Wednesday, June 24, 2009

Joining the Health Care Debate Once Again

Let me start off by listing some facts for you comparing the US health care system to France:

- The World Health Organization (WHO) ranked the U.S. 37th in the world in health care.
- France was ranked #1 (http://www.photius.com/rankings/healthranks.html)

- U.S. was ranked 24th in average life expectancy (70 years)
- France was ranked 3rd (73.1 years) (http://www.photius.com/rankings/healthy_life_table2.html)

- According to the CIA Fact Book, the U.S. has the 43rd lowest infant mortality rate (6.3 deaths/1,000 births)
- France has the 6th lowest (3.36 deaths/1,000 births) (http://en.wikipedia.org/wiki/List_of_countries_by_infant_mortality_rate)

- American citizens were ranked 72nd in overall health.
- French citizens were ranked 4th. (http://www.photius.com/rankings/world_health_performance_ranks.html)

- As of 2002, the U.S. spent $5,267 per person per year on health care. $2,364 (or 45% of that money) came from government spending on mainly Medicaid and Medicare.
- As of 2002, France spent $2,736 per person per year on health care. $2,080 (or 76% of that money) came from the government. (http://www.nytimes.com/2005/04/15/opinion/15krugman.html?_r=3&oref=slogin&oref=slogin&oref=slogin)

- In 2007, there were 45.7 million uninsured Americans. (http://en.wikipedia.org/wiki/Health_care_in_the_United_States#Shared_costs_of_the_uninsured)
- In France, there are ZERO uninsured citizens.


Remember... Those are FACTS. They're just STATISTICS and the links to the sources and studies that provide those statistics. Unlike the people who oppose nationalized health care, I actually use STATISTICS to back up my claims. Notice the lack of anecdotal evidence that the opposition is so fond of using. Notice the lack of unsubstantiated opinions. I provide facts so that when I do give my opinions on the subject, you'll understand that I'm not talking out of my ass.

There are 45.7 MILLION uninsured people in this country. That's roughly 1/6th of our population. People who oppose nationalized health care seem to have no problem with this though. They have health insurance, so who gives a fuck about those 45 million people who don't? After all, if they were worth caring about, they'd have insurance, right?

It seems like people only care about ME ME ME in this country. "I have a job. I have health insurance. Why should my tax dollars go towards giving everyone health insurance?"

I guess their right because those freeloaders on Medicaid we all love to rant about must make up maybe 1 or 2% of those 45 million uninsured citizens. Jeez, we wouldn't want to help out all the other outstanding citizens of our nation because a very small fraction of that money might go to someone that's trying to abuse the system. You know what they say... One rotten apple spoils the bunch. Because we are so loath to support fat, lazy, smokers who might need health care, the other 99% of those without insurance will just have to die or go bankrupt if they happen to get sick.

Clearly, the way to go is privatized health care. I mean, why wouldn't you want to put your health in the hands of giant corporations whose sole priority is to make money? Corporations that actually set goals for the percentage of rejected claims they should have. Corporations who will deny you coverage or send your premiums through the roof if you have pre-existing conditions.

You know what the hilarious thing is? There's no other country that has a similar model of health care as us. You can't look at some wealthy European country and say, "they have privatized health care. Look how good they're doing." Pretty much every other country in the industrialized world has nationalized health care, and statistically speaking, in nearly every way you can measure, those other countries put our health care system to shame. Again... This is statistically speaking. Not anecdotally speaking.

I used France in the statistical comparison for two reasons. One, France has the best health care system in the world and 76% of it is funded by its government. Secondly, Americans love to bash on the French. Well, the French are kicking our ass in health care. It's not even close. They spend roughly half of what we do per capita, and they get far better results in just about every meaningful way you can measure health care results.

Obviously, looking at the numbers, the problem lies in our system. It needs to be radically overhauled to eliminate the waste. There's no reason we should be spending twice as much as everyone else and getting worse results. The process needs to be streamlined. That means we need to bulldoze the whole fucking system right to the ground and start all over again.

Only this time, maybe we can put our American egos to the side and ask the French for help on this one because they surely know how to make a health care system better than we do.

We won't do that though because it's un-American to approve of the French in any way. We'll just continue going on bitching about Canadian wait times (which pretty much every study shows are greatly exaggerated)and how it's "immoral" to have to pay taxes to support fat, smoking slobs who develop heart and lung problems. That's the American way, and it must be great... because American is great... Right?

Tuesday, June 23, 2009

The Best Way to Get Prescribers to Write Prescriptions Correctly

I'm dead serious when I suggest this. I also know that it will never happen. However, it will stop prescribers from making stupid mistakes on prescriptions pretty damn quickly.

There should be a law mandating that every single prescription must be written correctly in order for pharmacies to legally fill it. That means every time a doctor doesn't write a quantity, doesn't include directions, doesn't sign his name, doesn't write the patient's full name, writes illegibly or makes any other stupid mistake, pharmacists send the patient right back to the office to get a new prescription. After a dozen or so patients return to the office by lunch to get their scripts rewritten, the prescribers will quickly learn to write them correctly.

I'm so sick of calling to clarify every other prescription I get. The percentage is even higher on e-prescribed scripts. Really... How hard is it to write a fucking prescription correctly? More importantly, how can you just laugh it off when I call to clarify it?

Today, I called the office because I couldn't read whether the doctor wrote felodipine or amlodipine on a prescription. It looked a lot like felodipine, but the patient had amlodipine in the past, so we had to call to clarify it. For one, they couldn't tell me right away. They had to call me back... 6 hours later. Then, the woman on the phone said, "It's for amlodipine, but I have no idea what the rest of the prescription says."

That's great! It's a good thing I could read the rest of his chicken scratch because otherwise, I might have had to wait another day to get the directions clarified.

Then, there was the e-script that came through just like this:

Valtrex 500mg
Quantity: 426
Sig: 2 tabs (1,000mg) three times a day for 7 days

426 Valtrex, huh? So, I called to clarify the quantity just to make sure she really meant 42. Yes, the nurse meant 42 tablets. However, she suddenly realized she made another mistake, saying it was supposed to be for 500 mg, 1 tab 3 times a day for 7 days.

"So, the quantity should be 21 then, right?" I queried with the feeling that she just screwed up.

"No... It's for 42 tablets. She's taking it 3 times a day for 7 days," she answered.

"Three times daily for 7 days would be 21 tablets. Seven times 3 is 21," I informed her.

"Oh.... Well, that's weird because the doctor quite clearly wrote for 42," she responded confused.

I was done playing games with her. "Listen, the original prescription came through for 1,000 mg TID. That's the usual dose for treating shingles (which this patient had). I'm pretty sure the doctor meant her to take two 500 mg tablets or one 1,000 mg tablet TID."

"No... the doctor quite clearly wrote 500mg, 1 tablet TID," she insisted.

I told her that I would feel much more comfortable if she asked the doctor to clarify the dose and get back to me. She begrudgingly agreed.

Ten minutes later, the prescription was e-prescribed again to us with the original directions of 2 tablets TID. She never called to tell me if she got clarification on the script, so I had to call her back. It turned out I had been right. Had I not been insistent about getting the proper directions on the script, it would have been filled incorrectly and those incorrect directions would have been verified with a member of the office staff.

Isn't it comforting to know that often times the doctor's office staff is guessing on prescriptions when they call them in to us? I go through this same speil every freaking day. And are the patients happy that I took the time to make sure the prescription was correct? NO!! They're pissed at me for making them wait.

When they're not pissed, they think it's a big joke. "Oh.. Dr. Whathisname's writing is so terrible. HAHA."

You know... It isn't fucking funny. It wastes my time. It wastes the patient's time. Most importantly, it's DANGEROUS. People get killed because of poor handwriting. People get killed by incorrectly written prescriptions. Pharmacists are fucking awesome at correcting 99.9999% of the mistakes that prescribers make on scripts, but while we just might be the most accurate and obsessive compulsive perfectionists outside of NASA, we do occasionally miss these mistakes. Many of us are working long hours, under high prescriptions volumes, and with little help, so it's hard enough for us to make sure that the right pills go in the right patient's bottle. We don't need the added pressure that comes from poorly written prescriptions... especially when those errors are so freaking easy to eliminate if prescribers would just take 2 extra seconds.

Therefore, I call for pharmacists to revolt and refuse to fill prescriptions unless they are written correctly. We need to stop wasting our precious time bickering and bargaining with the office staff, and let them realize just how often they screw up. Let them waste their OWN time correcting their OWN mistakes.

Friday, June 19, 2009

An Ability I Wish I Had

The renovations on my condo are well under way. The contractor and his workers are in there ripping stuff out and preparing to install all the new things I bought. Watching these guys rip stuff out and make repairs makes me wish I knew how to do stuff like that.

I can't build anything. I have absolutely no mechanical talents. These guys can do everything. They know how to do electical work, plumbing, carpentry, tile, everything. This man could literally build a house from the ground up if he wanted to. I can't do anything even close to as great as that.

I spent a little while just shooting the breeze with these guys today, and it's crazy how intellectually superior I am to them though. I mean, they have a hard time understanding even the simplest concepts. I have to make sure to use small, common words around them or else they won't understand me. However, they can look at my water heater for 2 seconds and tell me everything about how the pipes run through the house.

My contractor and his workers are all nice guys, but they all look at me like I'm a step above them in society. It actually makes me a little uncomfortable. For example, one of my neighbors is a girl that went to school with me. While I was outside talking to the workers, she came out of her condo to get into her car. She saw me, waved to me, and I waved back. After she drove off, the guys were talking about how "hot" she was, and how I'm the only one of all of them that has a chance with her. One guy even commented about how he should be a "doctor" like me so he could get girls like that. (I quickly corrected him saying I was a pharmacist. I don't like being called a doctor even if my abitrary doctor of pharmacy degree technically makes me one). The ironic thing, of course, is that I'm fairly certain that he gets way more woman than I do. Any amount is more than zero.

Since then, I've been thinking about how I often forget that not everyone can afford the things that I can. I bought a condo I didn't particularly like, so I hired a contractor, had him gut the place, and after they're done, I'll have basically a brand new place. A lot of people have trouble even affording a condo like this place originally was. My job enables me to have nicer things than most others. Why is that though? Why do I make more money doing what I do than the contractor and his workers do?

They can't do my job. Intellectually, it's way over their heads... and I don't even think my job is all that intellectually challenging. They wouldn't be able to handle the classes I had to take to get my degree. It's beyond their mental capacity. On the other hand, I could never do what they do. I just don't have the ability to build things. I've tried before. I just don't have that natural talent.

If neither one of us can do the other's job, then why do I get paid so much more than they do? What makes my job worth more money than their's? If anything, I would think that being able to build a house is a far more useful ability than knowing how to dispense drugs. Yet the world seems to think that because I went to school for so long, I deserve to be paid more. Are there really fewer people who could be pharmacists than can build a house from the ground up?

See... While going through these renovations, I think of how much easier my life would be if I could do this stuff my self. It would save me tens of thousands of dollars. In addition, it would be constantly useful. Knowing how to rebuild and repair things never loses its value. However, my pharmacy knowledge becomes completely useless to me the second I walk out of the pharmacy.

I guess that was my random thought for the day.

Wednesday, June 17, 2009

Silence

The silence gets to me sometimes. As I sit here typing this post, the only sounds I can hear are the soft clicks of my fingers punching the keys. It's been this way for hours now. No phone calls. No text messages. I can't even hear cars outside. It's just me in this little apartment. The rest of the world may as well not exist.

It's not so much the loneliness that bothers me but the sense of isolation. It's a feeling that I'm completely inconsequential. Even though I can't hear it, I know people are going about their lives all around me, and I have absolutely no effect on them. I don't matter. If I happened to die in this apartment, no one would know about it for days. No one would call looking for me. I'm not expected to be anywhere. I have no plans with anyone. It's just me in my little apartment, which might as well be my own universe.

No matter what anyone says or tries to convince themselves, you cannot be happy living like I do. That's not to say that my life is miserable. It's just not happy. How could it be? "Happiness is only real when shared." Without friends or loved ones in my life, everything I have and everything I do is ultimately meaningless. I have no one to reflect with. I have no one to be happy with me. No one to be excited for me. No one to be proud of me...

The question then becomes, if this life doesn't make me happy, then why don't I correct the situation? Why don't I make more of an effort to be with friends and family? Why don't I try to meet new people? Why don't I try to date? There's a million things I could be doing to remedy my situation, but I don't do any of them. If I refuse to do anything about it, then I really shouldn't complain about it, right?

Here's the reason I choose to live this way: I'm so acutely aware of my personal faults that I don't want to subject anyone to me. I tend to hurt the people I care about. The only conversations I have with my parents involve yelling and arguing. I don't even talk to my brother. I haven't seen my other relatives in years, even though, as an adult, I can hop in my car and see them whenever I want.

Even with my ex (who I haven't written about in a long time)... I can't even count how many times I made her cry in our nearly 6 year relationship, and I loved her more than I thought I could ever love someone. It was stupid stuff. It's always stupid stuff with me. I get frustrated over something dumb (like not being able to find a parking space), and I lash out. Afterwards, I always tell myself I'll never do it again. I get mad at myself and try to change, but I can't. I get easily frustrated, and when I get frustrated, I can't control my emotions.

It happens to me playing basketball too. I miss a few jump shots, and I start muttering to myself. Miss a few more, then the frustration really sets in. At that point, if I miss another one, I usually let out a FUCK!!!!! at the top of my lungs, so loud that everyone within 100 yards stops what they're doing and looks at me. It embarrasses me because I'm not at all that kind of person normally. I'm really one of the most soft spoken, well-mannered people you'll ever meet in most circumstances. However, if I get frustrated enough, I lose control. I hate that part of myself. I tell myself that I need to be calm, cool, and collected like my favorite player Ray Allen, but I can never do it.

My embarrassment over my frustrated outbursts causes me to be overly controlling of my emotions in every other aspect of my life. If you talk to me when I'm not frustrated, I come across as the most bland person in the world. I have no passions. Nothing excites me. Nothing pleases me. I'm just blah all the time. I'm afraid to let my emotions go unchecked because I don't know how I will react.

I just can't be like everyone else. My brain doesn't work that way. I accept that, and I make what I think is the best out of my situation. However, it doesn't stop me from desiring more. Think of it like a double leg amputee. Yes, the amputee can make the best of his life given his physical limitations. However, he'll always wish he could walk. Similarly, I know I can't handle any kind of personal relationship (friends, family, significant other) without inflicting mental anguish on the other person, and I've found ways to not be miserable giving my situation. However, I'll always desire to be like everyone else.

It's taken me about an hour to write this post. In that time, I didn't get an email. Didn't get a text message. Didn't get a phone call. No one knocked at my door. My existence has gone completely unacknowledged all day. Days like these, which happen far too often, cause me to think about stuff like this.

*** As a blog note... I've kind of given up on pharmacy blogging. I don't have much left to say about my job. I feel like I've written every thing worth writing about already, so unless some new and different ideas pop into my head, you'll probably be seeing much more of these kind of posts than anything to do with pharmacy. I apologize to those that actually cared about what I had to say regarding pharmacy. I figure I'm too pessimistic to be a voice for the profession anyway. Pharmacy is certain to go nowhere if people like me are writing about it.

Saturday, June 13, 2009

Condo Update

Last post, I complained that the worst decision in my life was to buy this condo. I still think that's probably true. However, what's done is done, so now I have to make the best of it. The only way to make the best of the situation is to just go out and spend lots and lots of money.

I have all my repairs and renovations lined up. I had an initial budget in mind when I bought the place, and I've gone over that initial budget by over 25%. I know that I will never get back the money I put into the place. However, I did significantly increase the value of the home, so I'll get a lot of it back. As someone pointed out in a comment to my last blog post though, I shouldn't think of it as much as an investment as it is a home. In fact, I've always said myself that I wasn't concerned with making money on a home. I intend to live there for quite some time, so it has to be something that I like. After these renovations, it will be quite nice.

The money in the whole thing is what's freaking my out, and it's also why I'm calling it the worst decision of my life. It's really a gamble on my part. It's probably a small gamble, but there's still a chance this could all blow up in my face. My financial philosophy has always been to stay well within my means, and always have plenty of money in savings to spare in case something goes wrong. Before buying this home, I had well over a year's worth of take-home pay sitting in my savings account. If for whatever reason I lost my job, I could have stayed in this apartment and lived the exact same lifestyle for about 3 years before running out of money. That's quite a safety net.

Now, I don't have that safety net. After all this is done, I'll be broke. My mortgage is small (all things included, I'll be paying about as much to live in the condo as I am to live in my apartment), so once the renovations are through, I'll be able to go back to saving money at the same rate as before. I'm good at saving money. I guess I should be good at it. I make a pharmacist's salary, and I'm single with no kids. There's just about no way for me to go out and spend more than I make unless I start blowing money on really extravagant things. Since I have no desire to live any more luxuriously than I do now, I think I'll be OK.

Of course, being OK is dependent on me having a job. This is where I get nervous. I don't have a crystal ball. I could lose my job tomorrow or a couple months from now. In order for me to recover to a point of comfort, I have to maintain my job for another year or two. That probably won't be a problem. However, maybe it will be. Maybe early in the fall, the economy takes another nose-dive, only this time worse than before. Maybe our store's business plummetts, and they have to cut another pharmacist. Anything can happen, which is why I've always planned for the absolute worst case scenario.

In that way, buying this home was a deviation from my normal financial philosophy. It was a purchase based on blind optimism. It was a decision based on the hope that everything will be OK. It's dependent on the economy recovering like it always has in the past. It probably will, but I can't help to be uneasy about it. I'm naturally a pessimist. I always think the worst is going to happen. Thinking optimistically does not suit me. In fact, I'm entirely incapable of doing it. I simply cannot see the bright side in anything. I always see everything that can go wrong. That's why I hate gambling no matter how much the odds might be in my favor. This condo feels like a gamble to me.

In a year, I may look back and say getting this condo ultimately turned out to be the best decision in my life. That's if everything goes according to plan of course. As for right now, I don't have a safety net because I'm completely broke. I'm just hoping everything goes well, but I know that there are a lot of factors that are beyond my control. That's what scares me. That's why I'm freaking out.

For now... I'm set in my path, so I'll have to see this through. I just feel like I'm steering blindly.

Friday, June 5, 2009

The Worst Decision I've Ever Made

I bought that condo, and now I wish I could give the damn place back. This is, by far, the worst decision I've ever made in my life. I bought a place that requires more work than I'm capable of doing at a price that was probably much more than it was worth, and worst of all, I realized I'm just not ready to be a home owner. I'm so disappointed in myself.

I've been waiting forever and saving up money in preparation for buying a place. I had the money. I had the plan. Then when the time came that to finally make a purchase, I rushed in like an idiot. I had the money to buy a really nice home. However, for some reason, I went out and bought a fixer-upper. I have no idea why I bought a place that needed so much work. I am not in the least bit handy. I have a hard time changing a light bulb. However, I went out and bought a disaster of a condo thinking that if I buy it cheap, I can spend a little bit of money and make it a whole lot nicer and worth a whole lot more.

Of course... I greatly underestimated how much it would cost to fix the place. Now, I'm struggling to figure out how to make all the necessary improvements with a very tight budget. I said "yes" to buying the place so quickly that I didn't really pay attention to all the things that were wrong with it. Since, I can't do anything by myself, I have to hire someone to do it. Contractors are coming in with estimates of over twice as much as I have to spend. Therefore, I'm trying to piece this giant home renovation project together for the cheapest amount of money possible.

Of course, if I was a person that actually liked to do little projects, this wouldn't be so bad. The problem is that I fucking hate it. I hate being bothered with this stuff. I hate calling electricians. I hate calling plumbers. I hate Home Depot. I just hate doing this kind of handy work even if I'm not really the one doing most of it. To save money, I'm trying to paint the place myself. I've never painted anything in my life before, and I already know that I hate painting. The last 2 weeks have been a living hell for me.

Through all of this, I learned the hard truth that I'm just not mature and responsible enough to be a home owner. I like the apartment life. If something goes wrong, I call maintenance, and they fix it. As long as I pay my rent every month, the apartment complex takes care of everything else. It's nice. It's hassle free. It perfectly suits my personality.

I kind of think of my apartment as a really nice college dorm room. It's not my home. It's just a place where I hang out in between going to work. You can't think of a house or condo in the same way. You own it. You're ultimately responsible for everything. No one is there to bail you out if something goes wrong. You have to take the initiative to get it fixed yourself. I'm not responsible enough for that. When I get home from work, I just want to throw my stuff on the floor, sit down, and relax. I'm often too lazy to hang up my clothes, so they just pile up on my dresser for a week or so. When you're not worried about your apartment's future value, you tend to not care what happens to it. With a home, you're constantly trying to protect your investment.

Maybe it wouldn't have been so bad if I actually bought a nice place in the first place. I was so set on living only a couple miles from work that I would not even look at a nice place that was more than 5 minutes away. I wanted to live in a certain condo complex, and I chose the first unit that became available. Unfortunately, it was a piece of garbage, and instead of saying "no," I bought a place that I didn't even really like that much.

I don't know why I do these things to myself. I limited myself to a certain price range even though I could easily afford twice as much. If I spent even just a little bit more, I could have gotten a place that I really loved that required little to no work. Then, I wouldn't have had to deal with all the shit I'm dealing with now. But nooooo.... I had to make it difficult on myself.

Sometimes I think that I subconsciously punish myself whenever the opportunity presents itself. I constantly have to rationalize to myself that I'm a good person and worthy of whatever I desire in life. However, in the back of my mind, I think there's always this lingering feeling that I don't deserve nice things and that I've taken the cheater's way through life. I try to convince myself that I'm nice and do a lot of good for a lot of people, especially at work. However deep inside, I can't stand myself. Therefore, I constantly sabotage myself to keep me from getting what I truly want.

I would say that I'm destined to be miserable for my entire life, but I don't believe in destiny. I'll just say that I don't think I'll be anything but miserable for the foreseeable future.

Monday, June 1, 2009

Sometimes I Get Tired of Being Rational

Like Pharmacy Chick I hate it when people call out sick. I know, I know. People get sick. They should be allowed to take sick days in order to get better. I completely understand, and I'm accepting of it.

Despite being understanding of people calling out sick, I freaking hate it. I shouldn't hate it. It shouldn't bother me because I know people need sick days every once in a while. However, sometimes I just get sick of being understanding, and I'm going to use this space to vent a little.

I've never called out sick for work. I've just never been so sick that I didn't think I could work. As I mentioned in an earlier blog post, I only get maybe 2 minor colds per year. They usually amount to a sore throat and a sinus headache. That's hardly a reason to call out of work.

In the time span between my minor colds, I have coworkers who get sick a dozen times and use several sick days. It's starting to make me feel like I might have a superhuman immune system. I have coworkers who are such germophobes that they keep bottles of Purell with them at all times and constantly wipe down the counters in the pharmacy with those Lysol wipes. Despite trying to kill every germ in the world, they still manage to get sick all the time. On the other hand, I take absolutely no extra precautions to avoid germs beyond washing my hands after eating and using the bathroom, and I never get sick.

That's part of the reason I can't stand when people call out sick. I never have to call out sick, so I question why they do. A part of me feels like they're faking, or at least exagerrating, their illnesses. Seriously, I'm the most average person in pretty much every aspect. Why would I have a better immune system than seemingly everyone I work with???

Unless you're on death's door step, I think you should drag your ass into work because that's what I do. My philosophy is that I'm very grateful to have a job, and my job pays for my life. Therefore, if I'm scheduled to work, you can bet your ass I'm going to be there. Plus, I take pride in showing up to work every single day. I don't love doing it, but I pride myself on being dependable. I think more people need to have that same sense of pride.