Monday, August 13, 2012

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.

8 comments:

Anonymous said...

For some reason EMR software can't multiply. A 90 day supply of a medicine taken 3 times a day should be 270. My doctor's software comes up with 180. D'oh!

MDB said...

I had one customer argue with me why her mother's copay was much higher than the last time she recieved medication X while waving a receipt in my face, the freaking thing was from 2009 and multiple different insurances ago. Said same idiot also wanted us to rebill a whole bunch of other claims ranging from months ago to a couple years back to the new insurance and refund her the difference.

Anonymous said...

E-scripts are only as good as the idiots that are submitting them. Honestly, how about re-reading that rx before you hit "send"!!! A while ago, we had an e-rx for Zithromax 1 gram, 1 qd x 30 days. After consulting with 2 pharmacists, we completed the rx and ordered in #30. The co-pay was ridiculous and we all felt uncomfortable with the rx. After a call to the office, Suzie smart-ass nurse informs me that they only want a Z-Pak, but they don't know how to input that in the electronic system so they just submit #30 1 gram, 1 daily. Yeah, maybe you might want to phone that one in next time.

Anonymous said...

Does anyone know where I can get a job teaching these morons how to use EMR? I'm sure that would help myself feel more useful than calling an insurance company to get a vacation override for Joe Blow's Viagra or Zantac.

Pharmd Blogger said...

At my pharmacy, the doctor's office will send the erx multiple times. It can be very confusing, and the patient will have multiple prescriptions if needed. If the government allows controlled substances to be electronically prescribed, my patients are going to have a field day! You forgot to vent about how long you were on hold until you spoke with a "customer service" representative. Did you get a Starbucks gift card for listening to their 20 minute lecture on their new combo med? By the way, good luck with tomorrow!

Anonymous said...

Atul Gawande has several books, you should read them, they are great!

Crazy RxMan said...

At my pharmacy there are not one, not two, but THREE medical facilities within walking distance... and the e-scripts show up MINUTES before the people walk in expecting them to be ready to pick up. What's more, the software only allows us to go through them ONE at a time without being able to cherry-pick the whining patient staring at us wanting his Z-pack NOW. So we have to whip through ALL of them to find the Z-pack!

Marietta Nixon said...

Wow! So far in my experience with using emr software, I haven't been that lazy to just write whatever I feel like on a script. I have seen a few other people do that, but I just think its more confusing. I don't think it's the pharmacist's job to understand and interpret what I am trying to give my patient. Just take the time and do it right. Thanks for your post!