Sunday, September 14, 2008

The pharmacist is your friend

Have you ever watched "It's a Wonderful Life"? Of course you have. I'm a big Jimmy Stewart fan, myself and I've probably watched it dozens of times. I have my own copy, still in the original black and white, no thanks to Ted Turner. Cry every time, too, cause I'm a big mush. One of the big turning points in Ole George Bailey's life is when he keeps Mr. Gower from poisoning a patient because he's drunk and distraught over his son's untimely death. "It's poison, I'm telling you, it's poison! Please don't hit me again!"

What does that have to do with this post? Nothin'. I just like the movie. Plus, I've been talking to a LOT of pharmacists lately. I used to work in an ER with a dedicated pharmacy, which was oh, so handy and the PICU had a pharmacy too. Nowadays, I'm on the phone just about everyday with a pharmacy because someone needs a prior authorization or a refill on their prograf or something. And oy! The prior authorizations! What a pain in my tuchis! (spelling? You know what I mean). I don't understand why, if the insurance is going to give me the epogen anyway, I have to go through the trouble of calling some 800-number and explaining WHY we're giving the patient epogen. Do they think we just hand it out like party favors? Anyhow.....

I haven't yet met a pharmacist I don't like (Although one seriously tries my patience, no pun intended). But I do have to say that I'm starting to have a special place in my heart for the local, independant druggist. I'm sure that there are very good, capable and compassionate folk in the local big-chain drugstore. (Like Drugmonkey!) My goodness, though, is it refreshing to call Joe's Pharmacy instead. For instance, most of the time when I call in to a pharmacy, I'm greeted with the usual recording, "Thank you for calling Big Drugs. If you're calling from a doctor's office, blah, blah, press 8. If you'd like to call in a new prescription, press 2. If you'd like to talk to a person, hang up and find someone in your office, because we're all too busy to talk to you. Have a nice day."

When you call up Joe's, though, you get a human on the line, right away. 9 out of 10 times it's Joe, himself. I start in with my schpeil. "This is TC, from Dr. Kidney's office, I'm calling in a prescription for Doris Dontfeelsogood, her date of birth is..." At this point, Joe cuts me off, "Oh, I know Doris, what is it that you need? Ok, with 5 refills. Yes, I know your office number. Thank you." And there you have it. One time, our doctor gave a prescription for a med to the patient, and then changed his mind and I had to call the pharmacy and the patient to make sure the patient took the new med. And the patient only spoke Spanish. They said, "I'll just bring this new prescription over right now and make sure I get back the other one so they're not confused." I'm not making it up-they brought the new med to the person's house. Do you know what that says? It says, "Screw you, CVS and your fancy, new drive-through, we do house calls."

So there you have it-support your local Mom & Pop drugstore, they're a dying breed. As an added bonus, if it's an especially old establishment, take a look around and you may find neat stuff, like Bay Rum or castor oil soap wrapped in silver paper or greeting cards from 1978. And to show you that I put my money where my mouth is, our family uses the little pharmacy in our town, even though the cashier is a little loopy and always follows the baby around the store so she won't break anything.

Just tell 'em Clarence sent you.


PJ Geraghty said...

when I lievd in Richmond, I used a local pharmacist. They were awesome. This was one of the bigger "small" stores I'd ever seen, and they had an operation that would rival any CVS. But even if we were checking out with a technician, the pharmacist would alwys call across the counter and ask if we had any questions, and I could get one on the phone any time I asked.

Now that I actually take medicine on a regular basis though, I live out here in the land of Homogeneity. I don't even know where I'd find an independent drug store. The Walgreens is right around the corner (actually, there seems to be one right around every corner) and they have a drive-through as well. If they'd sell my Old Style (Steve will recognize it!) at the drive-through it'd be perfect.

BreathinSteven said...

Yup, PJ, I miss them too... As you might imagine, I've had some pretty wonderful "real" pharmacists in my life...

One used to bust my chops about buying suppliments like Ensure or Boost -- he couldn't imagine how I couldn't just EAT MORE... I would explain how I would eat to live, and he would live to eat... When I HAD to pack in calories... Now I really appreciate how he felt... (I've put on 40+ pounds since I was with him and have to watch what I eat --With my new little belly, Laura jokes that, perhaps, in addition to Kari's lungs I may have received her uteris as well... Chicks... Whatever...)

I do miss my old pharmacist -- there are a lot of good new ones, but they ain't the same... It's like a good, old fashioned hardware store...

And I can still get all of the Old Style that I want, PJ -- that was always my Dad's beer -- it was always in the fridge. Once in a while when he was feeling extravagant, he'd get the Special Export. He was a good Dad and I miss him -- you would have liked him...

You two take care...



The Broken Man said...

I love all the little local stores - life is so much better when the local store owners know you!

The Broken man

Sex Mahoney for President said...

You're absolutely right. When the big pharmacy accidentally poisons you, all you get is a large cash settlement, but when an independent, mom and pop, pharmacy gives you thalidomide, instead of say Vitamin B6, to ease your morning sickness while pregnant, you get the added bonus of driving someone out of business and, possibly, to suicide; or, in Mr. Gower's case, to a broken life as the town drunk. That rumhead spent twenty years in jail for poisoning a kid.

Geoffrey W. Rutledge, MD, PhD said...

I think your blog is terrific, and I would like to feature you on Wellsphere ( Would you drop me an email?
Good health!
Geoffrey W. Rutledge, MD, PhD

Virginia said...

I had an enjoyable time reading your blog. I am thinking about becoming a nurse. Any advice?

Anonymous said...

Prior auths are a significant portion of my job as well (I'm a RN in a General Peds and Peds Rheumatology clinic).

Prior auths are a game. And in order for our patients to get the medications reimbursed by insurance, we must play the game.

The physicians I work with have learned the rules of the game; that is, exhaust the formulary options or whatever other criteria there is, and then have me call for the auth.

The most difficult part of the game is dealing with an insurance company for the first time, and trying to figure out who you have to call.

As one who has done auths, I'm aware of what a PITA it is, but as a patient (on Procrit), everything is done "behind the scenes", so I'm totally unaware of what the nurse went through to get my auth.