Subject: Miscellaneous

I've got a few things running around my head to vent about.

1. E-scripts.  It's official, I HATE them. I have never seen such a run of errors, ambiguities, lazy and nonsensical stuff coming through on these things.  Yeah, they're great if the prescription is "Amoxicillin 500mg, one TID."  But for anything that requires any degree of thought, forget it.  So we have the situation where doctors are sending us one set of directions because they are pre-loaded into the system, but telling their patients something completely different, because they don't know how to change it. They don't know how to add special directions, like where exactly to apply each of those 3 ointments they just prescribed. So, when it comes time for my little counseling session with the patient (who hasn't listened or has forgotten everything the doctor said),  we're both clueless. I actually had a doctor (attempting to prescribe nystatin cream) select an entry for a multi-ingredient compounded ointment because it 'contained' nystatin, which I guess was good enough for him, and stick the words 'nystatin cream' in the comment section of the prescription entry which was his way of saying...... I don't know what the hell I'm doing.  I mean seriously?

2. I got a big drug order from my wholesaler but was missing some of the paperwork. I call the wholesaler, give them my customer number and all that --- she types it into a computer and says, "I don't show any order sent to that customer," followed by....... total silence.  That was the SUM TOTAL of the amount of 'customer service' that she was prepared to offer me.  God, I hate that.   OK, I guess this stack of totes from your company is just a hallucination, then. Bye.

3.  I get calls at work from drug companies wanting to tell me about some new product.  Why do they insist on doing this?  I really hate to be rude, I know the person on the other end is just doing their job, but I simply cannot stand there and listen to any spiels with the place going crazy around me and customers staring me down.  I've got enough crazy customers wanting to keep me on the phone for twenty minutes because (and this is true) they want to discuss a pharmacy charge on a bank statement from TWO THOUSAND AND TEN. That's 2010. Twenty-frikkin-ten.

There is an article in the current New Yorker magazine by a surgeon named Atul Gawande called "Big Med."
It's very interesting and I recommend it .  This author has written many articles and at least one book that I know of, and I think he's an example of one of the smart people that we should listen to in the whole health care debate ---instead of these idiot politicians, I mean.   I come home after a particularly trying day and I think a lot about how we do things.  One day I'm working in a well-oiled machine with everyone at the top of their game, and the next day it's a different staff who can't even stick a label on straight.  But more on that later.