Just Questions
Every day I ask myself questions. Most are rhetorical...but they are pertinent questions. I will share these with you now. Feel free to comment with some of your own. OR Check Out Pharmacy Chick's version of this same exact thing from February 2008.
Why do old, toothless people always appear to be chewing on something?
Why is it than if someone is walking to my pharmacy, I can predict with 99% accuracy that they want to buy 12-hour Pseudoephedrine?
Why is it that someone that wants a script filled 10 minutes before closing will have had that prescription for no less than 7 days?
Why does the person wanting a rare, expensive C-II drug come to my pharmacy each month wanting it only to find out that I still don't have it and won't order it for them unless they fill it with me once and wait for the order to come in?
Why does someone on Medicaid give me their card only to ask me to "just fill it for cash" -- knowing full well that I'm going to bill it to Medicaid FIRST?
Why is it that people think they need Watson brand Hydrocodone/APAP? Nevermind - I know the answer to this one...more street value cause it can be identified by pill-heads.
Why does every person that I would idenfity as a drug seeker use "I have fibromyalgia" as the excuse for their early refill or other behavior?
Why does every complaint go to a non-pharmacist store manager rather than to me?
Why does every doctor's voicemail message have the same bullshit message that I can't skip over (they can press ZERO to get to me!)? "Leave the patient's name, date of birth, drug name with spelling, strength, quantity, last fill and pharmacy call back number."
Why do people have to ask for the pharmacist to give a refill number?
Why will people have pizza delivered to their home in an hour and be happy with that wait time but want their prescription in 15 minutes or less?
Why do people want name brand drugs then be completely happy with store brand soda, chips, water, clothes, and everything else?
Why would someone present a prescription for a child then refuse it when the copayment is anything more than free?
Why would someone call me a 'stupid fucking cocksucker' during one trip to the pharmacy then yell at me during their next trip when I use the word 'shit' in front of their child?
Why do I have to concern myself with HIPAA when any patient would be willing to yell, "Yeah my name is Fred Jones...3-14-51. Doctor Smith called in my Viagra refill this morning"?
"Sir, are you taking any other medications?" No.
"No OTC meds?" No.
"No Vitamins?" No.
"Any herbals?" Nope.
"No other medicines at all?" Well, I've been taking this Saint John's Wort for depression.
Why is the answer always, 'NO' to "Do you have any questions for the pharmacist" only to have the patient call the pharmacy back in 10 minutes later?
There are 24 hours in the day. Why does everyone have to spend their 30 minutes in the pharmacy on the cell phone?
Why does every patient with a new insurance card present that card at the cash register rather than the pharmacy drop off window when the read the sign that says "Please present your insurance card when you drop off your prescription"?
Why is it that 1 out of every 100 patients feel the need to poor their pills out on the counter and count them right there in front of all of us?
Why do Americans have the words, "I want to talk to your supervisor" into their brains for use at the first sign of a problem, dissent, friction, or trouble?
Why is there a direct correlation between the number of items in a person's shopping cart and the likelihood they will want them rung up in the pharmacy?
Why is there a direct correlation between the number of scripts filled in my pharmacy and the amount of alcohol I ingest every evening? Nevermind -- I know the answer to this one too...
Why is there a direct correlation between a patient's lack of teeth and oral hygiene and the likelihood they will present a medicaid card?
Why do I have to be the person to explain to some people that BEER cannot be paid for with Food Stamps?
I have a feeling this post has instant classic written all over it...
What to say about today?
Today was what I like to call, "Phuck Pharmacist Phriday," where everybody has problems that cannot be feasibly corrected on Friday. Refills, PAs, assorted Insurance problems. Essentially, we have a four day week where we can handle problems. Calling on a refill on Friday is a shot in the dark, sometimes we get it, most of the time it'll be Monday.
I got a call from a doc's office saying that they got a call from a patient about a PA. We had told the patient we called several times but the doctor's office said they received no notification about it. I assumed we were faxing to the wrong number. I flip to the applicable letter in our little "call doctor box" where we file the slips after the MD has been notified (and the date and time has been recorded) and low-and-behold, it's in there! Yet, no notification had been made. Why the fuck was it filed then? Slips that have not been called on go in the front of the box -- in front of all the letters -- or under the box itself. I was perplexed. I asked my tech what was up. He tells me, "Well I put them in there by the letter like your supposed to..." WRONG! He's worked for me for 3+ years. He's pulled this shit before, and I've bitched him out for it. I lost it this time. "Look. We call on everything once unless it's been a long time or the patient is at the register and is telling us to call again right now. I don't go through the entire box each time. There's tons of slips in there. I know you may go through the entire box each morning, which I've told you not to do, but from now on, you do it my way. If you don't call, it goes in the front. Once you call, put it under the letter. Now, because of you, this lady has to go without this medicine another weekend, and we look like incompetent dicks. Don't do this again. Now, go through this entire box and make sure that everything has been called on. If it's been in there longer than a week, call again. If it's been in there longer than two, throw it away." I was fucking pissed.
Later on in the day, a lady calls me and inquires about her refill request. She knew we had to call the doctor because when she called and requested it, I told her most doctors don't authorize refills on antibiotics, they'd want her to come in and be seen again. I told the lady that her refill request had been denied because the doctor was on medical leave and all his patients had to come see his replacement to authorize refills. [This denial was made a mere hour prior to her call] "When were you all going to call me and tell me this?"
"Well, ma'am, we usually don't call and tell people about denied refills."
"And why not? I guess I was just going to make a worthless trip up there? Would you pay for my gas?"
"Well, most people call and inquire about them prior to driving here...much like you're doing right now. So whether it'd denied or the call hasn't been returned, people call and check before coming. If it's approved and the person calls or makes a trip, it doesn't really matter now does it? If we haven't heard back, it's never an issue to give people a few tablets of a maintenance medicine they are on long-term to hold them over."
"That makes no sense."
"Do you want me to explain it to you again? Or, do you not understand why I don't call every person that requests a refill, which is a ton each day, whether their request was approved or denied?"
"I wonder what the board of pharmacy thinks about this?"
"Well considering we only call on refills as a service and it's not a requirement of any pharmacist or pharmacy, I'd bet they don't really care."
"How do I move my prescriptions to another pharmacy?"
"Since this one was denied, you don't have any prescriptions to move."
*click*
This lady was a pain in the ass every time she came in. Losing her one prescription a month means nothing to me...bitch...Ideally, I *do* call and tell people their Rx's were denied and see if perhaps I should've called a different/new doc, but I saw her name, knew she was a bitch, and avoided calling her. That's how we got here...:\
EARTH TO CONSUMERS
When the first words our of your mouth are, "I DON'T WANT THIS PRESCRIPTION RAN ON MY INSURANCE," prior to tossing me a prescription for a controlled or abused drug, chances are I'm not filling it...and if I do, I'm running it on your insurance first just for shits and giggles. Get a fucking clue...
It's like handing a policeman your license when he pulls you over and telling him, "Don't run this license number, it's suspended. Just write down my name and address." Give me a fucking break...
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Movie review and a stupid bitch
I went and saw the movie Juno recently. I absolutely loved it. The one liners, cutdowns, and internal commentary of Ellen Page as the title character, Juno, is flawless. She created the character and played her as if it were second nature. I recommend that everyone go and check this movie out as soon as possible. I must say, though, that Michael Cera as Bleeker was likely the most awkward and uncomfortable character I've ever seen. His character in Superbad was equally awkward. Granted, that's what the director wanted for these characters, but while he was on screen, the awkwardness he portrayed made me fidget in my seat.
-=+=-
On the pharmacy front, I recently had an uncomfortable and irrational encounter. This tank of a woman came in and requested a transfer of her Paxil CR from a nearby Walgreens to my pharmacy. I thought nothing of it, and we got it filled up with no problems. However, the insurance card she presented and we put in was not accepted by my pharmacy. When the lady came in to pick it up, she was told 100 bucks or whatever that mess of a SSRI costs. She, of course, was livid.
I told her that we didn't accept the plan. She told me I was a misinformed liar (which is rather contradictory, right?). "I talked to my employer and they gave me a list and your pharmacy was listed as a provider."
"Do you have a copy of that with you? It could have been a typo. We've never accepted this plan. Walgreens paid a lot of money to be the only pharmacy that accepts this plan in this area. And, as far as I've been told, that's how it still is -- and has been for the last five years."
"I don't have a copy of the letter with me. But, I know you're on it, and you're going to take it." [Condescendingly]
"Well ma'am, now you are misinformed. These computer communicate in real time with the computers ran by you insurance provider. They say we don't take it, and therefore, won't pay for it. The only way you can leave here with this medicine today is by paying cash. If they are in the process of adding us, and that takes place in the next week to ten days, we can reimburse you." [Of course, I said this like a huge dick]
"This is ridiculous. You're an idiot. I want to talk with the store manager." [yelled -- of course]
"I'm sorry to say, but the store manager has no control over the pharmacy. He can't help you. However, I want to help you, but the fact of the matter is, I can't help you." [I said this really nicely, because I know that I can't help her regardless of how badly I wanted to]
"Fine, I'll just call your corporate headquarters. I'm sure they'll be interested in knowing that you are refusing to fill my prescription."
"I'm not refusing you service. I've got your prescription filled....here it is right here. What I'm telling you is that we are not contract with your insurance. We cannot just give this $100 prescription away. I'm sure if you called my coorporate headquarters and told them the entire story, and not just the part about you leaving here without a prescription, they'd apologize for not being contracted -- but they'd go on to tell you that we have no control over that here. Walgreens has cornered the market, and there's nothing you , I, my boss, or my bosses' boss can do about it."
"You need to find a new job -- you're not very good at this one." [This is the second time some fuckhead has told me this in a week because they didn't get their way when a situation came up that was completely out my control -- fuck this fat bitch!]
"You're wrong. I'm good at this. You're just not good at listening or understanding that certain things are out of the realm of control of workers. Do you yell and make a scene towards the cashier at McDonalds when the McRib is taken off the menu? I mean, he could call up the CEO and say he wants it back on the menu...but, that's kind of futile isn't it? Anyway - what do you want me to do here to help you, keeping in mind that there is no humanly possible way for me to bill this to your insurance provider?"
"Just transfer it back to Walgreens - I know I'm never coming back here again!"
"Sounds good to me! Happy New Year."
As she left, I acted like I was calling Walgreens immediately. Right when she got around the corner, I hung up. She can wait for an hour or two at the WAG. That's her punishment for being an irrational bitch from hell. [PS - I'm aware that this was unethical, unecessary, and crossed even my line...but I'm a dick...I get mad AND I get even...]
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I have never been treated so horribly in my life
An Indian guy came up to the drop-off tonite. He wanted a refill for his wife. It was for amlodipine. The bottle 6 tablets left in it. It had zero refills left. I, very nicely, told the man that it had no refills, but I printed a note to call the doctor the following morning. He asked me why I couldn't call immediately. I told him it was 7pm, and the office was closed. He looked very discouraged and would have to call her. He grabbed his cell phone and I immediately knew where this was going. He spoke in an Indian dialect to her for a few minutes (I heard my name uttered as well). Then he tried to hand me his nasty, grubby ass phone. Side note: I refuse to talk on people's cell phones. I hate them. They are nasty, covered with ear wax, and who knows where they have been. I quickly handed him a business card and told him she would have to call me.
She called 7 seconds later and began immediately dressing me down. I got a word or two in and told her it had no refills. I explained that her bottle had 6 tabs left. I told her if it were empty I would have no problem giving her as many tablets as she needed. I explained how we have to call doctors every day for refills and there would be no problems filling the prescription tomorrow.
Then the berating began. I heard a swear-filled mix of Hindi, English, Sailor, Bihari, Tamil, and Irish. I didn't comprehend much of it because it was so fucking fast. I could make out the following phrases in this general order:
"I have a lifetime prescription"
"Dut dut dut"
"This is blood pressure medicine"
"Dut dut dut"
"I could die"
"Dut dut dut"
"I will sue you"
"Dut dut dut"
"You are not a pharmacist"
"Dut dut dut"
"I want to talk to the store manager"
"Dut dut dut"
"They fill this all the time without refills"
"Dut dut dut"
"Just put the pills in the bottle and shut up"
I'm sure there was more mixed in there. I don't remember it. Much like Unwritten Law, I was "Seein' Red" -- I told her (while she was still screaming in the phone at the top of her lungs) that I didn't deserve to be talked to like this and that I was hanging up. After a while, I did just hang up. She was no longer giving me a chance to speak. We were getting nowhere.
I went down to her husband. I told him that his wife was screaming at me at the the top of her lungs and was very rude. I told him I did not deserve to get spoken to like that. His reply? He acted like he was not shocked. "I figured she was going to do that."
I, once again, explained the situation to him. No refills. Six tabs remaining. Filled within 18 hours. Would front tablets if needed. He just got back on the phone with her, began speaking another language, and walked off. I wanted to tell him he needed to go home and give her a good beating. People that treat others like that need a good slappin'.
She called back again. My tech got the call this time and pretty much said the exact same fucking thing. Then got off the phone.
Next time this bitch brings in a prescription to me...I am not filling it. Conincedently, I see some ordering troubles with amlodipine. I'm pawning this bullshit off on Walgreens.
Update 12-11-07: I never wrote this up, but the next time this bitch came in, I asked her why she yelled at me. [She was handing me her bottle to refill] She halfway apologized and said she was having a bad day...dut dut dut. I told her that because of her, I had a horrible day because I didn't deserve that or enjoy having such words screamed in my ear. She then began to try and convince me I was wrong because I should have filled it - she tried to get loud. Then I said, "Hold on just one second. I'm going to talk now, and all I want you to do is listen. Don't speak. Don't yell. Don't interrupt. Just listen to me. Your prescription was out of refills. Regardless of how long you have been on or will be on a medicine, when your bottle has zero refills, we have to call your doctor for more. Your bottle had 6 tablets in it that would have lasted you SIX days. It was Sunday night at 7pm so your doctor's office was closed. I called for you the next morning and got the call back from their office that afternoon, less than 24 hours later. You never expressed a need for those tablets prior to that, and you had no reason to believe that I wouldn't fill the prescription. You just began screaming because you refused to listen to me. That is a horrible way to act and you should never ever do that again to anyone especially someone you entrust your health care with. Now, do you have anything to say?" [Hence, say you're sorry cuntbag]
"Yes...dut dut dut...I have lifetime prescription...dut dut dut...you should have just filled it...dut dut dut..." [At this point I put up both hands as if to stop her.] "Whoa. No. No more. Here's your bottle back. I'm no longer filling prescriptions for you at this store. You can take this bottle to any pharmacy in the country, of this chain or not, and they will fill it for you, but you are no longer welcome to get your prescriptions filled here. Goodbye." And just like that, I walked away. I could have handled it differently. Of course, she could have just as easily apologized. I love that I have the power and free reign to tell that bitch to go fly a kite...it's empowering and a good backup. It allows me to effectively manage. But, know this, I don't just run people off because I can. She's the 4th person I've told to never come in the last 4 or 5 years (and one of those people tried to steal a bottle of Beer by cramming it up her va-jay-jay) -- The others were doctor shoppers, users, and/or abusers.
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