The Pharmacy Chick

Flying the coup in retail

What is flakier, a bowl of cereal or my scheduled tech?

Filed under: Uncategorized — pharmacychick at 12:42 pm on Sunday, March 28, 2010

Pharmacy Chick has learned that almost every phone call that arrives at 8 am or earlier at her house is seldom good news.  In fact there is a part of me that wishes I could turn off my home phone like I do my cell phone when I go to bed. 

RING RING!   720am…A very groggy Mr Chick answers and and I can hear MY store manager’s voice on the other end.. WTF? he never calls me at home. Sleepy hands me the phone and Tom ( the store manager) says “Your pharmacist called in sick.”  WHAT?  My Man Friday never calls in sick, and if he did he would have called ME not the store.  So I asked WHO called in sick and was told “Tonya”.  Oh yes.  When I saw her on the schedule I cringed with dismay.  The tech scheduler at corporate must be scraping the bottom of the barrel by now to give me Tonya and sure enough she pulled this stunt….again.

My lazy Saturday off just turned into a cascade of SUCK!.  We can ALMOST work alone on a Sunday, but Saturday? no way. My first call was to Friday who had just received HIS call from Tom and was already planning on going in an hour early to try and fill everything he could before we opened.  My second (and WAY more reluctant) call was to Tech extraordinare.  She had plans that day. I knew it. Her family from out of state was coming in.   However, gracious as always she said she could come in around 11 am..could she at least get her house cleaned for the company who was arriving that afternoon?  (Like I was going to say no?)

I got myself out of bed and decided at the very least, I would  help Friday get all the que emptied and filled.  I had plans and obligations of my own that day.  I arrived at the store, and Friday and I went to work filling the 40 or so scripts waiting from the que.  I had to leave by 945am but we got everything done, leaving Friday alone for just over an hour.  We can all deal with just about anything for an hour so when I left I said a prayer that God would keep the people at bay until help arrived.

If this was an islolated incident I wouldn’t be so upset, but time and time again, I have a schedule full of relief people that 1) I know only by their name or reputation and 2) I have no way to reach them and 3) on weekends there is NO corporate back up to get help.  I DREAD the distribution of the monthly relief schedule and I see certain names on it.   I have been at the mercy of the scheduler since Tech #2 went out on medical leave.  Now her position has been made open for application because she didn’t return in time so I can start interviewing candidates.

I can’t blame the scheduler.  Geez, she does an amazing job just filling 100+ stores schedules each and every month but it seems that the term “relief” is pretty oxymoronic.  Perhaps she should be termed “GRIEF” tech because that is about all she causes me.

(So before any of you  readers that ARE relief assault me verbally….I am speaking of THIS tech..not YOU ok??? Save your flames for somebody else). If you show up to work, then you are doing your job.

I have missed 2 days of work in 19 years, and one of them I worked until the relief person showed up.   Tech Extradordinare has worked for me for 2 years and hasn’t missed a shift, and has in fact covered a lot of flaky relief techs who have bagged on shifts for one reason or another.   Friday has never called in sick in the 15 years we have worked together, tho I finished a shift or two for him when he looked about to die.  Maybe this is an anomaly but we have a certain sense of responsiblilty to each other.  

Tonya is supposed to work next Sat too.  I have already put the word out on the street that nothing short of  Death is an acceptable reason to miss work.  Arrange for it Friday.  If she comes in next week, I am thinking about serving her a bowl of cornflakes and she if she gets it.

And when I do the interviews?  You can bet that Attendance will be emphasized again and again.

Bring on the Simvastatin, I sense there will be a need!

Filed under: Uncategorized — pharmacychick at 8:35 am on Wednesday, March 24, 2010

The chocolate covered bacon intrigued me.  I love bacon….I love chocolate…but I am not so sure about the combo!

There is always room for one foot.

Filed under: Uncategorized — pharmacychick at 6:04 pm on Tuesday, March 23, 2010

So Pharmacy Chick was at work last night and one of her customers came in to say hi.  “Hey Dave! hows it going?”. I said…   “Oh, I just wanted to stop in and say hi, since I am not picking up prescriptions for my mom anymore”. (he was her primary caregiver)

“Oh, did she move to a new place?” (thinking assisted care that required bubble pack or something)

“Yes, she did”.  so i asked “Where did she move to?”

” She died March 9th”.

how do I get out of this one…

Cash on the barrel head II

Filed under: Uncategorized — pharmacychick at 4:30 pm on Sunday, March 21, 2010

“I need to go see Dr Seemore, my left eye is fuzzy”.   With that statement from Mr Chick, Pharmacy Chick remembered her own experience with cosmetic medicine. 

But first, a little PRE-story.

Over 20 years ago, PC worked in a drug store that was about 2 blocks away from an eye clinic.  This clinic performed all the usual eye clinic stuff but on Tuesdays, it was surgery day for RK (radial Keratotomy), which you might remember was all the rage for a while.  It meant for a really big day at the pharmacy because we got virtually ALL of their patients and ALL of them had 4 scripts each.  If you consider that the average surgery day was 25-30 patients, that meant an extra 100- 120 scripts, all cash.  Each received Alcaine, Tobrex, Demerol,and Pred Forte….we made sure we had lots of inventory!

 Most of the time the driving family member would bring in the scripts while the patient was undergoing the procedure but occasionally the patient would come in as well. Even tho I am severly nearsighted myself, the idea of having my cornea sliced into a star pattern never appealed to me, and was even less appealing after seeing the parade of patients come thru the pharmacy moaning  for the Alcaine and Demerol. 

At the time this was a cash only venture.  No insurance paid for it. On the horizon however was a new procedure called LASIK and that is where the Chick family steps into the story.

LASIK promised to be the painless (or less painful) alternative to RK.  Done only in Canada (at the time) Mr Chick was chomping at the bit to get it done but I wasn’t in so much of a hurry.  After all, I only had one set of eyes and there was no going back if something didn’t work so we waited until they had more experience under their belts. Eventually I consented, and off to Canada we went.  There were some clinics in the US doing LASIK by then but the cost difference was so significant that even the travel expenses + Cost of procedure was less than the US cost.

To make this part of the story shorter..Mr Chick had the procedure but I didn’t: I wasn’t a corneas were too thin to begin with.  Two years later the clinic went bankrupt and closed, and Mr Chick needed to find a local clinic to follow up care..and here enters Dr Seemore.

Mr Chick was the poster child for why you DONT get LASIK.  Treatment, regression, more treatment, more regression.  Over correction, then under correction, then re-correct the correction.  His presbyopia is bad enough now that he has to have glasses to read most anything and one eye still isn’t great at a distance.  He insists he is still glad he did it, but I am glad I didn’t….But lets meet Dr. Seemore….or at least his office…

Dr Seemore doesn’t take insurance…and has no reason to.  LASIK is a cosmetic procedure.  Nobody HAS to have the procedure.  His office is in a beautiful building.  The lobby has the look of a 5 star hotel.  Comfy sofas, wing chairs and end tables with Tiffany style lamps grace an overly large wait room.   No neat rows of attached chairs here.  The furniture is arranged so that you don’t have to stare face to face or get too close to anybody. He has a bookcase of books for people to enjoy as well as CURRENT (?!wow) issues of several magazines. There is lovely art on the walls and soft music playing overhead but not loud enough to be distracting.  The reception area has a granite counter and a large globe full of candy “help yourself!”.  The receptionist is impeccably dressed. It was almost spa-like in its appearance and feeling. I was expecting somebody to come out with a tray of  hor’d ourves to snack upon.  I haven’t been there in a while, but I’d bet it has wireless internet now too because the waiting family members have to sit around for awhile!

They were generous with their time.  They gave us all the meds we needed (samples no doubt) so we didn’t even need a trip to the pharmacy…interesting, given our profession…

It was the Rolls Royce of medical experiences.  And, considering that he picks his services and reimbursement and WE walk in with  all eyes wide open ( no pun intended), it should be nothing less.  Mr Chick felt it was worth every cent, and a lifetime of free follow up care.  Dr Seemore did an excellent job.  He really seemed to like what he was doing and because he was unburdened by the spector of insurance telling him HOW he was do to his business, he could run it as he chose.

And what business owner doesn’t like that?

Cash on the barrel head please…

Filed under: Uncategorized — pharmacychick at 6:36 pm on Friday, March 19, 2010

This Post name reminds me of a M*A*S*H episode where Radar asks Colonel Henry Blake to sign a bunch of forms, which he does obediently. After asking “what exactly am I signing?” Radar just says ” Oh, just  Requesting permission  to order  more Request  forms Sir..”

The Prior Auth process is a little like this M*A*S*H scene.  However the Pharmacy Chick’s customer was dealt a stealthy blow on Monday.

DrY prescribed for Patient X a tube of Tri-Luma, which we all know is basically a prescription cosmetic containing fluocinonide, tretinoin and a skin bleach.  It was no big surprise that it wasn’t covered by her insurance, but it left a small door open by saying “PA Required”.  My SOP is to fill out a form of my own design, filling in the blanks and faxing it to the office to start the PA procedure.

It wasn’t 5 minutes later that a rep from the office called us back.  ” We got your request for Prior Authorization and wanted to let you know we will not be doing it.  This is an asthestic medicine clinic. We do not take insurance and we do not do prior authorizations for clients.  She will have to pay or go without”. 

I wan’t mad.  In fact I was jealous.   I think this Dr found a way to make a living away from the oppressive thumb of insurance companies and live off the vanity of the masses.

I have already seen this trend in medicine.  Asthetic medicine, Cosmetic Dentistry,  Cosmetic Dermatology,  all making a living by finding a way to wiggle out of the insurance noose. 

I only know of two pharmacies ( in my area)  who dont take any insurance. One is in a pretty small community.  Run by one guy, he calls the shots and it appears that me makes a living, maybe not a zillion bucks but his overhead is low and his reasonble pricing keeps at least the cash payers happy.  The second is a compounding pharmacy.  Finding that crucial niche, they dont take insurance and compound specialty products for humans and animals alike.  I am not talking  your basic Salicylic acid in  aquaphor mix, I am talking SPECIALTY products, bioidentical hormones, thyroid compounds, LDN, rectal rockets for cancer patients and veterinary products.  She has a great business and I have sent a lot of people there for compounds I dont have the time or the supplies to make. 

I am all for it.  I for one am sick and tired of all the compensations I have to make for insurance.  They tell me everything I have to do but how I pee. Most of my recordkeeping and documentation is to placate insurance companies.  ENTIRE PROCEDURE BOOKS are sent by corporate dealing simply with insurance issues.  AND if they find one small anomaly, they take all their money back and laugh while they do it. 

 I once had an audit for 100 claims by one of our local  providers.  They  focused on this DAW-1 Claim I had for a MS contin patient every single month.  They had me pull over 3 years of hard copies and wanted to see if every single one of them had DAW-1 written on them.  It took me HOURS of labor to dig thru hard copies.. a colossal waste of my time.

They charged me back on one where the physician’s PA had signed it but we submitted the Physician’s name.  I hope they screw themselves sideways.

Another time I had a Medicare Audit where they demanded I produce the patients diabetic testing log to corroborate the dispensing record.  well, she kept a pretty good log but she said ” I don’t write ALL of them down”.  Medicare wanted their money back.  I think the company fought that one and won however.  WTF?  why should my reimbursment be tied to Mrs C writing down her tests?  The hard copy sig AND what I dispensed were in accorance with the days supply allowed. 

I see Walgreens is dumping Washington State medicaid for all new patients.  I’d do it for ALL of them frankly.  Im no fan of WAG’s but I’ll at least say “way to go” on this one.

We’ve already seen a lot of dr’s dump medicare.  With Obama’s plan starting to cement, I can see a lot of providers girding for it by moving from the Insurance sector to the Private Pay sector.

I think thats a solid move.

What is your opinion?

Grab a towel, my eyes are bleeding!

Filed under: Uncategorized — pharmacychick at 8:55 pm on Wednesday, March 17, 2010

Well, the town of Chickville went from mid 40’s to mid 60’s in about 24 hours.  The rumor is true, there IS a Sun, and it occasionally peeks from behind massive clouds and warms the surrounding air.  Unfortunately, the appearance of this SUN also seems to have the rather unusual effect of making normal-appearing people wearing winter clothes, shed them like they are full of fleas and start revealing body parts better left covered.

Lets just remember however people, that mid 60’s in March is still cool.  The wind is blowing a bit and I am still quite comfortable in my long sleeves and long pants.  Its not friggin 95 degrees outside.

This lady approaches the counter and I am all but embarrassed.  Her massive mammies are barely concealed by this deeply plunging t-shirt.   I dont want to look but how can I avoid it?  She either needs more shirt or less mammies. She is jiggling like jello while she hems and haws about the copay of her Oxycontin and all I can think is “dont stare dont stare dont stare dont stare”

This guy walks by the pharmacy and I about spit out my Coke ( a terrible waste I assure you of excellent Coke). He is wearing a golf shirt, and basketball shorts circa 1975….with black socks and tennis shoes.   I am not sure what he was aiming to say with his attire, but its safe to say it missed the mark.

This lady came by that looked as though PINK had puked all over her. Pink leather coat, Pink pants and  Pink FEDORA.  Who wears fedoras?  And where in the world would you find a pink one?

The upside of all this would be that people were way more jovial than usual.  Yea, they may look like they got dressed in a Goodwill dumpster in the dark, but Mr Sun was doing the trick today!

Spring Forward? How about sluggishly crawling forward?

Filed under: Uncategorized — pharmacychick at 7:41 am on Monday, March 15, 2010

Ugh,  the weekend were to change the clock. Who would have thought that one hour…one single hour would throw and entire body into disarray?  I dislike changing the whole idea of daylight/standard time.  Honestly, when I lived in Arizona, we didnt’ change the clocks and somehow we all survived.  Why do we really need to do this anymore?

Even my dogs can’t cope well.  Sunday morning we had to get up early for an engagement.  And back we are to getting up in the dark.  My body screamed “BUT ITS 530 am!”  and I had to scream back “NO, its 630 am!”..The dogs (who normally leap out of bed) didn’t even stir.  They looked at me with disdain because they too felt it was 530 am. 

We trod to work and change the clocks..and enivitably some employee fails to realize that the time is changed and misses his/her start time by one hour, always an interesting event.  “Claire, you are late..”  ” No I am not, its 10:00″…”No, its 11: 00..didn’t you change your clocks Saturday night?” 

Deer in the headlights looking back….

I vote we fuggetaboug this archaic practice.  Let the earth decide when it will get dark.  It seems to work for the rest of the planet.

Now excuse me while I grab a coke so I can stay awake for awhile…..zzzzzzzzzz.

Dont Run your household finances like this.

Filed under: Uncategorized — pharmacychick at 5:02 pm on Sunday, March 14, 2010

According to the Social Security Administration (SSA), from its inception,  they have always collected more in taxes than they have paid in benefits.  This keeps the SSA solvent.  This is good advice to anybody with a budget.  Spend less than you make.  The Chick family lives by this mantra…and hopes that Social Security will be play money and not necessary money to our household..

However THIS year, for the first time ever,  SSA will be paying out more money than it is taking in…29 billion dollars more.


What about all the money the SSA has been saving?   The Federal govt has borrowed it all…and issued IOU’s in its place…the SSA wants it back.

double OOPS.

Neither a borrower nor lender be. 

Sage advice..too bad SOMEBODY didnt’ listen to it.

Today’s Observations

Filed under: Uncategorized — pharmacychick at 10:14 pm on Saturday, March 13, 2010

It was a day out of the pharmacy and I made a few random observations:

On my walk was a couple of teenagers.  One was wearing a chunky pair of glasses….with no lenses.   Ive worn glasses for 40 years.  I wouldn’t wear them as a fashion choice…but if YOU choose do, I think lenses might give them more cred.

It was in the 40’s for most of the day today…and I saw a girl wearing short shorts and flip-flops… WTF?

It was just weird being at the bowling alley today and watching a woman in a Saree bowling.

I sang outloud to ABBA’s SOS music video at the same bowling alley.  If I had children, they would have died of embarassment for sure.

We brushed the dogs today…I am convinced my dogs are nothing but nose, butt and hair!

I found out my friends daughter sent over 6000 txts last month. 

If that was my daughter, she wouldn’t have a phone THIS month….or next month either.

Tomorrow I am going to learn now to pressure wash a drive way….unless I can convince MR chick to do it…

I am very good at convincing..

Obama’s Bounty Hunters?

Filed under: Uncategorized — pharmacychick at 11:38 pm on Tuesday, March 9, 2010

Time to jump on the Chick Soap box

So Obama is going to use Bounty hunters to root out health care fraud by providers?   Mr President,  How about starting your fraud units on the OTHER side of the fence and go after welfare abuse?  You know, like Ms Choo, who lives in a country  mansion with her son and shops twice a year in Hong Kong but shows NO ASSETS and obtains food stamps and health care on MY tax dollars?  Or Mr and Mrs Patel who live quietly with their son but have 2 homes in India..and again live on MY tax dollars.

Sorry, Just gotta vent here.  I have no doubt that there are providers with no concience who abuse the system, kinda like the $125 screwdrivers the army bought…but Chick Pharmacy doesn’t fraud anybody and works hard to do things just and fair.  But it really toasts my cookies when everybody looks at the providers and nobody is going after the welfare cheats out there…the fake “poor”, the illegals, and the multi-state collectors..

I’m just sayin!

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