What makes a challenging retail store?

[pillpharmer14]

Hey all,

I've been moved around a lot between CVS stores throughout the last 9 months and have discovered that all stores within a chain (and even a district) are NOT created equal.

What store characteristics have you found to be particularly challenging?

Here are some of mine.

1. Store with predominately hispanic patients. Nothing racist here, however the language barrier makes any patient interaction take longer with higher risk of miscommunication.
2. Low income areas are worse than high income. Medicaid is a pain to deal with. I much prefer someone who will pull out their black card and pay cash if insurance doesn't cover something.

3. Really slow stores have been more challenging than medium volume. Much easier to verify 400 per day than type fill and verify 200 by yourself with one less hour to get it all done in. Not to mention all the inventory and "tech duties".

4. Shopping strip stores with a highly utilized urgent care next door. Every patient gets 5 scripts which RXCONNECT aggressively times because WeCare. Patients show up before the scripts do.

The point of course being that comparing script volume and tech hours all day doesn't really paint the whole picture. Thoughts?

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[SClENCE]

There's a lot of factors, but in my opinion the most important thing is the skill and efficiency of the technicians.

"Bad stores" are their own worst enemy. If you are 2 pages in the red, you will be expediting scripts. Not only are you behind, but you have actually made more work for yourself. This is because customers will come in for pick-up and you will have to expedite the script. This wastes the cashier's time pulling them up in the system and explaining that it's not ready and production also wastes time printing and pulling 1 individual script. Then people show up for their scripts in QI and the order isn't even touched because the ques are so behind so you end up digging out individual drugs throughout the day and making them waiters (more time waste). The list goes on but in my opinion it's a massive snowball effect.

 

[Sparda29]

Hey all,

I've been moved around a lot between CVS stores throughout the last 9 months and have discovered that all stores within a chain (and even a district) are NOT created equal.

What store characteristics have you found to be particularly challenging?

Here are some of mine.

1. Store with predominately hispanic patients. Nothing racist here, however the language barrier makes any patient interaction take longer with higher risk of miscommunication.
2. Low income areas are worse than high income. Medicaid is a pain to deal with. I much prefer someone who will pull out their black card and pay cash if insurance doesn't cover something.

3. Really slow stores have been more challenging than medium volume. Much easier to verify 400 per day than type fill and verify 200 by yourself with one less hour to get it all done in. Not to mention all the inventory and "tech duties".

4. Shopping strip stores with a highly utilized urgent care next door. Every patient gets 5 scripts which RXCONNECT aggressively times because WeCare. Patients show up before the scripts do.

The point of course being that comparing script volume and tech hours all day doesn't really paint the whole picture. Thoughts?

This is where independents are superior. The one where I work, we only hire Spanish speaking or Arabic speaking pharmacy technicians.

 

[Estrace]

This is where independents are superior. The one where I work, we only hire Spanish speaking or Arabic speaking pharmacy technicians.

Hiring Spanish speaking techs helps but its still very stressful to have to rely solely on your techs to get through your shift daily.

In my opinion, it depends on the type of pharmacy manager and the quality and attitude of the techs the store has.

 

[Swishers]

It sucks that tech hours aren't calculated differently for stores that have a much higher "new prescription" count compared to other stores in the same district.

 

[Sine Cura]

Pharmacists vs. techs. Whoever is the weaker of the two groups, you can definitely feel it (i.e., a sea of red in QV vs techs who two-finger type and don't have problem-solving skills). If both groups are good then you probably have a good store regardless of particular challenges (high new script %, high Medicaid prescription %, high narcotic volume, upper middle class buffoonery, proximity to urgent care and ED... unfortunately I have all of these...)

 

[Gombrich12]

"2. Low income areas are worse than high income. Medicaid is a pain to deal with. I much prefer someone who will pull out their black card and pay cash if insurance doesn't cover something. "

I disagree, lower income people usually have less expectation of service than the higher income people. If you work in some of the rich areas the entitlement of the patients will blow your mind. These people are used to being waited on hand and foot and the average chain pharmacy can't offer the level of service some of them want.

What makes a store really annoying for me is a high C-II script count. I'd take a nice pay cut if I just didn't have to deal with C-II's anymore. They slow everything down and somedays I feel like a dope dealer.

 

[pillpharmer14]

QUOTE="Gombrich12, post: 16455293, member: 584471"]"2. Low income areas are worse than high income. Medicaid is a pain to deal with. I much prefer someone who will pull out their black card and pay cash if insurance doesn't cover something. "

I disagree, lower income people usually have less expectation of service than the higher income people. If you work in some of the rich areas the entitlement of the patients will blow your mind. These people are used to being waited on hand and foot and the average chain pharmacy can't offer the level of service some of them want.

What makes a store really annoying for me is a high C-II script count. I'd take a nice pay cut if I just didn't have to deal with C-II's anymore. They slow everything down and somedays I feel like a dope dealer.[/QUOTE]

High income areas definitely present unique challenges. I've experienced both and my personal preference is higher income. The people are just smarter and understand complicated issues that are out of our hands such as PAs and non-formulary products. Yes, they expect a lot but I would rather provide that extra service than waste hours of my day explaining to drunk people how to submit a refill request.

Again, I'm sure part of the country and just HOW affluent the area is has an impact as well. I was in an area with avg home value of 1.2 million. So not Bill Gates country, but still fairly affluent.

 

[npage148]

I'd take Medicaid pt over entitled Upper class people any day.

One old rich man wanted me to call my DM and file a complaint against the company because we didn't have free blood glucose logs we could give him. He wanted me to do it while he waited for a resolution.

Another is an Assistant state attoney General who routinely throws a level 5 hissy because we won't bill a 60d supply of cheap generic for her with a 30 day supply. Her logic, the doctor using the sig as directed lets bet dictate the day's supply

These people are more well off than me and just about everyone of my other patients and they are literally irate over 4$.

But yeah, I'll take a 20k/year pay cut to never touch a c2 again in a second. The stress 15 missing lortab causes me,by way of my dm, is completely not worth it. I feel like nasa engineers can bomb a satalite into the moon and get less fall out from their bosses

 

[PharmacistReb]

This is where independents are superior. The one where I work, we only hire Spanish speaking or Arabic speaking pharmacy technicians.

What's pharmacy like in NYC? Are you right inside metro NYC? I can't imagine the cost of living/food/transportation/general overhead. I feel like a pharmacist salary in NYC would qualify one for welfare.

 

[Estrace]

QUOTE="Gombrich12, post: 16455293, member: 584471"]"2. Low income areas are worse than high income. Medicaid is a pain to deal with. I much prefer someone who will pull out their black card and pay cash if insurance doesn't cover something. "

I disagree, lower income people usually have less expectation of service than the higher income people. If you work in some of the rich areas the entitlement of the patients will blow your mind. These people are used to being waited on hand and foot and the average chain pharmacy can't offer the level of service some of them want.

What makes a store really annoying for me is a high C-II script count. I'd take a nice pay cut if I just didn't have to deal with C-II's anymore. They slow everything down and somedays I feel like a dope dealer.

High income areas definitely present unique challenges. I've experienced both and my personal preference is higher income. The people are just smarter and understand complicated issues that are out of our hands such as PAs and non-formulary products. Yes, they expect a lot but I would rather provide that extra service than waste hours of my day explaining to drunk people how to submit a refill request.

Again, I'm sure part of the country and just HOW affluent the area is has an impact as well. I was in an area with avg home value of 1.2 million. So not Bill Gates country, but still fairly affluent.[/QUOTE]





I agree, I will take a high income areas over lower income area any day. I actually just moved from a store in a high income area to a predominantly Spanish speaking 99% Medicaid store and I hate it. These people are used to getting everything free so forget about suggesting they add flavor to their child's antibiotic. When they come to pick up their meds, they always show up with no money.
My old store had its own challenges as well but I would never have left that store if not for issues with my RXM. Yes, they complain about everything but I also have the perfect attitude to match their stuck up ass. I give off that stuck up vibe as well with them and I don't have time to explain myself more than once or at most twice. I loved everything about my job and it challenged the heck out of me. We have very educated customers (lots of medical students, doctors, engineers, attorneys) due to the location. I was always reading up on things or refreshing my memory because they will come for you with questions. I have every pharmacy app downloaded on my phone and was always prepared.
Now, I just go to work just for going sake. The spark isn't really there anymore because everyone speaks Spanish here and the last thing they want is you talking to them about anything. They don't understand PA, non formulary products and they are very slow with everything (OMG!) .

 

[Aznfarmerboi]

High income areas definitely present unique challenges. I've experienced both and my personal preference is higher income. The people are just smarter and understand complicated issues that are out of our hands such as PAs and non-formulary products. Yes, they expect a lot but I would rather provide that extra service than waste hours of my day explaining to drunk people how to submit a refill request.

Again, I'm sure part of the country and just HOW affluent the area is has an impact as well. I was in an area with avg home value of 1.2 million. So not Bill Gates country, but still fairly affluent.

I agree, I will take a high income areas over lower income area any day. I actually just moved from a store in a high income area to a predominantly Spanish speaking 99% Medicaid store and I hate it. These people are used to getting everything free so forget about suggesting they add flavor to their child's antibiotic. When they come to pick up their meds, they always show up with no money.
My old store had its own challenges as well but I would never have left that store if not for issues with my RXM. Yes, they complain about everything but I also have the perfect attitude to match their stuck up ass. I give off that stuck up vibe as well with them and I don't have time to explain myself more than once or at most twice. I loved everything about my job and it challenged the heck out of me. We have very educated customers (lots of medical students, doctors, engineers, attorneys) due to the location. I was always reading up on things or refreshing my memory because they will come for you with questions. I have every pharmacy app downloaded on my phone and was always prepared.
Now, I just go to work just for going sake. The spark isn't really there anymore because everyone speaks Spanish here and the last thing they want is you talking to them about anything. They don't understand PA, non formulary products and they are very slow with everything (OMG!) .[/QUOTE]

I have serviced both populations.

The key to Hispanic population or any low income area is educating the doctors on not to prescribe ******ed ****, keeping things simple such as "no covered" (they don't understand not..) or okay- 15 minutes... go over there... or 1 hour, and just smiling at them.

Trying to explain to someone that doesn't understand English much less the medical system here and understanding that chances are Medicaid wont grant the PA anyway, can be suicidal. That is why I take on a "paternal" role and just tell them "no covered" or 15 minutes.

The store is easier in terms of Patient adherence calls because they say okay I come to pharmacy to get, or they say yes to everything (Because there's no charge on most of their prescriptions or they don't understand what I am saying).

 

[Sparda29]

What's pharmacy like in NYC? Are you right inside metro NYC? I can't imagine the cost of living/food/transportation/general overhead. I feel like a pharmacist salary in NYC would qualify one for welfare.

I work in Queens live in Long Island. It's pretty good. I'd be relaxing if I didn't have those pesky student loans to pay back.

 

[doublehh03]

I agree, I will take a high income areas over lower income area any day. I actually just moved from a store in a high income area to a predominantly Spanish speaking 99% Medicaid store and I hate it. These people are used to getting everything free so forget about suggesting they add flavor to their child's antibiotic. When they come to pick up their meds, they always show up with no money.
My old store had its own challenges as well but I would never have left that store if not for issues with my RXM. Yes, they complain about everything but I also have the perfect attitude to match their stuck up ass. I give off that stuck up vibe as well with them and I don't have time to explain myself more than once or at most twice. I loved everything about my job and it challenged the heck out of me. We have very educated customers (lots of medical students, doctors, engineers, attorneys) due to the location. I was always reading up on things or refreshing my memory because they will come for you with questions. I have every pharmacy app downloaded on my phone and was always prepared.
Now, I just go to work just for going sake. The spark isn't really there anymore because everyone speaks Spanish here and the last thing they want is you talking to them about anything. They don't understand PA, non formulary products and they are very slow with everything (OMG!) .

I have serviced both populations.

The key to Hispanic population or any low income area is educating the doctors on not to prescribe ******ed ****, keeping things simple such as "no covered" (they don't understand not..) or okay- 15 minutes... go over there... or 1 hour, and just smiling at them.

Trying to explain to someone that doesn't understand English much less the medical system here and understanding that chances are Medicaid wont grant the PA anyway, can be suicidal. That is why I take on a "paternal" role and just tell them "no covered" or 15 minutes.

The store is easier in terms of Patient adherence calls because they say okay I come to pharmacy to get, or they say yes to everything (Because there's no charge on most of their prescriptions or they don't understand what I am saying).[/QUOTE]

+1. Literally my same exact thoughts. I worked at an area that served primarily millionaires (actors, doctors, lawyers...) then transferred to a district that served primarily Hispanics.

What annoys and pisses me off is how these damn patients on Medicaid refuse to pay for their kids' meds when they're not covered (cough meds less than 4yo for instance) and only costs < $5 and throw a damn hissy fit. And yet you see them driving in a nice car.

 

[trailerpark]

I hate Medicaid and all those damn C2 scripts. If I didn't have to work I wouldn't need Xanax. What do these welfare people have so much anxiety about? How they might have to get a damn job sometime? And I work for Walmart so you all can imagine the kind of Medicaid Jenny Craigs I have to deal with. They won't pay for antibiotics for their illegitimate children but happily offer to pay cash for phentiramine... lol wut

 

[SClENCE]

In my opinion Xanax is for people who have literal panic attacks from PTSD, but it seems like it's written for anyone with the slightest bit of what I would consider healthy social anxiety. Don't get me wrong, I know nothing about each patient picking up their prescription but based on volume alone I believe that my assumptions have to carry some truth. I'v never seen a person have a panic attack in my life yet we are handing the stuff out like candy.

 

[npage148]

The Rolling Stones were right on point

 

[Wheresmyaricept]

Untrained or undertrained staff can drag the show to a screening halt.


And in addition to the language barrier with Hispanics, I think they're a little more over dramatic than most other customers. Telling them there are no refills on a prescription is like telling them their grandmother died. But maybe that's just the area I work in.