For Father's Day, my mother and I took my dad out to eat at a local restaurant. While there, I observed a girl that could have been no older than 10 years old sitting at a table next to us. This poor girl had to weigh close to 200 lbs. There she was with her obese mother, both chowing down on a gigantic plate of buffalo wings.
I'm not writing this post to insult the poor little girl. You can't blame a 10 year old for being obese. The blame solely falls on the parents for facilitating the child to eat that way. Now I realize that not everyone is naturally skinny. I realie that some people are just genetically bigger than others. However, this girl's case went beyond genetics. No child her age is naturally 200 pounds. She got that way through a very poor diet, and since a 10 year old is not generally responsible for feeding themselves, once again, I blame her parents.
I think it's almost criminal for parents to allow their small child to gain so much weight. If you think about it, it's like the child is being slowly poisoned with food. Beyond the physical problems associated with childhood obesity, it has to wreak mental havoc on a child. No one wants to be the fat kid in class because other kids can be brutally insulting. Moreover, habits picked up in childhood tend to follow a person into adulthood. There's very little chance that this girl will grow up suddenly realize the importance of eating balanced meals and proper portions. Thirty or Forty years from now, she'll most likely be on a ton of medication to treat her health problems (high blood pressure, high cholesterol, possibly diabetes). It's sad because these problems could most likely have been avoided if her parents taught her better eating habits.
People who become obese after they've become adults have no one to blame but themselves for their weight. After all, and adult has reasoning power to understand that eating 10 Big Macs per day is going to make them fat. I don't feel the least bit sorry for these people. It's the kids that bother me because they don't know any better. Their parents allow them to become obese, and they're the ones who suffer from it.
Sunday, June 15, 2008
Saturday, June 14, 2008
Watching a pharmacy intern grow up and become a pharmacist
Earlier this week, I faced a disaster situation. I came into work and 10 minutes after we opened, the second pharmacist called out sick. 30 minutes later, our lead technician called out sick. We were down 2 crucial employees and were in the midst of a busier than usual day. On top of this, one of our printers decided breakdown and our store's order was being delayed by our warehouse. Nothing was going right.
... Except I was lucky enough to have our pharmacy intern there. She just finished her 5th year of pharmacy school, and is working with us before starting her 6th year rotations. To say she did an incredible job on that day would be an understatement. She took all the voicemails, did almost all of the data entry, and helped the technicians and clerks whenever they had a question. She really freed me up to be able to check prescriptions, take the doctor calls, answer customer questions, and still get all of the prescriptions for waiting customers done in 20 minutes. Without our intern there, I would have had to do everything myself, and not only would I not have gotten a lot of work done, I would have been stressed out of my mind. Our intern quite literally saved my sanity on that day.
That's not even all she did though. She was only schedule for 5 hours because she had a doctor's appointment in the afternoon. Well, both of our late shift technicians also called out on that day, and our intern came back to work after her doctor's appointment and worked until close. She saved all of our asses on that day.
Afterwards, I told her that she did a really great job that day, and she expressed to me that she was really nervous about rotations and the fact that she was only a year away from being a pharmacist, but she still felt like she didn't know very much. I then ran down everything she did for us on that day, which pretty much included every pharmacist task except checking a prescription (which really isn't all that difficult). On that day, she wasn't an intern; she was a pharmacist, and she did a damn good job. She's so far ahead of where I was at that point that there's just no way this girl will be any thing but a great pharmacist.
I've worked with her for 3 years now, and each time she comes back after a semester in school, she quite noticeable knows more and is more confident than before. She's grown up from being an unsure P1 student to being a very competent soon to be pharmacist. It has been really nice to see her development, and it gives me pride and hope for the profession.
That's one thing I think I want to incorporate into our pharmacy in the future. After a couple more years of work, I'd love to act as a preceptor for students on rotation. I feel like I could provide a good balance between clinical knowledge and real world situations. I think I'd find this to be very fullfilling..
... Except I was lucky enough to have our pharmacy intern there. She just finished her 5th year of pharmacy school, and is working with us before starting her 6th year rotations. To say she did an incredible job on that day would be an understatement. She took all the voicemails, did almost all of the data entry, and helped the technicians and clerks whenever they had a question. She really freed me up to be able to check prescriptions, take the doctor calls, answer customer questions, and still get all of the prescriptions for waiting customers done in 20 minutes. Without our intern there, I would have had to do everything myself, and not only would I not have gotten a lot of work done, I would have been stressed out of my mind. Our intern quite literally saved my sanity on that day.
That's not even all she did though. She was only schedule for 5 hours because she had a doctor's appointment in the afternoon. Well, both of our late shift technicians also called out on that day, and our intern came back to work after her doctor's appointment and worked until close. She saved all of our asses on that day.
Afterwards, I told her that she did a really great job that day, and she expressed to me that she was really nervous about rotations and the fact that she was only a year away from being a pharmacist, but she still felt like she didn't know very much. I then ran down everything she did for us on that day, which pretty much included every pharmacist task except checking a prescription (which really isn't all that difficult). On that day, she wasn't an intern; she was a pharmacist, and she did a damn good job. She's so far ahead of where I was at that point that there's just no way this girl will be any thing but a great pharmacist.
I've worked with her for 3 years now, and each time she comes back after a semester in school, she quite noticeable knows more and is more confident than before. She's grown up from being an unsure P1 student to being a very competent soon to be pharmacist. It has been really nice to see her development, and it gives me pride and hope for the profession.
That's one thing I think I want to incorporate into our pharmacy in the future. After a couple more years of work, I'd love to act as a preceptor for students on rotation. I feel like I could provide a good balance between clinical knowledge and real world situations. I think I'd find this to be very fullfilling..
Monday, June 9, 2008
It's 12:40 AM, and I feel like an idiot
I feel like an idiot because I just realized that I forgot to send the order on Sunday. That means that we won't be getting any of the items we needed to order over the weekend. It's the first time I ever forgot to send the order, and I feel like an asshole.
My day was all screwed up. I wasn't supposed to work at all today. Something came up for the pharmacist scheduled to work today, and I said I would come in to cover the last 3 hours of the day. I didn't mind doing it. The last 3 hours on Sunday are very slow and stress free. However, since it was a break from my normal Sunday routine when I work, I never quite got into that working mentality. I'm pretty sure that contributed to my mistake.
I just feel so stupid now. I pride myself on being responsible and dependable, and I screwed up. I know that in the grand scheme of things, it won't mean much. It will probably just be a minor inconvenience for a few customers. However, I feel like I let myself and the rest of the pharmacy staff down.
Well.. I'm going to bed now feeling stupid, and tomorrow, I'll go right back to being my responsible self. No one's perfect, including myself. I try to be perfect, and when you strive for perfection, you're occasionally going to be disappointend. I understand that. I'll learn from it and hopefully not repeat the same mistake.
I still feel like an idiot though...
My day was all screwed up. I wasn't supposed to work at all today. Something came up for the pharmacist scheduled to work today, and I said I would come in to cover the last 3 hours of the day. I didn't mind doing it. The last 3 hours on Sunday are very slow and stress free. However, since it was a break from my normal Sunday routine when I work, I never quite got into that working mentality. I'm pretty sure that contributed to my mistake.
I just feel so stupid now. I pride myself on being responsible and dependable, and I screwed up. I know that in the grand scheme of things, it won't mean much. It will probably just be a minor inconvenience for a few customers. However, I feel like I let myself and the rest of the pharmacy staff down.
Well.. I'm going to bed now feeling stupid, and tomorrow, I'll go right back to being my responsible self. No one's perfect, including myself. I try to be perfect, and when you strive for perfection, you're occasionally going to be disappointend. I understand that. I'll learn from it and hopefully not repeat the same mistake.
I still feel like an idiot though...
Thursday, June 5, 2008
One of the only things I hate about my job
For the past 2 days, I've been on the phone with an insurance company every couple of hours trying to get a prior authorization approved as quickly as possible for one of our customers.
She's an elderly lady who happened to somehow develop C. diff as an outpatient. I didn't really check if she just had a course of antibiotics which could have precipitated the infection. All I know is that she has C. diff, and she's failed metronidazole. Therefore, the next option to treat it is oral vancomycin. However, oral vancomycin is very expensive. A 14 day course of it is over $1,000. For this reason, the insurance company wants to make absolutely sure that all other options have been exhausted.
Well, this has been going on for 2 days now. The doctor's office faxed in the prior authorization paper work.... twice. It was marked urgent. Still no approval. I called the insurance company, and found out that they still want some more info from the office before they'll approve it.
WHAT OTHER INFO COULD THEY POSSIBLY WANT?????? There should be 2 things the insurance company asks before filling this prescription: Does the patient have C. diff? (YES). Has the patient tried metronidazole? (YES!!!) If both answers are yes (as in this case), they should instantly approve it. It shouldn't take faxes back and forth. It should take one 2-minute phone call.
It's stuff like this that really gets to me because it shows that this business isn't really about healthcare. It's about the freaking money before anything else. The insurance company doesn't want to spend $1,000 on the oral vancomycin. Therefore, they'll try anything to not approve it. Of course, that makes no fucking sense therapeutically or financially because if she doesn't get this medication, there's a very strong chance that she'll end up in the hospital, and it's going to cost a HELL of a lot more money to hospitalize a patient than it will to just pay for those damn capsules.
What's going to end up happening is the patient is going to pay the $1,000 up front and hope that the insurance will eventually approve it, and we'll be able to reimburse her. It should never come down to that, but that's the nature of the profession. Fucking stupid.
Let me make one more point: I don't understand why everything has to be done via fax. Whatever happened to picking up the phone and actually speaking to someone about this stuff. If the doctor's office (the patient's healthcare provider) calls the insurance company and verbally explains the reason for using a particular medication, then it should be either approved or rejected right on the spot. Why do we neeed to waste time and paper by faxing things back and forth?
It goes to really ridiculous lengths. Let me walk you through the process:
First, I'll try processing the claim and get a prior authorization required rejection. I'll immediately call the doctor's office only to have some secretary tell me to fax the rejection and insurance info to the office, and then they'll take care of it.
Upon receiving my fax, the doctor's office will call the insurance company, who in turn, will them to fax the prior authorization request to them. Of course, in order to fax the request, the office needs a certain prior authorization request form from the insurance company, which they can only get by having the insurance company fax them a copy of the form (or by going online and printing them out).
After faxing the prior authorization request, the insurance company will review it. Sometimes, it'll decide that the information is incomplete. In this case, they'll fax the doctor's office asking them to fax more information to them.
Then, the doctor's office will fax the necessary information to the insurance company. The insurance company will review it, accept or reject it, and then fax their decision to the doctor's office, which may or may not decide to send a copy of that fax to our pharmacy, so that we are aware we can now fill the prescription.
All that time and all that paper is wasted when all it should take is 3 phone calls: One from the pharmacy to the doctor's office, one from the doctor's office to the insurance company, and one from the doctor's office back to us.
The whole faxing process is fucking stupid. For simple things like refill requests, I understand the simplicity of fax requests. For stuff that requires clinicial review, there should be an active discussion between physician and insurance company. You can't have a discussion via fax. It would be like making clinical decisions via text message. It's stupid.
She's an elderly lady who happened to somehow develop C. diff as an outpatient. I didn't really check if she just had a course of antibiotics which could have precipitated the infection. All I know is that she has C. diff, and she's failed metronidazole. Therefore, the next option to treat it is oral vancomycin. However, oral vancomycin is very expensive. A 14 day course of it is over $1,000. For this reason, the insurance company wants to make absolutely sure that all other options have been exhausted.
Well, this has been going on for 2 days now. The doctor's office faxed in the prior authorization paper work.... twice. It was marked urgent. Still no approval. I called the insurance company, and found out that they still want some more info from the office before they'll approve it.
WHAT OTHER INFO COULD THEY POSSIBLY WANT?????? There should be 2 things the insurance company asks before filling this prescription: Does the patient have C. diff? (YES). Has the patient tried metronidazole? (YES!!!) If both answers are yes (as in this case), they should instantly approve it. It shouldn't take faxes back and forth. It should take one 2-minute phone call.
It's stuff like this that really gets to me because it shows that this business isn't really about healthcare. It's about the freaking money before anything else. The insurance company doesn't want to spend $1,000 on the oral vancomycin. Therefore, they'll try anything to not approve it. Of course, that makes no fucking sense therapeutically or financially because if she doesn't get this medication, there's a very strong chance that she'll end up in the hospital, and it's going to cost a HELL of a lot more money to hospitalize a patient than it will to just pay for those damn capsules.
What's going to end up happening is the patient is going to pay the $1,000 up front and hope that the insurance will eventually approve it, and we'll be able to reimburse her. It should never come down to that, but that's the nature of the profession. Fucking stupid.
Let me make one more point: I don't understand why everything has to be done via fax. Whatever happened to picking up the phone and actually speaking to someone about this stuff. If the doctor's office (the patient's healthcare provider) calls the insurance company and verbally explains the reason for using a particular medication, then it should be either approved or rejected right on the spot. Why do we neeed to waste time and paper by faxing things back and forth?
It goes to really ridiculous lengths. Let me walk you through the process:
First, I'll try processing the claim and get a prior authorization required rejection. I'll immediately call the doctor's office only to have some secretary tell me to fax the rejection and insurance info to the office, and then they'll take care of it.
Upon receiving my fax, the doctor's office will call the insurance company, who in turn, will them to fax the prior authorization request to them. Of course, in order to fax the request, the office needs a certain prior authorization request form from the insurance company, which they can only get by having the insurance company fax them a copy of the form (or by going online and printing them out).
After faxing the prior authorization request, the insurance company will review it. Sometimes, it'll decide that the information is incomplete. In this case, they'll fax the doctor's office asking them to fax more information to them.
Then, the doctor's office will fax the necessary information to the insurance company. The insurance company will review it, accept or reject it, and then fax their decision to the doctor's office, which may or may not decide to send a copy of that fax to our pharmacy, so that we are aware we can now fill the prescription.
All that time and all that paper is wasted when all it should take is 3 phone calls: One from the pharmacy to the doctor's office, one from the doctor's office to the insurance company, and one from the doctor's office back to us.
The whole faxing process is fucking stupid. For simple things like refill requests, I understand the simplicity of fax requests. For stuff that requires clinicial review, there should be an active discussion between physician and insurance company. You can't have a discussion via fax. It would be like making clinical decisions via text message. It's stupid.
Sunday, June 1, 2008
I was misunderstood
In my previous post, I wasn't saying that I don't think I should be acting youthful anymore. I was stating that on my current path, I'll be shooting hoops and screwing around until I'm 40 and suddenly realize that I'm old and still single.
I think this isn't only a problem with me, but it's becoming an increasing problem (if you could call it a problem) in society. Fifty years ago, a 26-year old would have been expected to be married with kids. Today, 26 doesn't even necessarily mean you've moved out of your parents' house yet. To illustrate this, I still don't really consider myself an adult yet. I still think of myself as some kid who just happens to have a grown-up's job.
It's this illusion of having so much time left that scares me. I'm almost 30! Yes, it's OK to play basketball and do all those other fun things, but at the same time, you have to realize that right now, I do those things at the expense of a social life. Shooting 500 jumpshots per day is great for my jumpshooting ability, but it's not getting me any women. I try to think that something will come along when I least expect it, so I should just go about my life without worrying about it. However, what happens if someone doesn't come along?
There's that saying: "Chance favors the prepared mind." Well, I think this situation is a good example of that. Yes, someone might enter my life or someone I already know may take on a larger role than I ever expected, but I have to at least put myself in a situation where those chances improve. Shooting hoops and playing cards with the same 4 guys several times per week is not helping me.
That's my point though. Those things are really fun now, but that's not exactly what I want to be doing 10 years from now. It's not where I envision myself, but if I keep going about my life as I have been, I probably won't get to where I want to be. And that would be a shame because I'm much more than those loser guys that are 40 years old, single, and do nothing but play video games and watch Star Trek reruns all day. I have so much to offer mentally and emotionally that it would be a shame if I wind up alone.
By the way... These last couple of posts are meant to have more of a thoughtful mood than a depressing one. I'm quite content at the moment and, for the most part, less anxious than I have been in a long time.
One more thing: I apologize for the lack of pharmacy-related posts, but I simply do not feel the need to write about my job right now. I don't get upset or frustrated with customers that much anymore. I'm just happy and grateful to have my current job, and I'm hoping that I'll have this job for a long time. Even if every customer yelled and screamed at me all day long, I'd be happy to go in every day. A lot of unemployed and minimally paid people would kill for the opportunity to endure our crazy customers and make 6-figures doing so.
I think this isn't only a problem with me, but it's becoming an increasing problem (if you could call it a problem) in society. Fifty years ago, a 26-year old would have been expected to be married with kids. Today, 26 doesn't even necessarily mean you've moved out of your parents' house yet. To illustrate this, I still don't really consider myself an adult yet. I still think of myself as some kid who just happens to have a grown-up's job.
It's this illusion of having so much time left that scares me. I'm almost 30! Yes, it's OK to play basketball and do all those other fun things, but at the same time, you have to realize that right now, I do those things at the expense of a social life. Shooting 500 jumpshots per day is great for my jumpshooting ability, but it's not getting me any women. I try to think that something will come along when I least expect it, so I should just go about my life without worrying about it. However, what happens if someone doesn't come along?
There's that saying: "Chance favors the prepared mind." Well, I think this situation is a good example of that. Yes, someone might enter my life or someone I already know may take on a larger role than I ever expected, but I have to at least put myself in a situation where those chances improve. Shooting hoops and playing cards with the same 4 guys several times per week is not helping me.
That's my point though. Those things are really fun now, but that's not exactly what I want to be doing 10 years from now. It's not where I envision myself, but if I keep going about my life as I have been, I probably won't get to where I want to be. And that would be a shame because I'm much more than those loser guys that are 40 years old, single, and do nothing but play video games and watch Star Trek reruns all day. I have so much to offer mentally and emotionally that it would be a shame if I wind up alone.
By the way... These last couple of posts are meant to have more of a thoughtful mood than a depressing one. I'm quite content at the moment and, for the most part, less anxious than I have been in a long time.
One more thing: I apologize for the lack of pharmacy-related posts, but I simply do not feel the need to write about my job right now. I don't get upset or frustrated with customers that much anymore. I'm just happy and grateful to have my current job, and I'm hoping that I'll have this job for a long time. Even if every customer yelled and screamed at me all day long, I'd be happy to go in every day. A lot of unemployed and minimally paid people would kill for the opportunity to endure our crazy customers and make 6-figures doing so.
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