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Showing posts from 2008
Had a call from some lady ...

wanting to compare what she paid this year to what she's paying for insurance (Medicare Part D). She thought that since she only paid about $300 the entire year that she should toss the plan, which had higher premiums than that. I counseled forbearance: Medicare is meant as a catastrophic plan, there if you need it when undergoing expensive treatments. I told her of a woman who did decide to terminate her plan, only to suffer a heart attack the very next month. She had to endure $1000 prescriptions per month until she was again eligible to sign on with Medicare.

She wasn't convinced. I mentioned something about too bad the U.S. didn't have a single-payer system such as Canada had. She assured me that that wasn't the way the country should head in. Said that Canadians are headed here in droves to get needed medical attention. I said that I really doubted that. No, she said; she had friends in Canada and apparently they were up in arms to get …
So Obama won ...

not my choice (I wrote in Steve Forbes), but maybe now we'll have a chance at national healthcare.
So we're 29th in infant mortality...

is that a big deal? Guess not, by the reaction of everybody (the media, the two presidential candidates, President Bush, Congress).

I think it was in 1960 that we ranked 12th in the world. We've dropped 17 places in 48 years. And we outspend the average industrial nation by (drum roll ...) 100 percent! Double!

Here's my take on this. The fact that we spend double and still drop back in the pack with regards to health care is not unrelated. Should we spend more? How much more?

The thing is, we should be spending less. We spend more and ipso facto we get less. The two factors are not unrelated, in fact they are inversely related. The more we spend the less we get. Why? Because the money that we inject into the system goes to fund insurance companies, stock dividends, CEO salaries, etc. The more the insurance companies proliferate, the less care we get. Insurance companies are in the business of not helping us, but instead helping their stockh…
You wanna see the manager? Ha! I am the manager!

So this really nice lady (sarcasm!) comes up to the counter just about as I'm putting down the gates, ready to close up the joint. I say, "May I help you? Do you have a pick-up?" She says, "K...N...I..." So I type her nicely enunciated letters into the pick-up screen and nothing comes up.
"Do you have a prescription here?" I ask. "K...N...I..." I try it again, thinking maybe I just hit the wrong key. Nothing. "What is it you're looking for?" "K...N...I..." "Why don't you come down here," I say, directing her to one of the PCs at the other end of the counter.
I look up her profile and Lo! eleven days earlier we had put up two prescriptions of generic Prozac for her. I explained that we can hold prescriptions for seven days and that after that they are put away.
"I have to be somewhere in half an hour! I had an emergency vacation--how was I supposed to know…
Where everybody knows your name ...

Remember that song from "Cheers"? It came to mind recently when a customer (a long-time customer) came up to the counter to retrieve her prescription. I recognized her, but when the day gets busy as it certainly was, I find it difficult to always match a name with the face. Sometimes I can come up with the first name, sometimes the surname, and sometimes neither. I usually get around the embarrassment by asking a date of birth. That can be a problem, however, when the gender is that of a female. Women can get quite ornery when asked a DOB (date of birth), especially when over the age of thirty-ish.

I asked for her name, thinking that that would be the lesser of two evils. Actually, I apologized, then asked for her name. Something like "I'm sorry, I can't remember your name."

She then remonstrated against my failure to recall her name. "Everybody else remembers my name!" she said.

Now, that may be true, and it may be…
My all-time fav lines from real, live, authenticated customers:

[Answering the phone] Hello, this is ******* pharmacy, how can I help you? [Customer] Are you guys open? [Duh, if I answer the phone then I'm here and I'm open]Is my prescription ready? Then I can pick it up? [Ah, but what is the secret password?]Can I use the restroom back there? [Of course you can--we wish to exceed your expectations after all--and help yourself to some of the samples on the shelf.][Banging on the gate, which is closed and locked, and obviously so ... closed] Hey! You guys closed?Does this come in genetic?[Plunking the prescription down on the counter, seen for the first time for maybe 2 nanoseconds] How much is this going to cost me? [Well, let me just reach into my memory banks and, oh, here it is, $117.58 minus the -- what insurance?--12.789% discount plus the $3.78 dispensing fee ... but wait, on page 29 of the contract--which I have right in front of me by some weird lucky chance--I have to …
... it's entirely illegal!

What happens is this: Some fellow traveller stops in and remarks how he needs a refill on his prescription. Unfortunately the prescription is either expired or is not refillable (a clue would have been to look at the label where it says "No more refills--contact your doctor"). What to do? Well, with the price of gas going up there aren't a lot of people willing to go home and then come back later on in the day, especially if they live in a rural district where a drive to the pharmacy might be half an hour or more. Nowadays it can take several days to get a refill on a prescription, so what I do is to give the poor bloke a couple of days worth of meds and send them on their way. I then fax the doc and when I get the prescription OK I then subtract the few tablets from the new fill. Simple, right? Everybody happy, right? Sure, except ...
it's entirely illegal.
No one gave me the right to give those pills. I'm essentially writing a prescr…
NYT: McCain barbs stir cries of distortion - The New York Times- msnbc.com

Now, normally I don't add non-health care news to my blog, but as this has, at the end of the article, some information about the Obamahealth care proposal, I thought I'd insert it.

But first I must reveal myself as a Republican, albeit one who supports truth and the American way, and as such cannot find anyone to support among the red staters. The blatant lies told by the McCain campaigners disgust me. There are so many I cannot place them all within the space of this blog. Suffice it for interested voters to go to Senator Obama's Web site devoted to the cause: http://my.barackobama.com/page/content/fightthesmearshome.

As to the NY Times article, McCain decries the Obamahealth care proposal as it would “force small businesses to cut jobs and reduce wages and force families into a government-run health care system where a bureaucrat stands between you and your doctor.”

Get a clue, McCain. It's alrea…
Top ten secrets you should know about visiting your pharmacy:
The antibiotic you're about to get probably isn't right for you. As stated in the Chicago Sun-Times article (http://www.suntimes.com/lifestyles/health/1152328,CST-NWS-health09.article) half of the prescriptions written for us when we go to the doctor for colds are … worthless. If you have a cold then you have a virus. An antibiotic does not work for a virus. Simple, huh? But you sure feel better getting that prescription don't you? Otherwise you'd think you spent a couple hours in the waiting room for nothing. But that's really what you did. Shame on the doc who is writing these things, increasing resistance in the bio world so that when we get one of those superbugs we won't have anything that works.
When the doctor or nurse tells you what something costs … don't listen. They don't know what they're talking about.
Despite the increasing use of PDAs (Personal Digital Assistants or small hand…
New record ...

464 prescriptions filled on the day after Labor Day. Few people know this but the two busiest days in pharmacies are the days after Labor Day and Memorial Day. So if you like quick and snappy service ... don't show up at the counter on those days.

I hope I didn't make any mistakes yesterday, but I'm sure I did. In a 10 hour work day, that's 1.54 prescriptions every two minutes.

Remember that episode on "I Love Lucy," when she got a job in a chocolate factory? That's what pharmacy is like now, with prescriptions coming down the belt instead of chocolate. I do seem to remember she started to eat the ones she couldn't get into the box ...
How about we follow some of these people to their jobs?

I do so want to go up to somebody just as they're about to leave for lunch and say something like, "But I just have to pick up a geology sample." OK, so there aren't that many geologists out there, but you get the point. If someone is leaving for lunch you don't go up to them ask for them to keep open just because you couldn't plan your errand better. Your lack of planning shouldn't ruin my day.

And another thing: If someone makes a stupid mistake and you run to the store manager or district manager and complain ... that makes you a delinquent. That's right. You don't try and ruin a person's life and career over some piddly little error. If some new person is on the job and cannot find where some product is (because they are new) then running off to complain should be seen as a character flaw. I don't even care if that person said something to offend you. Heck, everyone should be offend…
"Excuse me ...

but do you have shoehorns in the pharmacy?"

Well, that's a new one, I have to admit. No one has ever even mentioned the word "shoehorn" in a sentence before, that I can remember.

I may very well have identified a new disease: Pharmaceutical shopagnocis, a psychological ailment characterized by the metonymies of the department store (metonymy, you will recall from your eighth grade grammar lessons, is (from Webster's Collegiate Online)

a figure of speech consisting of the use of the name of one thing for that of another of which it is an attribute or with which it is associated (as “crown” in “lands belonging to the crown”).

What I think happens is that someone walks into the department store, happens on the pharmacy and remembering the last time they were in say, Rite Aid or Walgreens or CVS, they still think that everything in those stores is contained in our little section of a much larger store. Thus the shoehorn (which a normal, well-adjusted …
I encounter quite a few personality types at work. Maybe all of 'em. How many types are there? Let's see …
There's the codger (think Walter from Jeff Dunham), the rich codger and the rich codger's wife. Middle-age guy undergoing crisis; middle-age woman undergoing peri-menopause; the young guy and cute girl; the woman with family; the guy without the family (may be married but usually shows up alone and can't remember the wife's birthday … or the kid's); the beautiful woman (by definition rare—usually found gathering in makeup aisle); the guy in the suit (also rare, as they feed in theaters and party rooms); the retired gent (who may be "the codger" or a separate class: the nice guy); the impatient lady (is it done yet? I have an appointment! My husband is out in the car! I have ice cream out in the car! My dog is out in the car!); the poor—and I mean dirt poor—lady who has a cab or bus waiting outside the store ("Can you hurry? I have a cab w…
It's so disgusting ...

when people take the wad of bills out of their pockets as they're paying for their prescriptions, and then proceed to lick their thumb, count off a few, then hand the money to me. Oh thank you, sir; thank you, madam. No, I don't mind a bit, sir, that I am handling your spittle. Glad to. It's a privilege. If only you'd given me your dirty snot rag as well, then my day would be complete.
Today's my birthday ...

and while on the topic of birthdays, I'd like to mention one of my pet peeves. Not a day goes by when I am not faced with a man picking up a prescription for either his wife or one--or both of--his kids. Before handing over the medication we verify the date of birth of the patient, just so we know that 1) the person picking up the medicine is likely to be a representative of the patient and given instruction to do so, and 2) that we indeed have the right prescription in hand.

Simple enough, right? Wrong. You'll note I said earlier that it is a man picking up the prescription. The man does not know the date of birth of his wife. The man does not know the date of birth of this child. Many would say that this is an example of generalization, of stereotyping. Not so. While there are of course exceptions, the majority of men picking up prescriptions struggle mightily to come up with a date of birth for their loved ones.

Let me be clear: A man who does not k…
What's it made of...

gold? Well, unless we're talking about a certain compound given for arthritis (aurothiomalate, or Myocrisin for short), then, no, not made of gold.

Oil, maybe. Heh, heh. (Actually, LCD, or coal tar, is a petroleum product but it is quite cheap--go figure.)

So, what to say to these people with such inquiring minds?

How about, "Here's the 1-800 number to Blanketyblankety Labs; why not ask them? And call me back and let me know what they say; I'm kind of curious, myself."

Drugs cost whatever the company that makes them determines they cost. Pretty simple, eh? What goes into the price? Well, research and development, certainly. That's the ol' R & D in the P & L. What else? Marketing. Marketing is actually a bigger slice of the pie than R & D. Why? Well, if you're the CEO of Company XYZ then you probably make a lot of "me-too" drugs, which is the way we pharmacy types designate drugs that really have no great advan…
Thank God for Insurance...

O the humanity; O the irony. See, we shouldn't be thanking the insurance industry for anything. Nothing. Nada. Zero.

But inevitably someone comes in -- this happens on a daily basis -- thanking God for insurance. Of course, what they really mean to say is I'm so glad I don't have to pay $637.98 for my bottle of pills. (Pills, btw, are different than tablets or capsules: just a nitpick but a nitpick I just had to get out there.)

What these thankful people don't stop and realize is that the person in back of them isn't going to get their bottle of pills. No, the God-given insurance company that they have paid their money to is going to deny them because they need to take two capsules a day and they only allow one.
Doesn't matter if the doctor has already tried the one per day regimen. Doesn't matter that two per day works just fine.

Oh, and the person who was just ahead of that one who was so thankful? She left because she needed an anti…
Tea Tree oil is a great multipurpose treatment to use on a number of ailments. Whether you are looking to repel insects in your garden or if you are looking to clear up your acne, tea tree oil is a great alternative.

read moredigg story

Amazing herbal remedy! Cures Acne! Kills Lice! Empties...

Pockets! (of your cash). Actually, it isn't terribly expensive, but my point is that this isn't exactly science that is being bandied about here. I am not saying tea tree oil is snake oil: there may be benefits to using tea tree oil. But where is the proof? And I'm not talking about what the neighbor said concerning her little Johnny's case of lice ("Here today, gone tomorrow! Amazing stuff. You got to get some!"). I want some double-blind study to look over.

If something is so great -- remember the early buzz on coral calcium? Cancer cure, anyone? -- then we should be able to show that it actually, undeniably, works. Show me the study.

Homeopathy is the greatest example of …
"Pretty busy over there...

mind if I cash out here?" the guy says. Gee, nope. We were just sayin'--weren't we Sally (Sally over there is my technician, though heck, why would we be needin' a technician when we've got nuthin' to do I just cannot say)--that for the past two hours we done nuthin' but twiddle our thumbs. Mine's about to fall right off. Busy are they? I bet they are. Why they gots to cash out peoples like you and me and me and you and they just go on and on and on. We only have to answer the phone, call the insurance companies, call the doctors, call the hospital, fax the doctors, correct their mistakes, call back the doctors, call back the insurance companies, yell at the insurance companies, fill prescriptions (I like that part, personally)...and then we gots to ring all you fine folk out just like they do up at the front of the store.

Busy are they? Good. Son of a cabbage, that's just jimminy cricket good.

Don't Shoot The Pharmacist! - The offical website

Customer gives us a prescription to transfer into our pharmacy. Call said pharmacy. Busy signal. Busy again. Busy yet again. Customer comes back. Why isn't it done??? Um, busy signal. Customer goes away angry. Comes back five minutes later. I just called and I got through...the first time I called!
"Gee, wow. You're some really something with a phone," I think (but don't say). I call again, and get through. Transfer prescription. Tell her, "It'll be fifteen or twenty minutes." Disgusted and confused look. What?! She turns to her paramour. He said we have to wait. Why, he says. How do I know, she says. He's had my bottle for half an hour.
"I'll get it tomorrow," she says.
Whatever, I say.
Next day she comes in and when I tell her the copay is $25 she says, "What! The other pharmacy charges $3!"
I explain that I am only charging what her insurance says I need to charge, and that we don't price her prescription, her insurance…
Another Memorial Day...

another whine. This will sound a tad insensitive, but I cannot stand to hear another senior citizen whine to me about how "the golden years" are anything but golden. For instance, I have this one lady who has had cancer recur several times, fighting it off each time. At each episode she can only bemoan her fragile state. Now, I agree, being sick, especially with an illness such as cancer, is no picnic. But after seeing a few of my customers--gems all--go through fatal illnesses with nary a whimper, teaching all who encounter them what it truly means to die gracefully, teaching us, really, how to die, I no longer have much patience with them. Especially on Memorial Day.

I want to ask them how many young men died not seeing their nineteenth, twentieth birthday, how many died struggling up some beach in Normandy, Sicily, Okinawa. They never saw their eightieth, seventieth, heck their thirtieth. How about a little humility, a little thankfuln…
Ah, another Memorial Day weekend...

spent working behind the counter. Do I mind? Of course not. My friends and enemies alike are spending it camping and having cookouts and such, but I feel they are missing the point. Memorial Day is a day of memories, of harking back to pay tribute to the fallen, of those who have sacrificed for our benefit. Work isn't necessarily fun, at least for most of us; we shouldn't just spend this holiday frolicking without a care, without a hint of the loss we all bear. Isn't that right. It is.

And while we're at it, I rather like to bathe in the fluorescent's gaze and the soft glow of the computer monitor. What I don't like is the constant whine and cringe inducing honk of the customer's rant:
"You should be outside; it's gorgeous!"
"If you can get out of here for an hour you're gonna love it!"
"Too bad you're stuck in here."

Actually, it wouldn't be that bad being stuck in here, except I h…
Today's highlight...

A guy pays for a 27 cent --yes, $0.27-- prescription, with a check. He writes the check out (even though we print it out automatically, handing the check back to the customer) and then gives me the check which I then process. The check gets caught inside the register. I re-try. Re-try again. Finally, after describing my love for bank checks, I tell him I'll pay for his 27 cent prescription. Go. Get out of here. Buh-bye.
I received a comment on my March 26th blog regarding the equal nature of generics to brand name drugs. The comment was as follows:

If generics and name brand prescription drugs are "identical," why do doctors overwhelming only use name brand drugs for their family?

That was an interesting question. I'm wondering if there is a factual basis to it, i.e. is it the questioner's opinion or is there some data that underlies his comment? My own experience with MD's, PA's, NP's, and dentists is that almost all get generics. Some do insist on brand, but I can reclassify these as retired, or nearing retirement age, and coming from a, shall we say, snooty neighborhood. My feeling is that they can afford the best, and so choose to shell out for the
brand, as only the top shelf is good enough for them.

Also, you have to take into account that drug companies fuel the doctor's larder with free (the magic word for doctors) brand drugs. Doctors are pretty much like every…
Pet peeve #17...
calling the insurance company, inputting the pharmacy NPI number, the prescription number, the patient's ID number, hitting #3, hitting #1, hitting #2, holding, holding, only to hear this:
"Hello, my name is _______, may I have your NPI number? Prescription number? ID number? Thank you. I'm sorry, but this claim needs to be handled by our clinical line. I'll transfer you now. Is there anything else I may assist you with?"
Holding, holding, holding. Inputting the pharmacy NPI number, the prescription number, the patient's ID number, hitting #3, hitting #1, hitting#2, holdingholdingholding...then hearing:
"Hello, my name is_________, may I have your NPI number? Prescription number? ID number? Thank you. I'm sorry, but this claim needs prior authorization. Would you like that number? and is there anything else I can assist you with?"
No; but thank you for making our wait time for a prescription go from ten minutes to half and hour.
I am...
Captain Relion (as in rely on, get it?), force of good in the pharmacy universe, bringing the strong arm of Regulation and Law to the drug world. Bitten by the pharmacy bug (Arachnida apothicaricus) at the age of seventeen, Cap'n Relion has sacrificed his life and liberty in the face of unspeakable terrors...just to save a few lives. But what can only one lonely man do in the face of a hostile planet filled with egomaniac Doctor Evils and innocent, but unknowing patients (Homo idioticus)? It seems precious little, however the Good Cap'n has special powers which enable him to wipe medical incompetence off the map (or nearly so): Calligraphic vision, the ability to miraculously read any doctor's writing without need to call and verify, saving many precious seconds; Auto-insurance billing know-how, allowing our hero to simply know through his "pharmacy sense" what a person's insurance is...even when that person doesn't know him or her-self! Cap'n …
When you stand...

at the counter ready to pay, fiddling around with you purse or jamming your hands in your pocket fumbling for change...we hate that! Can you possibly think that we have nothing better to do than wait patiently for you to add your change up? Just give us the bill and deal with it. I have 20 prescriptions waiting, ten people behind you waiting for their medicine, two calls on hold, and reports to do.

And while we're at it...

throw all your checks in the shredder. Checks are bogus and a waste of every one's time. Why do we still have checks? I haven't made out a check in a very long time. I pay with my debit card or my credit card. I don't need to stuff bills in my wallet and have loose change jangling in my pockets. I wish I knew how many lost hours have gone by standing there at the register waiting for someone to fill out their check. There is one good thing about checks: I can tell when someone is beginning Alzheimer's. A wonderful lady who would co…
Ugh, the abortion question...
just wont go away. Pharmacists everywhere have been forced to make a moral decision regarding Plan B: Sell or don't sell. Which really means, sell or refer the sale to someone else thus bypassing you.

When the product came out (just an expensive high dosed birth control pill) I opted out. I felt that I just did not want to be involved in the possible aborting of some innocent kid. I know, I know--there are many of you who don't want to think of a fetus as a kid but "it" is and you'd know it if you ever cracked a biology text book--at least before they were rewritten by liberal fascists. Anyway that is how I felt: let someone else sell it and my conscience would be clear.

Well,I now sell it. It is going to be sold anyway so why put some girl through the embarrassment? I don't want to make her feel bad; she probably feels bad enough already. But the real kicker came when I thought through the entire process. What was going on in the g…
National Health Insurance...
is the only answer to the morass we find ourselves in. Unfortunately, none--none!--of the three major presidential candidates offer even the hope for a national program. Incredible. Even Clinton has shied away.

Why should your health insurance be tied to your job?

Why should we pay profits to some insurance company?

Why do we need ten thousand plans in this country? What waste.

The national plan could be expanded Medicare (guess what? we already have a national health insurance and it works pretty good: Medicare--so just expand it!) or some variation on the existing system, but with restrictions.

A Pharmacist friend once gave me his take on this: Why not divide the country into five or six regions. Let each region take bids from health insurance corporations to contract out benefits for a few years. That forces prices down and still gives people a measure of choice: heck, we could even vote on our plans. That way we wouldn't have ten thousand plans, but…
I've read that the vast majority of seniors are satisfied with their Medicare D plans. U.S. News reports [The National Interest, April 21, 2008]:

But even the elderly, who grew up in an America where big institutions--the U.S. military, big corporations, giant labor unions--made choices for them, turned out to be satisfied with the choices they had under Medicare Part D.

Who are these people? The customers I see hate Medicare part D. Hate it. Every December they get these letters saying how they may need to switch to a different plan, or they may be switched unless they do such-and-such and call so-and-so. And then they find out their drugs are no long covered and they need to switch or get prior authorizations. Who could blame them for hating this system? I certainly hate it.

But the reports are saying that everything is all hunky-dory. Are they daft? Maybe it depends on how the questions are written. Maybe more people respond who simply aren't on that many medications and so th…
No prescription for you! Back of the line!

The soup Nazi has now come to the drug store. If you make me work all the way through a prescription (or worse, several) only to tell me at the register that you are sorry but you have a prescription card and can you "just run that through"?

No, actually, I can't. We need to start over...from the stinkin' beginning. And you are now at the end of a very long line of people. I don't care if you are standing at the register like your about to set up a campsite, I don't care how pretty you are, I don't care how rude and obnoxious you are--I don't even care how nice you are about it...you're going to wait. A long time. No soup for you!
A young woman, I'd say she was around 23 years old, recently filled a prescription for Adipex, an amphetamine derived appetite suppressor. Adipex--or rather phentermine, the generic, as nobody gets the brand anymore--is a fairly powerful suppressant of the appetite, and isn't bad for starting a diet. [An aside: phentermine was FDA approved in 1959...my birthday!!] The problem is that after several months of use it doesn't do much; there isn't any study that I know of that shows successful weight loss with the drug for longer periods of time. It used to be hugely popular in the early nineties, as part of the Fenfluramine-Phentermine combo (Phen-Fen), taken off the market because of valvular heart ailments. Even with the combination, long term weight loss was iffy. Phentermine is now somtimes used off-label with Prozac (or one of the many "me-too" Prozacs like Celexa, Effexor, Zoloft, Lexapro).

Anyway, there seems to be a resurgence in Phentermine use, as our sc…
Got the flu...
probably not the real influenza flu, but pseudoinfluenza. The aches aren't as bad, you can still get around and do stuff. Just don't feel well, is all.

So what do pharmacists take for the flu? Usually either some favorite pain reliever like tylenol or naproxen or ibuprofen. I personally like to use a nasal wash like Alkalol. It has mucus solvents that can clear the sinuses. There is an instructional video on the use of nasal saline washes (Alkolol has oils and saline, but the concept is the same: go to instructables.com).

Don't be taken in by all the marketing for cough and cold and flu meds. There really is only a few drugs out there used for these illnesses: a decongestant, an antihistamine, dextromethorphan, and some pain reliever. And all of them are weak. Some, like phenylephrine and dextromethorphan, are so weak you might as well call them useless. So don't waste your time and money on them.

Make some chicken soup instead. Maybe some vitamins too; not …
Your name is...

Customer: It's right there on the prescription: John Doe.
Pharmacist: Sorry, couldn't read it.
Customer: You can't read the prescription?
Pharmacist: It's pretty bad handwriting. I can make out the drug, though. How are you supposed to take this? What's it for?
Customer: You don't know what the drug is for? How long you been at this?
Pharmacist (now getting testy): 25 years. Drugs are used for a lot of different reasons. This one for instance. Prednisone. Used for inflammation, asthma, lupus, MS, and about a dozen others. It's also taken in different ways, and if I could read the handwriting I might be able to tell you how you are supposed to take it. Did the doctor--Oh, nurse--tell you how it's taken?
Customer: Yeah. Three the first three days, then two then one. Something like that. These doc's and their bad handwriting. They make you take a class in bad handwriting, right? [laughs]
Pharmacist: No. And I don't think it's funny anym…
All in a muddle...
is what we are. I am surprised at how little we learn day to day, at least about how to work and live more efficiently. We complain about having no time, yet we waste it like a drunk's profanity.

Case in point: How many times will a customer come to my register at the pharmacy, plop down a dozen or two items and then wait impatiently while I go through the motions of ringing them out. Some tap their toes, some their fingers. You can almost hear the most impatient of them say under their breath, come on, come on, I gots to be somewhere!

But do they bother to take the hangers off the soft lines (that's department store-ese for clothing) or put the UPC bars where I can scan them? Uh, that would be a no. Do they put the items where I can reach them? No again.

I might tell them that that might speed things up but I might as well be talking to my big toe, as one of my tech's likes to say.

Another, particularly vexing example: After waiting for fifteen, twenty minut…
Slap a label on it...
is all I have to do, right? After all the guy was in a hurry. And he was from Manchester, snob capital of Vermont. "Can't you just do it right now? I can't run back here."

My technician explained (way too politely, to my way of thinking), that we were shorthanded, due to the flu going around, and that there were (gasp!) other people ahead of him.

Well where were they? he wondered. I wanted to tell him that not everyone plants himself down at the drop-off window like some potted shrubbery. "They're off shopping," is all I could come up with.

Later, after the guy took his prescription back, my technician said she wanted to "slap a label" on a box of ex-lax and give him that. After all, what's accuracy got to do with it when a guy's in a hurry.
Pisses me off....
when you try and save somebody a lot of money and they insist on wasting it. Case in point: A young woman comes in the the pharmacy wanting to fill her prescription for an antibiotic. How much is it? she asks. So we punch the little keys and tell her. $55.98 for the brand and $22.46 for the generic. I usually don't even tell the brand price as nobody buys them--heck, hardly anyone pays cash anymore so the insurance company gets to pick whether it is brand or generic and they rarely pick generic except when some special contract price has been negotiated--but this time I say both prices. She says she wants the brand. Huh? I say to myself. Do I even have the brand in stock? I check and we for some unknown reason actually stock it.

Well, what do you do? Just give her the stuff, I guess. If a customer wants to waste her money, then who am I to disagree. Except more than that is going on here. There is a trust issue exposed. I am trying to save her money, so I say that …
This from
Medical News: Campaign '08: Party Line Divides Views on Healthcare Campaign Issues - in Public Health & Policy, Campaign '08 from MedPage Today:
"For example, 40% of Republicans believe the U.S. healthcare system is better than other countries when it comes to making sure everyone can afford needed care. Only 19% of Democrats and 22% of independents share that belief.
Similarly, 72% of Republicans believe the U.S. offers better quality of care than other countries. Contrast that with the 49% of Democrats and 48% of independents who feel that way.

Huh? Now, I am a Republican, just so you know. More than 7 out of 10 Republicans think we are the top shelf in health care? 4 out of 10 think we can make sure everyone can get some kind of health care when they need it? Who are these people? Either they cannot read or they simple do not choose to read. But it isn't just the Republicans that live in fantasy land. About 5 out of 10 Dems and Independents also thin…
And here's another crap-happy product: Mucinex. Technically it does work. They performed tests and it shows a minimal effectiveness over placebos. The real question is: Why shell out nearly $20 for something that works that badly? Just drinking a lot of water or juice will do nearly the same thing. They're selling snake oil again folks, and you're buying it.
Finally! This week's Slate magazine (March 22nd) has exposed the cold remedy Airborne for the snake oil it is. The double blind study supposedly done wasn't, and the stuff will give you a good case of vitamin A overdose if taken as directed. All it is is some vitamins...but hey! it was "invented" by a school teacher, so its gotta be good...doesn't it?
Because it is basically a vitamin product the FDA doesn't have to say it is effective for what it says it is effective for (colds), but does that make any sense? If somebody comes out and says something will cure the common cold then it should give us some proof, right? (But then again, Oprah said it was great stuff so...?)
Or maybe we should all remember that if something seems too good to be true...then it isn't. True, that is. And remember, there is no cure for the common cold. Right? Right.
And one more thing: All you people out there wanting some product to get rid of your colds or the flu...TH…
Why is everybody upset, saddened, and, yes, surprised when they are told that they have to wait--wait!--for oh, maybe an hour before their prescription is ready...when it is the day before (or after) a major holiday? How many holidays do we have to live through before we notice that it sure is crowded here after Christmas, Labor Day (doctors tend to take the holidays off, people!), Fourth of July, Thanksgiving, etc.
Wouldn't you think that after, say, ten years--twenty, thirty?--we'd start to get the drift?
But no. Here is a sixty-something woman dropping off a bag full of refills at the counter on Good Friday. Could she have called them in the day before and waltzed right up to the counter and just picked them up? Yup. But now there is a line backed up to the men's toilet and when told she might have to wait an hour she seems rather disgruntled.
Well too bad, lady. Yer waitin'.
The New Mafia



Kay: It made me think of what you once told me: "In five years the Corleone family will be completely legitimate." That was seven years ago.
Michael Corleone: I know. I'm trying, darling. But things aren't as easy as they seem. The government pols are giving us money hand over fist. It just wouldn't do to turn them down. What would the Godfather think?Kay: Michael, is it true?Michael Corleone: Is what true, Kay?Kay: That you've never intended to get out of the insurance mafia and into a legitimate line of business? Is it true?Michael Corleone: Don't ask me my business, Kay.Kay: Is it true? Is it, Michael?Michael Corleone: No. Don't worry. We'll get there.Kay: Michael, they said that you killed that girl, Nataline Sarkisyan. When she needed a liver transplant you said no and she died. Said it cost too much.Michael Corleone: Kay, it's a lot more complicated than that. The doctors and the hospital, they never sent the right paperwork.…
Edit

There was a letter in the local paper decrying the evil of "socialized medicine." Since that letter appeared there have been a few follow-up replies. Those responding seem to feel that no system could be worse than what our country currently offers. They point out that we as a nation spend 15% of our gross national product on health care, far more than any other industrialized country in the world (those bad socialist countries France and England are 10% and 8% respectively), but that our care is currently lagging behind the rest of the world (107 health disease deaths per 100,000 people versus 40 in France). One guy pointed out that the health care that our wonderful public servants currently have is actually government administered...that is, socialist. Wonder why they did that? Maybe they figured they didn't want to be hassled with prior authorization requests and formulary changes. Maybe they just figured that this terrific system of private insurance companies…
A manual for filling a prescription
Twenty-five years ago I graduated from a five year program for pharmacy, a veritable manual for dispensing medicine, if you will. I realize now that these times demand a manual for picking up one's prescription. Fortunately you do not need a five—now six—year degree. But there is still a need for preparation. Times have have been a'changin'.
One: Prepare to wait. (See following.)
Two: If you have a new insurance card bring it. You may think we pharmacist's copy it or run it through some swipey gizmo but we don't. It does, however, have a phone number on the back of it so we can call and find out the numbers we need for billing. The numbers on the face of the card are a trick: they are probably wrong or missing entirely. Sometimes the insurance company puts a few letters in there to try and trip us up and we need to call and find out which letters we can ignore. Anyway, we need the phone number to call the company and get the inf…
Hit Clear?--
That will be $19.98. Will you please sign for the prescription insurance billing? Yes, right here on the signature pad. "Cancel"? No, hit "Continue." Yes, the button at the lower left. The one that says "Continue". Thank you. Now sign...no; I'm sorry, you've hit "Accept" before you signed your name. Let me reset the pad. There, now you can sign your name. Yes, that's right. Hit "Clear"? No; "Accept." Whoops, you hit "Clear." "Clear" actually clears the pad so your signature is erased...or cleared. If you hit "Accept" then your signature will be...yes, accepted. Try it again. There you are. Now that wasn't so hard, was it?