I have a question for all of the techs and pharmacists out there. How many times have you wished you could reach through the phone and slap some holier than thou because I have a doctors permission to call in prescriptions receptionist/nurse? I have been quite lucky in that I can count on one hand the number of confrontations I have had with these types. Well I could have, until today, now I have to use 2.
So I go in at 2pm this lovely Monday, I drew the short straw so I got to close. I had been there perhaps 30 minutes when the phone beside me begins to ring. I pick it up and say, "Really Big Pharmacy." Now I Know this isn't really a company approved way to answer. I'm SUPPOSED to say "Thank you for calling Really Big Pharmacy, Dedicated Tech pharmacy technician speaking how may I help you?" I'm not a robot, and I HATE giving my name out. In my experience once a customer learns your name they try to act like you are best friends and want you to do them little favors...like refilling controls early, and I don't believe in that so the fewer people who know my name the better I like it. Not to mention the fact that its always weirded me out when a patient I don't know and have maybe waited on like 2 times begins to call me by name and use it like 5 times in the span of 2 minutes. Creepy. Wow...can we say I got off topic? OK back to the story...So I answer the phone "Really Big Pharmacy" The voice on the other line says "This is Rude Richardson at Dr Richardson's office. We received a voice mail from your store this morning about getting a pa for Lamisil for Parker Bradley(name changed here obviously). The person who called spoke to fast for us to understand so we need to get the information." OK... 1. This is a dermatologists office where the Dr in question is old as dirt and I just don't like dermatologists. Especially NOT the 2 in my area...both jerks with DAW 1 on the brain. 2. This person calling is his relative whom he has employed, probably his wife and this is going to be bad news anyway because in my years as a tech its always seemed to be that if a Dr employs his wife she tend to think SHE is the one with MD after her name. 3. We call on these things early in the morning like around 8 am its now after 2pm and they JUST now call back. Lets not even get into the fact that we've been leaving messages about this patient for over 2 weeks. 4. She had all of the information already except the name of the person who called this morning. She didn't know who to ask for.
Now it just so happens that the tech who had called this morning had stepped out to assist a patient with finding AZO. So I picked the phone back up and told her that the person who had called was unavailable and asked if I could help her. She tells me that she got the patients name and name of the drug, that they needed a pa, AND the phone number to call. What she wanted to know was the name of the insurance company she was calling. I didn't think it mattered all that much but I told her and then the fun starts. She proceeds to BLAST me for the way the message was left. "You people talk ENTIRELY too fast. Don't you know that its impossible to write all of that down when you talk like that. You need to slow down and you need to tell the rest of the technicians to stop talking fast. Its just ridiculous." I stood there in stunned silence for like 2 seconds and then my smart ass reflex kicked in and I couldn't stop the words, "Really? The pharmacists here say that about the scripts left on voice mail, but they have no trouble using the replay button to make sure they don't miss any details."
It was my turn to hear silence. This time it was an affronted silence and then came "Humph!!!" Yes, she actually made that noise at me and then hung up. I wonder if they'll do the PA for the patient?
Tuesday, April 22, 2008
Thursday, April 17, 2008
Help From An Unexpected Source
Monday, the day of the week that makes us want to run away in terror screaming more loudly that Jamie Lee Curtis in Halloween and with much the same feeling of doom. My Monday was worse than a usual. I had the morning shift which is usually nice cuz you get work out of the way and have some time to relax. This time however, it wasn't so nice. Why? Because later on that day a "situation" developed. A situation that actually dragged on for 2 days. As you must have guessed by now it wasn't a pleasant 2 days. So what happened? Well let me tell you.
Its about 10 am. I'm working up a storm, posting orders, waiting on patients, answering phones and questions from a new tech who is really catching on but still needs help occasionally. Its quite busy. I am in the middle of a call with a patient requesting refills when one of our pain clinic patients arrives. Not just any pain clinic patient either, but one whom I have had to deal with at 2 different chains over my years. 2 chains and a total of 3 stores. He is well known to me. One of those who you must double and triple count because hes always "shorted". He is also one who always wants brand name. We'll call him Mr. Salvo. I finish my phone call and ask him if I can help him. He hands me his scripts from the pain clinic. We have 3 in my area. One is very good, very thorough. One is slightly off but at least keeps her patients somewhat reigned in and does treat them with more than JUST pain meds. Then there is Mr. Salvo's doctor....Dr. Shell. Dr Shell is in a league all his own. He writes more than just oxys and morphine, hydros, but his patients only fill what they want. Which means nothing but the narcs. If you call him he will OK this, and he will always say its OK for an early fill no matter how early. To give you an idea of the way he prescribes....Duragesic 100 mcg patches #15 apply 1 patch q 48 hours and 50 mcg #15 1 patch q 48 hours, for the same patient. 'Nuff said.
Mr. Salvo hands me 2 scripts, one is for Oxycontin 80 #90 and the other is for Valium 10, Remeron 15 and hydrocodone 10. He tells me he wants the Oxy in brand name. Now, I ALWAYS check that we have enough of a C2 to fill it before I allow the patient to leave. I don't like being yelled at by people who come back 2 hours later expecting their scripts to be done only to find out we didn't fill it at all. So the first thing out of my mouth on seeing that number one it was for a C2 and number 2 that he wanted brand name was "I'm not sure we have this in brand Mr. Salvo let me check." So I walk around the corner and speak with the POD (pharmacist on duty). He was on hold at the moment but told me he didn't think we had it. That he had looked for another strength earlier and saw only one bottle in the safe. That bottle was a partial. He then handed me his keys and told me to check. I walked to the back of the pharmacy and locating the correct cabinet proceeded to look for the brand name drug. Like the POD I only saw the one bottle with the X on it. I picked it up and shook it and could tell by the weight and sound that there were not 90 in there. I walked back to the front and told him that I was sorry but we didn't have brand name. Then he said in a very very hateful tone " You've lied to me about that before you need to have someone else look." I'm used to stupid statements like that so I really didn't take offense at this point, I just smiled and said "Mr. Salvo there is only 1 partial bottle but I'll be happy to go and count it to be sure." I walked back to the POD and asked told him I needed him to check again. He was still on hold with a Dr so he gave me the keys again and told me to go get it. I walked back to the safe...looked again...saw nothing different. I got the bottle and took it back to the filling station and began to count the pills, all the while answering questions from the tech we were training as well as the POD. I double counted the med and found only 64 in the bottle. I walked around the corner, bottle in hand and said "Mr. Salvo, I'm sorry, I counted them and there are only 64, we don't have enough to fill it." We then have to go through the explanation of not being able to "owe" him any and that if he took what we had he lost the rest. At that point I offered to call around and find the medication for him if he would tell me where he wanted me to try. He said, "No, do you have it in generic?" I hadn't even checked that so I told him I didn't know but I would look. So I go BACK to the POD, he is still on hold same office. He gives me the keys again. I go back to the safe. There is one bottle of generic in there. I opened it and it was sealed so we would have enough with 10 to spare. I walked back up front and told Mr. Salvo that yes we did have enough generic. I then again offered to call another store. I knew he didn't want generic. "Mr. Salvo I'll be happy to call around for you. We can fill your others if you'd like and I'll find you the brand name somewhere else." At this point he stated "No, just give me the generic" I asked him "Are you sure?" He said yes. I said OK. I finished entering and filling his scripts and then went to ring him up. Before I could scan the first one he took the bag from my hand ripped it open and popped a hydro and an oxy right then. His wife had to make him hand me the bag back to scan out. He asked if he could use the discount card he had that took $50 off of brand name. I told him no because it wasn't a brand name drug and that the coupon would reject when transmitted. He seemed fine with it and left.
Fast forward about 4 hours. I get a call from the night tech giving me a heads up. She told me Mr. Salvo had been back in and the he said I lied to him and he was going to have me fired. It seems that he still didn't believe me so calls back about 9pm. Pharmacy was dead and the fill in on duty went through the cabinet and found 1 bottle that had gotten put behind the wrong strength. I didn't look through all of the strengths, just in the place it should have been so I didn't see it, nor did the pharmacist who had been with me that morning. The tech told me that he was screaming that it was the 2nd time that I had lied to him about it and he would have my job. Now, I didn't remember any such thing so I checked his profile when I got to work the next morning. Every time my initials came up as waiting on him he had brand name, except for this one time. He asked for the corporate office phone number to complain and was given the number. He had called 2 times before I got in the next day.
Long story short he called the pharmacy and started yelling at me over the phone. Dr. Cookie was the POD Tuesday morning and he took it from me and asked him what his problem was. He went into this long diatribe about what a rotten tech I was and how unprofessional and that I was trying to kill him. Dr. Cookie explained it was a simple mistake and that 2 people had overlooked it and that the guy who had found it only found it by accident. Salvo then starts screaming that I didn't look hard enough and Dr. Cookie gave him a lecture on how many drugs were in that cabinet and that we didn't have time to go on a hunt. It got pretty nasty. He swore when he called our toll free number that it was a woman talking dirty to him and wouldn't believe that was the only phone number we had. Dr. Cookie asked him what we could do to make him happy and he said he wanted me fired and to be given brand name. Dr. Cookie at this point said, "So you only want the tech fired and not the pharmacist? You want her fired for making a mistake?" Salvo told him yes that I was unprofessional. He then demanded the corporate number again, and Cookie told him the toll free again. Salvo screamed, "That's a SEX line!" Dr. Cookie told him, "No, its not and see there even you make mistakes." I could have kissed him at this point.
All day long Salvo is calling us, he talked to the store manager who told him that he would let him have brand but only if the Pharmacy DM OK'd it. By the time She finally called back and got the whole situation laid out for her(She laughed at his demand that I be fired, stating that I had offered repeatedly to find it so we weren't at fault) She said we could give him brand but only if his doc wrote him a new script and he would have to pay the difference. Well the store manager, Dr. Cookie and myself all thought this would be very simple because after all it was Dr. Shell. So Cookie calls his office and tells the ENTIRE story to his nurse. She became incensed and told him that Dr. Shell would handle it, for us to make him keep the generic and she would call us back. When she did call back she said, "Mr. Salvo will not be bothering you again. Dr. Shell will NOT be writing him a new prescription. We told him to take the generic, there was nothing wrong with it and if he didn't like the service at your pharmacy to find a new one. We also told him that if he bothered you again we would dismiss him from our clinic." She ended with a plea to my store manager not to fire me because of him. He laughed and said that was never a question..
Dr. Shell and his staff are now on my Christmas card list. Lord knows how Mr. Salvo had been treating the office staff for them to stick up for a pharmacy. Its the first time I can EVER remember a physician standing up for the pharmacy instead of blaming them. I still don't like his prescribing habits but I'll cut him a little slack for a while. Forrest was right. Life IS like a box of chocolates.
Its about 10 am. I'm working up a storm, posting orders, waiting on patients, answering phones and questions from a new tech who is really catching on but still needs help occasionally. Its quite busy. I am in the middle of a call with a patient requesting refills when one of our pain clinic patients arrives. Not just any pain clinic patient either, but one whom I have had to deal with at 2 different chains over my years. 2 chains and a total of 3 stores. He is well known to me. One of those who you must double and triple count because hes always "shorted". He is also one who always wants brand name. We'll call him Mr. Salvo. I finish my phone call and ask him if I can help him. He hands me his scripts from the pain clinic. We have 3 in my area. One is very good, very thorough. One is slightly off but at least keeps her patients somewhat reigned in and does treat them with more than JUST pain meds. Then there is Mr. Salvo's doctor....Dr. Shell. Dr Shell is in a league all his own. He writes more than just oxys and morphine, hydros, but his patients only fill what they want. Which means nothing but the narcs. If you call him he will OK this, and he will always say its OK for an early fill no matter how early. To give you an idea of the way he prescribes....Duragesic 100 mcg patches #15 apply 1 patch q 48 hours and 50 mcg #15 1 patch q 48 hours, for the same patient. 'Nuff said.
Mr. Salvo hands me 2 scripts, one is for Oxycontin 80 #90 and the other is for Valium 10, Remeron 15 and hydrocodone 10. He tells me he wants the Oxy in brand name. Now, I ALWAYS check that we have enough of a C2 to fill it before I allow the patient to leave. I don't like being yelled at by people who come back 2 hours later expecting their scripts to be done only to find out we didn't fill it at all. So the first thing out of my mouth on seeing that number one it was for a C2 and number 2 that he wanted brand name was "I'm not sure we have this in brand Mr. Salvo let me check." So I walk around the corner and speak with the POD (pharmacist on duty). He was on hold at the moment but told me he didn't think we had it. That he had looked for another strength earlier and saw only one bottle in the safe. That bottle was a partial. He then handed me his keys and told me to check. I walked to the back of the pharmacy and locating the correct cabinet proceeded to look for the brand name drug. Like the POD I only saw the one bottle with the X on it. I picked it up and shook it and could tell by the weight and sound that there were not 90 in there. I walked back to the front and told him that I was sorry but we didn't have brand name. Then he said in a very very hateful tone " You've lied to me about that before you need to have someone else look." I'm used to stupid statements like that so I really didn't take offense at this point, I just smiled and said "Mr. Salvo there is only 1 partial bottle but I'll be happy to go and count it to be sure." I walked back to the POD and asked told him I needed him to check again. He was still on hold with a Dr so he gave me the keys again and told me to go get it. I walked back to the safe...looked again...saw nothing different. I got the bottle and took it back to the filling station and began to count the pills, all the while answering questions from the tech we were training as well as the POD. I double counted the med and found only 64 in the bottle. I walked around the corner, bottle in hand and said "Mr. Salvo, I'm sorry, I counted them and there are only 64, we don't have enough to fill it." We then have to go through the explanation of not being able to "owe" him any and that if he took what we had he lost the rest. At that point I offered to call around and find the medication for him if he would tell me where he wanted me to try. He said, "No, do you have it in generic?" I hadn't even checked that so I told him I didn't know but I would look. So I go BACK to the POD, he is still on hold same office. He gives me the keys again. I go back to the safe. There is one bottle of generic in there. I opened it and it was sealed so we would have enough with 10 to spare. I walked back up front and told Mr. Salvo that yes we did have enough generic. I then again offered to call another store. I knew he didn't want generic. "Mr. Salvo I'll be happy to call around for you. We can fill your others if you'd like and I'll find you the brand name somewhere else." At this point he stated "No, just give me the generic" I asked him "Are you sure?" He said yes. I said OK. I finished entering and filling his scripts and then went to ring him up. Before I could scan the first one he took the bag from my hand ripped it open and popped a hydro and an oxy right then. His wife had to make him hand me the bag back to scan out. He asked if he could use the discount card he had that took $50 off of brand name. I told him no because it wasn't a brand name drug and that the coupon would reject when transmitted. He seemed fine with it and left.
Fast forward about 4 hours. I get a call from the night tech giving me a heads up. She told me Mr. Salvo had been back in and the he said I lied to him and he was going to have me fired. It seems that he still didn't believe me so calls back about 9pm. Pharmacy was dead and the fill in on duty went through the cabinet and found 1 bottle that had gotten put behind the wrong strength. I didn't look through all of the strengths, just in the place it should have been so I didn't see it, nor did the pharmacist who had been with me that morning. The tech told me that he was screaming that it was the 2nd time that I had lied to him about it and he would have my job. Now, I didn't remember any such thing so I checked his profile when I got to work the next morning. Every time my initials came up as waiting on him he had brand name, except for this one time. He asked for the corporate office phone number to complain and was given the number. He had called 2 times before I got in the next day.
Long story short he called the pharmacy and started yelling at me over the phone. Dr. Cookie was the POD Tuesday morning and he took it from me and asked him what his problem was. He went into this long diatribe about what a rotten tech I was and how unprofessional and that I was trying to kill him. Dr. Cookie explained it was a simple mistake and that 2 people had overlooked it and that the guy who had found it only found it by accident. Salvo then starts screaming that I didn't look hard enough and Dr. Cookie gave him a lecture on how many drugs were in that cabinet and that we didn't have time to go on a hunt. It got pretty nasty. He swore when he called our toll free number that it was a woman talking dirty to him and wouldn't believe that was the only phone number we had. Dr. Cookie asked him what we could do to make him happy and he said he wanted me fired and to be given brand name. Dr. Cookie at this point said, "So you only want the tech fired and not the pharmacist? You want her fired for making a mistake?" Salvo told him yes that I was unprofessional. He then demanded the corporate number again, and Cookie told him the toll free again. Salvo screamed, "That's a SEX line!" Dr. Cookie told him, "No, its not and see there even you make mistakes." I could have kissed him at this point.
All day long Salvo is calling us, he talked to the store manager who told him that he would let him have brand but only if the Pharmacy DM OK'd it. By the time She finally called back and got the whole situation laid out for her(She laughed at his demand that I be fired, stating that I had offered repeatedly to find it so we weren't at fault) She said we could give him brand but only if his doc wrote him a new script and he would have to pay the difference. Well the store manager, Dr. Cookie and myself all thought this would be very simple because after all it was Dr. Shell. So Cookie calls his office and tells the ENTIRE story to his nurse. She became incensed and told him that Dr. Shell would handle it, for us to make him keep the generic and she would call us back. When she did call back she said, "Mr. Salvo will not be bothering you again. Dr. Shell will NOT be writing him a new prescription. We told him to take the generic, there was nothing wrong with it and if he didn't like the service at your pharmacy to find a new one. We also told him that if he bothered you again we would dismiss him from our clinic." She ended with a plea to my store manager not to fire me because of him. He laughed and said that was never a question..
Dr. Shell and his staff are now on my Christmas card list. Lord knows how Mr. Salvo had been treating the office staff for them to stick up for a pharmacy. Its the first time I can EVER remember a physician standing up for the pharmacy instead of blaming them. I still don't like his prescribing habits but I'll cut him a little slack for a while. Forrest was right. Life IS like a box of chocolates.
Monday, April 14, 2008
How to Ruin a Patients Vacation
So Ms. French comes in to the store today. Ms. French is one of our least favorite patients, a problem every time she arrives. See she and her hubby are from the other side of the US. Her hubby gets brand name only Vicodin. Always...ALWAYS prescribed by the same Dr. We'll call him Dr. West. Mr and Ms French have been patients at my pharmacy for over 4 years. In that time they have never once had a prescription filled by a local Dr. Dr. West prescribes everything for them. Smells awfully funny if you ask me.
Anyway, Ms. French arrives at the pick up window and says "I'm here to get my husbands medicine. I called it in yesterday. Hes out of refills. Dr. West is closed on Mondays so you can't get any. We're going on vacation. I need you to give me enough for 10 days." Ok...number 1. You knew your husband was out of refills. 2. You knew you were going on vacation. 3. You knew Dr. West was closed on Mondays. So I don't think its unreasonable to ask...WHY in the name of the Saints Cosmas and Damian did you not take care of this LAST WEEK?!?!?
I wanted badly to ask her this question but refrained and instead said "Ms. French we'll be happy to give you a 3 day emergency supply but that's all we can do without an authorization from your Dr." It was instantly apparent that she did not take this news well at all. She sucked her breath in deeply and rolled her eyes and hatefully spat out " Ask someone with authority." This immediately made tiny pinpricks of anger crawl up my arms. Normally I will bend over backward to help someone, but this particular woman has caused more problems in this store than you can ever imagine. I so wish we could fire customers, unfortunately our corporate office would rather kiss ass. With great amounts of effort I controlled myself and simply turned to the pharmacist on duty who had walked up behind me by this point and he repeated without me having to explain the situation that we could only do the 3 days and that it was a courtesy that technically we really should not even do. He then offered to get the refills and transfer the prescription to her vacation destination on Tuesday once she had chosen a pharmacy.
Ms. F didn't like that one little bit either....the next thing out of her mouth made me want to slap her and she should be on her knees thanking the Patron Saint of Idiots that I value my job. "So you are telling me that I have to interrupt MY vacation to stop and find a pharmacy?". Now I work for a very very large chain. Stores all over the place, and even should she choose not to use one of ours, shes going to a place where many people choose to retire...I don't think there is a pharmacy shortage there. He said "Yes ma'am it shouldn't be a problem to find one." She then very hatefully said "Give me the 3 days and when he runs out I guess I'll just have to sent him chasing all over hunting a pharmacy."
I hope it is a big hassle simply because of her attitude. Then maybe next time this happens and there WILL be a next time, she'll use a small portion of her gray matter to pick up a phone and call her Dr for refills at least 3 days before she leaves....I won't hold my breath though. It may be my favorite color but my face isn't very attractive when its totally blue.
Anyway, Ms. French arrives at the pick up window and says "I'm here to get my husbands medicine. I called it in yesterday. Hes out of refills. Dr. West is closed on Mondays so you can't get any. We're going on vacation. I need you to give me enough for 10 days." Ok...number 1. You knew your husband was out of refills. 2. You knew you were going on vacation. 3. You knew Dr. West was closed on Mondays. So I don't think its unreasonable to ask...WHY in the name of the Saints Cosmas and Damian did you not take care of this LAST WEEK?!?!?
I wanted badly to ask her this question but refrained and instead said "Ms. French we'll be happy to give you a 3 day emergency supply but that's all we can do without an authorization from your Dr." It was instantly apparent that she did not take this news well at all. She sucked her breath in deeply and rolled her eyes and hatefully spat out " Ask someone with authority." This immediately made tiny pinpricks of anger crawl up my arms. Normally I will bend over backward to help someone, but this particular woman has caused more problems in this store than you can ever imagine. I so wish we could fire customers, unfortunately our corporate office would rather kiss ass. With great amounts of effort I controlled myself and simply turned to the pharmacist on duty who had walked up behind me by this point and he repeated without me having to explain the situation that we could only do the 3 days and that it was a courtesy that technically we really should not even do. He then offered to get the refills and transfer the prescription to her vacation destination on Tuesday once she had chosen a pharmacy.
Ms. F didn't like that one little bit either....the next thing out of her mouth made me want to slap her and she should be on her knees thanking the Patron Saint of Idiots that I value my job. "So you are telling me that I have to interrupt MY vacation to stop and find a pharmacy?". Now I work for a very very large chain. Stores all over the place, and even should she choose not to use one of ours, shes going to a place where many people choose to retire...I don't think there is a pharmacy shortage there. He said "Yes ma'am it shouldn't be a problem to find one." She then very hatefully said "Give me the 3 days and when he runs out I guess I'll just have to sent him chasing all over hunting a pharmacy."
I hope it is a big hassle simply because of her attitude. Then maybe next time this happens and there WILL be a next time, she'll use a small portion of her gray matter to pick up a phone and call her Dr for refills at least 3 days before she leaves....I won't hold my breath though. It may be my favorite color but my face isn't very attractive when its totally blue.
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