Sunday, June 28, 2009

Exposure. It's not just for photography.

Internet has been back for a while. I've just not really been home much to use it, been working overtime on top of other fruitful ventures that seem to be taking up much of my time.

I've been given the opportunity to become exposed to many different types of pharmacists over the last couple weeks [more so than usual] and should be experiencing a few more in the weeks to follow. One of our main pharmacists is taking a nice 3 week vacation. By nice, I mean nice for me, we don't see eye to eye on many things but we have come to tolerate each other. So in her place we've had several pharmacists fill in for her.

I think this is very healthy, as it allows to get some fresh blood to help keep things interesting. This doesn't really mean it's always good a good kind of interesting, in fact, it's hard for many pharmacists who float from store to store to adjust to the work flow of our store. We do about 200 scripts a day on average, with one pharmacist and one technician from open until 2 or 3pm, which we have about a 2-3 hour overlap before the morning technician leaves. Like most pharmacies the volume fluctuated, some days we do around 150 scripts and these are very good days. On other days we, can do upward of 250+ with the exact same man hours and it can become really challenging to keep from getting disgusted with every tiny detail that seems to get in your way from staying on top of the endless influx of scripts.

There are at least two different types of retail pharmacies, most people aren't really aware of that. The first and MOST common type is your community retail pharmacy's. These are located in well established neighborhoods, with the bulk of their medications being maintenance drugs that aren't usually needed the same day. Auto-refills and central filling helps alleviate the work load on a community pharmacy, allowing them to work higher loads with a smaller staff. The most hectic time of the year, depending on many factors, usually come around the new year [oh yes, I can hear the groaning]. This is the time of the year that we grit our teeth and hope we daze out just enough to do our job well but to the point that we don't remember very much over the next 2-3 months. Why? Because the new year is when employer insurances usually switch over to new plans, existing plans might see a change in the co-pay structures and rates, and various other headaches that the patient finds out about when they try to fill a new RX and we try to bill their plan. At least in a community pharmacy this will level off, with the majority of their patients returning to a well established and recurring fill situation.

Another major type of retail pharmacy is known as a tourist oriented retail pharmacy. These, as the name suggest, deal in HIGH volumes of tourists on a daily basis which of course can fluctuate based on the season. These pharmacies not only deal with the same month to month maintenance rx's as community stores, they also have the added bonus of filling scripts for people from all over the nation or from all over the world depending on the location. In pharmacies such as these, the employees live in a perpetual state of REGISTER REGISTER REGISTER. This means going through that lovely dance between pharmacy employee and patient where we ask the patients phone number, address, date of birth, all possible last name, diseases, ailments, allergies, first memory as a child, vegetarian or meataterian, and other things that help us make sure we know who you are and that what we're giving you wont kill you based off previous conditions. We dont really ask some of those latter ones, but you catch my drift. So that stress level of constantly registering new patients [which can take upwards to 5 minutes a person], figuring out insurance companies, figuring out who the heck this doctor is from Oregon, explaining to the patient from Colombia who doesn't speak very much English that we need a script from an American doctor, and many other things that can and do go wrong. It just means there are a lot of more irregular factors that mean at ANY moment, you can have a patient come up to you and burn 10-15 minutes just trying to break the communication barrier so you can get them registered and their insurance for their $100 antibiotic suspension. These are also usually the ones who have to catch a flight leaving in an hour, have a cab waiting outside, and are breathing down your neck. [Cases this extreme aren't overly comment but we get them in some sort of varience quite often.]

So, you might see how the type of location that a pharmacist is accustomed to working can greatly impact the performance within the pharmacy. At a community pharmacy, doing 400 scripts a day is a lot of work, but with that kind of volume you'll see they will have the staff to man each station [at least 4/5 stations]. This brings about a "I'll do one thing at a time" mentality that some of these floater pharmacist exhibit in full force. That kind of mentality won't work in a store with two people [1 pharm and 1 tech] and 5 stations [in window, out window, drive-tru, filling rx's, and product verification].

I've had many pharmacists come to our location from 400-500 scripts/day locations in community pharmacy's and exasperate how even thought the volume is about half as much that the work is twice as hard because of all of the unknowns and unexpected issues.

I've run out of steam and gone off topic, but I'll try to continue this later.

2 comments:

Anonymous said...

I'm a pharmacy student working in a 300 scripts per day store. We are located in a tourist AND hospital area. If we aren't getting new patients, we are still getting new scripts... often one-time no-refill scripts (like ER scripts).

On a rotation, I was assigned a community pharmacy miles away from the nearest hospital. It IS a big difference.

The workload is tough. Some pharmacists don't last long there.

Anonymous said...

Oh, just read on one of your earlier posts that a hospital is not far down the street from you. Makes sense now... except the part where they short-staff you with only 1-2 pharmacy techs. :(