Let's all do some CE.....

We pharmacists are required to complete continuing education to maintain our licenses, and I wish that Americans were required to do the same to maintain their citizenship. I'm worried about the 'low information' voters. In fact, I believed that before they received their economic stimulus check, all Americans of voting age should have been asked to complete a CE packet. This would include things like how Congress actually works to pass bills (explaining things like veto-proof majorities and filibusters), what the Patriot Act actually says --- heck, what the Constitution ACTUALLY says, in plain language, and what it doesn't say. That way, when politicians make assertive statements which are in fact misleading or outright lies, we Americans would know better. I think there is a shocking amount of ignorance out there, and our politicians don't hesitate to cater to that lowest common denominator.

It's been shown that more people know the names of the American Idol judges than know the names of their Congressman or Senator. I had a few days off last week and in flipping TV channels was treated to "cage" fighting (where two guys beat the crap out of each other while the crowd screams for blood), Jerry Springer (enough said), Maury Povich (the 'paternity' show guy who determines who's the daddy of some poor kid born to a bunch of losers who scream at each other and then parade THE KID out there too), and of course the endless cheaply-produced reality shows that put a bunch of self-obsessed spoiled brats into contrived situations and then zoom in for those icky close-ups while they ponder their boring lives. I know there are many people who pay no attention to this garbage, but I fear there are too many that do. I guess with the election coming up, this makes me discouraged and worried.

Fact checking --- priceless!

Personalities

A friend of mine is miserable in his job because of one person, his immediate supervisor. He likes his job, but just can't take it any more and is forced to look for another one in a not-too-friendly job market. We have a few float pharmacists in our system who no one wants to see coming. They are either rude and confrontational or hopelessly disorganized, and some of our techs get almost physically ill at the prospect of working a shift with one of them. In my pharmacy career so far I've witnessed several situations where one person has been allowed to wreak havoc on an entire department -- that one person makes everyone unhappy, and the gossip and the behind-the-scenes eye-rolling goes on day after day and creates a crummy work environment.
I marvel at how these people came to their position of 'power' -- to impact so many people just on the basis of their personality and yet remain untouched and oblivious. There never seems to be a solution, and supervisors are reluctant to listen to complaints that are really just 'personality issues.' We all gotta get along, but I wish some people could get with the program just a little more.

With that, I'm headed off for a few days vacation!

I know it's been said before, but........

We send a refill request for Lisinopril 10mg, 1 tablet daily.
We receive a faxed prescription back for Lisinopril 40mg, 1 tablet daily.
We send it back to question the change in dosage.
We receive another prescription for Lisinopril 10mg --- Yay! --- oh, wait a minute, it says 2 tablets daily.

I really resent having my time wasted this way. I want to call the Dr.'s office and say, C'mon guys, this is the EASY stuff. I shouldn't have to spend one more minute on this.

Just a crabby, crabby day today.

September's coming.......

.... and that means it's back to school, and that means the ADD meds come roaring back to life with a vengeance. We have a lot of pediatricians in the area who are big prescribers of these. I don't have any great insights into our over-medicated kids, but in performing the transactions I often feel it's the parents who need the meds more than their kids. For some, I know that these
medications can be a god-send --- the kids read better, get better grades and feel better about themselves. The parents may be anguished about using medication but want to try to help their kids any way they can. On the other end of the spectrum are the parents who are impatient, self-absorbed and a nightmare to deal with. You can easily see the type of chaotic environment the kids must live in and why they may have some trouble behavior-wise. My least favorite of these parents are the well-off suburbanites who you suspect don't have the time of day for their kids. They act terribly put-out by the whole pharmacy visit routine and may even complain loudly about the co-pay going up while the kid stands miserably in the background. I just hate that. And of course the whole idea of having to plan ahead for that next 'refill', which needs a signed prescription, is foreign to them.

Some parents really have it together -- they will call and set things up during the last week of August in anticipation of school starting. Others, not so much. It will be the Friday before Labor Day when they suddenly realize school starts Tuesday, and then it will be my fault that they can't pick up the prescription in an hour. Sigh. Oh well, somethings never change ...!

Please Mr. Postman

Our pharmacy will mail your prescription medications to you -- it's a service we offer, although we have to do it to stay competitive. We don't charge for the mailing or the postage, and we'll even attempt to contact you when the credit card number you've given us for your copay declines. It does create a lot of extra work. But please understand, no matter how many times you ask me, I CANNOT tell you exactly when your prescription will arrive. Once it leaves the pharmacy it is out of my control. If you call to order the refill at 2pm today, and then ask me "Do you think I will get that tomorrow?", my best guess would be no.

"But I really need it and I just took my last one." My guess is still no.

"I'm going out of town and I've got to have it."

Well, on your way out of town, why don't you swing by the pharmacy and pick up the damn thing. Otherwise you will have to wait. I verified your address. And if it doesn't arrive in a few days, it may be sitting erroneously in your neighbor's mailbox or stuck in some sorting machine at the post office, but I just don't know what to tell ya.

I'm not sure what a pharmacy's responsibility should be when it comes to mailed medications that don't reach their destination. Should we be stuck for it and replace it? Do we charge the patient a second time? I'd be interested to hear others' policies on this.

My favorite time of the day

Lunch time! Of course, a lot of pharmacists don't get lunch -- they either skip it entirely, thus ending the day dehydrated and ketotic, or they are forced to wolf down some sort of stale sandwich while perched on a stool in front of a computer or huddled in the back room next to the sharps containers. They return from their luxurious 7-minute meal break hopelessly behind and wondering whether it was worth it at all.

Sometimes, when working with a second pharmacist, I actually get a lunch break. I can leave the pharmacy and come back after 30 minutes or so. I've never been one to run errands at lunch. My main goal is to (1) sit down and (2) enjoy some peace and quiet where I don't have to answer a phone or talk to anybody or answer any questions. I don't want any social interaction -- I want to eat and read a book. Some of the people I've worked with will actually go out and sit in their cars, just to enjoy that little cocoon of quiet. It is actually rejuvenating.

This is pretty standard in the pharmacy world. I'm used to it, but I often fantasize about having a different career where I'm working in a big downtown office. I walk out of the building at noon for my lunch hour (!), perhaps with some co-workers and we go down the street to a restaurant where we sit and look at a menu. We eat and maybe get some dessert. That would be awesome. except I would probably weigh 300 pounds. But I can still dream......

Playing Policeman

The Pharmacy Chick had a post recently about how Schedule II prescriptions used to be relatively rare, but nowadays our C-II cupboards may as well come equipped with revolving doors. I realized how true this is. And not only do we seem to dispense C-II's frequently, but in larger and larger quantities. Lately I feel like we've had to play policeman more than usual (is it something about August?) ----- the early refills because "I'm leaving town", the meds that were "stolen," the claim that won't go through because it's already filled somewhere else but the person figured they could double-dip.

Strangely enough, it's not the C-II's lately --- it's the clonazepam, the Ambien, the tramadol, and of course always the Vicodin. I don't really take any satisfaction in thwarting these people's attempts to obtain more drugs. It's got to be a crappy life. But then I'm waiting on the guy with cancer who's almost apologetic about picking up his oxycodone and tries to ask me in a round-about way if he should worry about becoming 'addicted.' I guess it's something all we pharmacists just deal with.

Mystery Science Theater

No, unfortunately, it's not Gypsy, Tom Servo or Crow. It's the individual who loudly proclaims, "I'D LIKE AN OTC RECOMMENDATION FOR MY ALLERGIES." This individual then proceeds to tie up one of our pharmacists for a good 10 minutes. We strongly suspect this is one of the mystery shoppers our company employs to make sure we're all being good. However, this person puts forth a thousand questions, like, "Do these allergies have anything to do with my age?" and "Will I have this the rest of my life?" The pharmacist gamely tries to use his crystal ball and give some kind of answer, but mystery shopper just won't wrap it up.

I don't think these people are supposed to tie us up that long. They are supposed to fill a prescription, or ask a couple of questions, or see if the shelves look tidy, or maybe just make sure we don't snarl at them. Most of the time we score pretty well because we can spot them a mile off. But they shouldn't back us into a corner for so long that the 'real' customers are kept waiting.

Tumbling Dice

I've got my head down frantically trying to catch up from a semi-regular computer failure when I hear one of my least favorite sounds --- the rustle of a plastic bag followed by the sound of multiple empty prescription bottles hitting the counter.

It's Saturday. I'm the only pharmacist and we have 'weekend' staffing. I glance at this customer and think why, in the name of all that's holy, couldn't you have called ahead (say, yesterday) and ordered those refills? They would be ready. You wouldn't have to wait. I wouldn't have to look at you looking at me and waiting expectantly like you had just revealed my Christmas presents. When you come in on a Saturday and plop down those empties, chances are you are going to have a long wait. You are gambling that you have refills available and that I have all the drugs in stock. I must admit I take perverse pleasure when one of those situations arises. That'll learn ya.