The view from another zoo.
Not a day goes by in my community pharmacy without some kind of goofy interaction with a patient. It has become evident over my years of practice that normal retail tactics cannot be applied in this setting. Once I had an encounter that went like this:
Woman: “I would like to get my alprazolam prescription refilled.”
Me: “I’m sorry, but your prescription is over six months old, and because it is a controlled substance, it cannot be refilled at this time.”
Woman: “What do you mean? I have two refills left on the prescription.”
Me: “The original prescription is over six months old, and the state law says that I cannot refill it unless I call your doctor for his authorization.”
Woman: “I never heard of such a law. And besides, my doctor doesn’t have hours today. This is ridiculous! I didn’t use up my refills, so I get penalized.”
Me: “Sorry, there’s nothing I can do for you today. I will contact your doctor tomorrow.”
Woman: “Never mind! I’m taking my prescription business to another pharmacy. You people don’t know what you’re doing back there!”
Now, if we were talking about a customer attempting to return a defective widget without a receipt, customer service would say go ahead and make the refund, because, as we have heard over and over, “The customer is always right.”
This adage cannot be applied in retail pharmacy. Laws have to be followed and patients must realize this, although they’re just as likely to respond, “I never heard of this law” or “You’re making this up.”
Then there are issues with the co-pay. I went to college for six years for highly specialized training, and now patients fight with me over their prescription insurance co-pays.
I hear, “My co-pay is only $5. What are you trying to do, rip me off?” Hey, we’re online with all prescription plans. They tell us what the co-pays are. But try getting this across to the patient.
I ran into this situation recently.
Customer: “I need a refill on this bottle.”
Me: “Sorry, this is not refillable, but I will be glad to call your doctor.”
Customer: “Oh come on, I have to take this medication the rest of my life. And don’t bother my doctor. He’s too busy to talk to you. Just fill it.”
Me: “If I do that, I’ll be breaking the law.”
Customer: “I never heard of such nonsense. I’ll just have to take my business elsewhere.”
Sometimes when I’m counseling, I feel as if I’m talking to a six-year-old: “Take this on an empty stomach.” “Don’t stop until you’ve taken it all.” “Keep this in the refrigerator.” Maybe a recalcitrant six-year-old: “Why haven’t you been taking your blood pressure medication regularly? You were due for a refill over a month ago. You have to be more compliant!”
Sometimes I can’t help myself. I was dispensing an albuterol inhaler to a patient with that productive, raspy smoker’s cough. Out it came: “Mrs. B., you gotta stop smoking!”
We’re in the business of supporting health, right?
And sometimes I have to get really personal with the patient. Now that Plan B is off prescription but behind the counter, I have to ask, “Are you over 18?” and inquire about the 72-hour period of unprotected sex. This, the patient understands, never questions, and gladly accepts. Yeah, right.
Similarly, telling a patient taking metronidazole that he or she should avoid alcohol is received just about as you’d imagine. You may be spoiling somebody’s weekend, but the information has to be given.
Occasionally, an interaction with the patient leaves me speechless.
A man dropped off a prescription for Tamiflu. While he waited for me to fill his prescription, he stood directly in front of me and tried to make small talk. Since the pharmacy wasn’t really busy, I listened to him.
“My doctor told me I have influenza,” he said. While typing away, I replied, “Oh, you’re not alone; the flu is going around.” He responded, “Oh no, I don’t have the flu. I have influenza!” I thought my tech was going to die laughing.
I say to myself every day, “Wow, they pay me big bucks to deal with these crackpots. What a rewarding career!”
Bob Spera is a community pharmacist, a hospital pharmacist, and a writer for pharmacy trade journals. E-mail him at email@example.com.