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:

----------------------------------------
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.

---------------------------------------------

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

Dear Dr. Smartass

Well, I’m going to begin today’s blog with a lesson with respect to requirements for prescription writing.  You see, due to the fact that there are a lot of slimeball narcs out there who will lie, cheat, steal and forge prescriptions for Narcotic and Controlled medications there are a lot of regulations around how physicians must write them.  Here in Saskatchewan we have the Prescription Review Program which is a program agreed upon by physicians, nurses and pharmacists as to regulations regarding how some prescriptions must be written.

I will point out one clause in the program of interest:

           
           Prescriber Participation:

Prescribers may prescribe any of the medications on the panel of monitored drugs so long as the following information is contained on each prescription in addition to the current legal requirements:

a)    The patient’s date of birth;

b)    The patient’s address;

c)    The patient’s health services number;

d)    The total quantity of medication prescribed, both numerically and in written form; except when prescribing electronically, by email, or by FAX when only one form is acceptable or available; and

e)    The prescriber’s name and address.

I have bolded d) because this one is of particular interest.  Keep in mind, there are added regulations regarding refills, signatures, etc. but that info will suffice for today’s rant.  Here’s why, lets say my Doctor gives me this prescription (and lets assume that everything else has been done as per the regulations, which is typically not the case).

Mr. Grumpy Oxycontin 40mg Mitte: 30

*By the way Mitte is loosely translates as “Please Give” for my non-pharmacist readers.

Now, here’s what I could do with this prescription if I was less than reputable:

Mr. Grumpy Oxycontin 40mg Take 1 Daily Mitte: 300

Or, if I were feeling super greedy I could do this:

Mr. Grumpy Oxycontin 40mg Take 1 Daily Mitte: 30000000000000

So, as you can see, the way to avoid this is to have the prescription written as per the bylaws so it looks like this:

Mr. Grumpy Oxycontin 40mg Take 1 daily Mitte: 30 (thirty)

Anyhow, when prescriptions are not written as per the guidelines it takes (ie: wastes) considerable amount of time for me to type up and then fax the doctor, who then has to read and sign and fax back the corrected prescription.  Of course the onus is on me to make sure the prescription is correct, not the person writing it, and if I were to get audited it would be me who gets my balls run through a meat grinder for not verifying the quantity or other info, not the person who screwed up initially

Anyhow, here is the prescription I was handed

Dr. Smartass Smartass Medical Clinic Big City, Alberta Phone: 403-555-1234                        Fax:403-555-2345             September 7th, 2011 Mrs. Happy, Health Services Number: 123 456 789 Address: Anytown, Sk, Canada Ph: 306-555-1234 Tylenol #3: 1 tablet every 6 hours when needed X 30     Dr. Smartass’ Signature

Now the one thing about Dr. Smartass is that she has very nice handwriting (weird, I know), so I was able to easily make out what was written.  Regardless, this does not meet the requirements so after I provided the patient with the meds (I could have been a real ass and made her wait, but I was confident it was for thirty tablets) I took a few minutes to send a fax.  What I do is I take a copy of the prescription, stick it on the paper and then in a box beside I type the message.  Here is what this particular message read:

            Dr. Smartass

Per Saskatchewan Regulations I must verify the quantity authorized for the Tylenol #3.  The quantity per Sask. Regulations must be written both numerically and in written form.

            As such can you confirm, by signing and dating below, that you have authorized:

30 (thirty) tablets

Thank you

Grumpy Pharmacist’s Signature

______________________________     ________________

              (Prescriber’s Signature)              (Date)

Pretty straight forward, just fax it and sign it back.  So, four days later I get it back with this snide remark written beside an arrow pointing to the 30:

            It would appear that way!!!!

Thankfully, she had signed the goddam thing so I wouldn’t have to fax her again, however, for those of you who know me know that you don’t make a snide little smartass remark to the J, the Grumpy Pharmacist, and not expect some sort of belittling comment back.  First, I photocopied the page of the Prescription Review Program that points out the requirements and put some nice big arrows and stars pointing at section d) (I figured that she seems to like stars).  Then I photocopied the fax and circled her little smartass comment with an arrow that read “Please see attached”.

Finally I typed her a new letter, I’m not sure if it was patronizing enough.  I welcome your comments below:

            Dr. Smartass

Thank you for signing and returning the request for clarification for Mrs. Happy (I have attached a copy for your reference).

Please note, as it relates to your written comment “It would appear that way”, I have also attached a copy of the Requirements for Prescribers under Saskatchewan’s Prescription Review Program.  As you can see, per the section I have indicated, as your prescription was handwritten I was required to confirm that this was indeed for 30 (thirty) tablets.  Thankfully as you have very clear handwriting I felt confident that it was for 30 tablets when it was dropped off four days ago and had provided the patient with the medication (something which I could have refused out of uncertainty).  Regardless, as you can see I am required to confirm (no matter how obvious or clear the prescription is) the total quantity as per the regulations.  Unfortunately for me, were I audited by the Saskatchewan College of Pharmacists I could be reprimanded for this simple oversight on your part.

I too share your frustration with this program, it does at time seem rather tedious, however I believe in the interest of preventing diversion of Narcotics it is a necessary evil.  Unfortunately, when prescribers do not write prescriptions properly it takes valuable time away from patient care to have to type up faxes, send them, have the prescriber review it, sign it and fax it back.  It is particularly unfortunate when I have to send another follow-up fax regarding this issue, again something which takes valuable time for both of us (for me to type this rather lengthy fax and for you to read it).

Regardless, should you have any further concerns regarding the Prescription Review Program I can provide you with the contact information for all of the participating partners (listed on the sheet I have attached).

Regards

 J The Grumpy Pharmacist

I'm taking my business elsewhere

As my blogging buddy mentioned, there are lots of choices in this pharmacy biz, all happy to take people's business....no matter how unsavory it may be.

The customers know this, and will often try to wield this, like an axe over your head to try to make you do things that you're either uncomfortable doing, unable to do for legal/ethical reasons, or just plain can't do because it would actually violate the laws of the universe.

Most commonly, I find the complaints are about price, but there are plenty of reasons I've had people threaten to move their business down the road.

• I won't do something illegal such as give out prescription medications without a prescription

• I won't do something unethical such as bill their insurance plan for their dog's medication

• I won't do something impossible such as warp their prescription out of the store they usually go to (that work sweet-assed bankers hours) and have it magically appear at mine so I can give them their medication (also...fyi....you already have your business elsewhere...you only came here cause you're in a jam...so acting like I owe you something is a pretty dick move)

So yeah...there's lots of things.  One of my true favourites is when I refuse to fill a medication for a potential substance of abuse ... lets say... sleeping pills ...   since they'd already received a 3month supply earlier this month.  The person will huff and puff and stomp their feet and turn blue and call me names....but I won't budge.

(Side note: Despite what people automatically think, I'm not just some asshole on a power trip....there are legitimate reasons to make sure people use their medications correctly and I'm not going to contribute to whatever is going wrong in their life that is causing this early refill.... maybe they're taking triple what the doctor directed because they're going through a rough spot right now, maybe they're selling it, maybe they're stockpiling it for a suicide attempt.... if they want to sit and talk about it, I'd love to see if I can help them out at all .... if they're going to be a complete shithead to me I'm gonna bounce em)

The next step is an insistence that we transfer their prescription elsewhere, or give it back to them.. Sure....that's no problem at all....just let me write on it that I refused to fill it, and document the exact circumstances.  You can head to that other store...and maybe have a little cooler head, and explain why it looks like you've gone through three months worth of sleeping pills in two weeks. There's a good chance that given the whole story they're not going to feel comfortable filling it either.....or maybe they will (see my upcoming post "Your Pharmacist is an Asshole")









Really though....my favourite are the threats over price.  "The grocery store or Wally-World down the street is cheaper, if you don't match their price I'm going there".  Ok.  Bye.

A threat to take your business elsewhere for pricing reasons requires a few things to be effective.

1.  Store A actually has to consider Store B their competition     - If I'm working at a small independent professional drug store, or a nationwide chain whose biggest selling point is their ridiculous convenience store hours, we don't even try to compete in $$$ with the big box stores.  We're both selling drugs but we're not in the same business.  Just like milk costs more at 7/11 cause you can get it at 3am.....drugs will often cost more at a store you can hit up at 11:55om than one that is staffed 9-9.
2.  The person you're talking to actually has to have to power to capitulate. - The drug price, dispensing fee and upcharge are all set and negotiated by head office, the government, and your insurance co... do you really think that I have the power to override it?
3. The person you're talking to actually gives a shit - seriously....I don't know you...you don't know me.  Don't read my name tag and address me by my first name and tell me how much business you bring in....you get 4 viagra tablets every 3 months..... (my dog fucks his favourite pillow more often than you're gettin it....) .... I don't owe you any favours...I work 2 shifts a month max at this store....just go away. 

Also.... 1a) if it's an urgent medical need....don't threaten to go elsewhere if you don't know they're open.  If you threaten to go to the grocery store and I know they're closed....I won't even put your stuff back on the shelf...I know you'll be back in however long the round trip takes....but you're still gonna wait the 20-30minutes as if I was doing it from scratch.

Oh....if you do take your business elsewhere because they're cheaper...and they forget to tell you a single goddamn thing about your medication....and now they're closed cause they work sweet hours (and I'm working until midnight, then turning around and working at 6:30 the next morning).... don't you fucking dare call me and ask me to counsel you over the phone for free.  You know that $2 you saved.....yeah...maybe that's part of what you were paying for here that you didn't get there....oh...and I'm open and they're not....maybe that's part of that outrageous price we were asking.  Better luck next time.  If you'd like to make an appointment, I'd love to have a private consultation with you.....$75/hr.

When Pharmacists Snap - A collection of Short Stories

What follows is a collection of humorous short stories I have collected over my career of funny moments in retail pharmacy when pharmacists lose their cool and bark back.  We are generally pretty good at letting shit slide, but sometimes the planets align and funny stuff happens.  Some are personal, most are from colleagues.  Enjoy

Chapter 1: All you do is put pills in a bottle

During a particularly busy day at the very first pharmacy I worked at (it was about a 400 script a day store), one very smug gentleman was dropping off a prescription.  When he asked the pharmacist (who was nearing retirement) how long it would take she replied “Oh, about 20 minutes or so!”

“20 MINUTES!” responded the gentleman “THAT’S RIDICULOUS, ALL IT IS IS PILLS IN A BOTTLE!”.

Without missing a beat the pharmacist reached behind her back, (without looking), grabbed a random bottle of prescriptions meds off the shelf and gently tossed it to the gentleman.  “There you go sir!” she said as he caught it.

“Uhh, but” the gentleman stammered after catching the bottle.

“Yes, is there a problem” replied the pharmacist.

“How do you know if this is the right stuff” replied the gentleman.

“OOOOHHHH” she said “You wanted pills in a bottle, I gave you pills in a bottle.  That is, afterall, all that I do.  I never realized you wanted it to be correct”.  She walked over, snatched the bottle out of his hands and said “It will be 20 minutes then”.

Red faced the gentleman walked out of the dispensary.  When he returned to pick up his pills he did not utter an apology, simply just paid and walked out.

Chapter 2: That’s so unsanitary

Another pharmacy I worked at was open from 9am to 10pm.  Unfortunately, on one particular day, only one of the staff pharmacists was available (due to doctor’s appointment and what not) which meant he would be pulling the 13 hours by himself.  Of course, per the regulations of pharmacy, he could not leave the dispensary without a pharmacist.  Were he to go for a lunch or dinner break.  As pharmacists we’ve all done this, its part of the game (Where I currently work I pull 9 and a half every day without a break) and we deal with it by packing lunches and eating on the fly.

Anyhow, it wasn’t an overly busy day so around 2pm the pharmacist grabs his lunch and begins munching away.  A woman, in her late 60’s, walks up and hands in a prescription to the technician.  The technician checks it out and says “It will be about 20 minutes.”

Without missing a beat, because she really wanted to display how smart she was, she walked over to the part of the dispensary where the pharmacist was chowing down and in an uppity voice says “You know, that is very unsanitary, eating your lunch while you are working.”

Without even a moment’s hesitation he stood up, looked at her and said: “You know, you’re right, it will be about an hour until your prescription is ready” Then shouting to the girl at the front counter “As soon as this woman walks out the door please lock it and put up the CLOSED sign, I’m going for lunch” at which point he walks out of the dispensary with his lunch and walks out the back door, slamming it behind him for effect.

“He’s not serious is he?” the woman asks the technician.

“I don’t know, he looked pretty serious to me, I guess I will see you in an hour” she replied.

As a side note, he waited about 2 minutes, walked back in and sat down and kept eating his lunch as the technicians killed themselves laughing about the look on the woman’s face when they locked the door behind her.

Chapter 3: Call me if you don’t get my fax

One day I was working (yep, this one is mine) and a customer came over and asked if we had received a prescription from her physician’s office.  We had not, but “No problem” I said “They probably just got busy, I will call them up and get them to fax it now.”

So I call up the doctor’s office and am greeted by a very snobby “Yes, what now” by the receptionist (obviously she has call display and is having a shitty day).  I tell her Mrs. Doe is here to pick up a prescription that was supposed to be faxed in, but which I never received.

Angrily the receptionist snorted “You know, we are very busy around here, the next time you notice that you haven’t received a fax from me just phone me right away instead of waiting 3 hours”.  I waited a couple of seconds to let that sink in, then I asked her “And how would I know if I didn’t receive a fax from you if you don’t send it?  Do you just want me to phone you every 10 minutes to ask you if there are any faxes you may have for gotten to send, because I’ll be honest, I think that would be a waste of both my and your time.”

“Whatever” she replied and slammed the phone down.  I’m not sure if she actually realized just how absurd her request was.

Chapter 4: Every Time I come here it’s the same thing

One of my favourites, happened while I was working.  Once again, at the very first pharmacy I ever worked for.  It was particularly busy (actually the place was always busy) and there was a line of people waiting to drop off prescriptions.  A gentleman in his mid-fifties gets to the booth and hands the technician his prescription.  She takes a quick look and says “As you can see we are a little busy, it will be about 20 minutes”.

Very angrily he says “You know, every time I come to this goddam place it takes you 15 or more minutes to fill my goddam prescription.  What the hell takes you goddam people so long?” (I added the 3^rd goddam just now for effect).

Very calmly the technician looked at the gentleman and said “Well sir, you see, there have been a couple of people who just dropped off their prescriptions ahead of you.  Of course, each time we do this the prescription has to be entered and then counted.  Then the pharmacist needs to go through your file, well sir, I won’t bore you with any more details, but as you can understand it takes some time for this process, and there are quite a few prescriptions pending.”

“Oh” he said.

“And” she continued “every once in a while someone bitches at me about how long it takes for us to fill a prescription which means I have to explain to them why it takes so long which puts us even farther behind, so now, unfortunately it will be 25 minutes for your prescription to be ready.”

She then walked back and handed the script to me with a funny smirk on her face as the customer stood there stunned and the other people in line had a good chuckle.

Chapter 5: I just waited for 4 Fucking hours

I have to put this one in, because it is one of the most common stories I tell (and one of the most common ones that happens on a daily basis).  I was working the evening shift at the previously mentioned pharmacy that is open from 9am to 10pm.  We had a walk-in clinic down the street that was hit or miss as to how busy it was at nights.

Anyhow, this was a particularly busy night.  It was around 9:30pm and we had already done 135 scripts since 6pm, and it was just myself and one technician.  So this dude walks in, already has a pissy look on his face when he hands me the script.  We were at the point of getting caught up, so when I took it from him I said it would be about 15 minutes (which means it could be as quick as 5 minutes as long as I didn’t get a bunch of phone calls and questions etc.)

The guy looks at me and says, “I just sat in that clinic for 4 fucking hours waiting to see a goddam doctor, and now you are going to take 15 minutes?  That’s ridiculous, just give me back the prescription and I will take it to Mall-Mart”.  (For some reason that is everyone’s favourite threat, as if Mall-Mart is somehow magically faster than all the other pharmacies in town).

Normally , I would just give them back the script, but I was in a particularly good mood (ie shitty) because it had been a night of crabby people from having to wait at the clinic.  I just looked at the guy and said “There is no way you can get in your car, drive all the way across the city, hand in this prescription and have them fill it faster than it will take if you just have me do it here.”

“Whatever, just do it then” he said.

In an event, the phone didn’t ring, I wasn’t interrupted and abracadabra it was done in five minutes and I handed it to the guy.  “That didn’t take 15 minutes” he said. “I know, I just get a little angry when people bitch at me about 15 minutes being to long when they just waited 4 hours at the doctor’s office”.

Chapter 6: I’ll have a double-double

This one comes from a friend of mine.  Once again, broken record here, it’s about people bitching about a 15 minute wait.  Its seems if you tell them it will be 30 minutes the just think “Wow, they must be busy” but when you say 15 minutes they seem to think you are just screwin’ the pooch and making them wait.

Regardless, homeboy walks in and hands my buddy a script.  He’s got a cup of coffee in his hand from the coffee shop located across the parking lot (the one named after a Hockey Player that is famous for their Double-Double’s).  Now his prescription is from his doctor across the city which means this genius went and got his prescription, then went and got his coffee, and then went to the pharmacy.  Smart thinking says he should have turned in his prescription first, then went and got his coffee.

So, anyhow, my buddy tells him it’s going to be 15 minutes, to which he is met with “Oh for Christ’s sakes, I drive all the way across town and I have to stand in line for my coffee for 20 fucking minutes and now you are going to make me wait 15 more?”

My friend calmly replies to him “so you are saying waiting in line for 20 minutes for your coffee is entirely reasonable, but waiting for 15 minutes for a prescription, which could kill you if I totally screw it up is not?  I love your priorities man.”

With a stunned look the guy just said “Whatever” and walked away.

Best part, my friend sent his tech over to the coffee shop to get him a coffee and when the guy came back he handed him the script and said “Cheers my friend”

Awesome.

J

My back is killing me!!! Oh wait, there's a knife in it!

So usually my rants are me bitching about the stolidity of my patient base.  To be fair, only about 1 to 2 % of people are morons, but they sure know how to totally ruin my workday.  I figured this week I would give them a break, they’ve been working hard lately.

So today’s rant is going to be about other pharmacists and our willingness to stab each other in the back (usually before we throw each other under the bus).  Pharmacists tend to be a very caring bunch, myself excluded of course (I’m just an ass, but ya gotta be good at something).  We also love stabbing each other in the back in an attempt to make money.  For some people you can never have enough.  Personally, I realize that I’m pretty well paid.  Being a pharmacist is a pretty solid racket one might say, which is why I decided to stop working on oil rigs and furthered my education (although, this nagging back pain makes me wish I had decided that a year or two sooner).

Anyhow, pharmacists are compensated pretty well.  In fact, owning a pharmacy is a great idea (or it was at one time) which is why corporations wanted to get in on the racket.  Some time ago pharmacists of a generation past decided it would be a great idea to allow corporations to own pharmacies.  Great move!  Cue the back stabbing. You see, corporate America (in my case Corporate Canada, but I say Corporate America, just rolls of the tongue nicer) could realistically give a shit about my profession.  In fact, they could care less about you or me, all they want is money, as much of it as possible as fast as possible, and if you have to screw over the little guy in the process, well, screw ‘em.  This is the essence of capitalism.

Cue insurance companies.  They too realized there is a butt-load of money to be made on the drug business.  Hence the huge number of insurance companies vying for your hard-earned dollar to get you to buy drug insurance.  Here’s where the fun begins.  You see, some pharmacists of a bygone generation view themselves as businessmen and not health care professionals.  I can’t blame them, this seemed to be what you went in to pharmacy for, to be a businessman and earn a living.  It came with the bonus of being a “healthcare” professional.  Younger pharmacists such as myself (I know, I’m not THAT young) went into pharmacy to be health care professionals first, the earnings are secondary.  This has created an issue in the profession with older pharmacists not understanding why younger pharmacists wouldn’t want to work 120 hour weeks to get as much blood out of the stone as possible, and younger pharmacists soon frustrated when they realize they are nothing but corporate whores peddling their wares to make money for large corporations.

In an event, how does this all tie together (I seem to be rambling).  Well, a couple of quick points:

1.       FYI, much like Dentist’s, Pharmacies are not required to provide direct billing to your insurance company (but they all do).  We could, if we so chose, make you pay the full price and then submit your bills to your insurance company to be re-compensated.

2.       Pharmacists in each Province negotiate deals with their provincial government as to how much they will be paid for filling prescriptions.  This is the dispensing fee.  We also get to charge a mark-up on the medications, which is also negotiated by the government (I can’t upcharge more than a pharmacy down the street for example, this upcharge is fixed).

3.       Each Province is different as to the amount of medication they will pay for.  Here in Saskatchewan we have negotiated dispensing fees for drug lists.  There is a 34 day drug list, a two month drug list, and a 100 day drug list.  The fee is the same for each drug list.  This means some individuals receive some of their medications 34 days at a time, and some for a full 100 days’ worth (confusing, I know).   A pharmacy can, if they so choose, fill ALL medications for  a 100 day’s supply (which for me, being a small independent pharmacy is the fast track to going out of business).

4.       Insurance companies are run by low-life scum.  They could care less about these agreements.  They want you to get your stuff for as cheap as possible so they save money, fuck the pharmacists and whether or not their pharmacies are profitable (who doesn’t love working for free, and besides, we all know that bills magically pay themselves).  This includes, of late, sending letters to individuals recommending that they request a 100 day supply of all of their medications (not just the ones on the 100 day list) as it is cheaper for them.  This means I have to argue with the mouth breathers about why I do not do this, even though I can, and about the pharmacy going out of business if I did that for everyone.  Of course the typical mouth breather response: “Don’t do it for everyone, just do it for me” which is the typical piece of shit me first attitude I just love (as will be the subject of a future rant).

So some insurance companies have come up with a great idea. In their little letters they tell people that they should transfer their prescriptions to pharmacies that will fill all meds for the 100 days’ supply.  Basically, they strong arm the little guy into complying for fear of going out of business.  I love corporate greed.  Luckily, there are low-life corporate pharmacies out there willing to cater to this type of stuff.  Of course, the pharmacists working in these pharmacies know full well that this type of thing is basically like stabbing their colleagues in the back, but I guess as long as the bills are getting paid they are good (which is also very self-serving and very short sighted).

My solution (knowing full well it has a 0% chance of working) is to have all pharmacies in the province of Saskatchewan refuse to bill 3^rd party insurance payors, or failing that, have them just abide by  the goddam contract.  When the insurance companies cut off their coverage to their clients it is then on them to tell the insurance companies they can take their half-assed drug coverage and stick it up their ass.

But who am I kidding, that won’t work.  There will always be that segment of corporate pharmacies willing to screw the rest of us over.  And the worst part is, they won’t even buy us dinner before they screw us.

J