Nov
Why Would I Lie?
Posted by The *Angriest* Pharmacist as Courtesy, Engrish, Insurance Companies, Laws, Me being a dick, Me hating others, PHARMACY SECRETS!, Patient Education, Rude, Stupid People, Technicians, True Story, Work Sucks
I hate how several times per day I find myself in a situation where the only possible outcomes in the mind of the patient is that I am either A) Idiotic and know nothing about what I’m talking or B) Lying.
For instance, a patient approached today (who was confrontational from the get-go) and told us he wanted all of his medicines filled as a 90 days supply rather than 30/month. I’m more than happy to do that. DUH!! Our profit margin is usually better on 90 days– especially if it is a generic drug or one of Wal-Mart’s famous 4-dollar respect killers. [One dispensing fee, one label, one count, one check, one vial/lid -- it's savings all around!]
The older gentleman, of course, had already called his insurance company and “Nancy” told him that he certainly could get ninety days for 3 times the copayment of one month. Guess what…Nancy was wrong.
The patient knew that this would happen though — Nancy told him so! Nancy told him that the Pharmacy would merely have to call after getting the rejection and the insurance company would input a code. Right…insurance companies are constantly helping people out, giving out correct information, and speaking English in an understandable accent!
At this point, my tech told him that she thought our keystone tech called the insurance company yesterday and confirmed that the 90-day option was a fallacy. He would have to use their mail order pharmacy. Whoever Nancy is was wrong or he misunderstood. This did not sit well with him — and he did what patients always do: act like an asshole and reduce yourself to the level of merely a customer.
He looked me in the eye and told me, “Now, lookie here. Ya’ll gun’ call that inshowance cumpny right herre an’ now to have’m put dat 90 day in der or he wuz gun’ take his bidness to ‘nother fahmucy that’a doo wut he say.” — This of course did not sit right.
“Now, you lookee here. There’s absolutely no reason to get nasty and make threats about going to another pharmacy. I understand you want 90 days. You see right here on this rejection that says 30 days max. However, since I cannot confirm or deny that my other tech called the insurance company for you, we will call again. Just hold on for a little bit.”
I called the insurance company. He cannot fill 90 days unless he uses their mail order pharmacy — big fucking surprise. I asked them if there was any way for me to fill 90 at the retail level, and to my surprise, there was. I would have to have the MD’s Office call and get a PA on each prescription (he has 5 total), and they will allow 3 mos.
How many offices will call at 5 different times over the course of 30 days for non-essential PAs for a patient? Luckily, this office has a nurse that will take care of this — she’s very good.
I asked this insurance company to fax me the PA form. He wouldn’t do it. Absolutely refused. The office would have to call, give their information, and have the PA Form faxed to them. Is there a portion for the pharmacy to fill out? Yes: Name, Addy, Phone, NCPDP, NPI, DEA, Rx#, and Signature Line. Why couldn’t he fax it to the pharmacy so I can fill out my portions and forward it to the MD Office? Absolutely not. Did he have a good reason? Absolutely not. He just “couldn’t do it” — or “didn’t want to do it.” Regardless of his reasoning (or lack thereof), I wasn’t getting that damn form faxed to me. Did I mention “Dut Dut Dut.” He called me MA’AM the entire conversation. I faked a very good cry at one point to try and get the form, but he didn’t know what to think. He just feigned empathy and told me he couldn’t understand me! HA!
Back to my original thesis of this post. The patient-turned-customer, holding a copy of the rejection plainly stating “30 days max” from the insurance company, and being told by a technician that a 90 day option wasn’t possible in a retail store, still challenged the facts we posed to him.
The only way he was right in the situation and we were wrong is that we are either OBSCENE IDIOTS or LYING TO HIM for some random, unknown, stupid ass reason. The thing is, we have nothing to gain by not filling 90 days — so that suggestion is asinine. Like I said, 90d in most cases is more profitable. I want to do what patients want if it’s in their best interests and allowed by governing bodies, insurance companies, and in-line with my professional judgment.
Patient’s need to understand that things in the world, and especially in pharmacy, are not black and white. Sometimes, there is a little gray — a little bit of gray area isn’t the end of the world. Open your eyes and see it!
Customers are like poodles. The world is black and white. There is no gray. If you even HINT that there is any gray area, what happens? Yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip, yip. Fucking Yip.
I think it’s bullshit that so many patients think I am lying. Especially on giving advice. I had a patient argue that Warfarin was for iron…I said well, sorta….Anything I said he was like no, I KNOW it’s for iron. Me being the stupid pharmacy intern I am, was trying to convince him otherwise. The pharmacist came over and just said yeah it’s for iron, bye. Patients can be really freaking stupid.
Also, I had a patient who said I was trying to get rid of them because I wouldn’t fill their Boniva even though the other techs/pharmacists did the past 3 months. When I told them it was their insurance the person said well that’s not the insurance’s fault…and would not listen to why I wouldn’t fill the Boniva except for cash.
Maybe hospital pharmacy looks promising!
Lol, pretty much a day in the life! I had that happen last week, a lady wanted to use one of those coupons for Singulair… the same coupon she’s used “every month” that says right on it, Valid for one fill per program. Even though I read this to her and told her it wouldn’t go through, she insisted it would screaming at me and saying I use it every single month so if it doesn’t you are doing something wrong. I went ahead and tried to bill the difference of her copay the same way we do for every other coupon, and it rejected saying that she had already had a fill during this program duration. Imagine that. I showed her the rejection, nope she still didn’t believe me. The thing is that lady isn’t even nice when she doesn’t have a problem… she consistently has a corn cob up her a$$! URGH!!!!
Oh, and I forgot to mention, she refused to pay the copay for her daughters meds (a minor) even though she has asthma and allergies really bad and NEEDS it!!! If she needs it why aren’t you able to pay your $25 copay for your daughters and just neglect only yourself and not take advantage of the drug company program!!! I’m sure she is one of the same people who then also complain about the cost of the new drugs… even though she is part of the cost!!!!!
Let’s see now. Usually, when I explain the “whipping boy” phenomenon in pharmacy, I refer to a cat o’nine tails. But we offer many more than just nine tails for these people to seize upon, when they satisfy every objection they have in their lives by pounding on US!
We have all these rules and policies we have to enforce, and it probably makes them come each time they recognize yet another opportunity to flog us. We almost invite it, like the “flagellants” did during the Black Death of the Middle Ages. Those were the people who thought that being whipped voluntarily would atone for their sins, and then they wouldn’t catch the plague.
Of COURSE they will not understand what you are telling them, or what a coupon says,or how a computer printout from the insurance company reads!!! They have having the time of their helpless lives beating on **YOU!** It is not at all a question whether or not they believe you. It just gives them a thrill in their loins to call you a liar , or an incompetent,no matter what the truth is.
Did you see James Claviziel (Jesus) get his flesh totally ripped apart by those gleeful Roman soliders with whips in “The Passion Of The Christ?” Same deal, different day.
Yeah….cept my dad isn’t me…or something like that…
I am, however, declaring myself the messiah of Pharmacy. [As in zealous leader of some cause or project; savior or liberator -- NOT a deity]
WE… as CARING EDUCATED PROFESSIONALS have allowed the corporations to do this to us and to our profession (the customer is ALWAYS right). As for me, I’m tearing off the REAR VIEW MIRROR and BLAZING forward into 21st Century Pharmacy where everything OLD is NEW again. If you build it, they will come…
I’m a Pharmacy Tech in the UK and we all follow your blog at work. Even though we are in different countries, the issues are the same. Keep blogging Mr Angry……..
aw! come on! now, how you gonna make me laugh so hard when you go to a boring hospital pharmacy job? you know you won’t have these stories to pass on from working there! —-I guess we will have to hope and pray that you will keep posting based on memories of your past experiences.
“I’ll take my business somewhere else”
I LOVE THOSE WORDS!!
All I ever say is OK. Problem solved! Have a nice day.
Or Mrs Angry…..keep on blogging….
I agree. why patients think we lie is beyond me. Especially when we tell them we can’t fill their Vicodin yet etc. I feel like telling them: “Listen, I make a living filling prescriptions. It’s how I put food on the table. Don’t you think i would fill this if I could?” of course, they won’t listen to what you say anyway so what does it matter?
One of the techs told the customer they *thought* the other tech called the insurance *yesterday* and was told it was a fallacy, when the customer only came in that day so they clearly did not call regarding the customer’s plan?
I’m kind of confused that they expected any outcome other than skepticism and having to call the insurance regarding his prescriptions.
So, yeah, that really does make it look like you’re idiots or lying to him. Especially since it turned out it was entirely possible to have a 90 day supply filled at retail- I don’t imagine it matters to the customer or the representative how exactly that is done, just the fact that it CAN be done.
Not to mention, half the representatives on the helpdesk are going to tell you to contact the doctor’s office – I can’t count the number of times I’ve been told a PA needs to be handled by the office, and I merely call back, talk to a different representative and somehow they use evil voodoo magic and I don’t have to do a damn thing but reprocess it.
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