Wednesday, December 31, 2008

Shoe Update and Bye to 2008

A little while ago I wrote about my quest for a new pair of shoes that I could stand in comfortably for those long long days at the ol' pharmacy and I got some great suggestions (Merrell, SAS, Dansko, etc.) I filed them all away for future reference but I decided to try the Merrells this time (style: "Encore Groove"):

I am REALLY liking them. Nice contoured footbed, great arch support, very lightweight. I always stayed away from slip-on or clog style because I didn't want my feet sliding around in them but these fit like a shoe and don't slip at all for me. Glad for all the tips on shoes.

Busy last day of 2008 today -- pretty much non-stop prescription action. At the end of the day one customer apparently got booted from his Part D plan with the reject "Coverage begins 1/1/09" -- of course he claimed not to have changed anything and we figured they probably re-enrolled him and forgot that he might need something on 12/31/08. I waited on hold for about 15 minutes with the insurance and had to give up -- pretty annoying.

Another person came in and wanted to look at our selection of blood glucose monitors. Not for herself, though -- she had money left on her flex spending account and thought she might buy one and 'give it to someone else.' Interesting thought (come to think of it, can you do that?) but it took a few minutes to get the whole story --I thought, maybe she's going to put it away for that day she becomes diabetic?

A Happy New Year to all fellow pharmacists in the trenches! We'll keep on doin' it in 2009 -- like we have a choice, right?!!

Saturday, December 27, 2008

If I Were King........

Y'know, I'm not a manager -- I've always been a worker bee, and I 'supervise' technicians to the extent that we work together, and I'm the pharmacist. I try not to get sucked into petty bickering and workplace politics. I'll lend a sympathetic ear to whoever wants to talk to me. But I find the one thing that comes up over and over (and I'm sure this is true for other businesses) is this: If you're a manager, and you've decided to impose a rule or a standard that you expect your staff to follow, then EVERYONE has to follow it. There can be NO EXCEPTIONS. NONE. And the staff members who decide to blow you off while others attempt to obey the rules, need to be DEALT with. Not doing so creates unhappiness, morale problems, bickering, bad blood and outright hostility.

I'm just talking about simple standard stuff -- if you have imposed a dress code, for example. Or decided that employees are to answer the phone in a certain way. Rules about calling in sick, coming in late, or leaving early. I have seen over and over in my pharmacy career how certain employees are allowed to walk all over the rules, and I will never understand it, NEVER. You've got to treat everyone the same, and if there are extenuating circumstances, just explain it to everybody. This seems so simple to me -- am I missing something?

As you may have guessed, this issue has raised its ugly head again in my place of work. What a distraction....

Sunday, December 21, 2008

Oh, the pamphlets you'll get !!

Since we often see customers as they are coming out of their doctor's appointment, I can't help but notice the materials they plunk down on the counter while fishing around for their insurance/credit card/prescription. Often it's a fistful of those pamphlets that the doctor's offices hand out --- "Understanding Hypertension", "Lower Back Pain", "Meet Your Sinuses" (0r something like that). Unfortunately I think these pamphlets are a poor substitute for actual patient education, but I realize the limitations placed on some young nurse practitioner to try and change someone's entire lifestyle in a 10-minute visit for a Vicodin renewal. I waited on a rather disheveled, cigarette-smoky-smelling man who, as he left with his pain meds, remarked sarcastically "Now all I have to do is quit smoking, lose 30 pounds and quit shovelling snow." I started to laugh at his little joke then I realized the look on his face was one of pissed-offedness. I guess having those suggestions thrown at you along with a bunch of pamphlets doesn't go over too well sometimes, but again I realize the daunting task some of the practitioners face -- to motivate someone to really take charge of their health is a special talent they probably don't teach enough in medical school.

I know that 'wellness' programs are the new thing now -- run by insurance companies who will give you a credit for participation. Of course, you have to have insurance first. But let's face it, even those of us in the health professions can resist the idea of being lectured to, even if we don't smoke or over eat. We shy away from the chirpy 'coach' who tells us to exercise more. These people make us feel guilty, and running away from guilt is the most basic human emotion.

The motivation always has to come from within. Will power is such a tough thing to maintain. Anyone who can figure out how to harness these things in patients like my crabby customer will deserve a Nobel Prize. Then, we can get rid of the pamphlets!

Tuesday, December 16, 2008

Layoffs and Loyalty

Our organization has been hit with some layoffs -- not the pharmacy department, but the health care organization/clinics where we are located have cut some support staff, including some pretty senior people. I know it's going on all over the country, but it sure sucks. One of the people I know who is laid off has a terminally ill family member. At Christmas, no less. The organization warned us it might be coming, but it's still kind of shocking. Even if you're not affected, you almost have a 'survivor's guilt.' You don't really know how to act.

I think of myself as a conscientious employee. I come to work to work -- not to stand around and chat, not to avoid the jobs I don't like, not to do the bare minimum until I can go home. I get angry at other people for doing those things. I try to be as helpful as possible to my customers and co-workers, whom I value and generally like very much. I have to be at death's door to call in sick. But when it comes to the 'company' or the 'organization' I have always kept them at arm's length, because I know when push comes to shove it's all about the bottom line. They won't go to bat for me. We get the philosophy lectures, the mission statements, the caring & sharing pamphlets -- all that stuff. I've seen it many times and I know it's just window dressing.
When I'm at work I do a good job not as a representative of the company, but of myself. I don't feel good about saying it, but you won't find me wearing a sweatshirt with my company's logo or volunteering at some company-run 'ask your pharmacist' event. I don't feel that kind of loyalty and unfortunately I know it's reciprocal.

I've always been able to get a lot of job satisfaction from pharmacy work. I don't need to work for the World's Best Company to get it. I'm glad to have job security and I truly wish everyone did.

Friday, December 12, 2008

I'm here to pick up prescriptions for (insert name here)

We had a rash of problems this week with people sending other people to pick up their prescription refills. You know the drill ---- boyfriend, girlfriend, spouse, neighbor, babysitter, caregiver, friend or family member comes in to pick up for their boyfriend, girlfriend, spouse, etc. and leaves with a sack of items that are filled and ready. Shortly, a phone call comes in from the customer who is angry because they didn't get 'everything.' A search of the pickup bins reveals another bag or two for that same customer which was separate from the other items.
There are lots of reasons for this -- prescriptions called in at different times, prescriptions waiting on doctor approval, prescriptions waiting for a supply of drug to come in --- these may all result in items being completed at different times and added to the bins. It's not always possible to keep everything together. And people can be pretty p.o'd that their errand person didn't come back with all of it (as in, "What do I do now because YOU guys screwed up??")

So, rule of thumb: when sending someone to pick up prescriptions for you, tell them HOW MANY they should be getting. Preferably, make an EXACT LIST. Check it twice. So you won't be naughty and we'll be nice.

One other random irritant: insurance companies who now cover only generic Imitrex -- but we can't get our hands on any, leaving us and our headache sufferers up the creek...

Monday, December 8, 2008

Because of the Economic Downturn, Do I have to Kiss Butt More than Ever?

It's starting to look that way. If numbers go down and people aren't going to the doctor, it's being suggested that we've got to take pains to bend over backwards for the customers.

Sure, normal customer service is expected. But I do not feel any more compelled to figure out someone's insurance plan who doesn't have the card and doesn't have a clue. I do not feel any more compelled to try and counsel a patient who is talking on his cell phone through the entire transaction and glares at me for the interruption. I do not feel any more compelled to tiptoe around a customer who I know to be getting his narcotics from several sources, and who has hopelessly duped his doctor.

Yes, they might go somewhere else. And with the number of copies I'm giving out lately maybe they are -- although I believe the gift cards are playing the biggest role there. But I'm not going to kiss butt to anyone who's being rude, sneaky or just downright lazy. And I'm going to feel the same whether the economy is up or down. Enough said.

Tuesday, December 2, 2008

Those cursed little rolls of labels

Most of the technicians I work with are accustomed to having different pharmacists come through from day to day, and some of those pharmacists like to do things different ways. I am impressed with the technicians who try to remember the preferences of each pharmacist, or who ask "How would you like me to do this?" if they haven't worked with you a lot. It can't be easy for them to keep track all the time. Some pharmacists like to receive the prescription for its final check in as 'finished' a form as possible (like me). Others seem to trust the technician only to count out or pour the medication -- the rest of the paraphernalia (receipts, patient info, med guides and other paperwork) gets dumped into the basket for the pharmacist to sort through and arrange in some presentable form. To me, this is a frustrating extra step especially when a patient's got multiple prescriptions and I'm up to my eyeballs in waiters.

One technician told me he worked with a pharmacist who didn't even want him to stick the label on the vials (!) and visions of a counter-full of unlabelled med vials gave me nightmares.

Anyways, we have one or two pharmacists who don't want the techs to put any auxiliary labels on the vials -- they only want certain ones and so they want to do it themselves. Now, everyone's computer software spits out some auxiliary labels that are not worth slapping on the vial ("Take exactly as directed"? --- I hope that was implied...). And we have a few in our system that I think are needlessly alarmist, like the statin prescriptions that say DO NOT drink any grapefruit juice EVER. But why would any pharmacist not allow a "Shake Well " label on an inhaler or antibiotic suspension, or a "May cause drowsiness" on just about any pain med?
My point is that I'm standing there fiddling with these silly things when I'm already way, way behind and I wish that other pharmacist would lighten up and let the techs do the obvious ones.

I know, we're lucky if the patient reads the label at all, much less these little extras. I remember in pharmacy school wet lab having to carefully note all the auxiliary labels that should be placed on my newly created medicine. I just can't shake the habit that my Rx's look naked without them.