Saturday, November 13, 2010

Some Thoughts on Working the Community Pharmacy Part 2

Drive thru in pharmacy can be the biggest help and the biggest pain all in one package. The idea is that you don't have to get out of your car, walk inside the building, go to the back of the store, get your prescriptions, and walk back. This is especially helpful for those who have difficulty walking, have a very contagious disease, or have another condition that would make getting into the store a difficult task. The biggest trouble with drive thru is that many people equate faster service to instant service. The time saver has more to do with the aspect of parking the car, going into the store and so on. Drive thru doesn't mean that the prescription bag will be ready and waiting in hand the moment you drive up or even soon thereafter. The same issues one could face coming in the pharmacy building are ones that will be dealt with at the pharmacy drive thru.

Insurance will always be a constant. Insurance changes with job changes, yearly enrollment, life changes, and other more minor events. It will always have to be updated. These issues can crop up without warning and often do, which is why it is impossible for anyone to predict when they come in or go through drive thru that their issue may take some time to resolve. Thus, it doesn't make sense to say that people who have insurance issues should come inside, because you can't exactly plan for this. Neither is it fair for those who have insurance issues to come inside. They have their reasons for going through drive thru and theirs, like everyone else's, should be respected.

Sometimes the pharmacist needs to go over the medication with the patient. At times that can be in great detail and take a great deal of time. Drive thru doesn't mean poor patient education nor does it mean that the patient already knows about their medication. They have the right to the same treatment in drive thru as they do if they come inside.

With that understanding, there are a few things that people must understand when they go through drive thru.

*Medication is an important part of improving and maintaining good health. However, all medication comes with risks and those risks are lessened with good patient education about the medication. As such, please refrain from using a cell phone, blasting loud music, or being too distracted by the passengers in the car to actually listen to the pharmacist. Not only is it rude, but it can also be potentially dangerous.

*If you don't want your health information shared with everyone in the car, either come inside where you can have a one on one with the pharmacist or come alone to pick up your medication. We try to keep the speaker sound down enough that only the car next to the speaker can listen in on the conversation, but we can't just limit it to the driver's seat- there's no way to keep the rest of the car from listening in to the conversation.

*Be patient. As previously mentioned, faster doesn't mean instant. The medication has to be located, rang up on the register, and the pharmacist must counsel, that's the law. Refill, new ones, doesn't matter. Patience is key in making the experience pleasant and as easy as possible.

Thursday, November 11, 2010

Some Thoughts on Working the Community Pharmacy

I love my job. I do. I wouldn't trade it for the world. I get to help people feel better and be the liaison between them and their insurance company to make sure they get the medications they need when they need it. I am the eyes and ears for the pharmacist whilst checking them out at the register to make sure that I note and mention to the pharmacist any OTC purchases that might interfere with the Rx meds the patient just picked up.

However, just like any job, there are frustrations. A pharmacy is not a fast food joint slopping medications together and putting them in bottles as if each one was the same. Even the "simplest" medications to fill have checks and balances that last (at minimum) fifteen minutes. What would that be? How hard can it be? Let me try to explain simply a process that is anything but simple.

0-7 minutes: Locate patient in database. Make sure information on script about patient matches the patient located in database. Scan in hard copy of the script into the computer under the patient's name. Type script into the form on the computer (check with pharmacist when in doubt of handwriting!!) Submit to insurance company. If insurance company rejects, research why- refill too soon, submission code clarification, needs a diagnosis code, insurance is expired, medication needs a prior authorization in order to be covered, insurance will only cover so many pills in a given time, insurance doesn't cover the medication at all, or any number of random odds and ends that aren't so common. Issues can double on multiple insurances. Send to pharmacist once insurance issue has been resolved, if any.

7-12 minutes: Pharmacist reviews typed work. Checks to make sure all fields are entered in correctly matching it up against the hard copy. Pharmacist checks medication against patient's known allergies, other medications that could cause an interaction, as well as any health conditions that may cause a problem with the medication. Once this is complete, the medication leaflet is printed and the filling process can begin.

12-14 minutes: Medication leaflet is printed and the filling technician locates the medication on the pharmacy shelves and counts out the medication. It can be "easy" with 30 or less, but a technician can see quantities of 200 or more. Specially controlled medications require the pills to be counted twice. Medication is placed in a tote with the leaflet and sent to the pharmacist.

14-15 minutes: Pharmacist verifies that the medication chosen is correct through visual inspection of the medication. Notes are placed in the computer or even on the leaflet if the pharmacist wants to double check information with the patient before dispensing the medication.

Fifteen minutes later, if there are no hiccups or special circumstances, the medication is ready to be sold to the patient. It's amazing, really, that the process doesn't take more time.