Monday, May 3, 2010

10 Things I Don't Mind Telling You

Mike's post inspired me to do a bit of thinking on the subject of pharmacy. Actually, what it got me thinking about was working in a pharmacy, and what we will and won't tell you. There are some places where people fear what goes on behind closed doors. Take restaurants (fast food joints in particular); people take even the slightest bit of stink eye from the guy flipping patties in the paper hat to mean "spit-burger." While films like Waiting may give you every reason to believe in these things, the fact of the matter is, most people are morally averse to doing something they wouldn't want done to them. Moreover, they tend not to do things they find disgusting. You can take this as gospel, I'd say, 85% of the time (in restaurants. 100% in pharmacies. Not to mention that most people are just too damn busy to rev up and hawk one into your pasta primavera.)

For some reason, the pharmacy has become one of these places. People tend to believe that there is something sinister going on behind the counter at their drug store. Well, I'm going to go over the 10 absolute worst things that might happen in a pharmacy, so that you can understand how futile it is to glare at me when you feel the need to let me know you have no confidence in my capabilities.

10.) We may force you to pay for every penny worth of medicine that you actually receive. This is not because I thought you were rude when you threw your refill bottle at me. It is because I'm unwilling to defraud your insurance company; we both have a duty to your insurance company, and we both are required to fulfill that duty.

9.) We may attempt to cut conversations short. This means that often, I can tell when you are badgering me in order to get me to a.) defraud your insurance company, or, b.) "give" you something. This something may be extra medicine, a cost break, or allow for an alteration in your prescription that is illegal. I can tell when you are looking for a hand out, and in this business, handouts are illegal.

8.) We may ask you to wait a little longer when you are in the drive-thru than we would were you in the store. This means that, when you come to the drive-thru, I have to take extra precautions to be sure I can complete your order. Were you in the store, I would have an extra moment to ask you to wait; you may shop; you may just wander; either way, you'll be there and not driving off as soon as you hand me a script.

7.) We may turn you away for a refill. If you are early. In no other situation would we ever turn you away. Don't assume we're turning you down because we don't want to work. Contrary to what you believe, we actually appreciate your business.

6.) We might ask you to call your doctor. This is after our attempts at communications have failed. We automatically contact your doctor when we have an issue. That doesn't mean they return calls or actually get resolution for your pharmacy. Sometimes, we need your help to give them a gentle kick in the ass.

5.) We might ask you to call your insurance company. We only have contact information for your processor, not your carrier (you can Google the difference if you don't know it). We cannot resolve every issue you have, and we don't know when your plan changed. No one tells us that, either.

4.) We might not have what you want. We cannot control an inventory of several thousand drugs when we are filling thousands of prescriptions for them each week. We just plain can't keep track of it; computer systems are flawed and no man short of Raymond Babbitt has the capability to do it from memory. Sorry.

3.) We might ask you to wait. Period. Self explanatory. Don't be a jerk because I'm busy. Is there a reason to be impatient? Think of it this way: you are complaining to one person. There are at least three in the pharmacy. It takes all three of them to be sure your prescription gets completed, and this can happen only after those before yours are completed. Telling one of the three won't do anything to get the other two who are currently inundated to move any faster. They're already moving as fast as they can.

2.) We might tell you to go to another pharmacy. Couple #4 with the fact that some medications are ordered in urgency. In other words: you need them, now. We ask you to look elsewhere when our better judgement tells us you shouldn't wait for treatment.

1.) We might be human. Look at 2-10. They all point at one thing: the humanity still inherent in pharmacy. It is an industry that cannot be mechanized, streamlined (any further than it is) or McDonald's-ized. This means that there are things that cannot be accounted for that hold things up (other than rogue pickles): insurance issues (billing, coverage, limits, plan changes, etc.), stock issues (manufacturer changes, shortages, etc.), safety issues (drug interactions, counter-indications, allergies, etc.), literal prescription issues (laws, regulations, requirements, etc.). Each of these issues are multi-layered; they can stem from your doctor's office, a drug's indications, or the cautionary practice of your pharmacy (sorry). These are things that go on because what we are dealing with, what you are dealing with, what the whole industry is based on, centered around, thrives on, is PEOPLE. And last I checked, I am still a person. Mistakes are made from time to time, despite all the safeguards. They are sometimes made by you, or by your doctors. They are sometimes made by people on my side of the counter, too. It happens. There's nothing the lot of us can do about it. Unless, of course, you're working to develop Skynet, and you know where I can get a neural-net processor (It's a learning computer). So please, spare a little patience. I promise, even when we are doing our worst, we're still doing our best.


MScottW said...

Well said, and much more eloquent than my original would have been. I thought the sincere approach would be better, so I went with it (I only wish I could be as well organized and thought out as you).

You are correct that we are people and, as such, are inherently prone to error. Given the amount of work put in front of us at any given moment (and the load piled on while we are working on the aforementioned work), it is quite amazing that we make as few mistakes as we do.

Unfortunately for us, the mistakes that do make their way past all of us and into the customer's impatient hands, are inevitably caught by the insurance company. At that point, the insurance pulls out the big guns (usually someone with big buns) to audit the store on many other prescriptions that they deem erroneous. This will always end in payments taken back from the pharmacy and/or fines levied.

As if that wasn't bad enough, the corporation then turns around and hammers the stores with payroll cuts and more sanctions than you can shake a stick at. This is the real shame. It is actually a bit of a catch-22 for the customers. The more you rush us, the more errors we make (yes, they count, even if it is something that has no visible effect to you), the more worse the problems get. Fewer people are allowed to work at a given time. This will result in longer waits. Let's face it: This is what you strive to avoid.

In closing (and I'm sure I missed something that I wanted to say), you are your own worst enemy. Give us a break. We will understand if, every now and then, you need something "now." If you give us a day or two, we can make sure the prescription is in stock, cross checked for interactions, billed properly and get's sold to you as painlessly as possible. Everyone wins and I get to keep my sanity, my liver, and my hair all in tact. Please: Think of my children. They need me around so that they can cause me stress, not you!

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