Monday, September 29, 2008

Special Orders

We frequently have customers coming in and looking for a specific OTC item that we don't carry. If they mention it's "really hard to find" I always offer to check our wholesaler's catalog and order it for them if it's available. This can be sort of an interruption and can take a few minutes, as sometimes finding the specific item is easier said than done. But I'm glad to do it, because I've wasted many a trip looking for hard-to-find items myself (I think every OTC med/hair/cosmetic/skin product I've ever really, really loved has gone from hard-to-find to discontinued right after I discover it.) If the customer asks me to order the item I do, and I advise them it will be in the next day. The next day it comes in and I carefully set it aside, sometimes with their name on it.

Which is why it kinda bugs me when they never come back and get it. It would be really easy for me to shrug my shoulders and say, "naw, we don't carry that". But I made the effort, so please, come back and get it cause I really have no use for it. We've had many of these oddball items sitting around for months collecting dust. Don't ask me to order it if you're not coming back --- I've got other stuff to do !!

Saturday, September 27, 2008

One more post about Med Guides then I'll shut up

I dunno, it seems to me that this whole med guide thing would be a fairly big deal to the standard operating procedure of most pharmacies, but it's being pretty much ignored. Everyone knows about these FDA-mandated drug information sheets that are supposed to be supplied with EVERY new prescription AND refill for a whole host of commonly dispensed drugs -- antidepressants, NSAIDs, warfarin, ADD drugs (Adderall, Concerta) to name just a few. The regulations state that a pharmacy's own printout is NOT a substitute. They also state that a prescription dispensed without this required information can be considered to be 'misbranded.'
That's a pretty big deal. There are some products (eg, Advair inhalers) where the med guide is included in the box and you don't have to worry about it. But I can confidently state that the pharmacists I work with are NOT grabbing that tear-off pad and enclosing that med guide with every (or any) of the dozens and dozens of ibuprofens, Wellbutrins, Lexapros and Methylins that we verify every day. It's not that I'm dying to do it either --- it's a cumbersome regulation to add to all the cumbersome regulations we already have. But I can't help but worry about the liability issue, and I think it is the job of our head office people to help us devise a way to comply with this, as long as it's on the books -- good or bad. But they're not doing anything and nobody really seems to care too much about it. It's just kind of puzzling. Of course, we'll get all kinds of directives every week about the stupid stuff -- full page memos about how to key in some discount coupon, or the 400th revision of the dress code......

I'll shut up now.

Saturday, September 20, 2008

I've got a question about Med Guides

How is everyone out there handling it? I'm sure some of the large chains have been able to incorporate the Med Guides into their own printed drug info that is generated with each prescription, but what about everyone else? Have you set up some kind of apparatus to store all the darn things so you can pull them easily as you're checking prescriptions? I'm really curious, as my employer has given us literally no guidance on this. I know some products have been able to incorporate it into their packaging... but, does everyone out there manage to throw one in with each antidepressant refill? I know it's kind of a dumb question, but every time I try to ask our head office about it, I get back a non-response (see previous post on e-mails).

Friday, September 19, 2008

Language Barriers

Today was one of those days when every customer interaction felt like a struggle to make myself understood. I attempt to explain how to take a Medrol Dosepak or a PrevPac or use an Advair inhaler and the person (of Asian, Hispanic, East African, etc., origin) nods and (sometimes) smiles. We complete the transaction and I walk away feeling very uneasy.

Sometimes it feels like the number of prescriptions and the complexity of the directions is inversely proportional to the recipient's ability to understand English. It especially worries me when a small child or baby is involved --- I point to the "1.5 mL" mark on the syringe and hope it's sinking in. Some pharmacies have the ability to print labels in other languages but I'm uneasy not being able to independently verify what the label says. And even if a translator or other family member is present, how do I know they are correctly translating what I'm saying?

I know, people should learn English when they come to this country. It takes time, though, and for some it may never happen, for whatever reason. I try to imagine if I had to learn Mandarin, or Thai, or Arabic, and was uneducated to begin with. Pretty tall order. I don't know what the solution is, other than trying to do the best you can under the time constraints. Come to think of it, we all know how frequently good old American English-speakers can screw things up --- I guess it can't be too much worse.

Tuesday, September 16, 2008

E-Mail Rules! (Sometimes)

PharmacistMike's comment on the last post regarding e-mail (how he always gets the e-mails on the lunch menu but not the important stuff) really had me nodding my head in agreement. I think e-mail is a great tool. Companies and organizations can communicate the same information to all their people with the touch of a keyboard -- it's so easy, DO IT! Of course you're assuming everyone checks their e-mail frequently, but assuming they do, it's far more efficient than phone calls or written memos. I almost always prefer e-mail as a communication method --- I don't get tied up on the phone, play phone tag, or end up babbling into an answering machine. I can state exactly what I want to say or ask a question simply and concisely and be done with it. It's there in black and white and the person on the other end (hopefully) is clear on the message.

It doesn't always go that way, though. How many times have you sent a somewhat lengthy e-mail with several questions in it and gotten back a one-line answer which in no way addresses your message? Or you are left wondering if the person got your message mixed up with someone else's, it's so totally unrelated to anything you said? Or the person answering you is simply unable to communicate with the written word and you're scratching your head trying to just understand it? That's when it can drive you nuts.

One thing's for sure though, the lunch menus will always come through!

Saturday, September 13, 2008

I hit the communication gap

Neither my company nor my wholesaler could explain the Sandoz Azithromycin suspension recall yesterday. Is this the deal where Pfizer claims it is misbranded? Considering we go through the stuff like there's no tomorrow, I figured someone could give us the lowdown so I would know how to reassure the wide-eyed mom who thanked me for not giving her child a 'recalled medicine.' Our company has a great tool to communicate with all its pharmacists (it's called "e-mail" ) but apparently couldn't figure out how to do it. Frustrating.

Friday, September 12, 2008

Where were you on 9/11?

I had the day off. I got up a little late, turned on one of the morning shows and immediately saw the picture of smoke billowing from the Trade Center. I thought, oh man, a high-rise fire --- that looks really nasty. Of course the reality quickly became evident, and as more planes started to crash I had this weird idea that the terrorists were tampering with our air-traffic control system (I had read a really good suspense novel called "All Fall Down" with this theme).
I spent the entire day in front of the TV, like many others. I had to call into work to check my schedule, and I figured the people there knew what was going on but weren't seeing the images yet. I exchanged a few nervous comments with one of the staff ("Crazy, huh?") and went back to watching the horror.

Putting aside the shock and grief at the loss of life, it makes me so sad to think of the lost opportunities and all that has been squandered since that day. On 9/11 America needed a president who was astute, strong and possessed of great wisdom. We needed someone who, as he accepted the sympathy calls from other world leaders would say thanks a lot, but we will ALL meet in one week's time at a designated location and we will TOGETHER form a plan to erase the scourge of terrorism from this world FOREVER.

Unfortunately, the people we had in office weren't anywhere near up to the task. It's now well documented that within hours (hours!) of the attacks they were trying to find a link to Iraq.
We were quite justified in going into Afghanistan but it should have been with 140,000 troops, not a force smaller than the New York City police department. Fifteen of the nineteen hijackers were Saudi nationals --- anyone know of any repercussions to Saudi Arabia? On September 12, the United States could have declared that we were severely restricting or stopping oil imports from Saudi Arabia (and believe me, the Saudis need us to buy their oil ---- it is the sole basis of their economy -- they have no manufacturing, no tourism, no nothing !). Remember how incredibly angry and upset we all were after 9/11? If Americans had been called upon to sacrifice, to conserve gas and oil, I have no doubt they would have responded mightily.

But we know the rest of the story. Arrogance, politics and incredible incompetence in Iraq--not the troops, the people who sent them there. Read the book "Imperial Life in the Emerald City: Inside Iraq's Green Zone" and you won't know whether to laugh or cry at the sheer idiocy of the "Coalition Provisional Authority. " When the British suffered a terrorist attack in 2005 the police had all the perpetrators either killed or in jail within days. They didn't invade anybody, didn't set up secret prisons, they just went after the people who did it and got them.

Normally I enjoy watching historical retrospectives on TV, like the History Channel often runs.
I have never been able to watch one on 9/11 --- I just find it way too painful. I can't begin to
comprehend what the people in those planes and buildings must have felt. I look back on the last 7 years and I don't think we have done right by them. It was the luck of the draw; we just didn't have the right people in charge. It should have been so much different.

Monday, September 8, 2008

Just a reminder to myself

A day rarely goes by when I don't remind myself how lucky I am. I was able to go to college, get a professional degree and work continuously in my profession, even with all its frustrations. I have never had to worry about supporting myself or about finding a job. I make good money and I never take this for granted. But in my pharmacy career I've worked with many people who live paycheck to paycheck, and many of the technicians I've worked with have been single moms who just barely scrape by every week. I feel guilty when I hear them talk about not being able to buy things for their kids. These are some really good workers who I depend on to help me, and there's no way they would rather be receiving unemployment or welfare. They come in every day and work hard and know exactly when that paycheck will show up in their account.

A technician once told me that she and her son had used the food bank for a time, and it helped her get back on her feet. Another one told me that a pharmacist she worked with had loaned her several hundred dollars to get over a rough patch --- the pharmacist just said, "You need it, I've got it, just take it."

I don't want to get political, because (a) I'm not smart enough, and (b) if you get political these days, you will alienate 50% of the people in the room. But there are a lot of good people out there struggling, and I really hope things will get better for them. We are told that the gap between rich and poor is ever-widening in this country, and that's not America. I believe in personal responsibility and obeying the law. I also believe that if a Category 4 hurricane destroys your town it's not your fault, and that the richest country in the world should be able to lend you a hand. I wish kids didn't have to pay the penalty for their parents' stupidity, and I wish the parents were never stupid. We've got to get smart in this country --- no more sneering at the experts, no more cowboy-redneck stuff, no more smirking at someone who 'went to Harvard.'

I guess what started this was that one of my clerks told me she was looking for a second job and all she could find was a job working overnight in a convenience store, alone, for 7 dollars an hour.
It just bothered me and made me realize again how lucky I am, even as I whine and complain about the ups and downs of the crazy pharmacy biz.

Saturday, September 6, 2008

What is it people don't get about insurance cards?

We asked for an insurance card from a customer this week. When the card didn't work, we asked if it was his most current card. He replied, "Well, it's the most current card I have ON ME." (Yeah, you're thinking what I'm thinking.) After some more unsuccessful efforts to get the claim through, we explained the situation and he proceeded to launch into some long explanation about primary and secondary insurance and something that had changed...... in other words, he presented this card knowing damn well it wouldn't work and stood there and watched us waste our time.

What do people think we are doing with these insurance cards? BRING THE CORRECT CARD.
It's a simple concept. We actually need the NUMBERS ON THAT CARD. It's not enough information to just say " I have Aetna (Caremark, Blue Cross etc etc)." We need the NUMBERS to bill your INDIVIDUAL PLAN. It's like trying to make a purchase with a credit card and telling the cashier, "Oh, I have Visa."

This customer finally ended up paying cash, and while tossing the bill on the counter made some remark about how this was 'always a hassle.' You got that right, bud.

Also, a heartfelt thank you to the out-of-state pharmacist who waited patiently while I tried to give him a copy, repeating his address and phone number twice, and waiting on me while I used the transfer function on the Worst Pharmacy Computer System in the World. You're a good egg.