This year's March break took the form of a road trip -- a pretty long one at that -- about 1200 miles passing through the Midwest and into the Southeast. I've done this drive before, but usually when it's hot and the cornfields are planted and well on their way.
Looking out the car window, there are a few things I noted:
1. Burger, burger, burger. Every exit off the interstate has a McDonald's, Wendy's and Burger King. There are some pizza places and Subways, but I'd give anything to avoid consuming 800-1000 calories in 5 minutes and then return to sitting on my butt for another 4 hours.
2. A lot of people across this land live in mobile homes or small modular houses -- we are a wealthy nation, but most of us aren't wealthy. The number of RV's sitting outside is striking too. A lot of them look like they haven't moved in a long while. But for many people, an RV is how they vacation -- they don't jet off to some distant land and stay in a hotel.
3. The truckers and truck stops. As the slogan goes, trucking really DOES move the nation. There are countless numbers of them, and late at night I think it must be a gritty, lonely job.
4. The number of places that are open 24 hours. Pharmacies, restaurants, drive-thru's, grocery stores. truck stops, gas stations --- always someone working late into the night hours.
5. Getting the farm fields ready for spring. Seeing two Amish men out in a field with a horse and plow. The young Amish woman sitting reading a book when we went into her store to buy some jam.
It's a very diverse country we live in. I just find it interesting to observe, whether you're standing in the middle of Times Square or driving through West Virginia coal country.
Now, back to work --- and no more burgers for awhile!!
Monday, March 30, 2009
Wednesday, March 18, 2009
Puh-leeze Read the Signs
The car wash I use has an automated pay station located slightly around the corner from the entrance to the car wash itself. You pay, and then a large green arrow lights up when the car wash is ready for you to drive in. There is a large, clear sign on the pay station: WAIT HERE UNTIL GREEN ARROW LIGHTS UP. So I watched with amusement as every car ahead of me paid, then plowed ahead and waited inches from the closed door to the wash. Of course eventually the sequence of payments got totally screwed up and the wash wouldn't open at all until the cashier came over the intercom and got things re-aligned, reminding everyone of what the sign said. Sigh.
Why don't people read the signs? We've all had the customer who spots you in the pharmacy and pounds on the window "ARE YOU OPEN??" when their pounding fist is literally inches away from the sign that states the pharmacy hours of operation. Public places, including medical clinics and pharmacies, are full of signs that are gleefully ignored:
Pick Up
Drop Off
Please present insurance card with prescription
For the privacy of the person ahead, please remain behind this sign
Please check in with pharmacy staff if your prescription has been sent by your doctor
Leave lab slip here, ring bell once, have a seat
.. and so on
Someone I know who works in a museum always stresses the importance of signage.
Its purpose is to give people direction in an unfamiliar place and to improve the success of that place by keeping people moving efficiently through it. But you've got to stop for just a minute and READ -- you've got to take just a second and OBSERVE, and that's the problem.
We deal with lots of people who are distracted and in a rush. There are lots of non-English speakers too (although many of our signs are in multiple languages.) I think there is a subset of people who just outright refuse to 'follow' the signs, though. You can spot them a mile away. One good example is the alpha male type who isn't going to be told what to do and certainly isn't going to be part of the 'herd.' It's ME first, and I don't have time to read your silly signs so you will have to give ME your personal attention. These are the ones I dislike the most. Nobody's trying to boss you around, your Royal Highness, we're just trying to make things run a little smoother. Just take a second and read the sign.
Why don't people read the signs? We've all had the customer who spots you in the pharmacy and pounds on the window "ARE YOU OPEN??" when their pounding fist is literally inches away from the sign that states the pharmacy hours of operation. Public places, including medical clinics and pharmacies, are full of signs that are gleefully ignored:
Pick Up
Drop Off
Please present insurance card with prescription
For the privacy of the person ahead, please remain behind this sign
Please check in with pharmacy staff if your prescription has been sent by your doctor
Leave lab slip here, ring bell once, have a seat
.. and so on
Someone I know who works in a museum always stresses the importance of signage.
Its purpose is to give people direction in an unfamiliar place and to improve the success of that place by keeping people moving efficiently through it. But you've got to stop for just a minute and READ -- you've got to take just a second and OBSERVE, and that's the problem.
We deal with lots of people who are distracted and in a rush. There are lots of non-English speakers too (although many of our signs are in multiple languages.) I think there is a subset of people who just outright refuse to 'follow' the signs, though. You can spot them a mile away. One good example is the alpha male type who isn't going to be told what to do and certainly isn't going to be part of the 'herd.' It's ME first, and I don't have time to read your silly signs so you will have to give ME your personal attention. These are the ones I dislike the most. Nobody's trying to boss you around, your Royal Highness, we're just trying to make things run a little smoother. Just take a second and read the sign.
Sunday, March 15, 2009
Random Things that Made Me Go Hmmm.....
A parent who rushes in to pick up a brand new prescription for a bed-wetting child who's going on a school field trip (like, leaving in a half hour). We don't have the strength they need, we call around to find it, get the Dr.'s office to re-send the script to the other pharmacy, and she rushes off. Hmmmm. You mean she's going to send this kid off on an overnighter with a brand new prescription he's never taken before and hope everything goes fine?
A female patient being checked out with a new prescription for a psychiatric drug. Paid up, ready to go, and then mentions that she and her husband are actively trying to get pregnant, and that she didn't mention this to the doctor. Hmmm. That definitely would have been a good thing to mention somewhere during the discussion -- this isn't M & M's we're taking here. In fact, we check the literature and find you don't want to be taking this drug during pregnancy, especially the early stages. We pony up with a refund and she decides to call her doctor tomorrow.
It's chaotic, and we're having the usual back-and-forth-question-and-answer discussion with a customer to try and determine the insurance plan to which we bill their prescription. Phone calls, trial and error, a few more questions, doctor NPI search, several interruptions, customer hovering and waiting expectantly and being told it's gonna be a few more minutes and we'll call you when it's ready and finally we are ready with the prescriptions and applicable co-pays. Customer looks wide-eyed and then informs us he didn't bring any money with him. Hmmm. I want to pound my forehead on the counter.
A customer who squawks about a 3.00 copay comes in for an antibiotic which, she informs us, is for an infection she contracted from a pedicure. Hmmmm. I've never had a pedicure. How much are they?
We always double-count controlled meds that are dispensed by the Scriptpro (automatic 'counting' robot machine). I decide to randomly double-count some other meds too. Every single damn one seems like it's off by one or has broken tablets or fragments in it. Hmmm. I wouldn't blame a customer at all for getting mad about that -- they're paying for it, after all. But we don't have time to double-count all of them, so I hold my breath and hope.
I LUV my great technicians, but I worked with one this week who I don't see that often. Every time she prepared an antibiotic suspension or tube of cream she covered up every pertinent part of the manufacturers label (that I obviously want to see in order to check the thing) with our store prescription label and wrapped it in enough tape to seal a mummy. I don't mean to be picky here, but when I check something I like to see the original label, NDC number and bottle size. Hmmm. I can't see through your label and I sure as heck can't peel it off through all those layers of tape. Maybe I could dig through the garbage to find the box? Whaddya think I'm doin' over here anyway? I'm checking! I REALLY AM!
A female patient being checked out with a new prescription for a psychiatric drug. Paid up, ready to go, and then mentions that she and her husband are actively trying to get pregnant, and that she didn't mention this to the doctor. Hmmm. That definitely would have been a good thing to mention somewhere during the discussion -- this isn't M & M's we're taking here. In fact, we check the literature and find you don't want to be taking this drug during pregnancy, especially the early stages. We pony up with a refund and she decides to call her doctor tomorrow.
It's chaotic, and we're having the usual back-and-forth-question-and-answer discussion with a customer to try and determine the insurance plan to which we bill their prescription. Phone calls, trial and error, a few more questions, doctor NPI search, several interruptions, customer hovering and waiting expectantly and being told it's gonna be a few more minutes and we'll call you when it's ready and finally we are ready with the prescriptions and applicable co-pays. Customer looks wide-eyed and then informs us he didn't bring any money with him. Hmmm. I want to pound my forehead on the counter.
A customer who squawks about a 3.00 copay comes in for an antibiotic which, she informs us, is for an infection she contracted from a pedicure. Hmmmm. I've never had a pedicure. How much are they?
We always double-count controlled meds that are dispensed by the Scriptpro (automatic 'counting' robot machine). I decide to randomly double-count some other meds too. Every single damn one seems like it's off by one or has broken tablets or fragments in it. Hmmm. I wouldn't blame a customer at all for getting mad about that -- they're paying for it, after all. But we don't have time to double-count all of them, so I hold my breath and hope.
I LUV my great technicians, but I worked with one this week who I don't see that often. Every time she prepared an antibiotic suspension or tube of cream she covered up every pertinent part of the manufacturers label (that I obviously want to see in order to check the thing) with our store prescription label and wrapped it in enough tape to seal a mummy. I don't mean to be picky here, but when I check something I like to see the original label, NDC number and bottle size. Hmmm. I can't see through your label and I sure as heck can't peel it off through all those layers of tape. Maybe I could dig through the garbage to find the box? Whaddya think I'm doin' over here anyway? I'm checking! I REALLY AM!
Saturday, March 7, 2009
New Drugs, Old Drugs and Borrowed Drugs
I usually try to be nice to drug reps, unless they are really obnoxious, condescending, or try to tie me up when I'm obviously really busy. They're just people trying to do a job (one that I would not want). Some of them are nice and even thank me for my time, and jeez, how often does someone do that? I guess I'm just a sucker for anyone who even fakes respect for me.
I got a visit from the Kapidex rep last week. I mean, I felt bad for the guy even having to TRY and sell this stuff. This is the new R-isomer of Prevacid -- another example of the many 'new' drugs which take an existing drug and tweak it a little to make it sound brand new and different.
You take that existing drug and you market the isomer, prodrug or active metabolite and promote it as the next best thing, especially when the original drug is soon to go generic. And the company offers a discount card for $55 off on Kapidex -- so you know if they are knocking $55 OFF it already costs too much. You look at all the glossy literature and you think, this is an especially unfortunate waste of resources in these tough times. I mean, seriously? I can't wait to see the TV commercials.
The other one out there in the TV commercials now is Oracea, a "unique" formulation (ie. lower dose) of doxycyline, another drug that's been around since the Stone Age. They were even running an ad on my TIVO service. I don't see too much hope for a market share for either of these drugs -- insurances will give them the cold shoulder --- but we'll be forced to stock some eventually and then allow it to expire.
Speaking of old drugs, I'm interested to see if the FDA will pull Darvon and Darvocet-N products. I remember being told in pharmacy school that propoxyphene was a pretty mediocre analgesic with more risks than benefits and I've never been real excited to dispense it to anyone. We've already had a customer panicking on this one.....
I got a visit from the Kapidex rep last week. I mean, I felt bad for the guy even having to TRY and sell this stuff. This is the new R-isomer of Prevacid -- another example of the many 'new' drugs which take an existing drug and tweak it a little to make it sound brand new and different.
You take that existing drug and you market the isomer, prodrug or active metabolite and promote it as the next best thing, especially when the original drug is soon to go generic. And the company offers a discount card for $55 off on Kapidex -- so you know if they are knocking $55 OFF it already costs too much. You look at all the glossy literature and you think, this is an especially unfortunate waste of resources in these tough times. I mean, seriously? I can't wait to see the TV commercials.
The other one out there in the TV commercials now is Oracea, a "unique" formulation (ie. lower dose) of doxycyline, another drug that's been around since the Stone Age. They were even running an ad on my TIVO service. I don't see too much hope for a market share for either of these drugs -- insurances will give them the cold shoulder --- but we'll be forced to stock some eventually and then allow it to expire.
Speaking of old drugs, I'm interested to see if the FDA will pull Darvon and Darvocet-N products. I remember being told in pharmacy school that propoxyphene was a pretty mediocre analgesic with more risks than benefits and I've never been real excited to dispense it to anyone. We've already had a customer panicking on this one.....
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