Wednesday, October 22, 2008

Sorting out the idiocy...

Common Misconceptions about the Retail Pharmacy

1) You charged me too much for my copay! - Sadly, we at the pharmacy level do not control how much your copay is, we electronically submit the medication, quantities, cost, and day supply to your insurance. Their computers check it against what is called a Formulary. The insurance then returns APPROVAL or DENIAL of your coverage to us, if approved they also send amount the patient must pay [your co-pay] as well as the few spare pennies they pay the pharmacy over the cost of the medication. This means your copay will always be dependant on the insurance company, what tier your medication falls into, and other variables tied into your money-hording insurance company.

There ARE indeed cases where the prescription is written in a way that we have to guess on the day supply. An example, lets say it's the first time at our chain and you drop off your prescription for Lantus which clearly says "Use as directed" and dispense #3 vials. Unfortunately we can't calculate day supply off of information we don't know, such as your A1C levels or your weight or anything else for that matter. So we assume a vial should last a month, run it for 90 days supply and get on with the other 250-300 scripts needing to be filled that day. You come in, we ring it it up and "HEY! why is this 3x my normal co-pay for a one month supply!?" We will inquire as to the dosing, and adjust the RX accordingly.

Lesson to be learned? Don't drop off a script for any new medication and expect to come back and pay $5.00 and be on your marry way. Ask about the typical pricing of medication if you don't know anything about it, we pharmacy techs LOVE to share information that WE actually know and aren't just parroting from what we overheard [sorry fellow techs, deep down you agree with this]. For example, as a pharmacy technician, I KNOW that Valtrex is not cheap and I KNOW that there isn't a generic option available and that most insurance companies require either prior authorization, a low discount [10-20%], or it falls into your tier 3 or non-formulary category with the insurance company which is your
highest co-pay possible. Just 21 of these puppies go for about $280 without insurance, so I can at least give them a heads up.

2) Why will it take xxx minutes to throw some pills in a bottle? - The process of filling a prescription isn't a complex one, nor is it really all that time consuming. The delay normally lies in the fact that there are people ahead of you which, to be fair, should be filled before yours. Granted, we do understand the difference between someone waiting in the lobby on a script and someone dropping it off to pick it up at a later time, and we actually note if a patient is waiting when we enter the script into the computer and we try to push it ahead, assuming there are no issues with deciphering the chicken scratch your doctor calls 'penmanship', billing your penny-pinching insurance company, or being out of stock of the medication. In addition to adhering to the first-come-first-serve policy, we have to answer phones, sell already filled prescriptions [believe it or not, they have been waiting longer than you for their perscription], correct insurance problems [which more often than not involve calling the insurance company directly as a service], general resupply of consumables, file reports, place out-of-stock orders, and so on.

3) The more obnoxious I am, the better/quicker the service! - If that's the case, just imagine the service you'd receive if you were a little more pleasant and understanding? Read on for a much more detailed explanation of how this REALLY works.

In this profession, it's a complete given that people will be agitated. As a patient, you're either short-term sick, got-some-serious-bad-news sick, or a life-long-ailment sick. In any case, people are sick [starting to see a pattern are we?] or are representing someone who is sick when they come to the pharmacy. I don't know how you feel when you're ill or uncomfortable or in pain, but the majority of people will feel like crap, are irritable, and very often are already upset from a bad doctor/hospital/clinical experience or wait. This usually results in a WIDE variety of people to interact with when they finally reach the pharmacy counter. Each person can be completely different from the next. This makes being on top of Customer Service slightly difficult, but it is completely manageable with a set of guidelines [for a later post].

Lets say we have a patient that is genuinely nice, accommodating, and understanding. These can be common enough to keep us from going insane, which goes to show that, in general, people are good and capable of a little flexibility even when not feeling well. Obviously this type of patient is much easier to make happy, but from a customer service standpoint, we want you to come back and we want you to bring your positive and uplifting attitude with you. We, as an industry, NEED people like this to make the day worth the snaggle-toothed remarks and sly jabs at our intelligence by those who aren't so pleasant to deal with. So we innately, end up putting a little extra effort into making sure your process goes as smooth, or at least trouble free on your end as possible. Drop-off, pick-up, feel better!

Next, we have another patient who is slightly irritated at the wait experienced in just dropping off the prescription, which is understandable but often unavoidable. The patient is rushed, short with you, and simply wants to get the medication and leave. These are also the ones who sometimes come off as being unable to cope with the reality that there is a wait between dropping off the prescription and picking it up. You can tell the patient you'll have it ready in half an hour, they'll come back at you asking "is there any way it can be done sooner" to which you can only reply saying "We'll get it done as soon as we can". I often wonder If I had initially said 45 minutes and upon being asked "if you can have it any sooner" and then tell them it'll be ready in 30 minutes, if it would make them any happier about our mutual plight. I say mutual plight because the patient is not the only one who doesn't want you waiting around, from a service standpoint. Not only does it annoy us to no end that you hover around the pick-up counter, or stare at us and make me feel guilty about that sip of water I had while waiting for the next person in drive-thru to pull forward, it also creates unhappy customers if the wait time gets too extensive, and unhappy customers may not come back [in some cases this is a good thing for us, but too often I feel really bad about the next pharmacy victimized by the truly rotten customers].

Everyone: Patients personalities extend well beyond these two types, and are affected by countless variables. Too often the blame is easily shifted between patient, doctor, and pharmacy. The important thing to note is that in the end, we all want the same thing, and that is the well being and comfort of the patient. It's also important to keep a healthy level of respect for each other, because in all honesty, we each depend on each other in far more ways than one.

Patients: Be aware. Nothing is final until you walk out that door with the medication in hand, if you suspect something doesn't make sense or add up then mention it immediately [with respect]! It's our job to make sure everything makes sense to you and if we can't answer something we'll direct you to your doctor. Once it leaves our pharmacy, by law we can't take it back except in the ultra rare case you are affected by a manufacturer recall or a misfill.


1 comment:

Anonymous said...

Hi, LPT,

Thank you for your comment on "Village Drug."

I have added your blog to my blogroll and am thoroughly enjoying your posts. Please keep writing!

I filled my final retail prescription in 1993, and have been in hospital pharmacy ever since. The blogs are my connection to the way retail is now. I salute you guys at full attention! You are putting up with a lot more than I ever had to. To see a list of these, go to http://oleapothecary.blog.com/2442680/.

The Ole' Apothecary