You forgot your 6 meds at the cottage, and you had just refilled them before you left, so you need us to bill to your drug plan 55 days earlier than when they would've run out. That's ok.
How can you forget your meds? If they are really that important, and something that you use everyday, like your toothbrush (maybe more important!), how is that so hard to remember?? Especially if there is 6 or 8 meds!! That would take up half a table or part of a dresser! You would have to see it! There must be something about cottages.
With all this extra money that these plans are shelling out for lost meds, it's a wonder they don't sponsor signs on the way back from "cottage country" saying:
DIDJA REMEMBER YOUR MEDS????
A friendly reminder from your Third Pary Payer.
Friday, August 1, 2008
A Note on Drug Allergies
How is it that a person can tell you they are allergic to a medication, and then pressure you to give them that exact (or closely related) medication when they come with a prescription?
The classic example is codeine. They state that they are allergic. A hospital Dr. writes a prescription for Dilaudid, and they are begging you to fill it. Of course they are in pain, of course they need something ASAP. Most of the time this is fine, they are not "truly" allergic to Codeine anyways (aka GI upset, nausea, stomach pain, vomiting), and they most likely have already been given Dilaudid in the hospital anyways, so we can go ahead and fill it.
But say they had a reaction to codeine such as hives, or swelling around the face: they don't want you to take the time to call the doctor, they know it will take awhile to hear back, so they just want you to give it to them.
It's amazing the types of rationale these people follow. Pain is terrible and it can lead you to make rash decisions, but if it could potentially KILL you?? That's something to pay attention to! The best story was one lady told me: "Yes, I swell up every time I take codeine, but then I bought some Dilaudid on the street and I wasn't allergic to that."
OK, first of all, how can I know FOR SURE that it was Dilaudid that you got on the streets? And second of all, if you can buy it on the streets, what will stop you from SELLING it on the streets? (Maybe she was just looking to sell it all anyways)
Luckily what most people report as an allergy is usually just a bad stomach episode (side effect), so things usually work out just fine. The worst is when the person doesn't actually remember what happened to them!
"Ummmmm it was about 45 years ago, and I don't know what happened"
Okay, so I want to err on the side of caution obviously, but it does involve calling their doctor and ME sounding stupid. "The patient reports an allergy to this med, but they don't know the reaction. What should we do? " This is where i really feel sorry for MD's! I don't know what I would do in their shoes. Especially if it's a pen allergy. If you are going to err on the side of caution, you would be eliminating LOTS of different meds from your arsenal. Most of the time I just see the doctor say "go ahead' and we fill the rx, and they don't react to it.
The classic example is codeine. They state that they are allergic. A hospital Dr. writes a prescription for Dilaudid, and they are begging you to fill it. Of course they are in pain, of course they need something ASAP. Most of the time this is fine, they are not "truly" allergic to Codeine anyways (aka GI upset, nausea, stomach pain, vomiting), and they most likely have already been given Dilaudid in the hospital anyways, so we can go ahead and fill it.
But say they had a reaction to codeine such as hives, or swelling around the face: they don't want you to take the time to call the doctor, they know it will take awhile to hear back, so they just want you to give it to them.
It's amazing the types of rationale these people follow. Pain is terrible and it can lead you to make rash decisions, but if it could potentially KILL you?? That's something to pay attention to! The best story was one lady told me: "Yes, I swell up every time I take codeine, but then I bought some Dilaudid on the street and I wasn't allergic to that."
OK, first of all, how can I know FOR SURE that it was Dilaudid that you got on the streets? And second of all, if you can buy it on the streets, what will stop you from SELLING it on the streets? (Maybe she was just looking to sell it all anyways)
Luckily what most people report as an allergy is usually just a bad stomach episode (side effect), so things usually work out just fine. The worst is when the person doesn't actually remember what happened to them!
"Ummmmm it was about 45 years ago, and I don't know what happened"
Okay, so I want to err on the side of caution obviously, but it does involve calling their doctor and ME sounding stupid. "The patient reports an allergy to this med, but they don't know the reaction. What should we do? " This is where i really feel sorry for MD's! I don't know what I would do in their shoes. Especially if it's a pen allergy. If you are going to err on the side of caution, you would be eliminating LOTS of different meds from your arsenal. Most of the time I just see the doctor say "go ahead' and we fill the rx, and they don't react to it.
Wednesday, May 14, 2008
You Wouldn't Rush Your Surgeon.. So Dont' Rush Your Pharmacist!
This is for all those people that are in a hell-bent hurry to get their prescriptions the second they drop them off.
I am polite enough to ask, "And when would you like to pick this up?" and you say, "Umm, Now!" as if it was a stupid question. I should know better to think you would give me more than an hour's notice to get your stuff done.
Sometimes this just proceeds as planned, and we rush your prescription through, and I try not to be affected by the fact that you are staring a hole into my forehead as I am checking your 5 refills. I try not to snap when you are jingling your keys on my counter, or even when you roll your eyes as I start to talk to someone about at OTC question. You think I am inconveniencing you on purpose, or that I am just a slow person. And then when it's all done and I see you unpacking your huge shopping cart of toilet paper and maxi-pads, catfood tins and giant milk bags, I wish I could pull you behind the counter and show you the 50 prescriptions waiting to be checked that you just budded ahead of, or the doctor I have to call about a pen allergy, or the elderly lady that has been on hold for me for 5 min, but no, you need your TP now, your Maxipads now, and hell, I better not forget to scan your points card or you will complain to management. Hey, the Catfood is only 53 cents each. But it says so on the sign. I have to call a merchandizer to check because I decided to draw the line at not perusing the cat food section to find out you read the wrong price. Oh, and thank you for taking 10 minutes to count me all your coins so I can help you get rid of your change. You sure don't seem to be in a hurry now, do you?
This is a good-case scenario. It can get a lot worse. Like when your ailing child is in the car waiting for you to fill this Rx. The kid just got out of the ER, and you can't drive him home to rest, but you want to get his liquid antibiotics and inhalers filled in a millisecond on your way home. He can wait in the car, it won't be long. Yeah, don't rush me on anyone's Rx, especially your childs! Pharmacists make more mistakes when pressured. Just let us do our job, take your kid home, or go to another pharmacy, but the time it takes for me to explain why we need more than 30 seconds to do his prescription is taking away from the time we could be using to fill the prescription!
Or when you are in a hurry AND have no refills. And you ran out of everything yesterday. And it's my fault if you miss a dose because I don't advance you one of everything, because the doctor told you to take it every day, and it's your docs fault that you ran out in between appts. AND you are leaving the country tomorrow morning at 5am for 6 months. Yes, this can be a lot worse.
To the general public: We do not write prescriptions. That's what doctors are for. We are not genies, puppets, or magicians. If we had any magical talents we would not be pharmacists. And don't blame doctors or us when you run out. Running out is okay, it's normal, and you don't have to freak out. You can see how many refills you have on your bottle, then when you are low, see you Dr, or get all your meds renewed at each visit. Just like any numerical sequence, they go down by one each time. It's not that hard.
But don't you start to notice your pills are slowly decreasing in number, 5,4,3,2, ooh, only 1 left, better do something. How is it such a big surprise that you ran clean out of pills! Don't you notice the trend.. every day you have one less pill, and eventually they will run out! So plan a week ahead.. even 2 days ahead, just pick up on the trend of decreasing pills and do something about it. In some places we can fill an emergency supply for a week of certain chronic meds, and that's ok, but you do have to pay the fee, because we are doing the same amount of work for 7 pills as we are for 100 pills, even more work because we are probably calling your doctor and listening to you complain.
There is a general rule in my store that one Rx will take 10 min, and 15 minutes for 2. That's just a guideline. Of course it takes us only a few minutes to do it, but there are the following other "Time Sinks" that must be accounted for during the time the pharmacy is open:
1. Phone Calls from Doctors
2. other phone calls
3. Counselling on new Rx's
4. Billing problems
5. Calling insurance providers
6. Faxing for refills
7. Calling for refills
8. All the prescriptions ahead of yours
9. Ringing in prescription pickups
10. Other prescriptions being dropped off
11. ordering stock
12. unpacking stock
13. preparing balances of owed meds
14. OTC consults
15. Screening for problems with your rx (interactions, dose, etc)
So we are not just standing there with an empty counter in front of us twiddling our thumbs. Behind that wall is a gigantic lineup of all the things that are waiting to be done, even if you can't see it, believe me, IT IS THERE!
I am polite enough to ask, "And when would you like to pick this up?" and you say, "Umm, Now!" as if it was a stupid question. I should know better to think you would give me more than an hour's notice to get your stuff done.
Sometimes this just proceeds as planned, and we rush your prescription through, and I try not to be affected by the fact that you are staring a hole into my forehead as I am checking your 5 refills. I try not to snap when you are jingling your keys on my counter, or even when you roll your eyes as I start to talk to someone about at OTC question. You think I am inconveniencing you on purpose, or that I am just a slow person. And then when it's all done and I see you unpacking your huge shopping cart of toilet paper and maxi-pads, catfood tins and giant milk bags, I wish I could pull you behind the counter and show you the 50 prescriptions waiting to be checked that you just budded ahead of, or the doctor I have to call about a pen allergy, or the elderly lady that has been on hold for me for 5 min, but no, you need your TP now, your Maxipads now, and hell, I better not forget to scan your points card or you will complain to management. Hey, the Catfood is only 53 cents each. But it says so on the sign. I have to call a merchandizer to check because I decided to draw the line at not perusing the cat food section to find out you read the wrong price. Oh, and thank you for taking 10 minutes to count me all your coins so I can help you get rid of your change. You sure don't seem to be in a hurry now, do you?
This is a good-case scenario. It can get a lot worse. Like when your ailing child is in the car waiting for you to fill this Rx. The kid just got out of the ER, and you can't drive him home to rest, but you want to get his liquid antibiotics and inhalers filled in a millisecond on your way home. He can wait in the car, it won't be long. Yeah, don't rush me on anyone's Rx, especially your childs! Pharmacists make more mistakes when pressured. Just let us do our job, take your kid home, or go to another pharmacy, but the time it takes for me to explain why we need more than 30 seconds to do his prescription is taking away from the time we could be using to fill the prescription!
Or when you are in a hurry AND have no refills. And you ran out of everything yesterday. And it's my fault if you miss a dose because I don't advance you one of everything, because the doctor told you to take it every day, and it's your docs fault that you ran out in between appts. AND you are leaving the country tomorrow morning at 5am for 6 months. Yes, this can be a lot worse.
To the general public: We do not write prescriptions. That's what doctors are for. We are not genies, puppets, or magicians. If we had any magical talents we would not be pharmacists. And don't blame doctors or us when you run out. Running out is okay, it's normal, and you don't have to freak out. You can see how many refills you have on your bottle, then when you are low, see you Dr, or get all your meds renewed at each visit. Just like any numerical sequence, they go down by one each time. It's not that hard.
But don't you start to notice your pills are slowly decreasing in number, 5,4,3,2, ooh, only 1 left, better do something. How is it such a big surprise that you ran clean out of pills! Don't you notice the trend.. every day you have one less pill, and eventually they will run out! So plan a week ahead.. even 2 days ahead, just pick up on the trend of decreasing pills and do something about it. In some places we can fill an emergency supply for a week of certain chronic meds, and that's ok, but you do have to pay the fee, because we are doing the same amount of work for 7 pills as we are for 100 pills, even more work because we are probably calling your doctor and listening to you complain.
There is a general rule in my store that one Rx will take 10 min, and 15 minutes for 2. That's just a guideline. Of course it takes us only a few minutes to do it, but there are the following other "Time Sinks" that must be accounted for during the time the pharmacy is open:
1. Phone Calls from Doctors
2. other phone calls
3. Counselling on new Rx's
4. Billing problems
5. Calling insurance providers
6. Faxing for refills
7. Calling for refills
8. All the prescriptions ahead of yours
9. Ringing in prescription pickups
10. Other prescriptions being dropped off
11. ordering stock
12. unpacking stock
13. preparing balances of owed meds
14. OTC consults
15. Screening for problems with your rx (interactions, dose, etc)
So we are not just standing there with an empty counter in front of us twiddling our thumbs. Behind that wall is a gigantic lineup of all the things that are waiting to be done, even if you can't see it, believe me, IT IS THERE!
Pharmacists Deserve to Eat and Pee
I understand that pharmacists are the most "accessible" HC professional, but do we really need to be accessible every second of the day? When will a standard 15 minute break be allowed for pharmacists!!!!! (Actually, nevermind 15 minutes, how about 5 minutes?). If we went to school to become a.. ahem.. professional, aren't we entitled to basic human rights like food and a place to pee?
I can't count how many times I have to wolf down the bite that I just put in my mouth because buddy at the front counter needs to talk about his diarrhea and what's normal when you have diarrea.. You have no warning that someone is coming to the counter. You just took a bite, and someone is running towards you and needs to tell you something NOW...! And you have to talk to them now, even though there is food in your mouth, or you have to show them that you are eating and can't open your mouth at that second. And yes, you feel incompetent.. like you are slacking. Then they give you a really strange look when they see that you are chewing something. Yes, we are human, and YES, WE NEED TO EAT! So I rush to swallow the bite, begin to experience my own episode of digestive distress, and run over and deal with whatever little emergency that person has. How about giving me 30 seconds to chew my freaking food, and stop staring at me. I dont' get a break over 10 hours.
Washroom breaks. I tried to take one the other day and instead I found an old guy wandering in our back room. Turns out he was blind, wanted the pharmacy, and wanted to know why we charged him for an Rx 3 months ago. Half an hour later, still no washroom break, and huge lineup.. no end in sight.
Then I finally have a chance to go when it's late and I have no tech. So I make it to the washroom, go, wash hands, leave. 30s at the most. Returning to the pharmacy... people peering inside, almost going in the dispensary to see where the pharmacist is.. like the ice cream man that's always in the truck, .. there should be a pharmacist in there at all times, why isn't there..what is the world coming to, who does she think she is leaving, she must be slacking off, etc. I don't know where they all come from, but they definitly are standing up for their God-Given right as a citizen to have access to a pharmacist at any second, and they are pissed when they can't see you. They start to panic, and look less relieved and more upset when they see you.
Then our cashier trots by on the way to her 2nd 15 minute break in 8 hours. Umm. And we are the ones responsible for checking prescriptions. If we make a mistake we could harm someone.. lose our license, and hence our ability to earn money in our field. A cashier makes a mistake and oops, you need to get the manager's key to open the till and make the correct change. Thank God she is well-fed and rested to be able to do that.
How about they give us our own TPN drip and a pair of Depends and we work for 24 hours straight.. hell, throw in some Concerta Q12H and make it 48 hours.
I can't count how many times I have to wolf down the bite that I just put in my mouth because buddy at the front counter needs to talk about his diarrhea and what's normal when you have diarrea.. You have no warning that someone is coming to the counter. You just took a bite, and someone is running towards you and needs to tell you something NOW...! And you have to talk to them now, even though there is food in your mouth, or you have to show them that you are eating and can't open your mouth at that second. And yes, you feel incompetent.. like you are slacking. Then they give you a really strange look when they see that you are chewing something. Yes, we are human, and YES, WE NEED TO EAT! So I rush to swallow the bite, begin to experience my own episode of digestive distress, and run over and deal with whatever little emergency that person has. How about giving me 30 seconds to chew my freaking food, and stop staring at me. I dont' get a break over 10 hours.
Washroom breaks. I tried to take one the other day and instead I found an old guy wandering in our back room. Turns out he was blind, wanted the pharmacy, and wanted to know why we charged him for an Rx 3 months ago. Half an hour later, still no washroom break, and huge lineup.. no end in sight.
Then I finally have a chance to go when it's late and I have no tech. So I make it to the washroom, go, wash hands, leave. 30s at the most. Returning to the pharmacy... people peering inside, almost going in the dispensary to see where the pharmacist is.. like the ice cream man that's always in the truck, .. there should be a pharmacist in there at all times, why isn't there..what is the world coming to, who does she think she is leaving, she must be slacking off, etc. I don't know where they all come from, but they definitly are standing up for their God-Given right as a citizen to have access to a pharmacist at any second, and they are pissed when they can't see you. They start to panic, and look less relieved and more upset when they see you.
Then our cashier trots by on the way to her 2nd 15 minute break in 8 hours. Umm. And we are the ones responsible for checking prescriptions. If we make a mistake we could harm someone.. lose our license, and hence our ability to earn money in our field. A cashier makes a mistake and oops, you need to get the manager's key to open the till and make the correct change. Thank God she is well-fed and rested to be able to do that.
How about they give us our own TPN drip and a pair of Depends and we work for 24 hours straight.. hell, throw in some Concerta Q12H and make it 48 hours.
Subscribe to:
Posts (Atom)