Sunday, September 9, 2012

Co-Pays and No-Pays

I guess because it's an election year people are thinking about the 'health care' debate and peripherally paying attention, although in their own typical way --- "hearing about" stuff, and rumors, and watching the cable news channel that they agree with most -- without actually doing any hard reading or research.  I'm no expert either, but from my perch as a pharmacist I detect certain trends.  It hit me the other day when I had a customer grumble about his $59 copay for a 3-month supply of 4 prescriptions. It's my feeling that during the time I've been a retail pharmacist, copays have been trending down. Most of the drugs we dispense are generics -- the big expensive brand-name drug with the big copay is becoming less common. Maybe that's why people's expectations are that everything's eventually going to be 'free.' But of course nothing is 'free.'   I don't have any problem with a reasonable co-payment for prescription medications.  I don't think that the $59 tab was unreasonable at all. The future legislation is called the "Affordable Health Care Act", not the "Free Healthcare Act."   People are flabbergasted at how expensive something like, say, Seroquel is;  well, yeah, it's a drug that alters your brain chemistry and which took years of research, testing and know-how to develop and put into a little tablet that you can swallow and fix your 'mood disorder.'  It might even change someone's life? What's the price on that? And yet people can also take a dirt-cheap drug that keeps their blood pressure under control and prevents them from having a heart attack or stroke.  That's pretty significant.  I don't think people get this.
  It's the same old story -- the cheaper something is, the less value it's perceived to have and therefore all the professional services behind it are cheapened too.

People used to treat a doctor's prescription like gold.  They would fold it and put it in a safe place (their wallet) and bring it to the pharmacy almost immediately. Now they are treated like grocery store coupons-- collect 'em, trade 'em, transfer 'em, and (my favorite), lose 'em.  And what they represent also seems to have declined in value, where $59 is apparently outrageous for those multiple 90-day prescriptions.  I guess I just remember a different era..... or something.....

Now on the flip side, I would like to address my workplace.  If you're going to complain that customers don't treat you as a professional, then for God's sake, ACT  PROFESSIONAL.
1.  Wear some decent clothes.  Wear your identification badge like you're supposed to.
2. Stop cooking your lunch in the pharmacy microwave so the entire place reeks.  It smells like a damn          Burger King in here.
3. Stop EATING, snacking and drinking all day in the pharmacy. IT LOOKS TERRIBLE.
4. If someone talks to you from out at the counter, get out there and talk to them. Don't holler across the   room. Respect people's privacy, even if they are oblivious.

Can you tell what's been bugging me this week?


MDB said...

Sadly, people are going to complain regardless of the copay amount at times. I've had people complain about four scripts costing a little less than $15 total and then while my tech was cashing them out at the register not bat an eye at paying all sorts of money for the huge stack of DVDs and other expensive things totaling over $100.

I also remember the screaming older barfly-like lady who came in screaming about how she was suppose to have all her scripts free through the state medicaid. She seemed to think waving this sweat-stained ratty letter in my face that smelt of serious B.O. (god knows where that was before) and demanding that I give her tramadol and any OTC products she wants because their suppose to be free. She didn't want to hear that the insurance was not covering the tramadol and she had no scripts for OTCs, not getting into how the state seems to only like sunmark brand which we have to special order if we can get it covered. I got sworn at when I gave her the ultimatum of "I'm sorry but the insurance will not cover the tramadol. You option is to pay cash or go without, I cannot force them (the insurance) to pay." I later heard the same customer came in to the clerks up front and demanded that she be given free cigarettes while waving the same letter in the clerk's and manager's faces. She claimed to have a prescription (some scribling with a doc's name and other crap with a short sentence saying she was allowed 4 packs a day, a month's supply at a time, all barely readable and clearly not from a doc's office, it was just a standard sheet of printer paper). She ended up getting hauled out by the police after she started threatening the people up front. Have yet to see her again thankfully.

Anonymous said...

So many pharmacists complain about no lunch breaks. They have to eat in the pharmacy in between filling prescriptions.

At my pharmacy, there is a 2.5 hour overlap. Same for the tech shifts. The techs are required to take lunch, but only during the overlap. So one eats right before they leave, and the other right after starting. Its ridiculous!

The pharmacists, on the other hand, opt out of lunch, and shorten their shift. So they eat at normal times, but right in front of people.

PharmD Blogger said...

MDB said it best. People are going to complain about copays or prices on everything no matter what. People are always going to want something for FREE! I agree with 1, 2, and 4. #3 I cannot agree with. I cannot go 6 hours without eating something. Doing 300 prescriptions a day with 1 technician. I have my protien bar at 10 to 11am. We have lunch for 30 minutes, but usually it is shortened to 20 minutes. We then have 5.5 hours until close. I eat a granola bar around 5 or 6pm. I cannot leave the checking area, but I eat my food discreetly, and I always have a water on hand.

Frantic Pharmacist said...

Absolutely, I don't have any problem with a coffee/granola bar/doughnut eaten discreetly... it's the full-course, microwave heated, knife-and-fork & fast food stuff eaten right on the dispensing counter that drives me crazy. To me, that kind of stuff needs to be eaten on the lunch break (away from the counter or in the back), or at home.

Crazy RxMan said...

1. Wear some decent clothes. Wear your identification badge like you're supposed to.

I AGREE! But I think it's also time that a nice clean Polo Shirt or matching shirt/tie combo is accepted. At most places in my rural area, as a male you have to wear a white shirt and tie -- no exceptions. That's crazy. It's 2012, not 1950.

2. Stop cooking your lunch in the pharmacy microwave so the entire place reeks. It smells like a damn Burger King in here.

I AGREE! Much better to go out and get Burger King and bring it in so the entire place smells like Burger King.

3. Stop EATING, snacking and drinking all day in the pharmacy. IT LOOKS TERRIBLE.

I AGREE. How about we give the pharmacists in my state a lunch break? Do you really expect me to work a 12 hours shift without eating/drinking?

4. If someone talks to you from out at the counter, get out there and talk to them. Don't holler across the room. Respect people's privacy, even if they are oblivious.

I AGREE! How about we get the customers/patients to stop yelling at us from 15 feet away "Where's the Neosporin?" WHILE WE'RE COUNSELING patients. At little professional courtesy could be afforded both ways.

pharmacy chick said...

As a veteran of 26 years behind the counter, I have always acted as professional as I can. I am sick of eating cold food, so my humblest apologies if i decide on any given day to heat up some soup in the microwave I purchased. chances are that by the time I actually GET TO EAT IT it will be cold anyway so sorry it offends your nares. 26 years of standing all day, havent had a legal lunch period since I was an intern. Do I care if a customer sees me eating? not anymore. Perhaps they will grasp the sorry concept that the person who is filling their prescription is denied the basic right to eat food, and have a bathroom break. Its a pathetic existence when in the period between my arrival at 745 am and my departure at 930 pm my entire consumption of nutrients consists of 2 cokes, some cheezits, and spray cheese on a cracker.

Frantic Pharmacist said...

I wasn't meaning for anyone to go the whole day without eating. I guess the reason this irritates me is because everyone at this particular pharmacy actually GETS a lunch break. There is always more than one pharmacist and at least 3 technicians, so everyone gets to go away and eat at some point. I understand that is often not the case, especially with pharmacists.