You guys are still sending comments to the DATING DOWN and WRITING PRESCRIPTIONS SO THE PHARMACIST WILL LOVE YOU pieces. However, you aren’t much interested in fluff pieces like this one. I’m a smart rat. I’ll write more substantive stuff. I Promise. Happy Halloween.
My second talk with this woman, 2 hours after the first talk.
Before I start. I am a 66 year old pharmacist who works for an independent part time. Two ten hour shifts a week, Thursday & Friday. Victoria fields the occasional call asking if I am looking for work. “Jim is satisfied right now,” is what she tells them.
I take chances because I can take chances and if my boss doesn’t like it, I’ll leave.
Right then. Just give me a minute to go pee before I walk out the door.
If you are younger and love your job and don’t want to walk out… use good judgement. Pick and choose your battles carefully, but do choose. There are so many battles to fight.
“But the doctor wrote for the Ultram ES. He doesn’t want the generic. ”
“Are you a nurse?”
Silence. “I am the office manager.”
“Then you probably won’t understand that convenience will not outweigh the hit on the patient’s pocketbook because her insurance will not pay for Ultram ES. The patient will have to pay and it is ridiculously expensive. If he wants this woman to have pain relief in a timely manner, he has to get a prior authorization or change to the generic”
“We will not get prior authorizations. We don’t do that.”
“Then get the doctor. I want to talk with him.”
“The doctor wants what he wrote for.”
“Did he tell you that about this one particular prescription? Or does your office think in terms of “the average patient”?
“The doctor has made his preferences very clear.”
“Are you challenged or something? I want to hear the doctor himself say that he insists that this patient pays over $100.00 from her own pocket when her insurance will for the generic.”
“What did you say?” Absolute ice in the voice.
Oh oh. She quit hearing me with the word CHALLENGED. “I apologize for that CHALLENGED business, but I am running out of fortitude and the patient is going without medicine.”
“The doctor is very busy this afternoon.”
“I suppose that you think I am not busy.”
Silence. More silence and I let her stew. “Well, I don’t know…..”
“I am just as busy as the doctor. I probably have more on my plate right now than he has at any one time in an entire day.”
“Well, I supposed I can leave a message on his desk.”
“When does he get to his desk?”
“After all of the patients.”
“Bingo,” I said, “You haven’t told him anything yet. I called two hours ago.”
“He wants all messages left on his desk.”
“You have not told him that the insurance won’t pay for Ultram ES and you have not told him that the insurance will pay for the generic?”
“I left the message on his desk.”
“Get him …. now.” Of course, she couldn’t do that. This guy’s office was set up like a fast food restaurant. The women who worked there became frozen if anything came up outside of their everyday way of operating.
The Rx was presented before lunch. She had been a morning patient. At around 6:00 PM, after all of the patients were long gone, the doctor called with seven words, “Use the generic 50mg. The Usual instructions.”
They act like Marie Antoinette. “Let them eat cake.” They don’t have a clue that the last step of the process is often FAILURE. There are a bunch of doctors out there who are not FINISHERS.