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.