Another Special Message from Your Pharmacy

17 05 2010

In my post about pharmacy pet peeves I promised further enlightenment. I’m sure you wondered if I’d keep that promise. Perhaps you lost sleep, thinking you’d be left hanging.

Are you that person? Today is your lucky day! I have a whole new list–things I would like you to be aware of.

  1. You’re an addict. Yes, you. The one getting all the pain pills. I don’t doubt you have legitimate pain. That’s how a lot of addictions start.  Heck, that’s how my addiction started. But there comes a point where you aren’t treating your physical pain anymore–you’re using narcotics to treat your emotional pain, and that’s really not okay.
  2. I’m not an idiot. I know you’re an addict. I’m pretty sure everyone knows…except your doctor. If he does know, he apparently doesn’t care, and you really need a new doctor. How can I be so sure? Let’s look at the facts: The average patients with chronic pain don’t pay hundreds of dollars (all cash) for Oxycontin. They take more frequent doses of much cheaper narcotics. When you whip out that wad of cash, it’s a pretty big red flag. Another red flag: I’m fairly certain your job doesn’t send you out-of-town every month–coincidentally 4-7 days before your next prescription is due to be filled.
  3. It really pisses me off when you waste my tax dollars. If you fill all your prescriptions on Medicaid but pay $700 cash for the Oxycontin they refuse to cover, I will call the abuse hotline and report you.
  4. Generics work just as well as brand name drugs. You can argue with me until the end of the world, and I will not change my mind. With a few rare exceptions, the generic equivalents of brand name medications look different but do exactly the same thing. Demanding brand name drugs drives prices up for everyone, so just stop it. Still disagree with me? It’s called the placebo effect. Go read up on it.
  5. You aren’t allergic to codeine. Or hydrocodone. Or most drugs that you claim to be allergic to. “But Jenny, I took some Lortab and started puking and itching and it was just horrible!” I’m sure it was. Many side effects of medications are quite wretched, but they’re still side effects, not allergies. Allergies frequently involve hives, rashes, difficulty breathing and other not-at-all-fun things. Puking and itching? Not so much.
  6. While we’re talking about side effects, let’s chat about your expectations when you take a medication. We’ll use Topamax as an example, because I have personal experience with that one.
    Patient A has frequent migraine headaches. Modifying diet and identifying triggers has decreased the frequency but not the intensity. Patient A starts taking Topamax for prophylaxis. She complains of pervasive drowsiness and numbness in the extremities, as well as impaired cognitive function.
    Sounds pretty miserable, right? But the migraines stopped. So Topamax did what it was supposed to do. Modern medicine quite frequently becomes a balance of risks versus benefits. It’s unrealistic to expect a medication to do its job without having any side effects. If that happens to you, count your blessings and enjoy the uncommon experience for what it is–a minor miracle.
  7. Transferring prescriptions is annoying. I’m happy to ask the pharmacist do it if you’re moving, or out-of-town, or even if you’ve decided you don’t like us anymore. When you’re doing it because a store has a $10 gift card offer if you transfer it and as soon as you’ve gotten that card you plan to transfer it right back…well, that’s not just annoying. It’s dangerous. Keeping your prescriptions at one pharmacy is the best way to make sure your medications don’t interact with each other. In an ideal world your doctor would be on top of that, but this isn’t an ideal world, and charts are frequently ignored. If you’re getting anticoagulants at one pharmacy but take your ibuprofen prescription to somewhere completely different, the pharmacist won’t know to warn you about increased risks of GI bleeding.
  8. I don’t set your copay, and neither does the pharmacist. If you have insurance, there’s a really good chance your prescription will cost the same at our pharmacy as it does at a chain pharmacy, unless it’s on the $4 generic list. And no, we can’t price match the big box stores. Consider it a fair exchange when you only wait 10 minutes for your prescription.
  9. I genuinely care about you and your health. I’ve cried with customers over their pain, their cancer diagnoses, the passing of a loved one. I can’t always do exactly what you want me to do, but that’s not because I have it in for you.

So there you go. Think about these things the next time you fill a prescription. Smile at your pharmacist and technicians. You don’t want to be the customer they blog about at the end of the day.

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5 responses

29 07 2010
9 Ways to Endear Yourself to Your Pharmacy « Like Swimming

[…] Very Special Message from Your Local Pharmacy, Part I Another Special Message from Your Pharmacy The Drive-Up Window is My […]

18 05 2010
Erika Hill

Every time I go to the pharmacy, I think of you. The last time I went (actually, it was the second to last time), something was going on that was taking a lot of the attention of the pharmacists. I think that someone was getting a complicated medicine regimen for someone else (who was sitting on the bench, wearing South Park pajama pants, and who looked like he’d been through hell. His face was all bandaged and ridiculously bruised/scabbed/kind of icky), and so they were explaining various side effects/routines to her. This doesn’t bug me. I am bugged by incompetence, not by people doing their jobs.

There was an older gentleman (actually, we’ll just call him a man) who kept cracking jokes to me (“They have two speeds here–slow, and slower!”), and I usually smiled politely, but I figured they were all doing their best. So finally he goes up to the register, gets his prescriptions, and he owes the pharmacy $4. He swipes his debit card, enters in the PIN, and the PIN is rejected.

Man, this comment is long enough I might as well post it on my blog. Oh well, I’ll just co-opt yours!

Anyhow, I know that line etiquette dictates that I avert my eyes/pay no attention to other customers especially when they’re entering in their PINs, but I’m going to admit that I looked. The man keyed in 3369. It was incorrect. The cashier told him it was incorrect, and the man insisted it was right and just started entering it again and again and again (stop pushing buttons man!). The cashier (who is speaking much too quietly for the old man to hear, so he has to keep repeating everything) asks if he could slide the card again, and re-enter the PIN. The man pushes 3369. It is again invalid.

At this point, at least 5 minutes have passed. The cashier asks the man if he would like to run the card as credit rather than debit. What he should have sad was “yes”, but instead he insists that it’s a debit card and it’s the right PIN. He keeps entering in 3369. They move to another register. 3369. Finally, they have tried so many times that the kid actually has to get the manager’s key and reset something. So, they try one last time, and the man enters 1169. It works.

As the man gathers his three prescriptions and walks away, he turns to me and says, “I hope I never have to go through that again!” Me too, man. Me too. I hope that next time, though, you don’t blame your own error on someone else.

18 05 2010
Jenny

I love you, Erika. That is all.

18 05 2010
Kristina P.

Do, when I worked for DCFS, my position was actually a Drug Court worker. They had been talking about this, back when I was doing that, 10 years ago, about a national database where doctors could share information and know who was prescribing what. Did that ever happen?

18 05 2010
Jenny

No national database, but there is a state database. The state database would probably be sufficient…if doctors ever checked it. Some are great about it (especially pain doctors, who look up their patients regularly), but a lot of them won’t take the time to run a search.

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