Pain

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Today was a bit busier than yesterday. We had quite the Sunday rush, and the front store was short a person thanks to the stomach bug that’s been going around. So, all in all, I guess I got what I was wishing for yesterday, haha.

The major theme I came across today was people’s reactions to pain. It amazes me how different people are when they’re in pain vs. when they’re not. They are almost a completely different person. I personally know a few people who suffer from chronic pain, so I have known about this phenomenon for a long time. But still, the reactions I see in the pharmacy sometimes surprise me because they’re so over-the-top.

There was one woman who came in today. She had just had major abdominal surgery done and was in a great deal of pain. She brings in a script for a narcotic pain medication. When it was run through her insurance, I received a rejection message stating it was too soon to be filled until the following day. I told her this, and she asked if she could just pay cash for it. I refused because of what the medication was. Had it been a non-controlled maintenance medication, then I would have let her pay out of pocket without any problems. But, seeing that it belonged to the most controlled class of medications, I politely told her no.

She immediately started screaming about how much pain she was in and that the doctor told her she could get it filled early because the directions were changed. Because she had gotten it at another pharmacy the previous time, I could not verify this without calling them, and they were closed. I told her if she got a hold of her doctor personally, and he authorized the fill over the phone to me, I would fill it, otherwise, my answer remained the same. She banged her fists on the counter and continued yelling. She couldn’t understand why it was her responsibility to call the doctor and not ours. At our pharmacy, when a person insists a narcotic is allowed to be filled early, the pharmacy personnel do not call on it. We have quite a number of people that have had past issues with prescription drug abuse, so we choose not to cater to them for safety issues.

To make this long story short, the physician did end up calling me and verifying that it was, indeed, allowed to be filled early. He stated that he gave her a very limited amount of pills for this very reason. I filled them for her, wanting to just get her out because her carrying on was making some of the other patients in the waiting area nervous. I went to the register to start ringing her out. That’s when it happened–the words, “I’m sorry,” escaped from her mouth. It’s very rare that we hear apologies from the people that have two year old inspired tantrums over their medications. I was shocked. She apologized for her behavior; she was just in a lot of pain. After some more apologizing, she left.

Other similar things happened today, all of which were due to the patient being in pain. But, that was probably the best story of the day.

 

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How Rude!

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Today’s theme was definitely rude behavior. In a community pharmacy, rudeness is a commonly observed trait. But, it seemed like there were several exceptionally rude people at the pharmacy today.

One example was that of a lady dropping off a prescription for another person. She didn’t like that there was someone ahead of her. As I was figuring out what that person’s copay would be, the woman behind her literally pushed this person to the side to throw her script on the counter. A fight nearly broke out between the two people.

Another example would be that of a person who came to the drive-thru to pick up a prescription. We had just received it about a minute or two prior to her arrival. We told her it would take about 15 minutes to get it ready and asked her to come back. She refused to move and shut off her car. She couldn’t care less that the people behind her were angrily beeping their horns.

A third example was that of a person who wanted her pain medication filled 10 days early. When we refused because it was too early to fill, she started yelling and threatening to sue our store. On her way out, she stopped random customers (including those in our waiting area) to ask them loudly how horrible they thought we were. When they looked at her like she had two heads, she told them they were just as bad as us.

I also saw two people fighting over a dropped dollar bill and an adult laugh at a toddler who tripped over his shoelaces (this adult was not with the toddler or his parent). It’s days like these that I wish I could send people back to preschool to learn manners again.

Truthfully, it doesn’t bother me when people yell at or act rudely towards us. It bothers me when they act rudely towards random people in the pharmacy that they don’t know. It grates on my nerves. Everyone comes to the pharmacy for the same general purpose–to get medications. Don’t pick fights or argue during the 15 minutes that you’re there. Show the other waiting patients the same courtesy you would want them to show to you.

The Golden Rule is such a simple concept, yet it eludes much of the human race. On days like these, I can only shake my head.

 

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Refusing

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So, today was a relatively busy day in the pharmacy. It was pretty much non-stop action all day. It wasn’t a bad busy, just busy. The day flew by pretty quickly, and most people were in good moods. I’m sure the sunny weather helped with that. =)

There was one man who came in today who had both a Medicare part B and Medicare part D plan. Both will cover diabetes equipment and drugs, but with varying copays. We had originally billed his prescriptions through Medicare part B just over a month ago. He received a letter in the mail the other day telling him that he has had Part D coverage for those prescriptions for a few years without realizing it. He asked me to rebill it through the Part D plan. I willingly obliged.

Well, it turns out one of the prescriptions was the same price either way, but the other was cheaper through Part B. I tell him this, and he asks me to undo the second one. Unfortunately, once it’s been over 30 days, you can’t undo things like that in our store. You can only bill under new plans. You cannot rebill and then undo it because it was cheaper the other way. That is technically fraudulent behavior. You, as the patient, are responsible for knowing which billing option you want to use beforehand. The pharmacy can only rebill and refund under very certain conditions, especially with government funded insurance (Medicare, Medicaid, Tricare, etc.).

So, because the price difference wasn’t that much, I was just going to absorb the cost, since he wasn’t previously aware of the price difference, but he wanted to hear nothing about it. Before I could tell him that I wouldn’t be charging him extra for it, he walked away and out of the store. That left me with an interesting story for my store manager tomorrow morning when the register is all totaled.

Listen, if you are ever in a situation where rebilling something makes it more expensive for you, most retail pharmacies will absorb the difference and not charge you. But never EVER just leave without completing the refund transaction. We need you to sign receipts verifying you were present for the transaction. Otherwise, the store can get in trouble. This is mostly for chain store pharmacies, but even for independents…it’s just plain courtesy to stay until any transaction is finished.

 

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Sharing is Caring…Right?

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So, today was, overall, a nice day at the pharmacy. I got to see a lot of my favorite patients, and the day wasn’t too hectic. It was a pretty smooth Friday, and I was actually able to eat lunch. One story stuck out in my mind, though, because it wasn’t as lighthearted and airy as the rest of the day.

So, for whatever reason, our drug supplier did not send us enough of a medication we had ordered. We had two women who were both owed two boxes of said drug. Only two boxes total came in our order. My technicians and I let out heavy sighs, knowing we would have to break the news to them somehow. One box would be enough to get them through the weekend, all of next week, and then some, but it was not enough for the full month. The decision to give each a box until we could get he rest in on Monday was an easy one to make on our end. So, my techs got on the phones to call each woman, while I continued to check prescriptions and counsel patients.

Apparently, both patients insisted that we give them both boxes and tell the other nothing came in. Without going into too much detail, I will just say that the medication is 100% necessary and both women were completely out of it for the weekend otherwise. The techs attempted to explain this, and, yet both women kept insisting that she needed it more. We ended up giving each one box, as it would be unethical to make one do without. Neither was happy but agreed since the only other option was to get nothing.

I couldn’t help but shake my head after hearing what happened. Both women were talked to separately and by different people. I was amazed that the response was identical. It made me wonder how much good is truly left in the world. Both knew how important it was for people to have this medication, but both were willing to make another suffer so they could have more. How greedy and selfish humans can be.

*sigh*

At least that situation was followed by a two year old running through the pharmacy playing hide and seek with his mother, while she desperately tried to lure him back out into the store. ^_^

 

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