September
1
2010
Hello Earl,
You don’t know me and I don’t know you but I’ve heard of your reputation. I hear you are a real Category 3 jerk and I also know you might stop by and visit my fair state. If you are going to cause trouble then reconsider your visit. Do us all a favor and just go deep sea fishing instead and skip the visit. You will just get everyone here in a panic and I know if you show up you’ll just mess everything up and then leave anyway. So I am asking you to just skip your visit if that is possible. It will make things easier for all of us. Thanks in advance.
TRP
In case you haven’t heard Earl might be coming by for a visit to an east coast state to be named later. An no, Earl isn’t that weird uncle every family seems to have at least one of or that guy you knew from college that no one seems to care for at all. Earl is a category 3 hurricane that is heading straight for the east coast of the United States. And that could spell trouble in more ways than one.
If you work in a pharmacy and you are in one of the states that could be affected by this storm coming then you know things could get real interesting at work in the next couple of days. I’ve talked about the panicked shopper phenomenon that occurs when there is impending severe weather coming that causes people to rush out and fill every prescription they think they will need for the next month plus. It always happens and a category 3 hurricane threatening the coast will definitely get everyone’s attention. Heck, I live in a state where a quarter of an inch of snow cause us to collectively go into crisis mode.
Besides the obvious possible threat to human life and property damage a storm like Earl also causes problems in the day to day operation of pharmacies. People tend to over react and order prescription refills for everything they can think due to the just in case mentality. And yes, if there is a threat that you might be stuck inside your home for a few days you should make sure you are stocked up on essentials like groceries and critical prescriptions like insulin. But what I see is people requesting refills for things like acne medications they just had filled 10 days ago. Is that really what you are concerned about if a hurricane comes?
I know it is just human nature to panic but I hope that my customers and patients will be prepared and not go into a panic just because Earl might be coming in the next few days. In my part of the country we should be used to the threat of a hurricane and know which steps are needed in preparation and which steps are unnecessary. That is one of the benefits of previous experience: you know how to handle the situation more effectively the next time it happens because of your previous experience.
So I am trying to send this letter you read above to hurricane Earl in an attempt to reason with the eye of an unpredictable natural weather event in hopes that somehow the storm will decide not to visit the eastern coastline of the United States. Earl would just cause more trouble than he’s worth should he decide to stop by so I will simply hope he decides to stay far off the coastline and maybe just send some rain our way. It’s just better for everyone this way. Especially if you work in retail pharmacy and you are located on the east coast.
The Redheaded Pharmacy
August
30
2010
Hey Big Pharma, I have a challenge for you today. If it isn’t too much trouble I’d like to request a little more innovation from you and a little less of the same old story. I’m sure that isn’t too much to ask is it? Thanks in advance from a community pharmacist.
I’d like to send an open ended letter to all the Big Pharma companies that would basically be that first paragraph you just read. I think they need someone to point out to them that it would be beneficial to us all if they would start using their knowledge to come up with some new innovative and novel compounds that would tackle some of the great health problems of our time instead of their constant quest for me too drugs and new dosage forms of existing medications. That to me doesn’t seem like I am asking for a lot.
From my point of view Big Pharma is in a rut. They seem to be more focused on coming out with the latest (and greatest of course) proton pump inhibitor for acid reflux or working on their major project of getting some allergy medicine converted to over the counter status then actually coming up with novel new drug compounds that can actually benefit the field of medicine.
Here is a hint Big Pharma, we don’t need another long acting form of an antibiotic that has been out for decades. I could do without some drug rep coming in with yet another prenatal vitamin with fish oil. No thanks to the 12th ACE inhibitor for blood pressure (or whatever number we are up to now). It’s been done before.
I remember when Big Pharma had innovative minds working for them that could discover new and novel compounds that were real advances in medicine. Now that innovative thinking seems to be all in the bio-tech world. What happened Big Pharma? Did you let all your top talent defect? That must be why you are partnering with that field now so often or even buying them out completely. If you can’t beat them, join them right?
I just want these big pharmaceutical companies to stop working on yet another combination of hormones that can be sold as a birth control pill (women have just a few choices already for that) and maybe come up with something that can help patients that they don’t already have available to them now. Put off that new 5th form of long acting methylphenidate tablet you’ve been dying to release and actually come up with something novel and new for a change. It could be fun.
I know I am asking for a lot. It takes time and money to actually research new ideas. And even if you get them there is no guarantee that those ideas will produce that next blockbuster drug for your company to make lots of money. But you never know if you don’t try Big Pharma!
And I have another request. If you insist on coming up with that 12th ACE inhibitor for blood pressure or that millionth proton pump inhibitor we know you are working on how about actually releasing some data showing why it is better than existing therapies for a change. I know that is a pipe dream that will never happen. But nothing irritates me more than seeing a new drug come out in a class of medications that is already crowded with choices by a company that simply proved their new drug was “a little better than placebo” which really means you’ve proven your drug is better than nothing. At a couple of dollars a pill I would hope that it is better than nothing!
I challenge you to do some real double blinded placebo controlled drug trials against the current standard of care or a representative of the same class of medication your new drug is part of in an attempt at some real comparison data. It sounds crazy but we’d like to know if your $2.50 per pill medication is better than that drug in the same class that has been out for more than a decade that costs pennies apiece. Believe it or not that is useful information for us.
Yes, I realize that there are new drugs that come out that really are breakthroughs in therapy for the given disease or condition that drug was developed to treat. It just seems to me that those few gems are hidden among a sea of me too drugs that really aren’t advances in medicine but are sure advances in the cost of medicine.
Don’t believe me? Do this little experiment today if you are going to work or reading this from work. Pick a random drug off the shelf and take a look at it. My only requirement is that it is a brand named medication not a generic. Then look it up to see if it meets one of the following criteria: it will be a drug that is part of a class of medications that has at least 4 existing choices, it is an extended release form of an older drug, or it is a combination of existing drugs that was simply put in a new dose. Do this experiment today and you’ll find that brand named drug falls into one of those categories more often than not.
Now do one more thing: pick any five brand named drugs off the shelf. Then look to see how many if any are actually novel new drugs that aren’t part of an existing class of treatment medications. I will be impressed if even one of the five drugs you pull is actually a novel new drug compound.
It is just easier for Big Pharma companies to try and come out with their twist on an existing product than to actually use some innovative thinking and come up with real breakthrough drugs that we don’t already have available to us. But what medicine really needs is some new innovative thinking to tackle some major health issues facing us as a nation and world.
So my message to Big Pharma is this: I’ll pass on that next latest and greatest PPI for acid reflux. I’d just assume use one of the existing over the counter products anyway. How about giving me and the rest of the medical community a dose of what we desperately need right now: innovation. That is a pill I think we all could swallow.
The Redheaded Pharmacist
August
29
2010
What ever happened to the old proverb that says “Good things come to those who wait?” Americans have seemingly completely forgot about this nugget of wisdom. And there is no better example of that fact than the waiting area at your local community pharmacy.
What is it about American culture that fosters this “instant gratification” mindset? We truly are spoiled rotten in some ways in the United States. Maybe that just answered my question for me! Think about everything you can get practically instantly if you so choose. Do you want a burger or taco at midnight but don’t want to make one yourself? No problem, there are fast food chains open late now. Want to check your checking account balance or withdrawal some money but don’t want to get out of your car? Not a problem, the bank has a drive-thru window and a drive up ATM machine for your convenience. It take a few minutes over the phone or online to get approved for a car loan or even get life insurance. There are few things in life you truly have to wait an extended time for anymore. Which of course means the fine art of patiently waiting for anything is a lost art at best or never learned at all for many Americans! That is just the way it is now.
Americans are heart set on buying goods and services that makes their life easier and there is big business and profits for anyone that can dream up any item that will improve you life in some way which usually means the product does something you had to manually do before but now don’t have to thanks to insert miracle product name here. Hey, I don’t have any problem with anything that makes life easier for me. Innovation and convenience is a good thing right? I am spoiled by the creature comforts of living in an industrialized world just like the next guy.
But we have become a society that lets machines, hired service workers, or computers do almost everything for us. We have become what some people refer to as the instant gratification society. We demand everything in an almost unreasonably timely manner now. And that attitude trickles down to customers of retail pharmacies as well. But why rush something that involves your health and well-being?
What ever happened to dropping off a prescription and coming back later to pick it up? Even if wait times were unreasonable (think several hours or more for one prescription) there are other things patients could do while they wait for a prescription. It isn’t like I have assigned a pharmacy staff member the duty to sit out in the waiting area with a gun to point at customers forcing them to sit or stand at the pharmacy and wait for their medications. Multi-task and find something else to do while you wait.
Heck, I work at a pharmacy that is in the middle of a grocery store. Talk about the perfect “kill two birds with one stone” opportunity. Patients can drop off a prescription, go grocery shop, and come back to pick up their medications after they complete their shopping. But often this doesn’t happen and the 15-20 minutes I frequently quote as a wait time for a prescription isn’t fast enough for the average customer. They want their prescriptions now just like everything else.
I know, I know. I’m not very original in complaining about customers who don’t seem to be able to wait for prescriptions. Want to get the average pharmacist to go off on a rant for no reason? Ask them about the patience of the average customer they see at work and sit back and be prepared for a string of complaints. Every pharmacist and pharmacy technician must deal with customers who are in a rush daily at work. It’s just part of the job.
But my question to you today isn’t why this happens, it just seems to be a part of the American culture now to want everything yesterday. My question is this: at some point isn’t our thirst for having everything given to us instantly tempered by the reality of the fact that certain tasks require a set minimum amount of time to complete? When I hired someone to paint the interior of my home last year I didn’t expect the whole interior of my house to be painted in one hour. And even if this was possible how good of a job could the painter possibly do in one hour? I had a reasonable expectation of how long the job was going to take to be completed even before hiring the painter because I know painting takes time!
The same mindset should apply when a customer is filling prescriptions. Is it reasonable to expect that if you are dropping off three new prescriptions AND you are a new patient that those prescriptions should be completed in five minutes? I don’t think so but I have had customers in my lifetime that have suggested that filling those prescriptions should only take five minutes or less! Is that a reasonable expectation of wait time as a pharmacy customer?
Maybe the problem is that patients don’t realize what id involved in the filling process because they’ve never done it themselves. To go back to my painting example I’ve actually painted rooms in my house before. I know how long the job can take (especially if you do it right) so I had some working knowledge about what time frame would be reasonable for having my entire interior painted. Customers you see at work dropping off prescriptions don’t have the benefit of this previous working knowledge about how long a prescription takes to be filled because they’ve never filled one themselves. Sure they may have gotten a prescription filled before but they are making assumptions about what is involved in the filling process instead of using actual working knowledge regarding what is involved in the process and how long that should take to complete.
And then there is the issue of accuracy. Say for example I actually could somehow get everyone their prescriptions in five minutes no matter how many prescriptions they needed filled or how many other customers were also waiting. Would I be able to accurately fill all of those medications? Probably not and in pharmacy errors can be costly. Giving the pharmacy staff the addition few minutes they need to fill a prescriptions accurately is far more beneficial than rushing them to complete your prescriptions quickly and increasing the risk that there is an error with your prescription order. Trust me, it is worth the time to wait so they can get your order right!
And I also can’t help but wonder if this phenomenon is unique to the United States? Yes, I realize that there are customers and patients in all countries that can’t wait for prescriptions (or anything else for that matter) but in America we seem to foster this “instant gratification” mindset to the extreme. Is it like that in other countries? Is the collective mindset that we must have everything NOW similar in other parts of the world? I’ve always wondered that.
You know that old saying “stop and smell the roses?” Most Americans are so busy going through their life they probably don’t even notice the roses so forget expecting them to take the time to stop and smell them! That’s just how our society has become: we are rushed and pressed for time. And that means that no one gives themselves extra time to complete a task such as getting a prescription filled. So I guess that means I will simply have to get used to dealing with customers that are always in a rush. They don’t care about counseling or pharmacy services (usually) or anything else other than getting their prescriptions right now. That is just the way it is in America.
The moral of the story for all consumers out there is that pharmacists don’t like to be rushed. We appreciate anyone that tries to give themselves enough time so that they can patiently wait for their prescriptions instead of rushing the pharmacy staff to complete what is a very important task: getting patients the right medication at the right dose with the right directions. We will try to fill your prescriptions as quickly as humanly possible but we ask you to give us a reasonable time to get our work done. That doesn’t seem like to much to ask does it? I didn’t think so! And feel free to stop and smell the roses.
The Redheaded Pharmacist
August
27
2010
You really have to admire some people. I am talking about that rare human being that can have life throw some very bad things at them and they will still get through everything with a smile. How do they do it? Maybe they have some secret they aren’t sharing with the rest of us? They seem to be working on a whole different level.
Maybe they have a strong support system of family and friends? Maybe they draw strength from their faith? Maybe they just have that never give up attitude and determination to get through anything that life throws at them? Probably it is a combination of things that makes these people stronger than the average human being.
I bring this up because I’ve seen these extraordinary people at work before. They have been co-workers, customers, and patients. They have all been given an unfair turn of events that would rattle the strongest of people and yet they didn’t give up.
I remember one such example of these extraordinary people from a while ago now. It was a female customer in her mid 50s. Within the course of a ten month period she and her husband had been diagnosed with different cancers. Then there was the car accident that broke her left leg. She then found out her daughter had lost her job and her son was filing for divorce. The black cloud that had been following her was getting bigger by the day!
Now keep in mind that according to her story everything happened within about an 18 month time frame. But was this woman the hateful or mean spirited customer you see all too commonly in retail pharmacy? Not even close, she was very kind and forgiving and she was thankful for the positives in her life. I really admired her for her positive attitude and her strength.
As it turned out this story had a happy ending. Both her and her husband’s cancers went into remission. Her daughter found a new and better paying job not long after she lost her previous one. And the son that was getting a divorce was thankful to be getting out of a bad marriage that wasn’t based on the one thing every marriage should be founded on: love. All in all everything worked out for this patient and her family. But I admire her because she stayed positive even before she knew everything was going to work out for the best. That takes a rare kind of strength I can only hope to achieve in my lifetime.
I’m not sure why I thought about this old patient this morning. Maybe there are some things in my own life that have me worried and I need the kind of strength she demonstrated to get through these times myself? Maybe I worry about work too much. Retail pharmacy is constantly evolving and not all of those changes are positive ones.
But if I get only one lesson out of my interactions with patients like that woman the lesson I take away from that experience is to be thankful for everything I have in this world. And as that relates to my job I need to be more thankful that I have the job I do in this economy. Retail pharmacy is far from a perfect job but it isn’t all that bad either! On a good day I actually get that feeling that I’ve helped someone today and that to me is a great feeling. And those experiences make it all worth it to me in the end.
I just hope everyone could have the strength this woman demonstrated when life throws us some curve balls. Because most everyone lives through their own series of unfortunate events at some point in time. But what happens to you isn’t even that important. It is how you repond to what happens that matters. In that sense I want to make my own reality and focus more on the positives going forward. I just hope I have the strengh and courage it takes to survive all of life’s troubles. It’s ok though, I’ve seen examples of the right ways to handle adversity in my life. The question is do I have what it takes to be that strong? Do you?
The Redheaded Pharmacist
August
25
2010
Pet owners and pet lovers are a funny breed. I would know. I am among those people that admit to being a lover of animals and I have had my dog for 10 years. Pet owners can appreciate the fact that animals can enrich your life and make you happy. And most pet owners will do anything for their pets including spending what non-pet owners might consider ridiculous amounts of money on their pets. Pets are proven stress relievers and can be great therapy for anyone that has had a bad day!
You see pet owners come into your pharmacy as well. They are the ones that have those sometimes strange prescriptions with weird drug doses for the customer’s dog or cat. I’ve filled insulin, antidepressants, seizure medications, antibiotics, and the famous “as needed for thunderstorm or fireworks” PRN anxiety medication for animal among other things in my career. You see all sorts of prescriptions for animals and you get all kinds of pet owners as well.
But one thing I can’t help but notice is the difference in attitude of customers picking up prescriptions for animals. If Mrs. Smith is picking up an antibiotic for herself she will not accept any antibiotic with a high copay and even ask me to call the doctor for a new prescription if it is too expensive. But if Mrs. Smith is picking up a prescription for her dog “Oreo” then she will gladly spend $50 plus on the prescription for the animal. I’ve literally had back to back customers at the check out counter with exact opposite experiences. The first customer spend at least 5 minutes complaining about a $20 copay for a drug that cost several hundred dollars cash. They thought “all copays were $10″ and reluctantly paid for their medication after arguing for some time about the price. The very next customer was picking up a prescription for their cat “Wiggles” and that patient gladly paid a little over $100 out of pocket for the medication.
It is just funny to me that patients are so price sensitive now with regards to purchasing prescriptions for themselves but if it is a pet’s medication then they are much more willing to fork out the big bucks so to speak to get that medication for their animal. I’ve always wondered why that is? Sure the $4 dollar generic list has changed this some and the smart vets will try to find a drug on that list for customers so they don’t spend a lot of money out of pocket for prescriptions but overall people are much more willing to spend money on their animals than on themselves.
Maybe it is because customers pay for their own prescriptions with health insurance plans most of the time but few customers bother to buy pet insurance plans for their animals. This means they feel that the insurance company should cover the medications. You know the old line: “why am I paying all that money in premiums every month if they don’t cover my medications anyway?” You do spend lots of money on health insurance so there is this entitlement mindset where people don’t understand why they still have to spend a lot more money on their prescriptions.
Maybe it is because the pet owner is like me and they are so used to spending hundreds of dollars on a vet appointment that spending $50 on a prescriptions doesn’t sound that bad by comparison. Veterinary appointments can get really expensive really quick. I rarely escape from the vet’s office without spending at least $150 or much more per appointment. Pet owners are used to this expense and spending money on a prescription doesn’t seem as bad somehow when compared to the price of the office visit involved in getting that prescription for your dog or cat.
Overall, I enjoy seeing prescriptions for pets at work. I love how creative some customers get with the names they give to their pets. It can get comical what name is on that prescription you are filling for an animal. I just wonder why customers are so willing to freely spend so much money on their animal companions and so resistant to spending that same amount of money or a lot less on themselves? I guess I should already know that after spending a couple of hundred dollars on a vet appointment myself the other day! Oh well, my dog is worth it because to me she is family. I think I just answered my own question!
The Redheaded Pharmacist
