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Wednesday, September 24, 2008

My all-time fav lines from real, live, authenticated customers:

  1. [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]
  2. Is my prescription ready? Then I can pick it up? [Ah, but what is the secret password?]
  3. 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.]
  4. [Banging on the gate, which is closed and locked, and obviously so ... closed] Hey! You guys closed?
  5. Does this come in genetic?
  6. [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 further discount the price since this is a tier two drug on the formulary, so ... wait, wait ... oh, nevermind.]
  7. I'd like this filled, please. I won't be able to pick it up though for three weeks. Will it be ready? [But of course, madam. We will merely put it in the storeroom for just such purposes as this. Do not worry yourself; we have ample room for keeping prescriptions for three, four, even five weeks--months, even. We are but your most humble servants, madam.]
  8. What do you mean you don't have a year's supply of Sprintec? You mean I have to wait? How long?
  9. It's so nice and sunny outside. You should get out there. [Fantasy moment: shutting the gate in her face and running outside ... before she picks up her prescription.]
  10. Now go on and enjoy you lunch! [Mentioned after she forced me to keep the gate open for ten, fifteen minutes after lunch break so that she could pick up the presciption she should've picked up yesterday.]

Saturday, September 20, 2008

... 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 prescription. But I do it anyway. And what's more, we all do it. Every pharmacist I've ever worked with does it. We're all thumbing our collective noses at the establishment.
And we're quite content in doing so.
Stick it to the man! Yeah!

Saturday, September 13, 2008

NYT: McCain barbs stir cries of distortion - The New York Times-

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 Obama health 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:

As to the NY Times article, McCain decries the Obama health 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 already happened. If you had the crappy health care everyone else has (except for government bureaucrats) you'd know that some bureaucrat already makes the real decisions as to what medicine to give, what tests to allow, and what everyone gets paid.

Wednesday, September 10, 2008

Top ten secrets you should know about visiting your pharmacy:

  1. The antibiotic you're about to get probably isn't right for you. As stated in the Chicago Sun-Times article (,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.
  2. When the doctor or nurse tells you what something costs … don't listen. They don't know what they're talking about.
  3. Despite the increasing use of PDAs (Personal Digital Assistants or small handheld computers) for writing prescriptions, which could tell the prescriber if something will be covered by your insurance, doctors simply don't know if you'll be able to fill what they are writing for. It's a crapshoot. Much of the time you'll get to the pharmacy (and how often does it turn out to be 6PM on a Friday or Saturday?) only to discover that your insurance thinks the drug is too expensive and so requires a prior authorization before they'll pay. Oh well.
  4. Having a prescription written for Over-The-Counter merchandise does not mean it will be covered by your insurance. Duh. They could write a prescription for socks but do you think BlueCross would pay for it?
  5. If you abuse narcotics your pharmacist knows it. You don't lie as well as you think you do. Tip-offs include notifying us as to how much you hate taking these things, and coming in about five seconds before we close (chances are that one is a forgery). And do you really think we haven't heard the one about spilling the Vicodin into the toilet? Another one is acting like we're long lost buddies. I'm not your buddy and I doubt I want to be.
  6. HIPAA privacy guidelines really are important and your privacy rights are guarded, but … your rudeness isn't. Come in and behave like a spoiled five-year-old and believe me, everybody in town will know it.
  7. Over-The-Counter stuff is pretty much worthless, at least at the dosing allowed (and many are dangerous and worthless at more than allowed dosing). Sudafed PE? Give it up. Simethicone for gas? Nope. Hydrocortisone cream? Too weak. Saw Palmetto? A big negatory. Weight loss products? Please. Children's cold syrups? Dangerous and proven ineffective anyway. Adult cough syrups? Not really dangerous, but still ineffective: honey works better. Pretty much everything in a pharmacy that really worked could be stocked on one four-foot shelf.
  8. The six years of pharmacy school are wasted. All the studying about M of A's (Mechanism of actions … usually unknown anyway), organic chemistry, medicinal chemistry, therapeutics, and all that, boil down to chasing prior authorizations and billing insurances. And ringing out customers at the cash register.
  9. Yes, sometimes pills drop onto the floor and yes we give them to you. Shocking, yes! Well, not really. Nothing is sterile you know.
  10. Pharmacist really can be trusted. I've never met a bunch of people more willing to help others at no expense to them than pharmacists. They'll give you free advice, free medicine (meaning they only charge you for the cost of the drugs, if that), a free medicine spoons. Who could ask for anything more (other than national health insurance)?
  11. Had to put this on in: Everyone—and I mean everyone—hates insurance.

Wednesday, September 03, 2008

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 ...