Thursday, May 30, 2013
I Will Remember You, Part III, the Patients...
I have a list.You do not want to be on this list. If you are on this list, you have made my life miserable on several occasions, and the sight of you standing at my counter causes my soul to sink into my shoes .
People make the list for a variety of reasons. There are the pharmacist stalkers who have a boat load of questions every time, no matter how busy we are. Questions are ok, unless they are just for the sake of asking something. There are the crabby, nasty patients, who never seem to be happy with anything. There are the oddballs, who request things like no staples on the bag, no bag, no receipt, or special bottles because they can't use the ones everybody else does. There are dirty old (and young) men who say inappropriate things, and the stool gazers and worry warts that also say inappropriate things. And show us inappropriate things! And there are people who have a ton of meds or take care of someone who does. They earn a spot on the list, not because of anything they have done, but because every time they come in there is some kind of hassle.
I told one of my technicians that every time one of these people goes elsewhere, for whatever reason, I breathe a sigh of relief, and do a little happy dance in private. I said that sometimes reading an obituary for one of these people makes me involuntarily breathe a sigh of relief, which is sick and wrong, but honest!
She told me I was awful, and I told her if she tried to tell me her soul did not emit an involuntary "WHEW"
when it knew there was one less tormentor coming in, then she was either a liar or a saint.
The most endearing patients to me are the ones that find a way to use humor in the face of their difficulties. While some people fuss and fume over every little inconvenience or perceived slight, these people seem to take it on the chin and keep their dignity intact. We had one little sweet lady who came in with her husband to pick up his medicine, and we had to tell them it was going to cost them some horrendous amount of money. She turned to her little husband and said in her southern drawl, ''well, Clifford, honey, I think it would be cheaper to just shoot ýe''. Of course, he just smiled.
Then there was the little old man who had to go in for a biopsy to check for prostate cancer, and he said he asked the doctor if it was going to be painful, and the doctor said ''well, Charlie, did you ever fall astraddle of a board fence?'' He laughed and said it wasn't a true story, but I suspect there might have been an element of truth (and fear) in there.
There are certain mannerisms, actions or statements that have come from people over the years that I don't completely understand. There are the old men who ''flick'' their credit card at us, or toss their money, including coins, on the counter at us. Was it cool in 1945 to throw things at the cashier John Wayne? ''Hey barkeep, here's two bits for me and my pardner a couple 'o whiskeys...'' toss, clink, bottoms up!''
''Well, there's fifty cents, if you never get anymore'' What???
''Who comes in here more than me?'' (Well, everybody that works here for starters!)
"I probably own half this company by now'' (pleased to make your acquaintance, Mr. Trump, your hair looks different in person!)
When you work in the same location for a long time, you see the rise and fall of humanity in this little microcosmos. When you see somebody go through something that takes them from the picture of health to the depths of despair, it scares the living shit out of you. Fortunately, it sometimes goes the other way. The girl who used to rock back and forth and arrange our vitamins in front of the counter for us, comes in bright eyed and coherent because they finally got her medications right. The girl who went through drive thru, who I remarked would be pretty if she had teeth, lo and behold comes through with a new set of choppers. The old man who wasn't supposed to make it comes in and says his cancer is in remission.
Aside from the generalizations I could make about my patients, there are a few characters who have earned their own special place in my memory. I already mentioned the "Hall of Fame'' members in an earlier post. Here are some more, names changed to protect the innocent:
"Annie McDuff'' the little Russian lady who wore a head scarf, had a mole with a hair growing out of it, and liked to drink '''wodka", heh, heh, heh, (picture a less than glamorous Natasha from Bullwinkle).
"Artie Jones'', my book buddy, who always had interesting reads to recommend, and who taught me that Somerset Maugham, is pronounced "Summerset Mom" not ''Summerset Maugam".
''Mary Steeple" who asked my pharmacy manager "Cora" if she could pray for her, and when she told her ''yes'' proceeded to put her hand on "Cora's" head and prayed right there in the store in a loud voice ''OH LORD, HELP THIS WOMAN!!!!!'' This same lady was in a constant fight with the lady in the apartment next to her, mainly because she put a glass to the wall and listened to her conversations.
"Beth'', who told me her parents house smelled so bad, because the neighbor lady had burned her dead horses in a field, and the smell drifted down to their house, and her Mom and Dad were so mad, which I believed and told several people before her Mom came in and scolded her for telling me the story, which turned out to be a complete fabrication.
"Bill Moody'' who came in to the pharmacy I worked at, and who also swam at the ''Y'' when I lifeguarded, and said "I have a crush on you, do you have a crush on me?'', and told me if I ignored him, he would ''come in every Wednesday and Friday and splash you, and that is not all I will do, either!''. The poor guy apparently got mad at some lady and went into the racquetball court and took her racquetball, which landed him in the local mental hospital where ''I can't have my tape player, or my tapes, or anything''.
There are a few memories of people who were more ''notorious'' than notable, like the girl who called me a ''white ass ho'' because I rang up the little old lady who had been waiting on her prescription for an hour before ringing up the candy bars she and her friend had tossed on the counter. Or the creepy old man who was scary looking , like Frankenstein, when he was mad, and even creepier when he smiled. And who did not want staples in his bag, or a bag for that matter, or a receipt, either. And who knew what kind of car each and every one of us drove. Or the guy who threw the phone over the counter onto the floor when his doctor's office refused to ok an early refill on his pain medicine.
Ahhhh. such lovely memories! Actually, they truly are. I have more than enough to last a lifetime!
BP
Sunday, May 19, 2013
I Will Remember You... Part II, The Technicians
The pharmacy technicians I remember the most fondly are the ones back in the days when there were no certification requirements or specific standards, other than being a decent human being and showing up with the best they had to give every day. There were always people who brought drama to the work place, but it tended to be minor.
Hospital techs are different from retail techs. The ones that worked in the IV room were smart, fast, and impatient, especially when they had to work with me right out of pharmacy school. They taught me everything I know about IV's, at least the hands on part of it. The filling techs and the delivery techs were more rambunctious, prone to playing practical jokes and harassing each other and the pharmacists. Some of them formed little cliques, which would sometimes battle it out with the other little cliques, but most of these tiffs were minor. I do recall one incident where one of the guys stuffed another guy into a trash can, and both of them got fired, even though they swore it was all in fun and no harm done.
Back in the 80's, the AIDS epidemic was just starting to emerge. Some sources pinpoint the official start of the epidemic as June 5, 1981, when the CDC reported an unusual strain of pneumonia (PCP) in 5 gay men in Los Angeles. In 1984, when I started my first job in a hospital, there were 3 gay men working with us in the pharmacy. I later learned that 2 of these guys died of AIDS. Two other men died at the second hospital I worked at, one with AIDS, and one who had a seizure disorder which was later determined to have been caused by a malignant tumor growing by his pituitary gland, where the optic nerve crosses. He was a sweet little guy, looked like Michael Jackson back in the day, skinny with an afro. He sang the song ''Memories" (from the movie'' The Way We Were'') to me and gave me a rose for my goodbye gift, which embarassed the hell out of me, but was still pretty sweet.
I had another technician, a stock boy actually, who ended up having the same type of tumor in the same location, but thankfully his was non-malignant and he survived and continues to do well. This guy was into restoring old cars and bought a Chevy Impala to restore. He and his Dad went to car auctions all the time. He told me that sometimes, they would find the original paperwork under one of the seats, and that they would collect boxes and boxes of parts from different shows. I could see the appeal of the hunt, and the fun of finding out the history of the car. He later told me he ended up selling the car and never getting it restored.
Another stock boy at that store went on to become a pharmacist, and he had me write a recommendation letter for him to get into pharmacy school, which I considered an honor, since this kid had a huge heart and a lot of integrity. When his grandmother was bedridden with breast cancer, she had some lymph nodes removed, and she had severe swelling in her feet and legs. One way to relieve the swelling is to massage the feet and legs and get the fluid to move out of the extremities and back into the blood stream. This kid would sit with her in the evening and massage her feet and legs, sometimes falling asleep at the foot of her bed.
There were two more pharmacists produced by that store, both girls, one who went on to be a doctor, and one we lost in a horrific car/train accident. She would have been a good one. It made me proud to know that somebody looked up to me that much.
Some of the best techs I have had were middle aged women that I could rely on to show up every day, who took care of the customers in a professional manner, and who kind of took care of the pharmacists as well.One lady was a dispatcher for the police department at night, slept a few hours in the morning when she got off shift, and came in to work with us at noon, never complaining, always nice and patient. I probably took them for granted then, before I had been introduced to the type of technicians I have now, who always have drama going on in their lives, who disrespect the pharmacists, and who may or may not show up or do their job on a regular basis. And who, I suspect, are employed by management as moles to report back any infractions or perceived shortcoming on our part.
When I worked in the little clinic pharmacy, there was one tech who stood out because she had an ornery streak and was a little hyper. When she sat at the computer to type, she actually faced away from the patients, and would be nice to their face, then turn around and mouth obscenities in our direction, so we had to control ourselves and not laugh, which made it all the more fun for her. Her parents had made her take care of the chickens on their farm as a kid, so she hated chickens. She would start by imitating the low, threatening '''baaaaawwwwwkkkkkkk'''they would start with whenever she entered the barn (there were hundreds of chickens, not just a little coop). They would escalate into a full blown cacophony of clucks and ''bawks'' , which she said was very disturbing. She used to be sitting there and suddenly say, ''did somebody say ''chicken?!'' and bust out into a loud ''ba cock!'' . This was a great tension breaker and made us laugh, until the pharmacy director told her to knock it off. Apparently she also used to get in the dumbwaiter that traveled between the pharmacy and the floors above and ride up and down before somebody put a stop to that, too.
I had one technician who actually remembered me from my first job in the hospital, and said I had trained her on IV's. I didn't remember, so I asked her if I was mean to her. She said, no, I was actually very nice and patient. Whew! Anyway, we met up later in retail, and she had the best stories of anybody I ever worked with. She, her husband, and their 3 sons, essentially could have survived quite nicely off the grid. They were self-sufficient in the way that people used to be when they had small farms and raised animals.
There was the time her husband stood up on the horse's water tank, lost his balance, and grabbed hold of the electric fence as he went into the water. There was the time her son went out in his pajama pants and slippers, smoking a cigarette, to round up a bull that had gotten loose.He ended up flicking the cigarette, kicking off the slippers, and running for dear life, clearing tthe fence before the bull could catch him. They had a nasty old rooster that would chase her every time she went out into the yard. Even when she would try to sneak out of the house, he would come charging out of nowhere and attack her legs. She finally had enough of it one day, took a broom, and beat the hell out of that rooster. I asked her if she killed, it, and she said no, but he walked kind of crooked after that! But by far, the best story she told was about how they used to do historic reenactments. Her husband portrayed a French Trader, and she was his wife. She made all their costumes, beaded buckskins and all, but she had no interest in learning the historical facts surrounding their portrayal, so she left that to her husband. She said ''I decided that Marie DuPree, the French Trader's Wife, was deaf and dumb." She not only lived off the grid, she thought outside the box, too!!
I still have a couple of the old breed left, but the pickings are becoming mighty slim. No one can survive on the wages they pay technicians, so we have a lot of women who tough it out in less than ideal circumstances with men who treat them badly because economically, they don't really have a choice. Another scenario we see is the here today, gone tomorrow, lost my job, got a DWI, spent time in jail, boyfriend or ''fiance'' who contributes nothing to the cause except an occasional black eye or domestic dispute. These women are understandably not fully engaged in their jobs, because their life is a train wreck.
Most of the male techs I have had are college students who move on after a few years, guys who need a second job, or guys who are semi-retired. Women have a reputation for causing drama in the workplace, but, believe me, men stir the pot, too, just in different ways. Gossip is not just for women anymore!
Next time, Part III , the Patients...
BP
Hospital techs are different from retail techs. The ones that worked in the IV room were smart, fast, and impatient, especially when they had to work with me right out of pharmacy school. They taught me everything I know about IV's, at least the hands on part of it. The filling techs and the delivery techs were more rambunctious, prone to playing practical jokes and harassing each other and the pharmacists. Some of them formed little cliques, which would sometimes battle it out with the other little cliques, but most of these tiffs were minor. I do recall one incident where one of the guys stuffed another guy into a trash can, and both of them got fired, even though they swore it was all in fun and no harm done.
Back in the 80's, the AIDS epidemic was just starting to emerge. Some sources pinpoint the official start of the epidemic as June 5, 1981, when the CDC reported an unusual strain of pneumonia (PCP) in 5 gay men in Los Angeles. In 1984, when I started my first job in a hospital, there were 3 gay men working with us in the pharmacy. I later learned that 2 of these guys died of AIDS. Two other men died at the second hospital I worked at, one with AIDS, and one who had a seizure disorder which was later determined to have been caused by a malignant tumor growing by his pituitary gland, where the optic nerve crosses. He was a sweet little guy, looked like Michael Jackson back in the day, skinny with an afro. He sang the song ''Memories" (from the movie'' The Way We Were'') to me and gave me a rose for my goodbye gift, which embarassed the hell out of me, but was still pretty sweet.
I had another technician, a stock boy actually, who ended up having the same type of tumor in the same location, but thankfully his was non-malignant and he survived and continues to do well. This guy was into restoring old cars and bought a Chevy Impala to restore. He and his Dad went to car auctions all the time. He told me that sometimes, they would find the original paperwork under one of the seats, and that they would collect boxes and boxes of parts from different shows. I could see the appeal of the hunt, and the fun of finding out the history of the car. He later told me he ended up selling the car and never getting it restored.
Another stock boy at that store went on to become a pharmacist, and he had me write a recommendation letter for him to get into pharmacy school, which I considered an honor, since this kid had a huge heart and a lot of integrity. When his grandmother was bedridden with breast cancer, she had some lymph nodes removed, and she had severe swelling in her feet and legs. One way to relieve the swelling is to massage the feet and legs and get the fluid to move out of the extremities and back into the blood stream. This kid would sit with her in the evening and massage her feet and legs, sometimes falling asleep at the foot of her bed.
There were two more pharmacists produced by that store, both girls, one who went on to be a doctor, and one we lost in a horrific car/train accident. She would have been a good one. It made me proud to know that somebody looked up to me that much.
Some of the best techs I have had were middle aged women that I could rely on to show up every day, who took care of the customers in a professional manner, and who kind of took care of the pharmacists as well.One lady was a dispatcher for the police department at night, slept a few hours in the morning when she got off shift, and came in to work with us at noon, never complaining, always nice and patient. I probably took them for granted then, before I had been introduced to the type of technicians I have now, who always have drama going on in their lives, who disrespect the pharmacists, and who may or may not show up or do their job on a regular basis. And who, I suspect, are employed by management as moles to report back any infractions or perceived shortcoming on our part.
When I worked in the little clinic pharmacy, there was one tech who stood out because she had an ornery streak and was a little hyper. When she sat at the computer to type, she actually faced away from the patients, and would be nice to their face, then turn around and mouth obscenities in our direction, so we had to control ourselves and not laugh, which made it all the more fun for her. Her parents had made her take care of the chickens on their farm as a kid, so she hated chickens. She would start by imitating the low, threatening '''baaaaawwwwwkkkkkkk'''they would start with whenever she entered the barn (there were hundreds of chickens, not just a little coop). They would escalate into a full blown cacophony of clucks and ''bawks'' , which she said was very disturbing. She used to be sitting there and suddenly say, ''did somebody say ''chicken?!'' and bust out into a loud ''ba cock!'' . This was a great tension breaker and made us laugh, until the pharmacy director told her to knock it off. Apparently she also used to get in the dumbwaiter that traveled between the pharmacy and the floors above and ride up and down before somebody put a stop to that, too.
I had one technician who actually remembered me from my first job in the hospital, and said I had trained her on IV's. I didn't remember, so I asked her if I was mean to her. She said, no, I was actually very nice and patient. Whew! Anyway, we met up later in retail, and she had the best stories of anybody I ever worked with. She, her husband, and their 3 sons, essentially could have survived quite nicely off the grid. They were self-sufficient in the way that people used to be when they had small farms and raised animals.
There was the time her husband stood up on the horse's water tank, lost his balance, and grabbed hold of the electric fence as he went into the water. There was the time her son went out in his pajama pants and slippers, smoking a cigarette, to round up a bull that had gotten loose.He ended up flicking the cigarette, kicking off the slippers, and running for dear life, clearing tthe fence before the bull could catch him. They had a nasty old rooster that would chase her every time she went out into the yard. Even when she would try to sneak out of the house, he would come charging out of nowhere and attack her legs. She finally had enough of it one day, took a broom, and beat the hell out of that rooster. I asked her if she killed, it, and she said no, but he walked kind of crooked after that! But by far, the best story she told was about how they used to do historic reenactments. Her husband portrayed a French Trader, and she was his wife. She made all their costumes, beaded buckskins and all, but she had no interest in learning the historical facts surrounding their portrayal, so she left that to her husband. She said ''I decided that Marie DuPree, the French Trader's Wife, was deaf and dumb." She not only lived off the grid, she thought outside the box, too!!
I still have a couple of the old breed left, but the pickings are becoming mighty slim. No one can survive on the wages they pay technicians, so we have a lot of women who tough it out in less than ideal circumstances with men who treat them badly because economically, they don't really have a choice. Another scenario we see is the here today, gone tomorrow, lost my job, got a DWI, spent time in jail, boyfriend or ''fiance'' who contributes nothing to the cause except an occasional black eye or domestic dispute. These women are understandably not fully engaged in their jobs, because their life is a train wreck.
Most of the male techs I have had are college students who move on after a few years, guys who need a second job, or guys who are semi-retired. Women have a reputation for causing drama in the workplace, but, believe me, men stir the pot, too, just in different ways. Gossip is not just for women anymore!
Next time, Part III , the Patients...
BP
Friday, May 17, 2013
I Will Remember You...Part I, the Pharmacists
Someday, when I am strapped in my wheelchair in the nursing home, shouting ''CAN I HELP YOU!'' every time a bell rings, and counting my peas by 5's , I hope I still have enough clarity to remember the people and places that have made my career more bearable. I am a storyteller, and I have a rich storehouse of material from years of being in a unique position to see people at their very best, and sometimes at their very worst.
Every time I complete another decade of work, I send my old Purdue class ring in to Josten's and have them replace one of the ''diamonds'' with a tiny little ruby. I wear it on my left pinky, so the poor thing is as battered and worn as I feel after a 14 hour shift. Next year I will be having them put in the third ruby. It's gonna be a little off , because of the uneven number of little pinkish red stones, but most people I know would tell you that's probably appropriate.
When I was in college, I used to work half a Saturday at a professional pharmacy. It was a very nice set up, and the owner and his son had a loyal following of customers. I wasn't licensed yet, so I had to work with a pharmacist. Once, on a particularly slow Saturday, we had our technician get into the sling on the Hoyer lift, and we cranked it up as far as it would go. Picture a very large baby being carried by a very unlucky stork. Then, of course, we wouldn't let her down. We let her dangle for awhile before we cranked her down, helped her up, and went back to work, before the boss found out what a bunch of goofballs he had working for him.
The next summer, I worked in a little hospital pharmacy, where the director was a grizzled old veteran of the trade, and a take-no-bullshit kind of guy. Back then, there were 2 ladies who did the billing, and they would write down numbers in a huge ledger, line by line by line. He would challenge them to pick any drug, and he could name the numbers that corresponded to that drug. He was always right, and these were very long sequences of numbers. He owned a powder blue convertible, and every Friday, he would ice down a six pack of beer, put on his Speedo under his cut-off shorts, and motor up to the lake. The beer would be gone by the time he got there. These days, we would call him a functioning alcoholic, but I didn't have sense enough to know it then.
My first job right out of college was at the hospital I was born in. I was thinking about saying something about ''coming full circle'', but then I thought, no, that's only if I would die there. Anyhow, they have torn the place down, now, but it was still there in 1984. There were a few characters in the bunch, and it didn't take long to find out who they were. Apparently I missed working with a really colorful Rph who would crawl up and stand on the med carts they were filling just for fun. He got in trouble for sleeping in his car in the parking garage when he had a back to back shift. They said he would eat food off the trays that people had put on the conveyer to be scraped off and washed. I guess he viewed it as a mobile cornucopia of half-eaten delights.
My next job was at another hospital in town, with about 30 pharmacists and a whole bunch of technicians. We had one pharmacist that would do a '' Charo'' imitation if we bugged her enough. One of the younger pharmacists was heavily into alternative music. He bought a little record (CD) store from an older guy, but he never really made a go of it, so he brought in some of the CD's to give away when he closed. He also volunteered at radio station that played some really weird stuff. ''And that last selection was by the Roche Sisters...''(check them out at www.roches.com). We used to tune the pharmacy radio to his show so we could listen on Friday nights. Some of the guys were pretty into bicycling, until two of the guys got hit by cars in 2 separate incidents. All in all they were a pretty smart and interesting bunch, but hospital wasn't my thing, so I moved on after 2 years.
Next stop was a little clinic pharmacy in the basement of an old building. My boss was a huge guy, picture Herman Munster He even had shoes like Herman's. He grew up in a little town by Lafayette Indiana, and his Mom turned their house into a nursing home. He said once in awhile somebody would die and he would have to take care of the body. He would find guys peeing in the curtains, stuff like that. Probably explained why he was a little different.
Next came 10 years with a little local chain pharmacy. They had been a pretty powerful player in their day, but by the time I went to work for them, they were starting to lose ground to the big chains, and I suspect the last few years were spent just trying to get even so someone would buy them. The old guy I worked with at one of the stores was pretty gruff, but a pretty nice guy all in all. He had little phrases he would say all the time. When the phone rang after close, he would always say ''anybody expecting a phone call? If not, let her ring!'' There was ''the robbery talk'': ''If you ever get robbed, after they leave, lock the front doors and circle the last transaction on the register tape and write 'robbery' on it !'' And the advice about the big patient with a seizure disorder: ''If he goes down, just stay the hell away from him, 'cause you might get hurt!'' He had a real shrew of a wife. I guess one year he was having trouble getting out of the store to go home on Thanksgiving. She called several times, and then, there she was out front of the store, banging on the window and yelling at him to come home, because everybody was ready to eat.
There were a lot of pharmacists through that little chain store. There was a ''cowboy pharmacist'' who used his pharmacy income to supplement his farming and truckdriving, and yes, he wore cowboy boots to work. He also rode a motorcycle, and one time he rode to the store in full leathers to turn off the alarm, and the police thought he was robbing the place until he showed them his pharmacy license. There was an odd little pharmacist who kept a picture of his dobermans in his wallet and went gambling with his Mom at a casino in Michigan all the time. Every time he worked, we had customer complaints, but they wouldn't fire him because he would work any time any where at the drop of a hat. There was an alcoholic who finally pushed it too far, and the manager had me come in and relieve him, and she sent him home. He was upset with her , but the smell of alcohol on him was pretty obvious.
I met another colorful old guy when I jumped ship from the little chain for about 6 months, until I realized it was even worse than the place I came from. He was what another old pharmacist described as a ''rounder'', apparently the old term for a player. He drove a little red Fiero, and had the smallest and coolest cell phone they made at the time, complete with a little case. He told stories about how he used to work in a hotel pharmacy, and he met several of the movie stars, including John Wayne, who came in one time to buy a fifth of vodka from him. He would call his wife at the end of his shift, and tell her ''I'll be home to get the lady''. Somebody said they went to a local steakhouse to have dinner every night and hang out with their cronies and have a few beers. He was a lot of fun to talk to, but he didn't get much work done. Before I left and went back to my old job, he bought himself a new Camaro with T-tops, which he only drove when the weather was nice.
Now that I work for a big chain, the rugged individualists are either gone or have gone underground. Individuality and independent thinking are not valued by the chains, so pharmacists learn to tone it down and ''dummy up'' for fear of drawing the wrong kind of attention to themselves from Big Brother. We are all kind of vanilla now, not even gourmet vanilla with the little black specks, but ice milk, really, bland and boring and compliant.
Next installment, Part II, the Technicians.......
BP
.
Every time I complete another decade of work, I send my old Purdue class ring in to Josten's and have them replace one of the ''diamonds'' with a tiny little ruby. I wear it on my left pinky, so the poor thing is as battered and worn as I feel after a 14 hour shift. Next year I will be having them put in the third ruby. It's gonna be a little off , because of the uneven number of little pinkish red stones, but most people I know would tell you that's probably appropriate.
When I was in college, I used to work half a Saturday at a professional pharmacy. It was a very nice set up, and the owner and his son had a loyal following of customers. I wasn't licensed yet, so I had to work with a pharmacist. Once, on a particularly slow Saturday, we had our technician get into the sling on the Hoyer lift, and we cranked it up as far as it would go. Picture a very large baby being carried by a very unlucky stork. Then, of course, we wouldn't let her down. We let her dangle for awhile before we cranked her down, helped her up, and went back to work, before the boss found out what a bunch of goofballs he had working for him.
The next summer, I worked in a little hospital pharmacy, where the director was a grizzled old veteran of the trade, and a take-no-bullshit kind of guy. Back then, there were 2 ladies who did the billing, and they would write down numbers in a huge ledger, line by line by line. He would challenge them to pick any drug, and he could name the numbers that corresponded to that drug. He was always right, and these were very long sequences of numbers. He owned a powder blue convertible, and every Friday, he would ice down a six pack of beer, put on his Speedo under his cut-off shorts, and motor up to the lake. The beer would be gone by the time he got there. These days, we would call him a functioning alcoholic, but I didn't have sense enough to know it then.
My first job right out of college was at the hospital I was born in. I was thinking about saying something about ''coming full circle'', but then I thought, no, that's only if I would die there. Anyhow, they have torn the place down, now, but it was still there in 1984. There were a few characters in the bunch, and it didn't take long to find out who they were. Apparently I missed working with a really colorful Rph who would crawl up and stand on the med carts they were filling just for fun. He got in trouble for sleeping in his car in the parking garage when he had a back to back shift. They said he would eat food off the trays that people had put on the conveyer to be scraped off and washed. I guess he viewed it as a mobile cornucopia of half-eaten delights.
My next job was at another hospital in town, with about 30 pharmacists and a whole bunch of technicians. We had one pharmacist that would do a '' Charo'' imitation if we bugged her enough. One of the younger pharmacists was heavily into alternative music. He bought a little record (CD) store from an older guy, but he never really made a go of it, so he brought in some of the CD's to give away when he closed. He also volunteered at radio station that played some really weird stuff. ''And that last selection was by the Roche Sisters...''(check them out at www.roches.com). We used to tune the pharmacy radio to his show so we could listen on Friday nights. Some of the guys were pretty into bicycling, until two of the guys got hit by cars in 2 separate incidents. All in all they were a pretty smart and interesting bunch, but hospital wasn't my thing, so I moved on after 2 years.
Next stop was a little clinic pharmacy in the basement of an old building. My boss was a huge guy, picture Herman Munster He even had shoes like Herman's. He grew up in a little town by Lafayette Indiana, and his Mom turned their house into a nursing home. He said once in awhile somebody would die and he would have to take care of the body. He would find guys peeing in the curtains, stuff like that. Probably explained why he was a little different.
Next came 10 years with a little local chain pharmacy. They had been a pretty powerful player in their day, but by the time I went to work for them, they were starting to lose ground to the big chains, and I suspect the last few years were spent just trying to get even so someone would buy them. The old guy I worked with at one of the stores was pretty gruff, but a pretty nice guy all in all. He had little phrases he would say all the time. When the phone rang after close, he would always say ''anybody expecting a phone call? If not, let her ring!'' There was ''the robbery talk'': ''If you ever get robbed, after they leave, lock the front doors and circle the last transaction on the register tape and write 'robbery' on it !'' And the advice about the big patient with a seizure disorder: ''If he goes down, just stay the hell away from him, 'cause you might get hurt!'' He had a real shrew of a wife. I guess one year he was having trouble getting out of the store to go home on Thanksgiving. She called several times, and then, there she was out front of the store, banging on the window and yelling at him to come home, because everybody was ready to eat.
There were a lot of pharmacists through that little chain store. There was a ''cowboy pharmacist'' who used his pharmacy income to supplement his farming and truckdriving, and yes, he wore cowboy boots to work. He also rode a motorcycle, and one time he rode to the store in full leathers to turn off the alarm, and the police thought he was robbing the place until he showed them his pharmacy license. There was an odd little pharmacist who kept a picture of his dobermans in his wallet and went gambling with his Mom at a casino in Michigan all the time. Every time he worked, we had customer complaints, but they wouldn't fire him because he would work any time any where at the drop of a hat. There was an alcoholic who finally pushed it too far, and the manager had me come in and relieve him, and she sent him home. He was upset with her , but the smell of alcohol on him was pretty obvious.
Now that I work for a big chain, the rugged individualists are either gone or have gone underground. Individuality and independent thinking are not valued by the chains, so pharmacists learn to tone it down and ''dummy up'' for fear of drawing the wrong kind of attention to themselves from Big Brother. We are all kind of vanilla now, not even gourmet vanilla with the little black specks, but ice milk, really, bland and boring and compliant.
Next installment, Part II, the Technicians.......
BP
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Wednesday, May 15, 2013
Don't Shoot the Pharmacist
I mentioned robberies in one of my previous posts, and whenever I work, the thought of being robbed, and what would I do, and could I handle it, is in the back of my mind. When I unlock the narcotics cabinet, I do a scan of the methadone, the morphine, and the oxymorphone, and I go through the scenario in my mind. Get one of the large plastic bags, talk about every move I am making, go over to the narcotics cabinet, unlock it and sweep everything into the bag. Walk quickly back to the counter and hand the robber the bag and hope that he leaves.
I profile people. I know, it's not politically correct and it's not 100% accurate, but when you've been doing this as long as I have, it pays to trust your instincts. I have had a few little old lady and little old men addicts, but I'm fairly certain that they don't have the desire or the inclination to pull a handgun on me. However, their no 'count grandson or granddaughter might.
From the news stories and the accounts given by pharmacists I know that have been robbed, the first thing that happens is the robber hands you a note. They usually have a gun, and sometimes it is hidden and sometimes they display it. One pharmacist told me the guy actually put the gun on the counter and conducted an impromptu therapy session, telling her all about his hard life and all his problems and how he wasn't going to hurt her, but his life was just so tough right now. There was another robbery in our district where the robber put the gun on the counter, but this time the pharmacist swatted the gun away, jumped the counter, and tackled the guy. We cheered for him when we heard about it, then we feared for his job.
According to the official robbery handbook, we are not to try to be a ''hero''. Since most of us are not combat ready, it is more likely that we would escalate the situation than save ourselves and the other people in the store. However, it does not tell us what to do if one of us is taken hostage, or if the robber starts shooting, or if he jumps the counter and holds a gun to our head. If I saw a chance, and thought I had the ability to disarm the guy, I would worry about not getting killed first, and then look for another job, if need be.
We are not allowed to carry concealed weapons, although some pharmacists do and it doesn't become apparent until they need to use them. I know a guy who wore a bulletproof vest on the night shift. It cost him over $600, and he said it was hot and uncomfortable, but it made him feel more secure. Of course I had to mention the fact that it would do him no good if they shot him in the head. I'm helpful like that.
We are still allowed to sell needles over the counter. Back in the day we also could sell Schedule V cough syrup 4 ounces at a time with a signature. I have gone back and forth, sometimes I would sell them and sometimes not. These days I don't sell them without a prescription, unless I know the patient, or the person is from out of town but can tell me their insulin type and how many units they use. We have questions we use to parse out the bullshitters from the legitimate patients, although sometimes if I'm busy and don't want to screw with it, I just tell them ''no''.
''My poor old granny is diabetic and she sent me in to get her some needles.''
''Ok, did she say how many units of insulin she uses, or what size syringe? Or, if you want, we can call her and ask her so you make sure and get the right ones.''
''No, Granny doesn't have a phone and she can't hear (or write???) and I think she uses the 100 cc syringes, so just give me those.''
''Oh really. Is your Granny a pachyderm, because otherwise I'm not selling you the damn syringes!'''
I have found out through the years that the druggie grapevine must be pretty efficient, because every time I have lost my mind and sold needles against my better judgement, within hours there are a raft of people suddenly needing syringes. They come out of the woodwork. My opinion is that the less of these people I have in my store, the safer the rest of us are. Most of these people are down on their luck and either desperate or unstable. Some pharmacists think that if we make them happy, they will go away. My experience has always been the opposite, so I would rather stand up to one scary person than 10 of his friends.
One story told to me by an older pharmacist illustrates my point. Years ago, pharmacists could sell laudanum over the counter. Laudanum (tincture of opium) contains approximately 10% powdered opium by weight, so people would boil it down in a spoon and inject it. Apparently there was a pharmacist who took to carrying the stuff by the gallon in order to keep up with the demand in his neighborhood. The folly of his ways became clear when a guy came in with a gun, told him to kneel down by the safe and open it, and then shot him in the head.
I think that there should be one or two stores per district that carry the narcotics for the whole area. Admittedly, this would be very inconvenient for cancer patients and other patients with chronic pain, or even for patients who have an acute need for narcotic pain medications. These stores should have an armed guard on duty, metal detectors at the door, and bulletproof glass enclosing the pharmacy. Not very professional or personable, but neither is getting shot or roughed up.
In conclusion, let me say that this is yet another thing I didn't envision when I was in pharmacy school. I don't remember Robbery 101 being in the curriculum. So, keep in mind that when I seem tense and nervous when I wait on you, it's most likely not you, but the ever-increasing horror show I have going on in the back of my mind that I can't seem to switch off anymore.
Pleasant dreams!!
BP
I profile people. I know, it's not politically correct and it's not 100% accurate, but when you've been doing this as long as I have, it pays to trust your instincts. I have had a few little old lady and little old men addicts, but I'm fairly certain that they don't have the desire or the inclination to pull a handgun on me. However, their no 'count grandson or granddaughter might.
From the news stories and the accounts given by pharmacists I know that have been robbed, the first thing that happens is the robber hands you a note. They usually have a gun, and sometimes it is hidden and sometimes they display it. One pharmacist told me the guy actually put the gun on the counter and conducted an impromptu therapy session, telling her all about his hard life and all his problems and how he wasn't going to hurt her, but his life was just so tough right now. There was another robbery in our district where the robber put the gun on the counter, but this time the pharmacist swatted the gun away, jumped the counter, and tackled the guy. We cheered for him when we heard about it, then we feared for his job.
According to the official robbery handbook, we are not to try to be a ''hero''. Since most of us are not combat ready, it is more likely that we would escalate the situation than save ourselves and the other people in the store. However, it does not tell us what to do if one of us is taken hostage, or if the robber starts shooting, or if he jumps the counter and holds a gun to our head. If I saw a chance, and thought I had the ability to disarm the guy, I would worry about not getting killed first, and then look for another job, if need be.
We are not allowed to carry concealed weapons, although some pharmacists do and it doesn't become apparent until they need to use them. I know a guy who wore a bulletproof vest on the night shift. It cost him over $600, and he said it was hot and uncomfortable, but it made him feel more secure. Of course I had to mention the fact that it would do him no good if they shot him in the head. I'm helpful like that.
We are still allowed to sell needles over the counter. Back in the day we also could sell Schedule V cough syrup 4 ounces at a time with a signature. I have gone back and forth, sometimes I would sell them and sometimes not. These days I don't sell them without a prescription, unless I know the patient, or the person is from out of town but can tell me their insulin type and how many units they use. We have questions we use to parse out the bullshitters from the legitimate patients, although sometimes if I'm busy and don't want to screw with it, I just tell them ''no''.
''My poor old granny is diabetic and she sent me in to get her some needles.''
''Ok, did she say how many units of insulin she uses, or what size syringe? Or, if you want, we can call her and ask her so you make sure and get the right ones.''
''No, Granny doesn't have a phone and she can't hear (or write???) and I think she uses the 100 cc syringes, so just give me those.''
''Oh really. Is your Granny a pachyderm, because otherwise I'm not selling you the damn syringes!'''
I have found out through the years that the druggie grapevine must be pretty efficient, because every time I have lost my mind and sold needles against my better judgement, within hours there are a raft of people suddenly needing syringes. They come out of the woodwork. My opinion is that the less of these people I have in my store, the safer the rest of us are. Most of these people are down on their luck and either desperate or unstable. Some pharmacists think that if we make them happy, they will go away. My experience has always been the opposite, so I would rather stand up to one scary person than 10 of his friends.
One story told to me by an older pharmacist illustrates my point. Years ago, pharmacists could sell laudanum over the counter. Laudanum (tincture of opium) contains approximately 10% powdered opium by weight, so people would boil it down in a spoon and inject it. Apparently there was a pharmacist who took to carrying the stuff by the gallon in order to keep up with the demand in his neighborhood. The folly of his ways became clear when a guy came in with a gun, told him to kneel down by the safe and open it, and then shot him in the head.
I think that there should be one or two stores per district that carry the narcotics for the whole area. Admittedly, this would be very inconvenient for cancer patients and other patients with chronic pain, or even for patients who have an acute need for narcotic pain medications. These stores should have an armed guard on duty, metal detectors at the door, and bulletproof glass enclosing the pharmacy. Not very professional or personable, but neither is getting shot or roughed up.
In conclusion, let me say that this is yet another thing I didn't envision when I was in pharmacy school. I don't remember Robbery 101 being in the curriculum. So, keep in mind that when I seem tense and nervous when I wait on you, it's most likely not you, but the ever-increasing horror show I have going on in the back of my mind that I can't seem to switch off anymore.
Pleasant dreams!!
BP
Tuesday, May 14, 2013
It Ain't Me...
I have a bone to pick with the movie and t.v. people. Whenever I see a pharmacist depicted in a movie or on television, I cringe to think that people may actually see us the way we are portrayed. Most of the time the pharmacist comes off as a dork, a jerk, a crook, or a lost cause. I can't think of a single movie or t.v. show that shows what a pharmacist actually does....maybe because it's not all that entertaining!
The South Carolina College of Pharmacy actually got a research grant to study the way pharmacists have been depicted in American film and other media over the last 35 years. Pharmacy professor Brandon Bookstaver, and pharmacy student Amy Yanicak led a team that watched these portrayals on the internet and Netflix, compiling a list of over 200 so far. The results are not encouraging.
"Unfortunately, it's very negative, '''Bookstaver said. ''Often, pharmacists are victims of crimes or perpetrators of crimes themselves. Even in a show like 'ER' they show up only once or twice, and when they do, they're either making a mistake or appearing unprepared.'' Here is the link to the article on the University of South Carolina's website:
http://www.sc.edu/news/newsarticle.php?nid=6138
I decided to do my own informal research and see how many pharmacists I could find depicted in movies or television. I also noted the pharmacists' basic characteristics in each case.
The Pharmacist 1933-W.C. Fields as himself (''Get away from me, kid, 'ya bother me!'').
In Old California 1942-John Wayne- Acts like, well, John Wayne
Pink String and Sealing Wax 1945- Puritanical, rigid, mean
It's a Wonderful Life" 1946-Drunk, mean, unbalanced
Murphys Romance 1985-Good old boy
The Check is in the Mail 1985- Frustrated, jaded, in debt
Drug Store Cowboy 1989-Bald, middle aged, frazzled
Nikita 1990-Victim (shot and killed in robbery)
Nuns on the Run 1990-character that is ''chemist assistant''
Niagra Niagra 1997-Vigilante
Signs 2002- Hallelujah! A female pharmacist!!
Are We There Yet 2005-hero (clown pharmacist)
Don't Shoot the Pharmacist 2008-Frustrated, jaded
The Pharmacist 2012- Obedient, compliant
Pharmacists, Unsung Heroes (PBS)- documentary
Grace Under Fire, 1993-1998- Russel Norton- fussy neatnik
Girls on HBO
Hannah goes home for her parents anniversary, meets up with Eric, a former classmate who is now a pharmacist. Hannah is a free-spirit and a bit of a mess, Eric has his life together. Doesn't go anywhere.
Miss Ellie on Andy Griffith
"Well, now, that's a nice smile, just as toothy...I 'spect people will pay for that!''
Grey's Anatomy
House MD
Marco the hospital pharmacist
Nurse Jackie
Jackie has chronic back problem which leads to pill addiction, which leads to an affair with hospital pharmacist Eddie Walzer, who becomes her supplier.
Fridays
Russell the Pharmacist 2 and 1/2 Men
Who has been known to both abuse and sell illegal drugs, and swig cough syrup straight out of the bottle. ''What, are you a cop?''.
The South Carolina College of Pharmacy actually got a research grant to study the way pharmacists have been depicted in American film and other media over the last 35 years. Pharmacy professor Brandon Bookstaver, and pharmacy student Amy Yanicak led a team that watched these portrayals on the internet and Netflix, compiling a list of over 200 so far. The results are not encouraging.
"Unfortunately, it's very negative, '''Bookstaver said. ''Often, pharmacists are victims of crimes or perpetrators of crimes themselves. Even in a show like 'ER' they show up only once or twice, and when they do, they're either making a mistake or appearing unprepared.'' Here is the link to the article on the University of South Carolina's website:
http://www.sc.edu/news/newsarticle.php?nid=6138
I decided to do my own informal research and see how many pharmacists I could find depicted in movies or television. I also noted the pharmacists' basic characteristics in each case.
Movies:
The Pharmacist 1933-W.C. Fields as himself (''Get away from me, kid, 'ya bother me!'').
In Old California 1942-John Wayne- Acts like, well, John Wayne
Pink String and Sealing Wax 1945- Puritanical, rigid, mean
It's a Wonderful Life" 1946-Drunk, mean, unbalanced
Murphys Romance 1985-Good old boy
The Check is in the Mail 1985- Frustrated, jaded, in debt
Drug Store Cowboy 1989-Bald, middle aged, frazzled
Nikita 1990-Victim (shot and killed in robbery)
Nuns on the Run 1990-character that is ''chemist assistant''
Niagra Niagra 1997-Vigilante
Signs 2002- Hallelujah! A female pharmacist!!
Are We There Yet 2005-hero (clown pharmacist)
Don't Shoot the Pharmacist 2008-Frustrated, jaded
The Pharmacist 2012- Obedient, compliant
Pharmacists, Unsung Heroes (PBS)- documentary
Television:
Caeser Presents (1955, Sid Caeser)-overworked, underpaid
The Andy Griffith Show-female! Plucky, confident, capable
Monty Python's Flying Circus-''chemist''- zany, mock professional
Grace Under Fire- impeccable grooming, dependable, dorky
Fridays (ABC)- pill popping, hallucinating, crazed
Desperate Houswives- filanderer, unethical, seeks revenge
Curb Your Enthusiasm- respected and moral
Family Guy-needy, whiney, dorky, renaissance fair attendee
The Simpsons- (pharmaceutical sales rep Ned Flanders)-religious, timid, a pushover
The Simpsons-Homer sees pharmacy in new superstore-"WooHoo!! Free medical advice!!''
Friends-Phoebe's dad is a pharmacist
Law and Order- unethical (dilutes cancer drugs)
House MD-longsuffering (he has to deal with House!)
House MD-billionaire owner of pharmaceutical company, unethical, on board (big donation$$$$$$)
Scrubs-pharmacy/pharmacist in background of scenes
ER-Invisible (drugs magically appear in the drug locker)
Grey's Anatomy-over-the-hill, retiree, second career
Girls (HBO) clean cut, responsible kid
I saved this ''gem'' from Jerry Seinfeld for last....makes me wish I didn't like the show so much:
'' Why does that pharmacist have to be two and a half feet higher than everybody else? Who the hell is this guy? 'Clear out everybody, I'm workin' with pills up here. I'm taking pills from this big bottle and then I'm gonna put them in a little bottle! That's my whole job. I can't be down on the floor with you people. Then I'm gonna type out, on a little piece of paper. And it's really hard'.''
Yeah, well, so is a show about Nothing, Jerry...
BP
Desperate Houswives- filanderer, unethical, seeks revenge
Curb Your Enthusiasm- respected and moral
Family Guy-needy, whiney, dorky, renaissance fair attendee
The Simpsons- (pharmaceutical sales rep Ned Flanders)-religious, timid, a pushover
The Simpsons-Homer sees pharmacy in new superstore-"WooHoo!! Free medical advice!!''
Friends-Phoebe's dad is a pharmacist
Law and Order- unethical (dilutes cancer drugs)
House MD-longsuffering (he has to deal with House!)
House MD-billionaire owner of pharmaceutical company, unethical, on board (big donation$$$$$$)
Scrubs-pharmacy/pharmacist in background of scenes
ER-Invisible (drugs magically appear in the drug locker)
Grey's Anatomy-over-the-hill, retiree, second career
Girls (HBO) clean cut, responsible kid
I saved this ''gem'' from Jerry Seinfeld for last....makes me wish I didn't like the show so much:
'' Why does that pharmacist have to be two and a half feet higher than everybody else? Who the hell is this guy? 'Clear out everybody, I'm workin' with pills up here. I'm taking pills from this big bottle and then I'm gonna put them in a little bottle! That's my whole job. I can't be down on the floor with you people. Then I'm gonna type out, on a little piece of paper. And it's really hard'.''
Yeah, well, so is a show about Nothing, Jerry...
BP
Grace Under Fire, 1993-1998- Russel Norton- fussy neatnik
Girls on HBO
Hannah goes home for her parents anniversary, meets up with Eric, a former classmate who is now a pharmacist. Hannah is a free-spirit and a bit of a mess, Eric has his life together. Doesn't go anywhere.
Miss Ellie on Andy Griffith
"Well, now, that's a nice smile, just as toothy...I 'spect people will pay for that!''
Grey's Anatomy
House MD
Marco the hospital pharmacist
Nurse Jackie
Jackie has chronic back problem which leads to pill addiction, which leads to an affair with hospital pharmacist Eddie Walzer, who becomes her supplier.
Fridays
Russell the Pharmacist 2 and 1/2 Men
Who has been known to both abuse and sell illegal drugs, and swig cough syrup straight out of the bottle. ''What, are you a cop?''.
Sunday, May 12, 2013
Happy Mother's Day!
For the first time in a long time I am actually off on Mother's Day. Nothing is more depressing than working the holiday and having people tell you ''Happy xxxxxDay ! Anything with Day in it is definitely not going to be happy if you are working retail. I usually try to take my birthday off every year for that very reason. Something about having somebody yell or complain on my birthday makes me want to scream ''It's my birthday, for crying out loud! Be nice to me!''
One year, a very kind hearted pharmacist who owns his own store drove by my store and called me on his cell phone to wish me Happy Mother's Day. He said he was sorry I had to work on Mother's Day. That helped some, mainly because it reminded me that although he takes Sundays and holidays off, he works his tail off the rest of the time.
There is an interesting phenomenon that occurs every Mother's Day and Valentine's Day, the only two days of the year when men are actually required to buy a card and gift all by themselves. Without fail, the day of the holiday (oh, no, not even the day before!)the card aisle is packed, and there are hoards of men gallumping through the store with their mouths hanging open, gawking at all the ''pretties'' and trying to find that one special item that will keep them out of the dog house and say that they care enough to give the very best.
Here's a huge hint....you ain't gonna find it here!! I smile to myself when these guys come up with their purchases, because they are so clueless. I'm sure your Mom has just been drooling over that Hurricane 360 Spin Mop, and your wife or girlfriend will love that Pocket Hose! Better pick up some trial size toothpaste and shampoo while you're here, I have a feeling you will be spending the night somewhere other than your home!
Anyway, short and sweet today, on a counta I gotta go to my Momma's house!
BP
One year, a very kind hearted pharmacist who owns his own store drove by my store and called me on his cell phone to wish me Happy Mother's Day. He said he was sorry I had to work on Mother's Day. That helped some, mainly because it reminded me that although he takes Sundays and holidays off, he works his tail off the rest of the time.
There is an interesting phenomenon that occurs every Mother's Day and Valentine's Day, the only two days of the year when men are actually required to buy a card and gift all by themselves. Without fail, the day of the holiday (oh, no, not even the day before!)the card aisle is packed, and there are hoards of men gallumping through the store with their mouths hanging open, gawking at all the ''pretties'' and trying to find that one special item that will keep them out of the dog house and say that they care enough to give the very best.
Here's a huge hint....you ain't gonna find it here!! I smile to myself when these guys come up with their purchases, because they are so clueless. I'm sure your Mom has just been drooling over that Hurricane 360 Spin Mop, and your wife or girlfriend will love that Pocket Hose! Better pick up some trial size toothpaste and shampoo while you're here, I have a feeling you will be spending the night somewhere other than your home!
Anyway, short and sweet today, on a counta I gotta go to my Momma's house!
BP
Friday, May 10, 2013
I Have a Dream...
When I think about the complexity of the healthcare system, I am amazed that it functions as well as it does. I
don't pretend to have knowledge of all the intricacies of financing and staffing involved in putting together a model that works. I do know that standing behind the pharmacy counter day in and day out has allowed me to observe some of the things that don't work.
Patient Advocacy is a step in the right direction. I researched this concept as a possible alternative to pharmacy practice, and found out that there are numerous programs and organizations dedicated to this idea of helping the patient navigate the healthcare system. Most people could use some help coordinating their healthcare. Usually this task falls to an over-burdened family member, a visiting nurse, or an independent caregiver hired to either stay with or look after a family member that needs help. By default, this patient representative often has to take on way more than just caring for the person in their home, since problems arise ''on the fly'' and cannot be predicted. If the caregiver is worth their salt, they end up trying to resolve issues that have nothing to do with what they were hired to do in the first place.The whole goal of healthcare is for people to be as happy and functional as they can be. The official term for day to day functionality is ''activities of daily living'' or ADL.
Think about basic things people want and need:
1. A grocery store or market
2. A pharmacy with over the counter products and sundry items
3. A clinic with medical staff, an optometrist, and a dentist
4. A restaurant or diner
5. Transportation
6. Exercise/recreation facilities
7. Other people
What if we could create complexes that contained all these amenities, sort of like little small towns, with everything within walking distance or at least a short drive away? Sometimes people choose where they want to live based on the fact that an area meets most of their basic needs. I have thought of retiring to a condo or villaminium where I can walk or bicycle to the places I want to go. In my dream world, I also see this place as being close to cultural centers and entertainment venues, as well as having a nice library, and a fitness center with state of the art exercise equipment and an olympic size swimming pool.
Ideally, there would be the option of assisted living, and eventual skilled nursing facilities if needed.
Sometimes churches build these types of complexes for their members, and these can work well, because social and spiritual networks are maintained, and the church community can assist the patient with transportation and other needs that arise that are not specifically handled by the facility itself .
Unfortunately, when I get around to the question of who would build and maintain such a mini-town, I keep envisioning the creepy Mr. Potter in the movie, "It's a Wonderful Life''. Potterville was a nasty little town, owned by a nasty little man. Big Brother would always be watching and controlling it's citizens.
So, I defer to city planners or social planners or whoever else might be qualified to put this idea into practice.
''Ýou may say I'm a dreamer...but I'm not the only one...''.
BP
don't pretend to have knowledge of all the intricacies of financing and staffing involved in putting together a model that works. I do know that standing behind the pharmacy counter day in and day out has allowed me to observe some of the things that don't work.
Patient Advocacy is a step in the right direction. I researched this concept as a possible alternative to pharmacy practice, and found out that there are numerous programs and organizations dedicated to this idea of helping the patient navigate the healthcare system. Most people could use some help coordinating their healthcare. Usually this task falls to an over-burdened family member, a visiting nurse, or an independent caregiver hired to either stay with or look after a family member that needs help. By default, this patient representative often has to take on way more than just caring for the person in their home, since problems arise ''on the fly'' and cannot be predicted. If the caregiver is worth their salt, they end up trying to resolve issues that have nothing to do with what they were hired to do in the first place.The whole goal of healthcare is for people to be as happy and functional as they can be. The official term for day to day functionality is ''activities of daily living'' or ADL.
Think about basic things people want and need:
1. A grocery store or market
2. A pharmacy with over the counter products and sundry items
3. A clinic with medical staff, an optometrist, and a dentist
4. A restaurant or diner
5. Transportation
6. Exercise/recreation facilities
7. Other people
What if we could create complexes that contained all these amenities, sort of like little small towns, with everything within walking distance or at least a short drive away? Sometimes people choose where they want to live based on the fact that an area meets most of their basic needs. I have thought of retiring to a condo or villaminium where I can walk or bicycle to the places I want to go. In my dream world, I also see this place as being close to cultural centers and entertainment venues, as well as having a nice library, and a fitness center with state of the art exercise equipment and an olympic size swimming pool.
Ideally, there would be the option of assisted living, and eventual skilled nursing facilities if needed.
Sometimes churches build these types of complexes for their members, and these can work well, because social and spiritual networks are maintained, and the church community can assist the patient with transportation and other needs that arise that are not specifically handled by the facility itself .
Unfortunately, when I get around to the question of who would build and maintain such a mini-town, I keep envisioning the creepy Mr. Potter in the movie, "It's a Wonderful Life''. Potterville was a nasty little town, owned by a nasty little man. Big Brother would always be watching and controlling it's citizens.
So, I defer to city planners or social planners or whoever else might be qualified to put this idea into practice.
''Ýou may say I'm a dreamer...but I'm not the only one...''.
BP
We Work For You...
Pharmacists are the easiest healthcare professionals to get in touch with for questions and concerns. We are available 24/7 (not each one of us personally, but there is always a pharmacist on duty at the 24 hour stores), and we do not charge you anything to talk to you. Part of our job is to perform ''triage'', in other words, to help you determine when and if you need to go to your doctor or the emergency room, or if there is a home remedy or over the counter product that can be tried first.
Many times, we can help you avoid an office visit, but there are other times you need to see your doctor, and we will tell you when we think it is appropriate. So many times, we hear ''I don't like to bother my doctor, because he is so busy'', or ''she is always in a hurry when I go in for an appointment, and she is in and out of the room before I get all my questions answered''. Or, ''I don't have the money to go to my doctor or the emergency room. I don't have insurance''.
Be that as it may, we cannot and will not recommend something that will not work, will make your condition worse, or will delay treatment, possibly causing your condition to get worse or take longer to treat.
What I tell patients to remember is that healthcare professionals work for them. If you feel intimidated, put down, marginalized or ignored, it may be time to switch doctors (or pharmacies, or dentists, or whoever else is on your healthcare team.). You are paying for a service. There are times when you may be willing to suffer a lack of bedside manner, for example when your physician is considered to be an expert in his field, but even then, there should be someone (such as his nurse or physican's assistant) who can serve as a liason and address your questions and concerns.
I feel the same time pressures as my patients when I go to my doctor, because that 15 minute time clock is ticking and I am in and out of the exam room before I know it. I write out a list of questions and concerns so I stay on track and don't forget to ask anything at my appointment. I keep asking questions until I get through my list. If I think of anything when I get home, or if I need to speak to someone in the office, I talk to the nurse (it is helpful to know the name of the nurses in the office, and especially the ones who get things done when you ask). Some receptionists seem to think their job is to keep you from bothering the nurse or the doctor. Don't be intimidated by the office personnel. If you are having a problem with any of the office staff, tell the doctor or one of his nurses. If it is a nurse, tell the doctor himself. He may not be aware of how his staff is treating his patients.
Sometimes, we all need a lesson in assertiveness. We need to remember that we are important and worthy of respect, just as we need to remember to treat others with respect. A degree in medicine does not give someone the right to be arrogant and treat other people poorly. Healthcare is a service profession. You are the ''customer''. Make sure you are getting the service you pay for.
BP
Many times, we can help you avoid an office visit, but there are other times you need to see your doctor, and we will tell you when we think it is appropriate. So many times, we hear ''I don't like to bother my doctor, because he is so busy'', or ''she is always in a hurry when I go in for an appointment, and she is in and out of the room before I get all my questions answered''. Or, ''I don't have the money to go to my doctor or the emergency room. I don't have insurance''.
Be that as it may, we cannot and will not recommend something that will not work, will make your condition worse, or will delay treatment, possibly causing your condition to get worse or take longer to treat.
What I tell patients to remember is that healthcare professionals work for them. If you feel intimidated, put down, marginalized or ignored, it may be time to switch doctors (or pharmacies, or dentists, or whoever else is on your healthcare team.). You are paying for a service. There are times when you may be willing to suffer a lack of bedside manner, for example when your physician is considered to be an expert in his field, but even then, there should be someone (such as his nurse or physican's assistant) who can serve as a liason and address your questions and concerns.
I feel the same time pressures as my patients when I go to my doctor, because that 15 minute time clock is ticking and I am in and out of the exam room before I know it. I write out a list of questions and concerns so I stay on track and don't forget to ask anything at my appointment. I keep asking questions until I get through my list. If I think of anything when I get home, or if I need to speak to someone in the office, I talk to the nurse (it is helpful to know the name of the nurses in the office, and especially the ones who get things done when you ask). Some receptionists seem to think their job is to keep you from bothering the nurse or the doctor. Don't be intimidated by the office personnel. If you are having a problem with any of the office staff, tell the doctor or one of his nurses. If it is a nurse, tell the doctor himself. He may not be aware of how his staff is treating his patients.
Sometimes, we all need a lesson in assertiveness. We need to remember that we are important and worthy of respect, just as we need to remember to treat others with respect. A degree in medicine does not give someone the right to be arrogant and treat other people poorly. Healthcare is a service profession. You are the ''customer''. Make sure you are getting the service you pay for.
BP
Wednesday, May 1, 2013
Why are you calling me?
Has your pharmacist called you recently? There are several thiings in play here, so I will go through them and try to clarify.
Some of the phone calls are mandated by corporate. If it looks like you are due for a refill and you do not order the prescription, your prescription infornation appears on a ''noncompliance'' list, or late to refill list. Noncompliance just means you didn't pick up your medication and we are checking to see if there is a reason, such as a hospitalization, an oversupply of medication, a change in doseage, or a discontinuation of the medication. When we call you, you can help us clean up your profile and make sure we have all the current medication information, which helps avoid potential errors in filling your prescriptions.
You may receive phone calls, or notifications via email regarding refills that are due. These are usually automated. There are also robo calls that tell you when your prescription is ready or delayed. These calls can be helpful, but if they annoy you, you can opt out of receiving these calls. Just let us know.
Your insurance company may ask us to call you if it looks like you have been started on a new medication. Typically, we check your profile to see if you have had the medication within the last 6 months, but if we are not sure, we will go ahead and call you to see if you have any questions or concerns.
There is a ''new'' thing called Medication Therapy Management (MTM) that is offered as a benefit through an increasing number of insurance plans, both governmental (Medicare and Medicaid) and private. MTM is not really that new, but it has taken awhile to get the ball rolling. Some pharmacists have focused on MTM more heavily than others, and so are training the rest of us to provide this service. MTM is intended to help avoid some of the problems involved in multiple medication therapies. Some patients have an extensive list of medications and health conditions, and it is these patients who are targeted to receive the MTM benefit. If you are eligible for MTM, your insurance company will let us know, and we will flag your profile so we know that you are an MTM patient. Once a year, your insurance will pay for a Comprehensive Medication Review (CMR). This is essentially the same thing as a ''brown bag session'', where the patient brings in all of their current medications and OTC products in their original containers, and the pharmacist goes over them and addresses any questions or concerns.
MTM's were developed as a way to help patients stay healthy and avoid unnecessary problems with drug therapy, and hopefully reduce costs by avoiding hospitalizations or other adverse events. Pharmacists have been providing these services for years as part of the prescription processing and dispensing process. Now, we are able to bill insurances for the services we provide. MTM also provides a framework for us to use when counseling you on your medications, so that we remember to address everything and are consistent each time we counsel.
Please feel free to call us with any questions or concerns. We will call you if we have any questions for you about your medication or insurance or any other concerns we may have. We will also call your doctor , or ask your doctor's office to call you, if we see a problem with your medication.
You need to look at your healthcare as a partnership between you and your providers. You have a responsibility to take charge of your healthcare, know what your medications and therapies are, and raise any questions or concerns with your pharmacist or doctor. If you do this, we can help you by providing you with our expertise and concern.
The healthcare system gets more and more complicated as time goes on. The good thing is that we have options to treat some of the problems that in the past were often a death sentence. Unfortunately, it is increasingly necessary that you take a hand in your own care. No longer is it ok to take what your physician or any other healthcare provider says as gospel. So call us, and ask us questions! The phone line goes both ways. We will be waiting for your call!
BP
Some of the phone calls are mandated by corporate. If it looks like you are due for a refill and you do not order the prescription, your prescription infornation appears on a ''noncompliance'' list, or late to refill list. Noncompliance just means you didn't pick up your medication and we are checking to see if there is a reason, such as a hospitalization, an oversupply of medication, a change in doseage, or a discontinuation of the medication. When we call you, you can help us clean up your profile and make sure we have all the current medication information, which helps avoid potential errors in filling your prescriptions.
You may receive phone calls, or notifications via email regarding refills that are due. These are usually automated. There are also robo calls that tell you when your prescription is ready or delayed. These calls can be helpful, but if they annoy you, you can opt out of receiving these calls. Just let us know.
Your insurance company may ask us to call you if it looks like you have been started on a new medication. Typically, we check your profile to see if you have had the medication within the last 6 months, but if we are not sure, we will go ahead and call you to see if you have any questions or concerns.
There is a ''new'' thing called Medication Therapy Management (MTM) that is offered as a benefit through an increasing number of insurance plans, both governmental (Medicare and Medicaid) and private. MTM is not really that new, but it has taken awhile to get the ball rolling. Some pharmacists have focused on MTM more heavily than others, and so are training the rest of us to provide this service. MTM is intended to help avoid some of the problems involved in multiple medication therapies. Some patients have an extensive list of medications and health conditions, and it is these patients who are targeted to receive the MTM benefit. If you are eligible for MTM, your insurance company will let us know, and we will flag your profile so we know that you are an MTM patient. Once a year, your insurance will pay for a Comprehensive Medication Review (CMR). This is essentially the same thing as a ''brown bag session'', where the patient brings in all of their current medications and OTC products in their original containers, and the pharmacist goes over them and addresses any questions or concerns.
MTM's were developed as a way to help patients stay healthy and avoid unnecessary problems with drug therapy, and hopefully reduce costs by avoiding hospitalizations or other adverse events. Pharmacists have been providing these services for years as part of the prescription processing and dispensing process. Now, we are able to bill insurances for the services we provide. MTM also provides a framework for us to use when counseling you on your medications, so that we remember to address everything and are consistent each time we counsel.
Please feel free to call us with any questions or concerns. We will call you if we have any questions for you about your medication or insurance or any other concerns we may have. We will also call your doctor , or ask your doctor's office to call you, if we see a problem with your medication.
You need to look at your healthcare as a partnership between you and your providers. You have a responsibility to take charge of your healthcare, know what your medications and therapies are, and raise any questions or concerns with your pharmacist or doctor. If you do this, we can help you by providing you with our expertise and concern.
The healthcare system gets more and more complicated as time goes on. The good thing is that we have options to treat some of the problems that in the past were often a death sentence. Unfortunately, it is increasingly necessary that you take a hand in your own care. No longer is it ok to take what your physician or any other healthcare provider says as gospel. So call us, and ask us questions! The phone line goes both ways. We will be waiting for your call!
BP
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