paperwork and leave the lot. Nearly IMMEDIATELY it becomes a “used” car and its value depreciates.  You are technically “underwater”, but you still have to pay $40k (plus interest) on the car.

So why is this such a travesty in the housing industry? Is it because we liken our houses to mini-banks?  Hey martha, I wanna new boat, lets get a line of credit on our house!. I have an equity line of credit on my house, that I used when we did a kitchen remodel and roof job.  I used it to improve the structure, not to buy a vacation, boat, or pay bills….( which in my opinion is robbing peter to pay paul)

Or do we blame the banks, who sold a lot of people a real bill of goods?  ok, so you two are a pre-school teacher and a waiter…hmmm Yes of course you can afford a 675,ooo house….let me draw up the papers now to pre approve you. I remember when Mr Chick and I were house hunting..we were preapproved for a phenomenally large amount of money.  NO friggin way was I going to buy a house that would make our payments 40% of our take home pay. ….for 30 years.  If we lost one of our jobs, we would be tight, but we could stay in the house…because we bought under our budget.

Or do we blame people who bought houses they probably knew they couldn’t afford?  Lets take this 0 down plan, and refinance when the balloon payment is due and our equity is up….(fast forward 4 years) uh oh, house has no equity earned! what do we do??

I have no idea if they still offer these things but for a while people were jumping on ” interest only” loans for a while.  Gadzooks! you never actually pay off any debt? What is the advantage of that?

I just don’t know what to think.  This isn’t about life circumstances that are being thrown a curve ball- when you lose your job, everything goes down hill, including your ability to pay for stuff.

What is your take on this matter–where-ever you are in the country/world? Who is responsible?  IS there shared blame?  Whats next?

Ashes to ashes..dust to dust.

Filed under: Uncategorized — pharmacychick at 11:07 pm on Saturday, February 25, 2012

In recent weeks, PC Pharmacy is getting a face lift.  The powers that be have decided to spruce up the facility and make it look nicer.  Its been an inconvenience at the very least,  and a total pain in the arse at the very most!   Scheduled to last 5 weeks, we are currently on week 6 and by all appearances, have at least 3 weeks left.  When it gets done, we will look very sleek and modern..if we ever get there.

Anybody who has ever undergone any type of renovation can attest that its a dirty job.  No matter what you do, a fine dust will float in the air throughout the day and settle gently on every surface.  Circle saws, drywall, electrical, HVAC…everything creates a mess. Every morning, PC and her beloved staff grabs a rag, wets it down and wipes off everything from the counter, to the computers, to the cash till…only to repeat it later in the day if need be.  We even posted a sign ( as if we had to explain WHY)  ” pardon our dust as we improve your pharmacy experience”. We fill a bag of rags each week, take them home to launder and bring back.  Suffice to say that we spend a lot of effort trying to keep things looking clean.

Monday night, about 1/2 hour before closing this lady came up to the counter, and before I can make the appropro greeting she took her index finger and raked it across the counter. “Your pharmacy is dirty!” she said in her heavily accented english. FYI, if you want to endear yourself to somebody, this is not the way to have done it… Suppressing the urge slap her along side the head and point out the massive construction zone she had to walk thru to GET to the counter, I pointed out that yes, we are dusty at the moment but it will be all cleaned up in a few weeks.

This brief explanation was apparently not good enough.  She just had to go on and on about our dust, as if it was some moral failure of mine.  I felt like a broken record repeating myself.  I finally asked the lady ” Have you ever undergone a remodel at your own home?”   She replied that she had not. In the sweetest voice I could muster I said ” well, THIS is what its like…gesturing around…its dusty and dirty.  These walls came down, new ones went up, and drywall makes a mess.  We clean the counters twice a day, so I am really sorry about the dust but until everything is done, its going to look this way and we ask ALL of our customers to be patient as we try to keep this pharmacy open while all this is going on.”

I can only assume that in her own personal home, any speck of dust must flee at the mere sight of her entering a room.   If that’s a skill she possesses, I would like to invite her back to the pharmacy at the completion of the remodel. That way I don’t have to waste anymore time cleaning the pharmacy for the Nth time.

Facebook Fatigue..and misc musings

Filed under: Uncategorized — pharmacychick at 12:55 pm on Monday, February 20, 2012

If they ever coin the above phrase and it goes viral, I hope I get credit for using it first…or at least using it first here.

Having undergone changes after changes, FB is one again making changes that I am less than enamored with: The Time line.  I am waiting until I am forced into the Timeline before I actually DO it because I was ( and am) quite happy with its existing format.  Timeline format is busy to look at while the existing format is streamlined and simple….like me.

Several months ago Pharmacy Chick dumped all the games on Facebook, then subsequently ( but gently) de-friended any of those people whose only reason for friendship was game neighbors.  I prefer to use the term De-friend instead of Unfriend because these people are nice people, but served no purpose on facebook but to play games…some were ” friends of friends” only and I had actually never met them…

Have you ever actually READ the terms you agree to when you play a game on Facebook recently?

This is what you allow when you play a game called Words with Friends…I copied and pasted this for your viewing pleasure. You allow them to:

  • Access my basic information
    Includes name, profile picture, gender, networks, user ID, list of friends, and any other information I’ve made public
  • Send me email
    Words With Friends may email me directly at  ·(removed for my privacy)
  • Post to Facebook as me
    Words With Friends may post status messages, notes, photos, and videos on my behalf.
  • Access my data any time
    Words With Friends may access my data when I’m not using the application.
  • Publish games and app activity
  • Words With Friends may publish scores, achievements, and other activity to Facebook.
REALLY?  I allow them to do all that?  WHY?  I wouldnt even allow MR Chick to post to facebook as ME…, and I am allow some GAME to post on my wall, access all my data, photos, friend list, etc for their own personal entertainment?  But the $64,000 question I have is this:   WHY do they need this access to play what essentially amounts to as ” scrabble”?   They dont need my pictures…my videos…my friend list…but they want it.
I say NO.
Moving on…
I have noticed that I have an ever increasing list of  ” friends” that I should rename “voyeurs”.  I have actually quit accepting friend requests with impunity because as I go thru my list I notice that an increasing list of them are work or customers that have ‘ found’ me on facebook and asked to be my friend.  Truthfully I think all they want to do is to delve into my private life, something they  cannot do while I am at work.  Other than my love of golf and dogs, I don’t share personal information with customers, or other employees.  I never post anything on facebook that is inappropriate or embarrassing but at the same time, its for my FRIENDS and FAMILY, not to foster work relationships.
And, lastly: This election year, by November, I may have half the friends that I have now if some of them dont quit spewing political rhetoric all day..Just saying…
Happy Presidents day…

    Feeling like the Float

    Filed under: Uncategorized — pharmacychick at 12:03 pm on Thursday, February 16, 2012

    I was pondering what I might write this week when my post dropped into my lap ( almost literally).  I was bemoaning yet another transfer and made the comment to tech extraordinare that with all these new people, I feel like a new employee..I dont KNOW everybody anymore…( and to be honest with you, some of these Big Box Rejects aren’t terribly impressive). She said ” I suppose thats how floaters feel”.  And it hit me:  Yup, thats exactly how I feel..like a floater.

    I dont know these people..and as I just said, I’m not enamored  with many of them, for a majority of them are on welfare and seemed to arrive with a “high maintenance” clause I think…  I don’t know their quirks, their likes/dislikes, their tendencies, or their habits.  After being in the same place for 15 years I pretty much KNOW most people.  I know that L.M. nearly always makes a bee line from the Dr office to the pharmacy so when I see a script for her, I try to scoot it along.  I know that B.B. always calls in several days in advance so I dont stress on getting his done right away.  I know that M.J. wants to pick all 4 of his Rx’s at one time so I keep track of his auto fills so they date out on the SAME day.    I know that J.D. doesn’t want ANYTHING on his bottles but the label ( for some  reason he has an aversion to auxillary labels) so I stick the aux labels on the receipt.  I know that M.H. keeps all her meds in a shoe box with a lid so she wants short bottles ( no 60 dram please).  I know that S.T. can’t have auto fill because of her insurance but can’t seem to remember her meds so the Chick is her auto fill.   I know that D.M hates vague messages so if I call him, I have to be specific ” HIPAA be dammed, tell me what you called about..quit leaving me guessing, the only other creature here is the dog! he says”.

    I could fill a page like this, so having a couple hundred new clients in the last 40 days has been a bit frustrating. First off, they are a tad pissed at having to get a new pharmacy. Sure, I can understand that, but its not MY fault so getting pissy at being asked for basic patient info isn’t really  necessary.  Once you are in the computer, we are all good so just chill.

    Secondly, they dont know  ( or care about) our routine, so assuming that how they did things at BIG BOX will be how they do things at Chickville pharmacy is probably not going to fly.  I really do not need to hear ( for the 100th time) how much it sucks that I do not have a drive thru.  Unless the company is going to build a road directly thru the store and blow out the freezer ( which I am in front of), we will never, ever  have a drive-thru. I am also sorry that my clonazepam is pink instead of yellow, but chances are the world will not tilt off its axis because of it, even tho you think your life will never be the same.

    Its a crazy world..I know that eventually this storm will reach some calm.  I will probably get to know most of these new patients. Some will love us, others will never get over how Big Box did it and will probably switch a few more times before they find something acceptable.  In the mean time, I just come home tired…one more day closer to retirement.

    Why is “standard” such a dirty word: Part 2

    Filed under: Uncategorized — pharmacychick at 11:59 pm on Friday, February 10, 2012

    Moving on to Part II-  Hard copies..you know those sheets of paper that patients hand you and ask you to fill?  At one time they used to be your basic 4×6 piece of paper. It had the Dr name on the top ( when each Dr had is own address and phone..which when called, someBODY actually answered), an address, and a phone number. The dr would scribble something on the prescription and the patient would drive that piece of paper to the local pharmacy where the pharmacist would squint at what was written and fill the rx….provided he/she could read it. If the RPh needed clarification, all he had to do was call the office and somebody would yell at the dr at his desk. Ah, the old days.

    Things are a bit more complicated now.  1) we have WAY more regulation .  2) we have WAY more drugs and 3) we have way more prescribing entities.

    When I first became licensed I was in a smaller community. There weren’t many prescribers .  I now live in a huge metro area. Lots of pharmacies. Lots of Doctors..and since there is a TEACHING hospital nearby..lots of residents, PA’s and NP’s.  The joke in Chickville is that everybody INCLUDING the janitor can write prescriptions and GTH ( Giant Teaching Hospital).

    And therein, lies the problem….who are signing all these prescriptions?  Cuz I surely don’t know.

    Last Saturday:  2 pm. Customer brings in a GTH generic discharge blank.  Written on it is a list of 4 prescriptions including a C-II drug.  Not only is the DEA number missing but the signature is a scribble, 2 dashes and what appears to be either a g or s.  NICE.  When I ask the patient ” WHO wrote this?”  I got  the answer I often get  in these cases….

    ” isn’t it written on there?”…well sir, if it WAS, would I be asking you?

    How does this problem go away?  STANDARDIZATION.

    A standard prescription can be quite simple.  Be a doctor, have a pad of blanks..Rule no. 1.  If you write a prescription, it must meet certain criteria to be legally filled.  This has already been established by the board of pharmacy.  Sadly it seems its up to US to make rx’s legal by filling in the blanks ourselves.  Time to stop that nonsense.

    At the very minimum the following standard preprinted information should be on all prescriptions given to patients:  1) The doctor’s name,2)  address, 3) phone ( fax), and 4) NPI and DEA number.  If Dr’s are pissy about putting the DEA number, then pre print all but the last 3 numbers and have the rest filled in if the rx is controlled. With the advent of hand helds and computer rx programs, nearly every rx can and should be computer generated.  With that in mind, even more valuable information can be pre printed…such as the Patient name, address, phone, dob and allergies. then we can finally get to the Drug, dose, sig, and refills. It should be easy to read and in a format easy to read. It should be 1 drug, one prescription.

    PRINT..sign and give to patient.  DONE.

    About a year ago I tossed a bucket of water the wrong way and sent my neck and shoulder into a spasm I will not soon forget.  After about 12 hours of agony I went to a local immediate care center ( note NOT a hospital emergency room).  I had been unsuccessful trying to stretch, massage or heat the spasms out.    The dr saw me, and went to issue the prescriptions.  He did NOT whip out a pad and scribble Vicodin and Flexeril.  He went into another room and came back with 2 rx’s, neatly produced on a computer, signed and dated.  It was made on security paper, one page per rx ( yea, thats a bit of paper waste, but with printers, what can you really do?.. they print in 8×11).

    I filled the cyclobenzaprine, had no use for the vicodin, so that went on hold.  But the point is this:  this script was COMPLETE.  Nothing was missing. It was easy to read, everything was there, nothing was left to guess about.

    Of course,  it wont prevent human input error:  Like the one I got today:  Doxycycline 150mg monohydrate caps # 20: sig: take 100mg twice daily for 10 days.  OOOOKKAAY…

    We still have a way to go to hurdle over that problem, but Standardizing hardcopies is a good start.

    Why is “standard” such a dirty word? part 1.

    Filed under: Uncategorized — pharmacychick at 11:06 am on Tuesday, February 7, 2012

    It used to be said if you wanted to compare to something good, you would say it was the “standard” by which something was measured…A solid foundational concept. I mean, EVERYTHING has standards.  We have standards in the workplace:  My company has a standard for DRESS: we all are to look alike.  We have a standard for the pharmacy layout so when a float comes in, that he/she should be able to find the drugs in basically the same areas from store to store ( given similar construction).  We also have a standard for procedure so that every auditor should be able to locate who filled a script by the placement of the initials, etc.   Its just simple business practice.  We also have standards at home, tho they are probably a lot more flexible than in the workplace.   When I put my dishes away, I always put them in the same place so I can find them again.  Mr Chick is another story..he is a bit of a fruitcake, but that’s another post..

    So, (getting back on topic) if STANDARDS are a good thing, why is it such a dirty word in 1) insurance cards and 2) RX hardcopies.  Any pharmacy that has been open this Jan knows that a lot of changes occurred and we have had to change BIN numbers, Group numbers, etc on a lot of Medicare D patients.  It hasn’t been LIMITED to Med-D patients by any means.  After all these years, we still lack a simple standard for prescription insurance cards.  Some cards are ” all inclusive”: which means they are essentially an encyclopedia of info.  One card, one family.  Some insurances send out a medical card, a vision card, a dental card and a rx card, something that the average patient will never keep track of ( I guarantee it).

    But the worst are the incomplete/inaccurate cards…ones that simply miss the mark by either placing information that is NOT needed or leaving out information that IS!.  I cite Crapola Insurance Co.  They have a card that has something like 15 characters in the ID field,  but as pharmacists soon find out, we need to LEAVE off the first 3 letters…just so you know…I have no idea what Crapola’s purpose is in eliminating the need for those first 3 letter, but if you put them in the ID field, you will get a rejt ” non match ID”.    We also have a fair number of cards that leave off the ever-essential BIN number.  Since we are long past the days of the ” big 2- PAID and PCS holding 99% of the market, we have literally thousands of PBM’s which have dozens of different BIN’s and PCN’s themselves.  I may very well be billing a Caremark card ( cuz it says so) but if I have the wrong BIN or PCN, it rejects out.

    We pharmacies need only 5 ( here it comes) STANDARD bits of information:  1) BIN  2) PCN 3) GROUP 4) ID and 5) person code.  All the rest will usually fall into place. Is it that hard really????

    Unless of course you are ANTHEM ( and Yes I am using their real name). I am mad at Anthem today.  I spent a lot of time on the phone trying to get a claim thru. I even called his previous pharmacy and verified I had exactly the right numbers in the right fields. I finally got LaTwitt on the phone from God-knows-where-istan who (after much hand-wringing) said ” you are submitting Robert as his name”.  Here’s a real eye opener LaTwitt…that IS his name She said “Change it to ROB”.

    ( Can you hear the head hitting the counter?) Robert was not pleased, but at least his anger was directed at the right place…ANTHEM.

    I am now used to having to move numbers around to find the right placement: some want person codes at the end of the ID, some want them in the person code field. Some now want 3 digits on the person code field, and some now are using letters instead of numbers ( wtf).

    So why is “standard” so dirty?   Lets STANDARDIZE!  One format…One layout.

    Next up?   hardcopies…

    Another “dealing with the dull” moment.

    Filed under: Uncategorized — pharmacychick at 1:01 pm on Monday, February 6, 2012

    Don’t coupons just bring out the absolute best in people?  I mean really. The very best in human nature can be demonstrated every time you bring out an monetary incentive. ( she says with tongue firmly in cheek)

    As mentioned in my previous post, we are doing a phenomenal amount of transferring since the new year. We were going to do nearly all of these transfers anyway so its beyond my understanding why we are giving away money to do what we were already going to do, but most of the corporate people think store employees ride the short bus anyway and never want our input so I quit offering my opinions on that subject.

    There is a certain segment of the population who will take an offer and throw it in the trash.  There is another segment who will decide to use the offer, read the terms, go forth under those terms agreeably.   But there is another segment of the population who will decide to take an offer so it becomes their life mission to milk as much from it as they can get away with, to the point of complete embarrassment.

    customer 1 wants to transfer 4 prescriptions ( same patient) and wants 4 coupons.  The offer allows them one per person, and max of 2 per household…so they argue.  They decide to attempt to transfer ONE each day..it fails…so they argue some more. My broken record response ” one per person, 2 per household” falls of deaf ears. I am being unfair…so she says. I tell her ” transfer another family member’s rx and you can have ONE more coupon”.

    Another wants to bring in new prescriptions and get a coupon..thats for TRANSFERS ONLY.  I dumb down my answer to make it simple ” quite simply sir we are trying to steal business from our competitors”.  He still argues.

    Yet another wants a coupon, but she is on Medicare D, a plan federally excluded from receiving such offers.  She argues at the cash register that we are “ripping her off”.  I make no response. Anything I will say will not solve the problem.

    And lastly, a NON coupon “dull” moment:

    A lady comes up and sees our construction zone all cordoned off. Half the pharmacy is a mess and we have temporary walls up all over.  the waiting room is gone. We have a couple of folding chairs strewn about for those people who must sit down for some reason. She wants to use the blood pressure machine that is stuffed in a corner with a tarp over it.  I tell her that is impossible at this time. 1) it is a construction zone and no body is allowed in that area and 2) there is no power over in that section anyway..it hasn’t been wired.  She protests ” How am I supposed to check my blood pressure!!!!”. Oh, I dont know, perhaps any one of the other 400 pharmacies in the Chickville metro area?? Including the one 500 yards down at the end of the parkinglot?? She doesn’t grasp this  concept and brings the store manager into the foray. She actually wants him to move the entire machine to an area of the store with a plug in.  ( eye roll). He declines.

    Another day in the life…