One of my favorite things!

Quick Post - One of my favorite things just happened today.  I will recount the conversation on the phone.

Customer (on crappy cell phone): Jason, it's John (doesn't tell me his last name, I mean, how many John's could there be). I need my two blood pressure pills filled and my Crestor.  I have the Crestor prescription with me so you get it ready and I will drop it off because I'm in a hurry.

Me:  Who wrote your prescription, what is the strength and how many refills did they give you (and yes, I realized at the time I was asking him to read while he was driving).

Customer: It was Dr. Smith (name changed for HIPA reasons), and it's for Crestor, 90 tablets.

Me: Alright then.


Now then, I used to be a real hardass in the past when people do this.  The general public, contrary to what they seem to believe, are not qualified medical professionals, and I cannot accept verbal orders.  Shit, sometimes I cannot read physician orders.  In any event, I've gotten some what tired and concussed due to repeatedly smashing my head against a wall when people want to do this and then get pissy with me when they drop it off.  In any event, it was a renewal, and John's usual (note I said usual, this is a bit of foreshadowing) physician uses a computer generated prescription system so I figured (ie hoped) that it would be the same.

Soooooo, John comes in and drops of his script (I was able to recognize his voice so I figured out who it was) and low and behold, different doctor, different dose than last time.  Anways, after I woke up from smashing my head against the wall I told him that this is why we do not let customers call in prescriptions, now I will have to correct your prescription and redo it, which is going to take me longer than it would have if you had just dropped it off in the first place and waited.

To which he responded: I'm kind of in a hurry.

sigh.

J

The New Motto for Pharmacy

So I've been reflecting of late of the direction that we have allowed our profession to take over the past 30 or so years.  Pharmacists have slowly but surely failed to unite, consistenely stabbed each other in the back, and basically whored ourselves out to corporations to the point that we are little more than... um, well the whores of the health care world.  If that language is too strong for you then how about the fast food dealers of health care, everything cheap, fast and with a free toy.

Now we are scrambling.  You see, as we have failed to consistenly stand up for ourselves and each other, worrying too much about stealing business instead of being good pharmacists, we have in effect failed ourselves.  The problem is, the people who pay for our services, namely insurance companies and government figure that since we apparently don't give a shit about our profession, neither should they.  Basically, we are getting what we deserve.

So, following that string of thought, I have come up with a new managment strategy for my pharmacy:

At Grumpy Pharmacy you pick how you get your prescription filled.  You can have your prescription filled in any two of the three ways listed below, however, choosing two autmatically negates the third:

1.  Fast
2.  Cheap
3.  Correct

So, if you want it fast and cheap, it may not be correct.

If you want it fast and correct, it won't be cheap.

And if you want it cheap and correct it won't be fast.


They say giving your customers choice keeps them happy.  I hope this works

J

The Pleasures of Small Town Living

I grew up in a small town, the same small town which I now call home.  I often remark that my 5 year pharmacy degree was the best 8 years of my life and following graduation I moved in with some University friends for a couple of years to continue the fun.  During this stint I met my wife and got married.  My wife and I continued the fun life for a couple of years, but after we decided we wanted to start a family I decided that it was time to grow up.  I had to be a father figure and partying like Van Wilder just isn’t acceptable. 

After we had our son we decided that we would move back to our home town so that we could be close to family to help.  Our son has a great relationship with both sets of his grandparents.  He spends a lot of time with them and this has helped him to become the wonderful and caring boy he is.

About 6 months ago I developed a slight tinge in my hip.  This tinge gradually migrated to my lower back and down my left leg.  It affects me to the point now that I have difficulty walking more than one block.  For those people who know me and know of my love of recreational sports you can imagine how much this bothers me.  I have been diagnosed with severe sciatica.  Tests with my pain management specialist show that I have a high tolerance for pain, which is a good thing, because if I did not I would not be able to continue working.  I cannot take any type of pain killers for this pain as sciatica is basically fake pain.  The only thing wrong is a pinched sciatic nerve which tricks my body into thinking there is something wrong with my hip, leg and foot.

For the past two months I have been having regular physio therapy, as well as having a series of intra-spinal steroid injections (which are a real treat I might add, and make me once again thankful that I have a high tolerance for pain and have also given me a true appreciation for pregnant women who have epidurals).  I have slowly been improving.  My goal is to get better without having surgery.  I occasionally have a setback in therapy but this is to be expected.  This chronic pain has also given me a greater respect for patients who are dealing with chronic pain.  There are times when I just wish it would go away so I could go to the park and play with my son.  I can understand now why individuals with chronic pain can develop depression, can become hooked on meds.

I will get better.  Of this I have no doubt, but it will take time.

So how does this relate to the title of this post, you may be asking.  Well allow me to elaborate.  A couple of blogs ago I ranted about people who complain about the fact that I do not open my pharmacy in the evenings or on weekends.  How dare I put my family first when I should be working 80 hours a week to provide service to ungrateful sheep who can’t get their shit together.  The thing is, I could really give a shit about people who bitch about the fact that I choose to spend time with my family versus being in the pharmacy.  Complain all you want about me.

Also, when I took over my pharmacy I came into an environment where a previous pharmacist seemed to believe that Bylaws and Ethics were secondary to profit.  Who gives a shit if you haven’t seen your doctor in 3 years, here’s another 3 month refill.  What’s that, you have a sore throat, here’s some amoxil!  The list of unethical and outright illegal shit is long.  Unfortunately, all these things which made people think this pharmacist was a good pharmacist were the reason the pharmacist was a bad one.  People, unfortunately, do not realize that we often need to protect them from their own stupidity and so once again they bitch about me being an awful pharmacist because I’m not willing to go down that road.  Fuck ‘em, go somewhere else then, I’m not losing my license for you, and go ahead and spread rumours about the awful pharmacist who makes you go see your physician early or who won’t just give you drugs because you think you have a sore throat.  That shit doesn’t bother me.

Ultimately, I am a father and husband first, a son and brother to my family second, a friend to my friends third, and a pharmacist last.  A pharmacist is part of who I am but it is not who I am.

So you can imagine my utter outrage and disgust when I find out that there are rumours circulating in my town that the long-term pain issue with which I am dealing is merely a cover for the fact that I am having an affair on my wife.  Secondarily, I have chosen this issue so that I can have fake physio therapy appoinments so I can go spend time with the woman I am having an affair with.

If there was ever one time I wish my blog was not anonymous this is it.  I use this blog to rant and rave in an attempt to maintain sanity.  To protect the personal health information of individual (which I think is important) I blog anonymously.  But there comes a time when I am utterly disgusted with individuals in a small town.  Some people are obviously not happy unless others are miserable.  There is only one thing that pushes me over the edge, and that is when people would imply that I am an unfaithful husband or bad father.  You can bitch about me being an asshole pharmacist.  You can think I’m a bad person because I’m an atheist and not an indoctrinated Christian sheep.  None of these things matter to me.

But if you dare imply or spread rumours that I am a bad father or husband and you will feel my full wrath.  I struggle to convince my wife who grew up in a city that living in a small town is great for raising a child. I try to have her understand that you need to have thick skin and just ignore the rumours.  People wonder why we cannot attract young medical professionals to live in a small town, or to have them stay once they are here, but I must confess when this type of thing happens I often question this myself.  Maybe moving back to the city and becoming a corporate whore pharmacist who works 40 hours a week just to collect a cheque is where it’s at.

J

More of your questions answered.

Due to the overwhelming response to my previous post regarding my post on everyday questions for pharmacists I have decided to answer more of your questions.  To see my previous post go here: http://twogrumpypharmacists.blogspot.com/2011/10/collection-of-questions.html

In any event, as promised I will continue to educate, as is my calling.  Enjoy.

1.       Q: I have a new prescription for my medications, but I left it at home.  Do you actually need it or can you refill my prescriptions without it?

A: Absolutely Not.  Realistically, as per my previous blog-post listed above, you didn’t actually need to see a doctor ever to have refills.  The fact that you did is actually rather bazaar.  In any event, I have the ability to telepathically read your prescription from afar.  In pharmacy school we have a class called: ESP 110.  This class teaches pharmacists several important skills:

-         Mind Reading:  This skill enables us to know that you need your refills without you having to phone us and actually request them.  If you go to your pharmacy and your refills are not done even if you didn’t phone ahead it is safe to assume that your pharmacist failed this class and isn’t really a pharmacist at all.

-         The ability to see into the future.  A subset of this class teaches us how to build a time machine, but that class is optional.  This allows pharmacists to see into the future and make sure we contact your physician well in advance when you need refills so that you do not have to bother.

As you can see, Pharmacists do not actually need the prescriptions.  By simply rubbing our temples and slamming our heads against the pharmacy counter we are able to read your prescription from afar using our mind’s eye.

2.     Q: My Doctor gave me a new prescription, but I am too busy watching “The Price is Right” to bring it in.  Can I just read it to you over the phone and then come pick it up later?  I’m in a bit of a hurry because after TPIR I’m taking a nap and Bingo starts at 2:00.

A: Of Course.  As I have previously said once you have been diagnosed with a medical condition you are automatically as qualified as your doctor to identify issues with your own health.  Secondarily, this translates into the ability to read and write prescriptions properly. As well, pharmacists can decipher mispronounced drug names and directions thanks to our ESP class stated above.  Here is an example.

Patient: the prescription says Lasec 2mg (could be a 20), take 1 tablet oddly.

Pharmacist: ahh, Lasix 20mg one tablet daily, gotcha.

Patient: Yep, the pink ones for my stomach.

3.     Q: I have a new prescription for my Narcotics.  I’m too busy to bring it in today.  Can I just fax it to you and have my brother pick it up?  I promise I will shred it.

A: Of Course.  You see, the bylaws of the Saskatchewan College of Pharmacists are not actually bylaws at all.  We are currently having them renamed “By-Suggestions” meaning that they are a rough outline as to what we are required to do.  The government also has this crazy and ridiculous program called “The Prescription Review Program” which oversees Narcotic and Controlled drugs.  It is a particular pain in the ass, as it requires silly things like the correct patient name as well as an actually quantity of drug to be dispensed as well as a bunch of other nonsensical B.S. for filling Narcotic prescriptions.

Apparently, in some places, people have attempted to fax their Narcotic and Controlled prescriptions to several pharmacies in an attempt to get more than what their doctor prescribed for them.  Weird, I don’t actually believe anyone would do that, so fax away.

4.     Q: Does this look like Herpes to you?

A: Eww, gross.

J

What Defines a Good Pharmacist?

I made the mistake a couple of months back of doing a customer survey and focus group.  “What a great way to improve my business” I thought.  I could really get at the meat of the issues as to what customers expect from me and find areas where I could improve myself as a pharmacist and what I offer to my patients.

Well, let me tell you, my fellow pharmacists, if you ever want to get totally shit on as a professional have one of these.  They are great for upping your personal rage level.  Following the survey I have decided to compile a “What we think is important to our patients” versus “What our customers want” essay.

First off, my essay as to what I would expect from my pharmacy.  This is based on several things.  Naturally, my knowledge of pharmacy (being a pharmacist and all) and what I would expect as a patient receiving a prescription.  Tied into this is a little bit of what we are taught in pharmacy school as to what we should expect as professionals.

Things that define a good pharmacy/pharmacist

Most importantly, focused patient care.  My pharmacist should be attentive to my needs with respect to helping me understand how to properly use my medications as well as educating me about what I can and cannot do as a result of this medication.  Follow-up phone calls to ensure I am taking my medications properly would also be a bonus.  I would also find it beneficial if my pharmacy offered patient Education and Clinical days.  My pharmacy should be involved in the community by offering community education events about various health related topics.  This includes, but is not limited to, medications.  As these types of services have value, I believe it is reasonable to charge a fee to attend them.  Finally I want to be treated like a member of the health care team.  I would hope to have a good working relationship with my community pharmacist and the rest of the health care team, including my physician to optimize my health outcomes.  A relationship built on mutual understanding and respect by all members of the team.

So there it was.  Short and sweet.  I could have droned on and on, but basically that was a flowery (ie boring) look at community pharmacy, and realistically I know you are all waiting for the other one. So, following the survey and focus group, here is what I have generated from the public’s perspective:

Things that define a good pharmacy/pharmacist

                Most importantly, fast and cheap (just like a good whore).  I could really give a shit about side effects or other medications I can and cannot use.  Just hurry the fuck up and it better be free.  And if it’s not free then I’m not taking it, I need to buy smokes.  Oh, and you better be open about 27 hours a day, 8 days a week, because I’ve got shit to do and I need you to be open when I finally remember to pick up my  medication, which I cannot go without, but which I ordered 12 days ago and have been without for 7 days.  And those little artsy farsty health fairs had better be free and you damn well better have free coffee and doughnuts too.  Don’t dare offer me carrot sticks and water you tofu farting tree hugger.  Oh, and when I call you at midnight to come down and fill the emergency Amoxil script I received 4 days ago but was too busy to fill (I’m retired, I’m busy) you had better be prompt and fucking happier than a kid in a candy store because without me you would be out of business.  By the way, I don’t need you to counsel me on drugs, that’s what my doctor is for.  Can you please, however, be sure you know what’s going to be on sale on next week’s flyer, because I’m getting low on Cheezies. Oh, and when I run out of refills you had goddam better automatically fax my doctor for refills.  I’m too busy to go and see him (Bingo starts at 7:00pm you know, and you close at 6:00pm).  Oh, and finally, I want airmiles with the full co-pay on my prescription (it is afterall about as important to me as a loaf of bread) and you better act like you are happy to see me whenever I come in because I’m your only customer and my prescription pays your bills.  Shit, I own half your store.

Well, ok, it’s not really that bad.  Realistically, it’s only a small percentage of patients who are like this (I could say it’s about 10% but like 80% of stats that’s just a guess).  Realistically, everyonce in a while I get to help someone with their medications and truly make a difference.  It is these rare moments that make me glad I became a pharmacist.  It is difficult, however, because most of the time it mainly just feels like I’m in the fast food department of Health Care, getting shit on all day.

I recently tweeted to another pharmacist friend, that I only drink alcohol on weekends and if I’ve had a shitty day at work.  I’m down to 6 and a half days a week.

J

Why is it that...?

Just some quick pharmacist’s questions for this weeks blog:

1.        Why is it that the guy who refuses to pay $5.00 for his meds, because that’s too expensive, can afford $30.00 in lottery tickets?

2.       Why is it that people bitch about having to see their physician for a new prescription regularly, but have no problem making sure they get the oil changed in their car regularly?

3.       Why is it that the only people who whine about reduced pharmacy hours are retired old ladies who have nothing to do but drink coffee all day?  Oh wait, because they need something to complain about when they are having coffee of course, my bad.

4.       Why is it that when  it takes any more than 5 minutes to fill a prescription some people get totally unreasonable, but standing in line at Tim Horton’s for 20 minutes for a fresh Double-Double makes total sense?

5.   Why is it that George Lucas would rather spend money making updates to the original Star Wars Trilogy instead of just making epidsodes VII, VIII and IX?

6.       Why is it that Narkies always open their Oxycontin bottles over the toilet and accidentally dump them all in to said toilet, but this never happens with their Ramipril?

7.       Why is it that these same Narcies always fill their Oxycontin on time, but forget to take their diabetes medications regularly?

8.       Why is it that when some patient’s would rather take advice regarding the proper use of OTC medications from some random person with no medical training instead of their pharmacist?

9.       Why is it that J, The Grumpy Pharmacist, is such an @$$Hole?

10.   Why is it that the single mom who is on social assistance and has 4 kids from 5 different men can afford a nicer car than I can?

11.  Why is it that old people are always in a hurry, but drive ridiculously slow?  Oh wait, that's why they're in a hurry, it's going to take them a long fucking time to get home.

12.  Why is it that I can't get the goddam spacing to work right on this week's blog (thus making it look like, ie: revealing, that I have no idea what the hell I'm doing)

And finally

13.    Why is it that J, The Grumpy Pharmacist, couldn’t come up with anything good to write this week so he whipped this off in 2 minutes and hope you wouldn’t notice?

Have a great week everyone!

J

A collection of questions.

Here is a collection of fun questions I have been asked over my career, some (like the first one) are on a daily basis, some only once a week or so.  To save time and to help inform both of our faitful readers I have provided the answer as well.  Enjoy!

1.        Q: It says here on my bottle that I have no refills remaining.  Does that mean I have no refills remaining?

A: Nope, I’m just messing with you, you busted me.  In fact you will never have to see your doctor ever again for refills.  I merely put that on the bottle as to stimulate conversation and make my otherwise dreary life bearable.

2.       Q: I had a sore throat a couple of years ago (hands me bottle of antibiotics dated March 3^rd, 2004) and the doctor prescribed these.  Can I have a refill or do I have to go see a physician.

A: Absolutely.  Actually, you will never have to see a physician for this problem ever again.  Once you have experienced symptoms for any kind of disease you immediately become a certified medical specialist in the field as it relates to that particular disease or condition.  This means that although you have no previous medical training there is absolutely no chance you have misdiagnosed yourself and as such are qualified to prescribe yourself antibiotics.

                For the same reason, and for future reference, lets say you have a heart condition requiring open heart surgery.  As a result of a heart-attack and subsequent surgery you are immediately qualified to do open heart surgery on yourself the next time you have a heart attack.  This is how we save money in the medical system.

3.       Q: I hear pharmacists in Saskatchewan can now write prescriptions.  Does this mean I don’t ever have to see my physician for refills and I can just continue coming to you instead?

A: Yes, you are correct.  Interestingly enough, now that pharmacists have prescribing rights the Province of Saskatchewan has realized they can cancel any and all pre-existing contracts they may have with physicians as they are no longer needed.  The Province feels that the average Joe is more than qualified to regularly assess their own medical status and can tell when things such as a new condition might come up, or if their current medical condition has changed in anyway.

                For example, let’s say that 10 years ago you were diagnosed by your physician with hypertension (high blood pressure).  Well thankfully, because your body never changes over time, and especially not over a 10 year window, you will never have to see the doctor for refills.  We can safely assume that the dose of medication you were initially prescribed 10 years ago will never change.  Similarly many other medications “require” regular blood tests to ensure that the dose is correct.  In reality this “requirement” is just put in place to ensure lab techs (who pay a lot for their schooling) are able to secure a job.  To simply tell if your dose needs to be changed all you have to do is lick your forearm and tell me if it seems ok to you.  If you think it is normal you are good to go.

4.       Q: I need my medications filled today, but I don’t have the money for it.  Can you just give them to me and I will come pay you in two weeks?

A: For sure.  Once again you have stumbled upon a well-kept secret.  While other businesses expect to be paid for providing goods or services, pharmacies have magical money trees growing in our back rooms.  You see, the government developed these trees to ensure pharmacies get paid.  As you all know Canadian Health care is supposed to be free.  This means drugs are supposed to be free as well.  In fact, it extends to everything in the store, so go ahead and pick up some pop, chips and a couple of lottery tickets on the house.

                By the way, would you like me to call ahead to the grocery store so you can fill a cart full of groceries and walk out without paying for them as well?

5.       Q: My friend and I were chatting.  Her symptoms seem awfully like mine.  Can I get some of this medication she is taking from you, or do I have to go see a doctor?

A: Well, that’s a tough one, you see it all depends on your personal confidence with both your and your friend’s combined diagnostic abilities.  You see, as per numbers 3 and 4 above your friend could request this medication for themselves; however they cannot request them for you unless one of the following criteria is met:

a)      They are your best friend (or at least a very close friend).  The closer your friend is to you the less likely they are to make a judgment error as it comes to medical issues.

b)      It is your mom (or primary caregiver when you were growing up).  Your mom would never do anything to hurt you.

c)       The person was wearing glasses – glasses make you smarter

d)      They are a doctor (pfft whatever).

6.       Q: Can you lend me $20.00, I will pay you back when my welfare cheque comes in?

A: I’m surprised you haven’t asked me before.  You see, pharmacists are able to expense random amounts of money to their patients.  It’s the “born yesterday” pharmacy legislation clause.  We may also co-sign loans, buy you a case of the finest wine, and even provide you with our first born child.

I will keep collecting questions as I go and look forward to answering more of your pharmacy related queries in the future.

J

The Psychic Pharmacy Tech and Mr. Oblivious.

Well, I figure it’s time for another round of insane, hilarious, ridiculous stories of the kind of stuff that can happen in a pharmacy.  Once again, some are personal, some are second hand.   Enjoy.

Chapter 1: He can read minds. No really!

On a slower day in the pharmacy we were standing behind the counter having a chat.  It was just myself and the two technicians I was working with.  It was most likely a Friday evening.  Anyhow, the technician was in the middle of telling a story.  Just then a real beauty of a gentleman walks around the corner.

Now, I’m not a profiler, but nine times out of ten, when I see a person walking towards me with a dishevelled “I just woke up in the gutter down the street” kind of look I brace myself for what comes next, because it usually ends up with the whole “Tylenol #1 or Gravol” question.  Anyhow, the gentleman who strolled around the corner had just this look.  Just as he came around the corner the technician said, as a part of his story “and so I told the guy I could read his mind”.  Mr. Shitty pants thinks he’s really cool so he says to the technician “Ok, if you can read minds, why am I here?”

Without hesitation the technician looked at him and said “You want a bottle of 200 generic acetaminophen with codeine”.

The guys face goes white… “How did you know?”…

Needless to say I was rolling around on the floor laughing my ass off.

Chapter 2: Bad Timing

During my internship in my fourth year of pharmacy I was working a night shift with my preceptor.  At around 9:30pm or so this rather stunning young lady came stomping down the aisle with a prescription in her hands and a rather pissed off look on her face.

She slaps down the script: “Azithromycin 1 g stat”… aaaah Chlamydia, what a great disease.

Anyhow, I take the prescription from her and tell her it will be just a few minutes.  I go up and get everything ready and chat with my preceptor about what I am going to counsel the young lady on, etc.

I walk back down to the waiting are and hand her the prescription and proceed to counsel her “Take all four tablets at once… blah blah blah”.  When I’m done counselling her I ask if she has any questions, at which time she snaps.

Her: YA, I’ve got a question for you.  Why are all men dirty pigs?

Me: ummm

Her: My boyfriend was screwing around on me and now he gave me a goddam STD from that skanky whore he’s been banging.  I already chucked all his shit out of the house, it’s laying on the front lawn.  When he comes home he better not come in the house or I’ll cut his balls off

At this point she stormed off.  I stood there stunned for a second and my preceptor just had a laugh.  I was just about to step back up into the dispensary when my preceptor whispered “She’s coming back”.

I went back down to the counter and asked her if there was anything else I could help her with.  She told me she was sorry for blowing up on me and that she had just needed to vent to someone.  I told her it was ok and that I imagined it was a little stressful.  The next exchange stunned me, here is what was said next:

Her: Anyways, you’re new in town, did you just start here?

Me: Yep, last week, I’m doing my internship here.

Her: You should give me your phone number; we can go out for drinks some night.  As you probably guessed, I’m single now.

Me: (at this point I didn’t know what to say, because a woman who konws I know has an STD is asking me out) Uhhh, I’m only here for 2 more weeks doing my internship then I’m moving back to Saskatoon to finish school.

Her: Oh, well, make sure you come out to the bar on Saturday; I’ll be there with some girlfriends.  I’ll buy you a drink and make sure we show you a good time and see if we can’t convince you not to move back.

At this point she turned around and walked away and left the store.  My preceptor and I stood there stunned and then she looked at me and said “I guess she likes you, give her a week and she’s good to go”. I stayed as far away from that bar as possible.

Chapter 3: For a newspaper?  Seriously?

I was working one day in Calgary.  It was not a particularly busy day, and the technician and I were just moving things along.  At one point I was behind the counter on the phone answering a question from a patient while the technician was receiving a prescription from another customer at the drop-off counter.  As I’m talking with the patient an elderly gentleman (mid 70’s) is hurrying down the aisle waving a news paper at me with an angry look on his face.  He comes to the till and shouts at me “Get over here now!” and points at me.  I covered the receiver up on the phone and told him I would be with him as soon as I was done with the phone call.

I heard him mutter some other obscenity and he waved the newspaper at me and kept talking so I just turned my back to him, now facing my technician, and kept speaking with the person on the phone.  The technician suddenly looked at me wide eyed with this “WTF” look on her face and I wondered what was going on.  Then it happened.  I felt a very forceful tap on my right shoulder.  I turned around and was standing face to face with the little old man.  He had walked behind the till and let himself into the dispensary.  Very calmly I asked the woman on the phone to hold for just a moment.

Before I go any further I will say one thing.  I’ve only ever actually lost my mind and snapped once in my pharmacy (this was it).  I’ve gotten irked and made some snide and smart ass comments on occasion (i.e. daily) but I’m generally a very calm guy.

Anyhow, I turned around and just lost my mind on the guy, asking him what was so goddam important that he thought he had to let himself into the pharmacy, to which he replied:

“I bought that copy of the Globe and Mail at the front and I wanted the Calgary SUN and that girl at the front told me I had to come back here to get a refund.”

Now this made it worse, for some reason this ass thought a refund on a Globe and Mail was of earth shattering importance.  I reached in my pocket, took out a $2.00 coin and told him to get the Hell out of my store.  He said, very snidely “I’m sorry, I’m in a hurry” to which I replied “Don’t give me some half-assed apology, I better not every see your impatient ass in here ever again”.

I think I handled it quite well.

Chapter 4:  There’s no way he’s going to come back here… WTF, here he comes!

One night a particularly grubby looking guy plops himself in front of me and shows me  this prescription:

Oxycontin, 40mg

Take 1 tablet twice daily

Give: 120 tablets

I could immediately tell the prescription was a forgery.  This dude obviously had stolen the physician’s triplicate prescription pad.  He then says to me “Do you have this in stock because I was just at the pharmacy across the street and they don’t”.  This of course means the other pharmacist recognized the forgery as well.  Quickly I said “No, but if you like I can order them for tomorrow”.  To which he says he would try a couple of other pharmacies instead.  I told him I would order them anyhow if he liked, but to do that I would need to set him up a file.

Now, this scumbag was smarter than most.  A lot of idiots, when they forge prescriptions, get greedy and will write stupid shit like “give 1200” or write ridiculous instructions like “Take 1 tablet every 30 minutes”.  He wrote for 120 tablets, and the directions weren’t ridiculous.

Anyhow, I convinced the guy to let me set him up a file.  I got his Driver’s license number, his health number, his address and his phone number.  At that point he left.  Once he was gone my technician said to me “There’s no way that dude is coming back here tomorrow”.

The next day I did the standard call the doctor, confirmed it was forged, no I didn’t fill it and then I notified the police about what had happened.  Pretty straight forward.  At around 7pm the next night guess who comes traipsing down the aisle?  You guessed it, Mr. Scumbag.  The tech starts freaking out “Oh no, he’s back, what are we going to do”.  I just told her “don’t worry, I’ve got this.

He asked me if I had the stuff.  I said I did, but it would take 20 minutes to get it ready because we were busy.  He said no problem, handed me the prescription and left.  As soon as he was out the door I called the Police and told them to meet the store manager at the back door, and that I had told the guy it would be 20 minutes so they had better hurry.

In about 10 minutes the guy comes back and sits down in the waiting area.  Of course, it’s not busy, and now I don’t know how to stall him.  I just had the tech pour out and count tablets repeatedly from the same bottle, while I would randomly call out names for prescription pick-up and then look puzzled when the people never showed up.  All the while Mr. Scumbag sat there with a smirk on his face already counting the money he was going to make selling the stuff.  Finally the phone rang and it was the manager.  The police were in the back.  He showed them the surveillance camera so they knew what he looked like.  I saw them coming down the aisle.  Thankfully Mr. Scumbag was sitting with his back to them.  The one officer pointed at him, I nodded my head and the officer then said “Excuse me, Mr. Scumbag”.  The guy, still oblivious, turned his head.  He then turned back and just frowned.  I smiled and just looked at him as the officers asked him to stand up and they cuffed him.  I gave them the forged prescription and he was on his way to the big house.

Funny thing is, he never showed up for his court date (which of course I was summoned to) so I never got to see him again.

J

Why does it take so goddam long to fill my bloody prescription?

I did not write this, another pharmacist blogger originally came up with it.  You should visit the blog at:
http://drugmonkey.blogspot.com/2006/08/i-realize-today-ive-done-you.html

I will repost here, however, as it is awesome and I think it deserves a read on this blog by both of our faithful readers.  I have made some amendments to it so that it makes a little more sense for Saskatchewan.  For your reading enjoyment:

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After strolling around the store for about 15 minutes you finally make your way to the pharmacy department. I am on the phone with a drunk dude who wants the phone number to the restaurant next door. After I instruct him on the virtues of 411, you tell me your doctor was to fax in your prescription to me, which he hasn’t, and you’re unwilling to wait until he does. Being in a generous mood, I call you doctors office and am put on hold for 5 minutes, where...

The phone rings.
... I am then informed that your prescription was faxed in to my competitor across the street. You tell me you would rather not walk across the street to pick up your prescription, so I ask the physician’s receptionist to fax me a copy of the prescription and I tell her I will contact my competitor to have them cancel your prescription...

The phone rings.  
...Phoning the competitor I pick my way through their auto-answering system until I finally get a clerk on the phone, who puts me back on hold to wait for the pharmacist.  When I finally get through to the pharmacist I can tell by their voice they are having a splendid day as well.  Your prescription is then cancelled, and now I have to get the 2 phone calls that have been put on hold while this was being done. Now I return to the counter to ask if we’ve ever filled prescriptions for you before. For some reason, you think that “for you” means “for your cousin” and you answer my question with a “yes”, whereupon I go to the computer and see you are not on file...

The phone rings.

...You realize you have forgotten to do something very important, such as go back and browse through the monster truck magazines. You return eventually, expecting to pick up the finished prescription...

The phone rings.

…only to find out that I need to ask your address, phone number, date of birth, if you have any allergies and insurance coverage. You tell me you’re allergic to codeine. Since the prescription is for Tylenol #3 I ask you what codeine did to you when you took it. You say it made your stomach hurt and I roll my eyes and write down “no known allergies” You tell me...

The phone rings.

...you have insurance and spend the next 5 minutes looking for your card. You give up and expect me to be able to bill your insurance company anyway. To solve this problem I call my competitor again and pick through their auto answering system only to be put on hold. Upon reaching a human, I ask them what insurance they have on file for you. I get the information and file your claim, which is rejected because you changed jobs 6 months ago. An asshole barges his way to the counter to ask where the pop machine is...

The phone rings.

...I inform you that the insurance the other pharmacy has on file for you isn’t working. You produce a card in less than 10 seconds that you seemed to be unable to find before. The reason you were doing this is apparent as soon as I look at the card which clearly  "Drugs 80% Reimbursed" meaning you were hoping your old card would still work so you didn't have to pay for your drugs. When I ask you about this you confirm that you pay up front and submit your receipts after, at which point I sigh and...

The phone rings.

...A lady comes to the counter wanting to know why the cherry flavoured antacid works better than the lemon cream flavoured antacid. What probably happened is that she had a milder case of heartburn when she took the cherry flavoured brand, as they both use the exact same ingredient in the same strength. She will not be satisfied though until I confirm her belief that the cherry flavoured brand is the superior product (which I am unwilling to do), but which some other random shopper with absolutely no medical training is able to confirm…

The phone rings.

...I pull of up your Provincial Drug Profile and discover that you had 30 Tylenol #3 filled at a pharmacy two towns over. When I ask you about this you swear on your mother's life that you did not have a Tylenol #3 prescription filled recently. I call the pharmacy and am immediately placed on hold. The most beautiful woman on the planet walks buy and notices not a thing. She has never talked to a pharmacist and never will. Upon reaching a human at the pharmacy, I am informed that the Tylenol #3 prescription was indeed filled there. When I tell you this, you say you got Acetaminophen with Codeine filled, not Tylenol #3, at which point another part of me dies inside...

The phone rings.

...It turns out that a few days after your doctor wrote your last prescription, he told you to take it more frequently, meaning that what looks like a 30 day supply is actually a 10 day supply with the new instructions. I call your doctor’s office to confirm this and am immediately placed on hold. My laser printer has a paper jam, and It’s time for my tech to go to lunch. When I finally get through to the secretary she confirms this for me, at which point I tell her she needs to re-fax me a new prescription with the correct instructions.  She then gets pissy with me about this, at which point I inform her that it is the Provincial Drug Bylaws that say I cannot take a verbal order from a secretary, not my own personal beliefs…

The Phone rings.

...She tells me she will fax it right away (which in doctor speak means “sometime within the next 4 hours).  You are now getting a little irritated about the process and ask me if this will be much longer.  As I am fairly certain the physician will fax me the corrected prescription (which of course he does not, forcing me to call his office again the next day) I go ahead and process it through the provincial drug plan which saves you a whopping 85 cents off the regular price of the prescription...

The phone rings.

...I hand you the completed prescription, at which point you inform me…

The phone rings.

……. that you’re glad that your last pharmacist told you you shouldn’t take over the counter Tylenol along with the Tylenol #3’, so you have been using the acetaminophen instead. I break the news to you that Tylenol is simply a brand name for acetaminophen and that you shouldn’t be taking them together, you don’t believe me. You then ask me why the tablets look different than those you got at the other pharmacy. I explain that they are the generic version, at which point you tell me they don’t work as well and that you want the brand name Tylenol #3…

The phone rings.

...I head back to the dispensary and re-do the entire billing and filling process to switch your prescription to Tylenol #3.  When I come back and present you with your new prescription you are astonished to see that the brand name version costs more.  However, you take a look at your watch and realize you are in a hurry so you remark “I’ll just take these, I don’t want to take up too much of your time…” and another small part of me dies inside.

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Now of course, this isn't actually you, this just the person who was in the pharmacy 10 minutes before you.  Now you understand why it takes so long for your prescription to get filled.
J

Me first, Screw Everybody Else.

While this week’s rant ties in to pharmacy (it has to, I’m a pharmacist and my rants are of course affected by my own experiences) it is more of a general commentary on society, and specifically the “me first” mentality that seems to be more and more prevalent (which it probably isn’t but these things always seem to get worse with time). 

I work in a rural Saskatchewan community, and as is often the case in this type of setting, I’m the only pharmacist in my store.  As per the regulations of the Saskatchewan College of Pharmacists, and due to the fact that I do not presently have a “Lock and Leave” dispensary, I am required to be present in my pharmacy at all times while the store is open.  This means 8:30am to 6:00pm no lunch breaks and no coffee breaks (I occasionally take a bathroom break, but only when my bladder is ready to explode, and even then I’m sometimes on the phone while in the loo).  Now, I’m not complaining, I knew when I came back to run this pharmacy that this would be the case, so I’m fine with it.  During the summer, when I open my pharmacy on Saturday I also work that entire shift without a break (once again as I am required).  This means, I work Monday through Saturday with no breaks.  Thankfully, I only get called in for “emergencies” on Sundays once every other week so I get the odd day off here and there.

This work schedule comes in handy.  Those of you who read this and know me personally know that I absolutely despise my wife and son and absolutely hate spending any quality time with them.  I prefer to work and am considering opening my pharmacy from 9am to 9pm seven days a week to appease the old retirees in my community who need a place to shop late at night.  (Please note, the preceding paragraph is just oozing with sarcasm in case you didn’t pick up on it).

Last week one of my co-workers was on vacation.  Her husband owns his own electrical business.  We were discussing how, when they let it be known that they were going on vacation, they were getting harassed.  Once again the “me first” attitude rears it’s ugly head.

So how does the “me first” attitude work?  Well, allow me to enlighten you oh faithful reader (and please bare with me, I ramble).  The one thing about people is most of us like to “save face”.  I will elaborate; suppose, for example, I call a town hall meeting.  While at the meeting I propose the following statement: “By a show of hands, how many of you feel it is important for people to be able spend time with their family outside of work?”  Similary I ask, again by a show of hands, about vacation, lunch breaks, coffee breaks, and personal time for family emergencies.  I guarantee you that every single hand in the room would shoot up, and I believe that the people would be sincere when saying so.  You see, the “me first” attitude hasn’t kicked in yet.

Nope, we see the “me first” attitude show up when my co-worker and her husband want to take vacation.  “Oh sure, it’s good for them to get away, everyone needs a break now and then” people will say… right up until the moment they personally need something from them (on a side note, she doesn’t take enough vacation in my opinion).  Then good old “me first” shows up and bitches at them for going away because “I” need service.  "What do you mean you are going on vacation?  I have something that I have needed done for the past month, and now that you are leaving it has to be done, so you can't go".  The truth of the matter is, for a large portion of our society, people don’t give a sweet ass fuck about other people and their free time, and only actually care about themselves.  It's the McDonald's mentality of I want it now, fast, and cheap and I don't care whom I have to step over to get it.

They don’t give a shit that the small town doctor is almost ready to burn out because he’s on call 27 hours a day, 8 days a week.  “That’s so horrible” they will say and "He needs some time off with his family", yet they will call him at home at 1:00am about that sore throat that has been bothering them all week.  “Oh, its horrible when other people call for ridiculous requests, but it’s absolutely ok when I do it”.

This is a horrible attitude, and anyone who harbours it should be ashamed.  So why did I start this rant with the background about my pharmacy.  Well, you see, when I took over I made it very clear that I was putting my family first.  I do not think it is ok for a pharmacist to work 6 or 7 days a week for 35 or 40 years.  You miss out on too much time with your family, time which you cannot get back.  This was why I chose to close my pharmacy for 10 months of the year on Saturdays so I could spend time with my son and wife.  The sad commentary on life and society is that very few individuals have said they admire me for putting my family before my career, but on an almost daily basis someone with a sense of entitlement and high self worth comes in and shits on me for closing on Saturdays (or better yet, bitches at my employees because they are afraid to get blasted by me).  When asked point blank if they think it is important for me to spend time with my son and wife they will all say “absolutely”… but yet again only if it doesn’t affect them.  You see, me first wins over for way too many of us.  I even had one little old retired lady (note the "retired" meaning I have nothing but time for the entire week) say that if I wasn't prepared to work 7 days a week I shouldn't have become a pharmacist.  Abso-friggun-lootely brilliant.

We should respect the personal lives of others as much as we want our own personal lives respected.  We should not admire the workaholic who sacrifices time with their loved ones so they can put an extra zero by their name at the end of the year.  And finally, we should feel ashamed that some individuals cannot make a decent living working 4o hours per week and must hold down two or more jobs to make ends meet, sacrificing time with their children so they can put food on the table.  Instead we call them horrible parents when realistically we have failed them as a society.

I finish with a quote (one of my own) that I posted on a social network page: If being a workaholic is what defines "good pharmacist" for you, then my goal is to be the shittiest pharmacist you know.

J