Tag Archive: stupid patients


It’s not my fault, I swear!

So it looks like I blogged too soon about not having any drama. Nothing major, but I keep telling myself I need to blog some more, so here goes:

Yesterday, a guy asked us to transfer his Viagra from another store (within our company). When I transferred the prescription, it came up with an interaction with his Imdur 60mg. For those of my followers who aren’t in pharmacy, Imdur is a NITRATE (you know, those drugs that have such a bad interaction with Viagra they warrant both an onscreen and verbal warning from the narrator in the commercial.)

So needless to say, the pharmacist didn’t want to fill it without verification from both doctors that it was ok. (Though, in her words, “What can the doctor say that will make me feel comfortable enough to fill it?”)

When the patient came back to pick up, the pharmacist went out front to talk to him and say she wasn’t comfortable filling the prescription, and he lit into her. I thought at one point I might have to call security, but he didn’t get violent, just mad. “Can’t you see I’ve been getting both drugs for two years!?”

He was kind of trying to steamroll her, so I went out to try to explain things in a different way. (“Do you really want your prescription filled by a pharmacist who isn’t comfortable filling it?”), but he just stormed away. We were both a little shaken by the situation, but felt good knowing we at least tried to keep somebody from dropping dead.

Then, today, another patient came in with a transfer from another company. He paid out of pocket the last time he came to our store (which was the first time, too), so we didn’t have his insurance on file. When I went to ring him out, I said, “That’ll be $10.99.” All of a sudden, he got very mad. “I have insurance! I don’t pay anything for my prescriptions!”

I went to the computer, and saw that he had paid out of pocket for the last medication he got. When I questioned him on it, he said, “That isn’t covered by my insurance, so I didn’t give you the card.”

My retort: “So, how can I bill your insurance if you never gave me your card?”

His response: “…”

I’m good, but I’m not that good.

Happy (Pharmacy) New Year

So, did you work today?

If the answer is yes, and you work in a pharmacy, you know what Pharmacy New Year is. For those of you who don’t know, let me explain:

January 2nd is the first day doctor’s offices are open again, many of them since before Christmas, or at least since last Friday. That means, a ton of faxes (though for some reason I got even more on New Years’ Eve than today), and a lot of “patients” realizing they are “sick” because they don’t want to go back to school/work.

Plus, it’s a new insurance plan year, so lots of people have new cards or deductibles (that they never seem to know about until their script turns out to cost $300) or formulary changes.

On top of that, Zyrtec just went generic, and is going OTC later this month, so all of the insurance companies’ computers are confused.

So please don’t complain that your prescription isn’t ready when you didn’t tell me you had a new insurance card, didn’t respond to my repeated pages to return to the pharmacy, and then hand me a card written in igPay atinLay that doesn’t have the essential information (like the bin number or, god forbid, the ID number.)

I offered to switch three people to generic Zyrtec today. All three of them (all of them Argus/Carefirst), were rejected for “non-match NDC number.” Well, ok, it’s new, not in their system yet. Let’s try the brand name Zyrtec: Reject “NDC not covered; OTC available.”

Umm, you mean it’s January 27th already? Because as far as I’ve been told, that’s when it’s going OTC. Thankfully, all three patients were willing to wait until tomorrow, when Argus says they’ll have it straightened out.

Today was also the day for people to call in all their refills (as in 8 or 9) at the same time. Some because they were waiting to be out of the dreaded Medicare donut hole, some because they’re trying to get everything on the same schedule.

We had one patient who used to be on Avalide, and was warned ahead of time (a shock, I know) that is was no longer going to be covered. He was prepared last month with a script for Benicar HCT, another ARB+diuretic that was on the list the insurance had mailed him. When he called in the Avalide, it was rejected (as expected; hey that rhymes). So, I tried the Benicar HCT and it was rejected, too. It turns out the insurance had a change of heart, and now prefers Diovan HCT. I faxed the MD for a change, and thankfully got it fairly quickly.

An 18-year-old girl (I can’t call her a woman) brought in 3 scripts: Doryx 100mg, Tazorac cream, and Duac. We filled the scripts; the two creams came to about $120, and the Doryx was about $300; she had a $1500 deductible, then everything is $7. Of course, she didn’t understand that. “Last month at the other pharmacy they were $7! Why are you charging me almost $600!?” Because, girl, you have a dumb-as-dung insurance plan. So, she put me on her cell phone with her mom, who argued with me, but ultimately seemed to understand that I couldn’t do anything about it. I handed the girl back the phone (did I forget to mention I had a cold?) and she demanded the scripts back.

So, Happy Pharmacy New Year. Are you ready for a vacation yet?

I know more than you

So this lawyer-type came up to the pharmacy counter the other day with a script for Keflex. Of course, he had never been to our store before, so I had him fill out a patient profile. When he was done, I looked over it to check for missing information (which is common in my store; I mean, who really forgets to write their name down?)

Well, he had forgotten to write his birthday down

Liar, Liar, Pants on Fire

Ah, druggies, don

Transfer Happy

Ok, so, yeah, I

Good Feelings

It’s nice to be able to send a script to an independent pharmacy for one. Usually, we’re transferring them from the independents.

This afternoon, someone called asking for the price of 40 capsules of Vancocin 125mg capsules ($615). They didn’t ask if we had them, so I just figured it was another pharmacy price-matching–that is, until they brought the script in four hours later. Of course, we didn’t have it.

Pt.: But I called earlier!

Me: Yes, but you only asked how much it was. I didn’t know you were coming in for it.

Pt.: Well, can you call another pharmacy? I have to start taking it in less than an hour.

So, I, being the nice person that I am, pulled out my list of other pharmacies, and started calling all the pharmacies up and down the highway. After the fifth call, the pharmacist started calling from the other extension, too. At the same time, I found it at an independent pharmacy that is close by (but whose price is $725) and the pharmacist found it at another one of our pharmacies which is further away (by a considerable distance.

The patient thought it over for a second, then decided to go our other store since we were cheaper. Since he was in a rush to get it, we offered (again, out of the goodness of our hearts) to get his info at our store and then transfer the script to the other store. So, we had him fill out a profile, and he whips out an insurance card.

Me: Sir, you didn’t say you have insurance. You can just go the closer pharmacy; it will cost the same there as here.

Pt.: But, I have a percentage copay (actually called coinsurance).

Me: Yes, but it’s a percentage of the Maximum Allowable Cost (MAC, a dreaded acronym in pharmacy, almost as bad as IRS).

So, we sent the patient down the road instead of across town. And it felt good to be able to help out an independent pharmacy. (Plus, I’m sure they were anxious to get that Vancocin out of their inventory.)

Timekeeping

If one more person tells me this week how long they’re willing to wait for their prescription to be filled, I’m think I’m going to explode. Some examples:

Me: Okay, that will be about 20 minutes. (no joke, that’s our usual wait time)

Pt.: Well, do you think it will really take 20 minutes?

Me: Yes, I do. (thinking) No, I’m just going to make you wait that long for the heck of it. It really only takes about 30 seconds.

and:

Me: About 15 or 20 minutes. (this was the day before the 4th of July)

Pt.: (in a thick New Yoa(r)k accent): I’d really appreciate it if it was 15 minutes. I have a plane to catch at National in 90 minutes.

Me: I’ll do my best. (thinking): Good luck. I hope you get put on standby. Now your script will take 21 minutes, just out of spite.

Pt.: Well, you’d better.

and finally, when we were really busy:

Me: Just to let you know, it’ll be about 30 minutes.

Pt.: What?! Can’t you get it done any faster?

Me: Not with five people ahead of you sir.

Pt.: Well fine! I’ll just take it down the street to XYZ Pharmacy.

Me: Fine. Here’s your script back. (thinking) Great! One more annoying patient I don’t have to fill a z-pack for, especially since happen to know XYZ’s wait time right now is 45 minutes.

A word to the wise: Making your pharmacy tech (or pharmacist) angry is just as stupid as doing the same to your waiter. Just be glad I have too high a standard of ethics to switch your antibiotic for an erectile dysfunction pill. Goodbye bronchitis, hello four-hour erection!

In my pharmacy we are (or at least I am) very superstitious about the dreaded “S” word–no, not that one; “slow.”

Well, today being the day before a holiday, the pharmacist had the (mistaken) impression that today would be, umm, s**w, since everybody should be travelling out of the area. I told her not to say that word, and she just said I was being superstitious.

Around 10am, a “nurse” called in a script for Vicodin ES, #30, 1-2 twice daily. All in all, not a weird script, except for the following:

  1. She had a very (very, very, very) fake “briddish” accent, making it obvious she was trying to disguise her voice.
  2. She was calling from an emergency room. In this area, at least, ER’s don’t call in scripts.
  3. There was no background noise; if she were really in an ER, there would have been the usual sounds of an ER

So, the pharmacist called the ER, and the nurse who answered quickly said, “Well, we don’t even have a nurse by that name.”

RPh: Well, I need to speak with the doctor to confirm that it really is fake.

RN: Dr Soandso is busy right now.

Rph: Well, I’m sure Dr. Soandso would like to know if someone is calling fake scripts in under his name.

RN: Ok, I see your point.

Well, the doctor confirmed that it was fake as well, so we called security, who then called the police. A really nice policeman came and took a report of what had happened. He waited in our back area where he couldn’t be seen for about half an hour before deciding to leave his cell number (something he said he doesn’t give out to just anyone) with instructions to call if she came.

I said as he was leaving, “Of course, she’ll be here in ten minutes.” (and of course, I was right; an early-20-something very-pregnant woman wearing daisy dukes, a tank-top, and flip-flops came strutting in.)

To stall her, we had her fill out a new patient profile. “We haven’t filled anything for you since 2005 (which was true) so we need to update your information (which was pure baloney). Meanwhile, the pharmacist got on the phone and called the officer.

As the “patient” finished filling out the profile, a different officer came in behind her and yelled at her to drop her backpack. He then proceeded to cuff her and lead her to the bench by the bath room. Evidently he loosened his grip just enough, because she decided to make a run for it; not easy to do when you’re very pregnant and wearing flip flops, not to mention hand cuffs behind your back.

By this point, the first officer had come in, the assistant managers on duty came back to the pharmacy, and half the employees were wondering what was going on. We also had one patient waiting for about an hour in the store while this was going on; thankfully she was nice, and it was an otherwise sl…er…not not not busy day. (Hopefully that will keep me from jinxing myself for the next time I work.)

I was sent to make copies of the “script” that she called in and the profile she filled out. When I came back, one officer was asking her name (“I don’t have one,” being her response; gotta love stupid criminals) while the other officer pulled out 4-5 prescription bottles and half a dozen presumably fake scripts from her back pack.

When it was all over, I turned to the pharmacist and said, “See, I told you not to say the “s” word. It gets us in trouble every time. (of course, I meant we’d get a lot of scripts, not a nearly nude pregnant girl running from the police.)”

—–

Hope everyone has a happy 4th.

See-too day

(aka, C-II day)

After the 3rd perco script in a row, I started calling today a C-II day. After the fourth, I jokingly said we just just keep the percocet out on the counter, and after the 5th, we started keeping it out.

And it wasn’t just percocet; there was also metadate, focalin, and Daytrana (more on that later). There was even one really spooky, “Scary Door” moment. A man came in with a script for 120 tabs of Percocet 10/650. The pharmacist, however, knew that it was about time for some of our regular patients, a husband and wife, to get their monthly supply (he gets 80, she gets 200.) If we had filled the 120 script, we wouldn’t have had enough to fill the 200+80, so we turned the script down (well, that, and the guy looked kind of shady.)

Not 30 seconds later, the wife brings in their scripts.

I told you it was spooky.

Then there was the Daytrana (ritalin in a patch) script. Monday, we had a mom call to see if we have Daytrana 10mg patches, #60 (the kid was to use 2 patches daily). Of course we didn’t have it, so we told her we’d have to order it. Long story short, we eventually agreed to order it without the script (our first mistake); the mom wanted to try a few more places before bringing the script to us.

When the Daytrana finally came in, the lady’s husband brought the script in, but he had a coupon card that is good for 40 free patches. Since the kid had never used the patches before, we asked him if he would like to just get 40 patches for free (and lose the rest) to see if they even work for the kid before they had to pay any money for it. Well, he thought that was a great idea, so we ran the script through and sent him on his way.

About 10 minutes later, I get a call from an angry lady (guess who) demanding to speak to the pharmacist, who was helping a patient out in the aisle. I put her on hold, but before the pharmacist had a chance to pick up, the lady had hung up and called back, screaming (and I quote): “Don’t you dare put me on hold again! I’ve been trying to get this straightened out for a week!” (Yeah, lady, 2 days equals a week in this country.)

She demanded to know why she would lose the remaining 20 patches, and we explained to her that on schedule II medications, we can’t give refills. We promised to contact the doctor’s office and let them know the situation (in fact, we already had), but she wouldn’t have it; she demanded (her word) to get the rest of them, even if she had to pay the $45 copay.

My response would have been, “Sorry, the medicine has already left the pharmacy.” The pharmacist’s response was, “Fine, whatever, just as long as I don’t have to deal with it anymore.” (to me, not to the mom.)

The husband was very apologetic when he came back. He gave us back the 10-pack, and we gave him another 30-pack (thankfully Daytrana is sealled with ultra-hi-tech holographic seal thingies) The situation left me wondering who the medicine was really for; the kid or the mom.

Adipex cheater

Edit: sorry, the pic was lost during a site upgrade.

Look closely at this prescription (finger added to protect the, ahem, not-so-innocent). I finally understand why this doctor always writes the quantity twice on controls.

It’s not so obvious in this RAZRized picture, but if you look at the second line, “Disp: 30 tabs” was changed to “Disp: 80 tabs.”

Well, we of course called the doctor’s office to verify that the script was valid. The nurse told us to go ahead and fill the prescription (for 3o with no refills, as it was originally written) but to fax them a copy of the rx.

Well, the next day, the nurse called and I picked up. She wanted to know if the patient had picked the prescription up, and unfortunately they had. The nurse told me, “Well, just so you know, he is no longer going to be our patient.”

Sting. And the thing is, the patient isn’t even fat.

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