Tuesday, April 27, 2010

I'm Sorry........ What?

This past week I can't count the number of people I waited on who had a cell phone pressed to their ear. Now, this isn't going to be another cell phone rant (although I'll say it AGAIN; if you don't terminate that call immediately, you have given the person on the other end of that call permission to hear EVERYTHING I'm going to say about your prescription. And I'm not going to wait one SECOND for you.)

In waiting on multitudes of people all day, I just can't get over how DISTRACTED everyone is.

We're supposed to counsel people on their prescriptions and believe me, I keep it as short and simple as I possibly can. I figure we should talk about the prescription at least briefly, but in addition to competing with the aformentioned cell phone, I've got people more concerned with trying to corral and discipline their kids, juggling their numerous bags and purses stuffed with everything imaginable, digging into those bags for money, credit cards, check books --- writing that check (which is a whole 'nother process in itself -- asking me the date & who they make it out to and then proceeding to balance that ledger), gathering up the other crap they have decided to buy and asking me if I've got it in any other flavors/colors/sizes, questioning the copay on the prescription before anything else and making it clear to me that actually using this medication has long since ceased to be anywhere on their radar screen.

With all the talk about the importance of 'education' in our country my biggest beef has always been that people don't take the time to READ, and if they do read they don't COMPREHEND. "Listening" is another skill that is similarly deficient. I told someone last week to get two doses of their antibiotic in on that day ---" take one capsule NOW, and another one TONIGHT." He calls me up 30 minutes later and says he took 2 capsules at once and is anything bad going to happen? .... And this is the easy stuff, folks.

With all the patient information and med guides we are required to stuff into every prescription bag, I'm honestly kind of surprised we don't get more questions from people.
I'd love to know how many people actually sit down and read through the instructions on that Spiriva or Asmanex or Maxair inhaler before they use it. People don't seem to know how to read and understand things that are right in front of them.

It's unfortunate that most of the children's cough/cold medications had to be pulled off the market recently -- not because they are inherently unsafe, but because too many parents couldn't read the damn directions and give their kid the correct dosage.

I find this worrisome. We can't live our lives in text messages and e-mails and Twitter feeds... but no one seems to have the time or the focus anymore.


Unknown said...

Agreed, everyone thinks they are an expert on everything nowadays since they have the internet.

I've also wondered for awhile now whether patients are just overwhelmed with the amount of information given to them, so they don't know where to begin and don't read any of it. We give them one page long printouts with each medication they receive, but to an average person one page is a lot to read.

Grumpy, M.D. said...

I agree that... SQUIRREL!!!

WarmSocks said...

I'd love to know how many people actually sit down and read through the instructions on that ... before they use it.
My parents taught me that the first thing you do with a prescription, before you take the medicine, is to get a magnifying glass so that you can read the entire package insert. The only time I didn't do that, I regretted it.

A little common sense would help, and less blind adherence to bureaucracy. How many times do I have to be given the same information? Some of us do listen. My doctor prescribes a medication, goes over the information with me, and gives me a phamphlet to read. I phone the pharmaceutical company's info line and discover that I can save $240 on my out-of-pocket expenses for this med if I will listen to them read the information to me. Then, just in case I have a short attention span, they mail me that information in a slick, multi-colored booklet. A few days later, the same information arrives in the mail again along with a sharps container (because they apparently couldn't ship it all in one box). The next week I return to the doctor's office and the nurse goes over the information with me again when she gives me my first dose. Finally have a written prescription to take to the pharmacy, where I receive a "patient education sheet" plus an extra "medication guide." Get home, open the box, and find all that information neatly printed on yet another piece of paper that takes up more space than the med. Two weeks later, the postman delivers a travel-sized sharps container and another brochure full of the exact.same.instructions. By now I can just about recite the warnings in my sleep. Not to worry if I forget, though, because every month I go back to the pharmacy and get the same information three more times (patient education sheet, extra medication guide, and box-insert). No, I don't read it any more; what a waste of paper.

Anonymous said...

I switched to the pharmacy I use now from a pharmacy that, when I read the partial insert I got and found that it said there was a potentially lethal drug interaction with a med I was already taking, got pissed off at me, refused to specify what the potentially lethal interaction was, and refused to take the prescription back (I had only gone about 3 feet away from the counter before pulling out the insert) when I said I wasn't buying it until I confirmed with my doctor that she thought the potential benefit was worth the risk. Then the tech started screaming at the pharmacist that he had to come void my sale because I was "refusing to take [my] meds."

They billed my insurance company anyway, and they refused to give me the meds when I came back after having talked to my doctor because the insurance company wouldn't pay for a second month's supply 3 days after the first month's supply.

So I switched pharmacies.

And even though I had read everything the first pharmacy had given me about each of the meds I was taking, I had some surprises when I looked at the materials from the second pharmacy. The first pharmacy had edited out an awful lot of side effects and drug interactions.

Sometimes I get annoyed when it's a new prescription for a drug I've taken for years and the pharmacist wants to discuss it with me. I shouldn't do that, and I really try not to show that impatience. I'd much rather spend a few extra minutes a year listening to the various things I should know -- and already do -- than not get the information at all.

And yes, I did have the exact interaction problem that the first pharmacy didn't want to warn me about -- and I'm very grateful that I was able to recognize what was happening and address the problem fast.

Frantic Pharmacist said...

Thanks for the comments. I'm always somewhat uncomfortable at being 'waved off' by someone with a brand new prescription who just wants to get out of the pharmacy and claims to have no questions at all. Legally, I'm just required to 'offer' counseling. I can't force anyone to listen. Which is why I hope they will read the written information. That's when I expect someone to call me back later in the day and ask a question. It doesn't happen that often, though.

The Redheaded Pharmacist said...

I'm sorry, did you say something Frantic? I was on the phone. Could you repeat that?

Just kidding, Today alone I got the wave off by a couple of people who were busy talking on their phones. If you aren't working on world peace or negotiating the release of hostages it can wait until after you pick up your medications!

FYI, my favorite thing to do is to ask an excessive number of questions all right in a row to people on their cell phones. It's fun and it confuses them. But I am like a little kid so maybe it's just me!

Anonymous said...

In my nicest voice possible, I say, "Let me know when you're done on the phone."

And if they hold the phone away from their ear for a sec to let me know it's ok to interrupt their conversation briefly to consult them, then I say, "Oh, no, when you're done." And my face says, "Not EVEN when you're on the phone."

They usually take the hint.