Technicians | The *Angriest* Pharmacist

Two months worth of reader email

Posted on December 2, 2011

Sorry, I've been....deficient the last two months. I'm not going to promise any more, but I can tell you this. I will have a response for Mr. Plagakis pretty soon. Don't expect anything revolutionary. Don't expect anything mindblowing. Just expect a clear, concise response. Naught but the truth. I also want to look back at some older posts in which he referenced me about releasing steam (in a hilarious masturbation simile) and how/why the post titled, "Jay Pee catches Wal-Mart peeping through the window" relates directly to all of it...

Below, I'm going to post several different things that came to me via email or the CONTACT link. I'll lead with the user's name, and if you wish to reply to one, just reference that name....or don't...I don't care...

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Liz writes: In the past few weeks, our pharmacy has started checking ID for controlled drugs, scanning in new Rx and scanning in hard copies. All of a sudden, our workload has tripled, but our company is cutting tech help. Is anyone else finding this hard to manage?

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Rodney writes: I work as a reimbursement specialist at an LTC Pharmacy, and I'm writing to share an interesting exchange I've had with representatives at Prescription Solutions over the past few days.

I've had a few basic rejections which, were the representatives at Prescription Solutions even modestly intelligent by today's decidedly low standards, should have been able to resolve with much rapidity. Instead, I got stuck with slack-jawed yokels and embittered, defensive inner-city youth. They turned requests for overrides to simple rejections into drawn out, unintelligible arguments, and once they'd been cornered or otherwise became bored with the exchange, they hung up on me mid-sentence.

I may not be the bubbliest person in the world. On the contrary, I'm frank and to the point, but never did I become enraged, and never did I insult or otherwise disrespect the reps in any way. Prescription Solutions - hell, the insurance industry as a whole - has no shortage of stupid, rude, and disinterested people, but I've never had any with the gall to abruptly hang up on a service call. Now, over the past two days, it has happened to me four times.

Though I feel somewhat vindicated by the fact that return calls yielded exchanges with intelligent reps who applied the necessarily overrides with absolutely no hassle, I am perturbed by this sudden shoddy treatment. I know PS has seen extraordinarily long hold times as of late, what are the odds the reps have been granted free reign to terminate calls from "problem callers" (that is, of course, callers who question the rep's ill-informed initial judgment)?

Any thoughts? Similar experiences?

[TAestP's thoughts: I believe the reasoning behind this is, as always, money. When the question is, "Why?" most of the time, the answer is money. In this case, I'd bet if you timed your calls, you got hung up on at specific intervals....something like 3 minutes, 59 seconds. If the agents keep their calls (or a certain percentage) less than 4 minutes, they probably get higher ratings or a bonus at the end of the day. They may also have rewards/cut offs at 10 minutes or 15 minutes. Of course, the person could have just been an asshole, accidentally hung up, or hung up on you because they are lazy and/or didn't know the answer.]

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Lillian writes: I found your blog a few days ago and I love it so far. From your posts, you seem to know a lot about retail pharmacy so I was wondering if you could answer a question for me: Is it true that the field is getting very saturated, very quickly?

A few of my professors warn us that it will be much harder to find a job in retail by the time we graduate (2016). And I've been hearing a lot of people saying that retail is going downhill.

I know there will be more competition for the jobs in several years because of there are more students going into pharmacy now. And I get the feeling that maybe one of my professors is exaggerating the situation to encourage us to go into other pharmacy fields. But do you think this saturation is something to be seriously be worried about?

For the record, I would try to go into retail no matter what the situation is...I just don't want to be completely caught off guard after graduation.

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Kristin Writes:
Dear TAestP,
I know someone who filled a Rx at a CVS. The pharmacist later called and texted her saying "Remember me from CVS? Would love to get coffee with you some time?--Weirdasspharmacist [sic] " She responded that she wasn't interested. She didn't get any more fills there, but she was afraid of contacting his manager or pharmacy baord because CVS had her information on file and the pharmacist could look it up and perhaps do something scary like stalking.

TAestP, what would you recommend doing?

[TAestP's thoughts: If this is true, it is creepy as hell. You are right that CVS would have the info, and he would have access to it. But, he's already pretty much risked his license by doing this -- taking it from creepy to full on stalking would definitely result in a meeting with his state's Board of Pharmacy. If he is not the pharmacy manager at that location, I would call and speak with the pharmacy manager about the incident. Tell her it made you (or her) uncomfortable and that you would like the manager to give your information to their district manager so he/she can call you at their earliest convenience. Then discuss the matter with the DM. I'd be almost anything this would squash absolutely any issue -- cause that DM does NOT want you making a formal complaint with the board. If he is the manager at that store, call a nearby store's pharmacy manager and do the exact same thing. If this does not get you to an ends that you are happy with -- or you get blown off at any level -- google the state's board of pharmacy. One call to them with an accusation like this would definitely result in an investigation and something would be done. Tell your friend I'm sorry my text creeped her out -- she's not gonna like the photos I'm sending tonight....just kidding of course.....:-D]

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Mike writes: so...i witnessed a patient ingest 90mg of methadone...the patient's prescribed dose was 40mg...i gave him the wrong bottle

i'm getting kicked out of pharmacy school 4 months before graduation...what do i do now? should i submit my resume to the nearest McDonald's?

[TAestP's Thoughts: Either this is untrue and you're trying to waste my time, you're just a general dumb ass, or you have done a ton of other stupid bullshit. Regardless of what anyone may think, there is only one person responsible for what pill goes out the door and into the hands of a patient -- the pharmacist on duty. I don't care if the technician accidentally typed in Oxycodone instead of Omnicef for an infant, I still believe the ultimate responsibility should lay on the pharmacist that verified the prescription. (intentional bullshit and other types of lying and deceit aside -- I'm talking about true accidents by ancillary staff not caught by the pharmacist) However, it does sound like you are in some other kind of facility or setting. Since you witnessed the patient do it -- not sure what that means as a patient should never be handed a pill by pharmacy staff to take -- that changes the role from dispensing to administering which we cannot do (in terms of pills).

If the school threw you out, and this is a true story, you're probably fucked. Sorry dude. I guess you could appeal and plead to the school, but that's the thing with private universities, they can do whatever the hell they want whenever the hell they want. Other than that, see if another school will take you or get a lawyer....or get a job and good luck paying back all those loans....]

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That'll do for now....check back for the next post coming soon....

Helping a young pharmacist establish authority when faced with strong technician personalities

Posted on September 9, 2011

Note: Please visit this lady's website. The Wicked Chemist! She "affectionately" called me a troll, but she likes my posts!

This is a submitted question/dilemma from a young pharmacist known as "M" -- s/he is requesting that the community help her with some professional advice and recommendations from our little blogosphere community.

-=+=-

As a new pharmacist, I have a dilemna concerning my role/authority in the pharmacy. Since I'm new to the store, I have a lot to learn from the senior techs as far as managing the pharmacy is concerned. In essence, they are actually training me to run the pharmacy. For this reason, I sometimes feel like they take advantage of that, and they do whatever they want. They often come in late and call off last minute. One technician doesn't like to 'fill' so I end up filling most of the scripts, verifying, and then ringing it out as well. She claims she has other stuff to do, which she sometimes does. I can't complain much because she will do certain tasks and help free my ear from the telephone. However, I'm just not comfortable with her not listening when I ask for her to help in filling. I'm trying hard to learn much so I don't find myself solely dependent on them (technicians). So far, I've been nothing but nice to them, and they've yet to call in on my shift. But I know that day will eventually come... Regardless, this has got to stop. We must be able to depend on them as our patients depend on us.

Please help me by providing me some ideas on how I can approach the situation with both my pharmacy manager, other staff pharmacists, and most importantly, address my concerns gingerly with the technicians without alienating them and subsequently finding myself on the wrong end of a string of sick days! I've also got to consider various friendships (or grudges) between techs and pharmacists, or even techs and techs.

Any advice would be most appreciated! Thanks!

-=+=-

Do you want to submit a guest post or discussion topic [since I don't post nearly enough]? Type it up and email it to me via the contact page. Also, let me know if you want your name/email address shared publicly, what POLL question you would like to accompany it (if any), and anything else you think is important. Guest Posts will be edited for grammar and spelling. I may also add emphasis, clarification, funny links, or other silly stuff [I might remove inappropriate stuff as well]. I will NOT alter the content/message of your post.

Filed under: Courtesy, GUEST CONTRIBUTOR, Just a question, Management, PHARMACY SECRETS!, Politics, Prescriptions, Technicians, Work Sucks 6 Comments

Your refill? Yeah, it’s too soon

Posted on September 6, 2011

This is a guest post from a technician known for now as J.S. -- s/he will be responding to all comments as necessary. Should you want to send a private email, please use the CONTACT Page and I will forward it on to him/her.

-=+=-

"REFILL TOO SOON," GUYS. That means, in pharmacy lingo, your insurance will not pay for your prescription until the resubmit date. One late night at the pharmacy, which by the way is in the ghetto, a woman comes in to refill her son’s prescription. As I processed the prescription I explained to her that it is a REFILL TOO SOON and the insurance wouldn’t pay for the refill until tomorrow morning. She obviously wouldn’t accept that answer and went into a rant against me (a technician), the pharmacist working with me, and our drug store. As I recall it went something like this:

“My baby needs his medication! He is sick! He needs it NOW!!!!! You stupid white bitch you had better fill my prescription or im going to kick your ass! Her's too. That other bitch pharmacist! What you think yous better than me? I want it now! Ima get me suma that shit now and my momma gon' pay for it! Make it now! Get it ready, Bitch!”

I looked at her, looked at the pharmacist, and explained to the woman that if she would WAIT ONE MORE DAY [less than 18 hours, actually], the prescription wouldn’t have copay because this woman was on state assisted insurance.

I told her that the medication would be $45 and if she wanted it, she could pay for it, but that amount wouldn’t be refunded the next day. Her response, although not responsive to the information, went something like this:

“What you think I’m broke, bitch? I can’t pay for my babay's medicine? Fuck you ima just buy it ima just buy it you can’t tell me what to do, this my babay, THIS MY BABY AND HE NEEDS HIS MEDICINE NOW GET IT READY DUMB BITCH.”

You're not broke? Oh, okay. Then I guess you’re just one of those lazy folks who doesn’t work and just expects the government to pay for your prescriptions. I can safely assume you are probably on food stamps too? Welfare? You're yelling at me, and I am partially paying for your prescription by paying taxes? I have no choice but to have my tax dollars used to pay for “your babay's medicine,” and I have no choice but to abide by your every wish and want because 'the customer is always right,' right? So, I swallowed my insults, and I bottled my anger, and filled the prescription.

By this time, her mom (the "babay's" grandma) came to the counter and apologized profusely with the accurate explanation that woman was mentally retarded. MENTALLY RETARDED. And she has children? What the fuck. You can draw your own conclusions on that one. And by the way, after all that, she didn’t, or better yet, her mom didn’t buy the medication because she, having some sense about her, WANTED TO WAIT UNTIL THE NEXT DAY. By the way, the drug was for SEASONAL ALLERGIES. Not seizures, not juvenile diabetes, not horrible psoriasis, not dangerous asthma, not epi or glucagon. SEASONAL ALLERGIES. Couldn't wait 18 hours, and *I'm* the dumb bitch.

-=+=-

Do you want to submit a guest post [since I don't post nearly enough]? Type it up and email it to me via the same contact page. Also, let me know if you want your name/email address shared publicly, what POLL question you would like to accompany it (if any), and anything else you think is important. Guest Posts will be edited for grammar and spelling. I may also add emphasis, clarification, funny links, or other silly stuff [I might remove inappropriate stuff as well]. I will NOT alter the content/message of your post.

Filed under: Courtesy, Disgusting, Drug Seekers, Engrish, Government, GUEST CONTRIBUTOR, Lazy People, Me hating others, Money, Prescriptions, Rude, Stupid People, Technicians, True Story, Welfare, Work Sucks 7 Comments

How to get a Prior Authorization — RN-style

Posted on March 15, 2011

This is a message for all you nurses out there. This post is now the PREMIER AUTHORITY on how to get prior authorizations -- in STEP BY STEP FASHION. It's an overly simple 4 and 1/2 step process. As a wonderful "side effect" of this process, you will waste at least one week of a pharmacist's time and, an added bonus, really piss them off as well. It's a win-win for every RN!

4) REPLY TO ALL FAXES REQUESTING YOU GET A PRIOR AUTHORIZATION BY SIGNING IT AND AUTHORIZING "1+2" REFILLS. This is a GREAT way to both waste a pharmacist's time and really frustrate them. In most instances, they've told the patient 48-72 hours. By replying to the fax with refills, you show that you really want the patient to get the medicine, but it shows the pharmacy that you've got better things to do than read their stupid faxes. To really put a cherry on top of this one, schedule the fax to send at 4:55pm. This will ensure that even if the fax even goes through successfully in the first place, the pharmacy can't contact you again until the next day because the phones cut off at 5pm on the dot (and you cut out at 4:30pm in the first place)!

3) When they call you the next morning, make sure they have to leave you a voicemail. If you're feeling particularly randy, respond to that with a copy of the fax from the day before and a SNARKY NOTE at the bottom of the fax. Some suggestions for the note are:
"Authorized (1+2) yesterday. Is your fax machine working?"
"I got your VM -- here's the auth you need. Thought I faxed this yesterday. WEIRD!!
You could also just skip the reply all together...

2) When they finally get a hold of you at the end of the second or the third day, tell them your office's standard is at least 3-5 business days on a PA Request. Tell them you'll get back with them at the beginning of next week. After you say this, don't do anything. Don't even ATTEMPT to get the prior authorization. Why you ask? Duh -- the pharmacist will probably call and remind you again on Tuesday or Wednesday when you actually need to do it anyway. Out of sight out of mind! [If you wanna be a real bitch, at this point you need to send another refill authorization in to pharmacy. No note this time -- you don't want to appear "catty."]

1) After they call you Wednesday, if it's a different pharmacist than the one you talked to the previous week you need to go off on him. Make a huge scene. Act as if everything that was sent in and you cannot figure out why the pharmacy refuses to fill the prescription. When they explain the PA Process to you, acknowledge it, say you'll get right on top of it, and completely ignore every word of it. At this point you need to go straight to your doctor and tell them the following, "Doc, I don't know what the heck is wrong with Walgreens. They are pretty much refusing to fill Mr. Johnson's _________. I've dealt with several different members of their staff. I've faxed in the prescription at least two different times, called it in once, and I can't seem to get them to fill it!" Then, the doctor will call and ABSOLUTELY TEAR THAT STUPID PHARMACIST A NEW ONE! Sit back and laugh. You've done a good job. You've waste almost a week of the pharmacist's time, and you've not had to do much work or call for the PA.

Final Step) Now, when the doctor returns to you, he'll explain to you that they just need you to get a PA. They'll be so scared of the doctor, they won't say anything about your prior shenanigans. Your response should be, "Well, why didn't they just SAY THAT!?! STUPID PHARMACISTS!" He will agree and, at this point, you need to call the pharmacy again and have them fax you the information on how to get the Prior Authorization. They will probably say something about how they sent you the information -- just tell them you never got anything. Now, buckle down and actually get the PA...dag nabbit!!

And that is how you get a PA!

Filed under: Courtesy, Doctors, Education, Insurance Companies, Lazy People, Me being a dick, PHARMACY SECRETS!, Prescriptions, Stupid Doctors, Stupid Nurses, Technicians, Work Sucks 12 Comments

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