Persnickety

When did a pharmacy become a part of the fast-food nation? You walk into a pharmacy with your prescription in hand, present it to the technician or pharmacist, and start to walk away, confident that in a few minutes you will have your medicine and begin your life anew. When did that happen? I started in this business in 1983. At that time I remember this same expectation of quick, efficient dispensing, though I also remember that a busy pharmacy back then did about 100 prescriptions a day. We were still typing labels, though a few envelope-stretching chains and independents did have computers. So if we did ten Rx's an hour that was a busy. That works out to be one Rx every 6 minutes. Nowadays we do one Rx every minute or two. (That doesn't mean you get your prescription in two minutes; it's more likely to be an hour as the volume has sky-rocketed.) But back in the Jurassic period of pharmacy, independents used to fill prescriptions in a back room, beyond the view of custome...

  Since everyone else and their pet dog gets to sound off on what is the best plan to overhaul the United States healthcare system, I thought I'd put forth a few of my own. (Note: anyone who has been following this blog knows my reasons for advocating a single-payer system, so the following remarks are meant to be as an alternate to that most desired of solutions.) Lacking any real reform, which indeed seems now to be the resultant predicament we find ourselves in, we could save millions just by having one uniform billing form, and one uniform insurance card. I have seen insurance cards without any ID number, group number, processor number, or even a logo to let us know whom to bill. Honest. Give pharmacists the power of therapeutic substitution. If your insurance wants you on Prilosec OTC instead of Aciphex I could switch you to that drug without having to fax or call the office and wait the three days to hear back from them. They're only going to say switch it anyway. Advocat...

or not to err, that is the question. Lately I've noticed interesting reactions from patients when something unusual is noticed with their prescription. Let's say someone receives a prescription for a quantity that they did not expect. Joe Schmoe gets some Zantac 150mg, and takes it twice a day. He looks at the bottle before he leaves and sees that it is for sixty tablets. He points out, none too courteously, I might add, that we've made a mistake. He had asked for a ninety day supply. We should have given him a quantity of #180. Note: We've made a mistake. Us. The pharmacy team. The druggist. The stoopnagle with the white jacket who can't count. You know the guy, the one who can't read the prescriptions with the silly handwriting on them. Except that guy didn't make that mistake. Didn't make too many others either. This is the guy whose job it is to catch mistakes. That's right. The job of a pharmacist is to catch the mistakes of others. It is no...

  As reported in The New York Times today, Sunday Sept. 13 th , 2009, Nikki White died not from her lupus but from a horrific health care system that refused to care for her. Every half hour another person dies from lack of care in this country (National Academy of Sciences). And there is no outrage. As Nicholas Kristof writes, every two months as many people die in this country as died in the World Trade Center attack, which resulted in this country spending hundreds of billions of dollars to prevent such an attack from happening again. But we balk at universal health care. No outrage. Christians sit on their hands. Republicans call the President a liar. Fox News spreads misinformation. And no one cares. If you care that Nikki White died needlessly, then you need to do something. Fax a congressman, the president. Something. Anything. Why be part of the problem when you could be part of the solution?

  in England. Not here in the good old U.S. of A. Here it's $148 for that prescription of a highly popular cholesterol lowering agent. But, you say, maybe that's just for that particular drug. Nope. Doesn't matter how newfangled a drug is. In England it's $12. Yeah, but they must have some expensive health care system over there, right? Nope, again. Per person they spend about half what we do in the U.S. What about the horror stories? The rationing, the death squads? The people in the UK seem quite happy—only 1 in 10 people think there's something deeply wrong with their system. In the U.S. it is 1 in 3 people. And they're right. Maybe the argument has been high jacked in favor of the insurance industry? Perhaps. With all the money we're currently spending, you'd think we'd be all as healthy as newborn babes (babes born in England anyway; babes born in the U.S. don't often aren't quite so lucky), but sadly we're not. So where's all th...

  It is becoming clear that the U.S. is going to have some form of health care reform this year. Equally clear is the inevitability that this reform package will be lacking in some important aspects. What we're left with might be considered one of those "half empty, half full" sorts of questions. On some points anything might be considered an improvement over what we currently have. There is near unanimity on the need to cover those without insurance, for instance. That would be a decided improvement. The greatest need right now in this country is the need to provide for those people without the ability to pay for health care. That is job #1, and it looks like we're going to get there. Unfortunately the packages making their way through Congress are protecting the insurance industry, not the people needing better care at lower costs. So what we might very well have at the end of the day could be similar to what we now have—plus coverage for 47 more million people—at a...

Is Canada the best example of a nation's regard for its citizenry (this side of Great Britain), or is it the bumbling bureaucracy portrayed by FOX News? Which Canada is the truer picture? Today, after another stupid encounter with a patient's insurance company (the group number on the card was not actually the group number), I conversed a bit with the rather patient patient. Turns out she's a nurse and has little regard for insurance. She said that she didn't know what the answer is to our predicament in this country. Not being shy about my own particular views I shared with her my own views. The only good answer is single-payer. She said that that might be good, but not if it produced the lines in Canada that her friends see there. I said that that wasn't due to any single-payer plan, but simply to a lack of doctors. Massachusetts has the same problem now that they've mandated insurance coverage for everyone (except legal immigrants!). Americans seem to regard...