An open letter to all those who have ever had a prescription filled - Why I Love My Job!
Oh, the thoughts I think as a pharmacist!

So - I was driving home from work tonight and I was, as I always do when I leave, going over everything I did  . . . and everything I did not get to do. I thought about all of the calls I got tonight from other pharmacies whose stores were open, but whose pharmacies were closed. I thought about how I was able to help a man find a medicine for his toddler daughter, even though he was at a competitor's store. He was able to call me, knowing my store is open 24 hours with a pharmacist on duty, and get help to find a much-needed medication. I got five calls of this type in the 6 PM to 7 PM hour alone, the first hour after which all of the other pharmacies close. And, though these calls may sometimes add to my stress while I am trying to serve the patients who are in my own store, they make me smile. I remember why I spent all of those years in school and I feel a warmth spread over my cynical and callous exterior. It is still stressful, and I am dealing with people who are sick and have usually spent several hours in the ER before visiting me on the weekend. They don't feel well and they are tired of waiting. Then they bring me a tiny piece of paper that looks like it's written in some martian language, and they have to wait some more while I try to read that martian language that the MD must surely have meant for no one to ever be able to decipher. Then I enter it into the computer system, and pray that the insurance works with the information I was able to gleen from the insurance card, assuming the patient was able to locate the one specifically made for us pharmacy people to process. For those of you who have never had the honor of working in healthcare and having to bill insurance, "Well, I have Blue Cross and Blue Shield" is not an appropriate answer to insurance issues. The short of it is long: insurance conglomerates such as the afore-mentioned one pay insurance processors ( of which there are thousands ) to process these claims on-line. They print the info that tells me which processor to use via tiny little numerical codes somewhere on the card in smaller-than-tiny-bible-print, if I'm lucky. Once I figure out the processor, I must still figure out the patient's personal codes to put in and run through the system. So yes, sometimes I will ask for your social security number. The insurance company has tried to protect your identity by not printing it on your card, which is nice. But I still have to find you in the system somehow. And not only must your personal number be correct and submitted to the correct processor, but the group to which I am submittimg must be right, as well. If there are thousands of processors, then there are MILLIONS of groups. This relates to what your formulary is, etc, etc. So when you call and ask me "How much will my Crestor be on my Blue Cross and Blue Shield?" this is why I cannot honestly answer you.

Now that I have deciphered your prescription and successfully billed your insurance, I will double-check everything before it is filled. I will re-read the martian lingo and make sure that it makes sense. I may ask you if you are really allergic to that antibiotic, or did you just get nauseous after taking it on an empty stomach? I will want to know if you have been taking this medication at this dose, or if you have taken it with all of your other medications previously. I may ask if you have a family history of seizures, or if you have ever had one yourself. I may have to call your doctor back and ask for something else. That is why I am here. I want you to get your medication, but I want you to get the RIGHT medication for YOU, for your INDICATION, for your insurance's FORMULARY . . . And no, just because I am the pharmacist does not mean that the doctor will rush to the phone to take my call; I usually have to leave a message for the nurse, just like any of you. Then we will be waiting together for the physician to call me back and let me know what else I can use. Usually this means that I will have asked you what we are trying to treat and if you have any other allergies. I am not trying to be nosy, I am trying to find something in my stock that will work for you and your situation, so that when the doctor calls me back and asks me what we should use, I will have an answer ready for him. 

Now that I have everything the way it should be for you, I will get a label printed and actually fill the prescription by counting, weighing, measuring, mixing, or whatever else is necessary for you and your medication. Then I will check it once more before I package it up and ring you up and make sure that you don't have any other questions or concerns that need to be addressed. The thing I want you to remember when you leave is that if you get home and don't remember what the doctor said about when to take it, or you gave the 6-year-old's cough syrup to the 2-year-old who was supposed to take the antibiotic or vice-versa: PLEASE CALL ME. You are not a bother. I may answer the phone talking so fast that you don't catch my greeting. I may be gritting my teeth because I'm fighting with an insurance company. But if you have read this entire rant, then you will realize that most of the sentences end in " . . . for you." And that is what I love. I love that I am able to be there for you.

All of us folks in my store are stressed. 'Tis that wonderful season again. Not the holiday season, but cold and flu season. In fact, we have already been victims of these ourselves at my store. We do not want you to have to wait. We want you to feel better and spend as little as possible doing so. We want to help you.

So as I drove home tonight, I thought about all of the people I was able to help. And I thought about the ones that I was not. I thought about the phone calls that went unanswered while my only technician took her break. And the ones that still went unanswered while each of us was tied up with a patient or another phone call. I thought about the patients who came in whose medication I was unable to get at this time because of supply shortages and such. I thought about the fact that I was unable to get the schedule for next month put into the computer system. I thought about the business reports I was not able to complete. But mostly, I think about each patient, and how, if they were my mom, would I have treated them any differently? That is how my professor put it to me four years ago: "Treat every patient like she is your own mother." And that is how I try to practice.
I love my job! I want to help! I just want my patients to have a little patience!

Rain   Rain wrote
on 2/21/2010 8:20:16 AM
I loved this piece. Well written, and very enlightening. I am a Pancreatic Cancer survivor, and spend a great deal of time at CVS. I've come to love them. I have taken heavy narcotics, and am a 9 year survivor. 75% of PC patients die within a year. I have the greatest respect for you, and thought this piece filled with excellent insights. Good work..

StarPoet   StarPoet wrote
on 1/19/2010 1:34:05 AM
Thanks for the heads up on a very important job for 1 little mistake can cost so much. I will take into consideration what those who work in a pharmacy have to go through and I will always remember this story here.

lauralee   lauralee wrote
on 12/1/2009 5:23:51 PM
hey, john! i'm loving it here, so far. sorry about the over-use of then, but i kinda wanted it to be a list, for two reasons: commercial pharmacies require work-flow to be done as in an assembly plant. (that is why even though you only need a z-pak, it will still take me at least 15 minutes to get it for you; everything has to be put in and go through the entire process. this is not always true with ma & pop pharmacies, however.) and i wanted everyone to be able to step with me through all of the 'stations' of that plant, every part in which something may go wrong or break down. would that it were not so, but each step is a potential for error, human or machine. that is why i look through everything in my memory on the way home; it's one more chance to catch anything my mind may not have revealed when i was trying to please the patient (or, as the conglomerate thinks of them, the customer.) because until you put the chemical in your body, i have a chance to fix anything that was wrong. i called one of my patients at 11:15pm one night after having to call info to get his phone number, due to one of my daily reviews, because something he said to me on the phone just didn't sit well. i called him and told him to take his wife to the ER, something had occurred to me. he hung up and called 911, and she had a pacemaker put in at 6 the next morning. i had NOT filled any medications for them, but the people who call and just ask questions go into my review, too. i love to write, but i never want to be less of a pharmacist than i am now!

jlew1973   jlew1973 wrote
on 11/30/2009 4:53:54 PM
Hey buddy! Great read and educational. A lesson for those of us without a clue what you and your hard working colleagues go through for us. I enjoyed the way you book-ended the letter with your thoughts on the way home from work. Made me think of your dedication. Some things that can make this better: Watch how many times you "then." It can make your writing read like a list. Always use the strongest verb possible rather then a form of "to be"--as in "is, was, were." The professor's quote was a nice touch. Might be more powerful to replace the "it" with the pronound "she." Makes it more personal and less like the patient is an "it" to be dealt with which is exactly antithesis of your open letter. Nice work! And welcome!! ~John

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