Tuesday, April 21, 2009

Be careful what you wish for...

I really enjoy my days off because I get so few. More often that not, one of my patients finds out that I have a day off and has to come into my Pharmacy and be a big enough asshole that my staff has to call me. This weekend (my weekend off) was a prime example...

So...I get not one, but two phone calls about the same patient - one from the floating Pharmacist and one from a member of Management in the store. Long story short is that a patient called complaining that we shorted him zolpidem (only gave him 6...yeah right...), Pharmacist confirmed our on-hands as correct (Yeah team! Good job double counting!) and told the patient he'd have to speak to the Pharmacy Manager on Monday, the patient told him he was coming in and that it better be ready (yeah right...like you get to dictate) and when it wasn't ready he went to store Management and said he was going to get 20 friends to protest the store unless he got his drugs (gotta give him credit for being tenacious!...stupid, but tenacious...). I tell everyone involved that I will deal with him on Monday...

Monday...sweet Monday...ahhhhhh...anticipation of this ridiculous confrontation that is not going to go well because I'm not giving him a damn thing...and then the phone rings...."Who is the opening Pharmacist?" Yep, you guessed it...not only do I have to deal with Mr. zolpidem but also a no-show Pharmacist with only 5 minutes to open...and (yes, you guessed it) by the way, Mr. zolpidem is there waiting. FABULOUS!!

After I arrive and we enter the Pharmacy and see Mr. zolpidem waiting to pounce on me it occurs to me that I had intended to go about things the wrong way...I view his profile and find that Mr. zolpidem has filled 120 days worth of drug in 30 days (cash paying customers fly under the radar in our system unless you look at their profile or know them...and apparently the floating Pharmacists coming through my Pharmacy were not curious...). I decide I'm going to give Mr. zolpidem what he wants...

The doors open and he pounces directly upon my consultation window (now I'm salivating)...I print out his fill history (giggling in my little head)...our conversation went something like this:

Me - Hello Mr. zolpidem. I spoke to the Pharmacist and Management this weekend from home while you were here and I understand you allege you were shorted some zolpidem.
Him - Yes. I only got 6. Did you get the fax from Corporate? I was on the phone with them this morning and they faxed you two hours ago about this (gloating...ready to begin the fight...).
Me - No, I did not receive a fax (get ready for the smack-down Mr. zolpidem). I don't know who you spoke to, but they are obviously uninformed about what type of authority they have in my Pharmacy. Regardless, I'm not interested in arguing about the shortage of drug...I think that is a lose lose conversation...I'm refunding you the money you paid for your last fill because our on-hands are correct and I'm unable to justify dispensing more drug. What I'm really concerned about is your safety...
Him - What do you mean?
Me - You've refilled 120 zolpidem in the last 30 days...can you explain this history for me?
Him - Like I told your other Pharmacist - I do a lot of traveling.
Me - A day is a day...traveling out of state doesn't change that...I'm very concerned about your zolpidem usage. So, in addition to refunding what you paid for your last fill I'm going to fax a copy of your refill history for the last 6 months to your prescriber...we should never have filled this prescription for you with this frequency and he needs to be informed of the error. In fact...according to my calculations we will not be able to fill any more zolpidem for you until the end of July or first part of August...
Him - Well...I'm going to see him today...so I'll tell him. You don't need to fax him.
Me - That is great...I've already faxed him so your appointment will be timely enough for him to review my fax prior to your arrival.

...he says nothing as I give him his refund...

Me - Please let your Doctor know that if he has any questions that he can call me...and you have a nice day (turning to leave)...
Him - Wait a minute...don't you want to take a look at this (shows me a receipt from us with lots of notes about his fill and his conversations with people during his rant this weekend)?
Me - (He hasn't got to fight with me...which is really what he came for...now's my chance to really steal his fire...) No...it's not really relevant to the issue at hand, but thank you. You have a nice day and feel free to call me if you have any further questions.

I hope that shit-sandwich he spent all weekend making tasted good...

8 comments:

monkeylovin830 said...

-pure genius-

I have to try this next time this happens.. I can't believe I never thought of it before.

Totally brilliant...

"Ms. Mean" said...

LOL! Sometimes you just gotta give them what they want! hee hee hee.

Ashley said...

that is the most awesome thing I've ever read, no kidding.

Wow...I wish I'd seen his face. Did he cringe? Turn pale as a ghost or simply shed a couple a tears? I'm SO impressed!

Shalom said...

This only helps if all four prescriptions were from the same doctor. Of course, you could always fax all four. Sooner or later he'll run out of doctors.

(On the other hand, the situation wouldn't have come up in my pharmacy. *Any* controlled substance where the customer claims he has no insurance -- and you take one look at these folk and you know damn well that they're on Medicaid -- not only do I go back through their profile, if I'm at all suspicious I tell them to come back in ten minutes and call the other three independent pharmacies in town to see where else they filled it. I don't care how they're paying for it, if they have enough per the written days supply they get zip from me. That's one advantage to working independent: no corporate PHBs to try to override you on stuff like this.)

word verification "icingsht". Damn what a lovely picture that brings to mind.

"Ms. Mean" said...

Shalom...you are right, this should never have happened...floating Pharmacists don't know my patients...and it was the same prescription (embarassing!)...and he hasn't been back (hee hee hee)

What is "icingsht"?

Grumpy, M.D. said...

Oh, that is awesome. Yeah, I love it when I catch one of my patients getting multiple narc fills, so I can chew them out and fire them.

If a patient pisses off my front office the girls get really aggressive about calling pharmacies in their zip code to see if they can nail them... and usually they do.

"Ms. Mean" said...

LOL! Now THAT is priceless! Your girls must be sisters to mine!!

Silver said...

Oh, yes, I love it when my office gets faxes like these.
And if I'm comanaging the patient, I'll send the fax to everyone else seeing him/her - covered under coordination of care.
And I'll have my front desk check the pharmacies closest to you, as well as any other pharmacies we've ever sent rx to. (I never write and hand rx to patients, other than C-IIs. I fax or e-rx... because I want to know where they're going. And when I write for C-IIs, I ask the patient to tell me where he or she will be filling it, and I write the name of the pharmacy on the rx. Why? Because I used to work with a methadone clinic.)

Lovely story. Keep it up!