Monday, December 17, 2007

Notes from a Pharmacy

I don't know why anyone decides to be a pharmacy technician, because I think they should be paid much more than they do make, but I am so glad some people do. My first days as a new practitioner I came close to the record of prescriptions per day that this location held. The only thing that pulled me through was my joy to finally be in the driver's seat, and the wonderful trio of staff I am currently working with. They solve insurance problems more quickly than I can at this point. The crazier the environment became, the more confident I felt because of those wonderful, smart and dedicated techs. I am sure they wish I would stop singing, but that's not going to happen.
I love that the company I am with values my time as a professional and provides enough help so that I CAN counsel on new prescriptions, help people choose the appropriate OTC product and answer questions. Yesterday I worked alone for the first time due to a huge snow storm, and I could feel the difference: I filled fewer prescriptions, and it felt like more work.
I believe people don't understand how much work goes into filling a prescription and they get angry if we say it's going to be fifteen minutes. We take in the hardcopy and ask for your birthdate; are you in our computer system? (No, our computer system does NOT take your information from all the other pharmacies and magically put it in ours!) Any change in insurance? Let us see if we have this in stock (somehow people get offended when I say this- how do we know what to stock until a patient orders it?). We need your drivers license. No we cannot fill without it, it's required by law for drugs in class II like Ritalin and Percocet. The Rx goes to the tech to type- what is this drug? Does it say Zocor or Zoloft? Call the doctor for clarification. He is in with a patient, the nurse will call back. Sometimes the doctor has the nurse collect all messages and he calls back once a day; this means that we can't fill in 15 minutes, and it's NOT our fault even if you choose for us to be the ones to yell at. Yes, we know it's a pain in the butt to have to come here twice. We get the call and now we know the correct drug, so we proceed, Choose the correct drug and put a basket together. Locate you in the computer, or type in all your info. Yes it IS important for us to know your allergies. You say you are allergic to codeine but the drug you want us to fill is Vicodin, which contains a product that belongs in the codeine family. What happens when you take codeine? You get constipated. Does your throat close, or do you have trouble breathing, or do you get a rash? No. But since you have never had Vicodin before, we have to call the doctor and confirm your allergy status. It's not going to be fifteen minutes. Doc says no you are not allergic and have had other codeine products in the past according to his records. We fill the prescription, choosing the correct NDC number for the drug. We bottle and label it and it comes to me. I ensure this is correct patient, correct drug, correct amount, and verify that the drug in the bottle is the drug from the stock bottle in the basket, and the NDC, name, strength and dose form match. If new, I check all the directions off from the original hardcopy, and we file it. Then we dispense it to you. Why does it cost so much? We asked you if there was any change in insurance and you said no. It was rejected by the insurance so we put it through for cash. You have another insurance card? That's why we asked. We send it back to enter all the new information, and we run it through again. It costs more than it did last time? Maybe that's because you have new insurance and the last time you filled with the old insurance. Why is their co-pay higher? You need to talk to your HR person at work.
Most of the time these wonderful techs are dashing about handling all this craziness while I am checking, answering questions and running out to help choose a product outside the pharmacy. I'd say 95% of the customers are pleasant, but the 5% left over can go a long way in raising the energy level for keeping a pleasant environment. The toughest are people who hate to wait, and who call in their prescriptions, then never get around to picking them up. It's considered insurance fraud to keep a prescription on the shelf more than 14 days. Technically, the insurance has paid for a product that the patient they cover has NOT got possession of. So we return to stock, but then in comes the patient the very next day and now the patient is mad that it's going to take 15 minutes for us to locate, fill and dispense. The patient doesn't care that we wasted time filling it then returning it then filling it again. All he cares about is he didn't want to wait- didn't he say that in the first place?
In the middle of all this, we had a few problems, some got solved, others must wait until the manager has time to give me guidance.
I like the tasks, especially when the work is flowing nicely. I like the challenges, and solving problems. No two days are alike. I like when the situation requires creativity, and I like when I turn an unhappy person into one whose situation is resolved. I like when people stop by to say they feel better. A mom came to thank me for taking the time to show her daughter how to use and care for her new asthma inhaler. The patient who thanked me for giving her a list of prices so her doctor could choose medications she could afford. The guy who didn't know he could get better control of his cholesterol by taking his med at a different time of day until I mentioned it while ringing him out. And the man with the very sick wife came in to say she was better and to thank me for my prayers.
But best of all, I like my techs.
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