Comments on: “I’m Not Giving It Away” http://www.jimplagakis.com/?p=2118 ABOUT PHARMACISTS, TECHNICIANS AND TROUBLE AT THE DRUG STORE CORRAL Thu, 09 Sep 2010 17:22:30 +0000 http://wordpress.org/?v=2.7 hourly 1 By: sumotoad http://www.jimplagakis.com/?p=2118&cpage=1#comment-144538 sumotoad Wed, 09 Dec 2009 05:13:46 +0000 http://www.jimplagakis.com/?p=2118#comment-144538 I was a chemist for 20 years before becoming a pharmacist. I am a master compounder. I had a maggot who worked for state medicaid question my fee, telling me my capsules were only worth about nine dollars a hundred, because the raw ingredients only cost about a dollar. I asked the maggot if he could make capsules. He hemmed and hawed, and I said "If you can come into my pharmacy and make a hundred capsules that are consistent and elegant, then I will accept your opinion." He never showed. I love it when the patient says, "The doctor says this should be about twenty dollars..." I tell them, "Have your doctor make it..." <strong><em>Sumotoad, I love it. Your writing is as elegant as your products. Phat, above, talks about the editorial page. I suggest that every pharmacist, who values her/his unique professional talent, write a note explaining just why compounded Tamiflu liquid costs a bit and why some products, like yours Sumotoad, will be elegant (and that word is the word my professor used in "Galenicals" and "Dispensing") and others might be chunky. The elegant product must be worth more than the chunky one. Like the difference in a Starbucks latte and one made by machine at McDonalds. (What was McD thinking? It is an embarrassment). Compounding is all ours. When you got it, you can flaunt it... with attitude.<strong><em></em></strong></em></strong> I was a chemist for 20 years before becoming a pharmacist. I am a master compounder. I had a maggot who worked for state medicaid question my fee, telling me my capsules were only worth about nine dollars a hundred, because the raw ingredients only cost about a dollar. I asked the maggot if he could make capsules. He hemmed and hawed, and I said “If you can come into my pharmacy and make a hundred capsules that are consistent and elegant, then I will accept your opinion.” He never showed. I love it when the patient says, “The doctor says this should be about twenty dollars…” I tell them, “Have your doctor make it…”
Sumotoad, I love it. Your writing is as elegant as your products. Phat, above, talks about the editorial page. I suggest that every pharmacist, who values her/his unique professional talent, write a note explaining just why compounded Tamiflu liquid costs a bit and why some products, like yours Sumotoad, will be elegant (and that word is the word my professor used in “Galenicals” and “Dispensing”) and others might be chunky. The elegant product must be worth more than the chunky one. Like the difference in a Starbucks latte and one made by machine at McDonalds. (What was McD thinking? It is an embarrassment). Compounding is all ours. When you got it, you can flaunt it… with attitude.

]]> By: Mayreau http://www.jimplagakis.com/?p=2118&cpage=1#comment-144095 Mayreau Sat, 05 Dec 2009 05:14:06 +0000 http://www.jimplagakis.com/?p=2118#comment-144095 Rick, You are providing services, gratis, for the insurance company. You are in essence, their lackey. You are also taking good valuable time (a shortage in a busy pharmacy) away from the person or persons waiting for your services. As you play into the scheme that the insurance companies have so adroitly woven for pharmacists, you are perpetuating a unfair situation for yourself and your peers. I'm not knocking your desire to help,but being a unpaid pawn for the insurers is not in your best interest nor the long-term interests of the patient. Who's going to do their insurance work for them when you are out of a job due to some insurance company or PBM raking away all of the profitability in pharmacy? Ask that same person if they would give their time to you, at their place of employment, free of charge. Rick, You are providing services, gratis, for the insurance company. You are in essence, their lackey. You are also taking good valuable time (a shortage in a busy pharmacy) away from the person or persons waiting for your services.

As you play into the scheme that the insurance companies have so adroitly woven for pharmacists, you are perpetuating a unfair situation for yourself and your peers.

I’m not knocking your desire to help,but being a unpaid pawn for the insurers is not in your best interest nor the long-term interests of the patient. Who’s going to do their insurance work for them when you are out of a job due to some insurance company or PBM raking away all of the profitability in pharmacy?

Ask that same person if they would give their time to you, at their place of employment, free of charge.

]]> By: rick http://www.jimplagakis.com/?p=2118&cpage=1#comment-144090 rick Sat, 05 Dec 2009 02:57:30 +0000 http://www.jimplagakis.com/?p=2118#comment-144090 Peon, it takes you 20 minutes to hash it out with the insurance? I can deal with most insurance in under four minutes flat, and I keep working the entire time (bluetooth). It's NOT our job but I help when I can. Call me crazy but I find satisfaction in helping our patients. Peon, it takes you 20 minutes to hash it out with the insurance? I can deal with most insurance in under four minutes flat, and I keep working the entire time (bluetooth). It’s NOT our job but I help when I can. Call me crazy but I find satisfaction in helping our patients.

]]> By: Pharmacy student http://www.jimplagakis.com/?p=2118&cpage=1#comment-143977 Pharmacy student Thu, 03 Dec 2009 22:22:58 +0000 http://www.jimplagakis.com/?p=2118#comment-143977 Couldn't one also point out that compounding takes time, and that time is money? <strong><em>Student, a pharmacist's time is worth about a dollar a minute. That can be measured. Add a fee, overhead and you get $1.50 a minute. There are skills in play that cannot be measured. ONLY A PHARMACIST IS CAPABLE OF PREPARING A COMPOUND. Technicians who compound are pharmacist-trained. This is our thing. We need to hold it high and value it. Flaunt it and CHARGE FOR IT.</em></strong> Couldn’t one also point out that compounding takes time, and that time is money?
Student, a pharmacist’s time is worth about a dollar a minute. That can be measured. Add a fee, overhead and you get $1.50 a minute. There are skills in play that cannot be measured. ONLY A PHARMACIST IS CAPABLE OF PREPARING A COMPOUND. Technicians who compound are pharmacist-trained. This is our thing. We need to hold it high and value it. Flaunt it and CHARGE FOR IT.

]]> By: peon http://www.jimplagakis.com/?p=2118&cpage=1#comment-143747 peon Tue, 01 Dec 2009 22:52:35 +0000 http://www.jimplagakis.com/?p=2118#comment-143747 It is funny how this whole matter came about because the patient did not know they had a deductable. Now, whose responsibility is it for knowing and keeping up with their deductables? Is it the physician? Is it the pharmacist? As far as I am concerned, the patient can pay for the med or not, take it or leave it, and if the price is more than they expect then they can phone the insurance company. I don't work for the insurance company and I don't like being their puppet. Sure....get all google eyed and feel all "altruistic", go "help" that patient, by YOU calling the insurance company, by you spending 20 minutes on the phone trying to hash out the situation...spend your day "helping" all these folks with THEIR insurance...be the insurance company puppets. For the most part, I just don't have time to try and answer peoples questions about their copay. It is the DAMN insurance company that is setting the copay. It is their insurance...they can call!!! Do you think I got my message across? :) It is funny how this whole matter came about because the patient did not know they had a deductable. Now, whose responsibility is it for knowing and keeping up with their deductables? Is it the physician? Is it the pharmacist? As far as I am concerned, the patient can pay for the med or not, take it or leave it, and if the price is more than they expect then they can phone the insurance company. I don’t work for the insurance company and I don’t like being their puppet. Sure….get all google eyed and feel all “altruistic”, go “help” that patient, by YOU calling the insurance company, by you spending 20 minutes on the phone trying to hash out the situation…spend your day “helping” all these folks with THEIR insurance…be the insurance company puppets. For the most part, I just don’t have time to try and answer peoples questions about their copay. It is the DAMN insurance company that is setting the copay. It is their insurance…they can call!!!
Do you think I got my message across? :)

]]> By: rick http://www.jimplagakis.com/?p=2118&cpage=1#comment-143420 rick Sun, 29 Nov 2009 02:26:03 +0000 http://www.jimplagakis.com/?p=2118#comment-143420 Although it is not our responsiblity to call the insurance and investigate the reasons for copays, I will usually try to do it in a case like this. Having a tech give a call to the insurance could have prevented the confusion and drama. Or, I would have instructed the patient to call the insurance and ask them why the copay was so high. Either option would have prevented the call to the physician. In my experience a copay is never $350. When the price comes back that high, something else is going on; deductable, donut hole, plan exclusion, etc. On a different note, Pulmicort was generic at my place for about three months and then not available. I hate when I generic comes out and then is pulled off the market. Recent examples- Oxycontin and Catapress TTS. Although it is not our responsiblity to call the insurance and investigate the reasons for copays, I will usually try to do it in a case like this. Having a tech give a call to the insurance could have prevented the confusion and drama. Or, I would have instructed the patient to call the insurance and ask them why the copay was so high. Either option would have prevented the call to the physician. In my experience a copay is never $350. When the price comes back that high, something else is going on; deductable, donut hole, plan exclusion, etc. On a different note, Pulmicort was generic at my place for about three months and then not available. I hate when I generic comes out and then is pulled off the market. Recent examples- Oxycontin and Catapress TTS.

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