Thursday, April 3, 2008

A little bit about my "duty" as a pharmacist

Yesterday a man walks up to the counter with a couple prescriptions to dropoff and a refill to pick up. The prescriptions dropped off were for a glucose monitor, test strips, and lancets. Pretty standard fair. Nothing overly complicated about them. The refill he wanted to pick up was for Apidra.

Apidra is a rapid acting insulin, kind of like Humalog or Novalog, except hardly any doctor prescribes Apidra. This was one of the rare patients who actually uses it. His refill for Apidra wouldn't be covered for about another week because it was too soon. It turns out the man was going on vacation and needed a vacation override. Once again, pretty standard. No big deal.

I called the insurance and got the vacation override. I went to the refrigerator to grab the 2 vials that the prescription called for and found out we only had one vial. We'd have to owe him a vial. This is not unusual in any way, especially for a medication that hardly anyone uses. We'd get the rest to him the next day.

Anyone who works in a pharmacy knows what came next...

"I'm leaving this afternoon for the entire month, and 1 vial won't last me that long."

Well, this guy had a little bit of a problem then. I offered to transfer the prescription to another pharmacy, which he said would be fine. However, not a whole lot of places stock Apidra, nevermind having 2 vials of it. I called the nearest competing pharmacy. No luck. The man then told me to try a couple other pharmacies in our chain, so I did, and once again, no luck.

Upon informing him that all 3 pharmacies I called did not have a single vial, he said he didn't believe me and wanted me to keep calling around. He was angry, and his anger was starting to get me irritated. I told him that I'd try one more place, but after that, he's on his own. We were busy, and I couldn't call every pharmacy in existence looking for his Apidra.

"You have to. It's your DUTY!," he exclaimed to me.

That was all I could take. I looked at him and told him, "No it is not my duty. It was YOUR duty to call the pharmacy several days BEFORE you were leaving on vacation to make sure we had your medication in stock and inform us that you would be leaving for vacation and needed them filled early."

That didn't sit too well with him. "Give me all my prescriptions back. I'm going to another pharmacy and never coming back."

"Great," I said. I reversed his test strips, glucometer, and lancets, but since the Apidra was a refill, I couldn't hand him the prescription back. "Because it's a refill, I can't give you back the prescription for Apidra. You can call around to other pharmacies, and when you find one that carries it, you can have them give us a call, and I'll gladly transfer it there."

In the end, the man took up 20 minutes of my time and left without us filling a single prescription for him, and you know what, I'm quite satisfied by that. The asshole tried to lecture me on my duty as a pharmacist. While I did respond to it, I could only do so in a semi-courteous fashion. If someone had presented that kind of stupidity to me outside of work, I would have made sure he was well aware of just how much of an idiot he was.

Seriously, how fucking stupid do you have to be to wait until the day you are leaving to come pick up insulin prescriptions? You know... Insulin is pretty important. It's not something you want to be without because, oh I don't know, you might die. I think that would be reason enough for me to call the pharmacy at least a week ahead of time to ensure that not only would they have my prescription in stock, but that they had no trouble getting them filled through the insurance. Hell, I'd probably call the insurance company too just in case there's some sort of problem.

I guess I just have that weird thing called common sense though. Actually, from now on, I'm going to call it uncommon sense because if it was so fucking common, you'd think more people would have it.

In my ideal world, I would have been able to call the guy a moron and an asshole to his face and tell him to take a hike while physically throwing his prescriptions back at him. He thinks it's my fucking duty to drop everything I'm doing and call every pharmacy in the state because he did a shitty job planning for his vacation. I like to think that I have a higher duty to all of humanity to help rid the world of clowns like him.


Carol said...

"failure to plan on your part does not constitute an emergency on mine". True words. did the idjit find someone to fill his 2 bottles of

susan said...

Good for you that you actuallly put him in his place. I'm so sick of the "customer is always right" crap. You can only be so nice to to someone who treats you like crap or is just plain stupid. Now, if the customer genuinely has a reason to be that's another story.

Anonymous said...

Good for you. I will never EVER understand why people wait until they are completely out of ANY prescription before wandering into the pharmacy for a refill -- and then it's our problem... On second thought, I guess that's their intent. And of course this vacation thing drives us all crazy.

the technician extraordinaire said...

The best part is when they just wait until they're completely out, as usual, and just expect a hand out. "Well, I don't have refills, but you can call my doctor, oh yeah, and you can give me a few pills, too."

I don't agree with it at all. I've also started telling people to call because the doctors' throw us on a pile on their desk, and they look at me with confused looks. Someone actually told me they thought we had a direct line, and I chuckled. We do have a direct line .. to a voicemail.

Anonymous said...

I encountered a man one time who did not believe his copays were correct (as if I had any control over anything in this rediculous profession) and suggested 2 things-
first knowing his ins.was my job and 2nd maybe I was crooked. I left the pharmacy and faced him-"I have hundreds of ins.plans to deal with, you have one and you pay for it. You don't know your own coverage, so who is the idiot here?" I took his bag of meds, tore it open,dumped bottles out and told him to find the door. I own the store so I told him there was no dm to call, just me, and he was done coming in my store. It is one of the perks of owning your own business. I couldn't stand it any other way.

Anonymous said...

Hi Pharmacy Mike,

I am P1 student and yesterday in our public health class we had a RN/MPH come in and tell us that there is no such thing as a "non compliant" patient and that it is wrong and ignorant of us to think any patient is non complaint. I was actually thinking about pursuing a MPH one day until I heard some of the shit she was spewing at us.

Pharmacy Mike said...

No such thing as a non-compliant patient?


Oh man... fucking hilarious.

Anonymous said...

I would say only about 50-60% of my patients are actually compliant.

Mike send him over my way I have 6 vials in stock, I have a patient that gets 6 a month so we always have it in stock.

I have a patient in the other day, doc called in 2 new insulins, some test strips and some other crap. She was completely out of her BP med and wanted me to call her doctor to get more refills. I asked if she had talked to her doc yet. She said no, you do that for me. I let her know that it is not my responsibility, she needs to call them and they will fax me a new Rx, this is how it works, if she wants to call me a couple days ahead of time I will gladly contact the doctor when it is convenient for me during the day (i.e. fax them), but if you show up at my counter at 9AM on Monday when I have about 8000 things to do, it will not happen...Please non-pharmacy folk, have some courtesy for us and call ahead of time!

Also, she goes through 7 of her insulin pens per month. Well, I don't know about you guys, but I do not break up boxes of insulin pens. So then she wants 2 boxes instead of just 1 (he insurance max is 30 days supply). I try to explain that for me to run 10 pens through is about a 50 days supply, and for me to run it as 30 is insurance fraud and I can get fined for it (not me, but my company, thus pissing off my bosses).

Sometimes people just dont understand

Anonymous said...

i love reading your blog, pharmacy mike! Especially when you have rants such as this.

Anonymous said...

You handled it well. Once I offered to call around to try to locate a cream for a patient. I called about 4 locations with no luck and you would think that she'd be appreciative of your effort - but instead her response was, "What do you mean you called 4 stores and they don't have it? Someone in this town has got to have it and you WILL find it. I don't care if you have to call every pharmacy around! I need it right away and I am going to stand right here until you locate it!" *throws purse down on counter and crosses arms* ....yea right, like i'm going to magically pull it out of my ass.. Anyway, great post mike!

Anonymous said...

Pass it on.

The Ole' Apothecary said...

To all:

I just posted something similar to this comment at another blog:

RELAX--"feces" is what the public does not give. Nor do they give an airborne intercourse. All of you should EXPECT this kind of behavior. This is what the public does. That is why we call them the public.

(Substitute appropriate cuss words. I do not cuss.).

Anonymous said...

I don't know about your customer base, but it seems like most of our problem customers are diabetics.