Dealing with difficult patients

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McZyprexalynn

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or situations.

So, I've gathered some phrases and such that seem to work pretty well from various places across the net, so I figured a thread of comebacks could be useful. Plus, I need some more for my repertoire.

The one issue I could really use some help with is the people who refuse to budge from the drive thru - the "I'll wait RIGHT HERE!" people. We have parking spaces that are visible from the through window, and I always offer to wave at them when it's done if they wait over there. Every so often there is someone who is insistent that they are not going to move, and then it turns into a battle of me saying "You can wait over the to the right or inside the store, but I need to keep both lanes moving" and them screaming "NO!" I know the easiest thing to do is probably to just fill the damn prescription ASAP and get them out of there, but sometimes that just isn't possible and I don't think it's a good idea to let patients bully you into anything.

And a few ways of wording things that usually keep people calm:

It almost always seems to lessen the blow when we're out of something if I say, "We acutally are all out of XYZ. I can order it for tomorrow or I can try to locate it at another store, whichever you'd prefer." I haven't had anyone too pissed off at me for not having something in a while.

When trying to explain a prior authorization. "Your insurance company is requiring something called a prior authorization. Basically, that means that they want some paperwork filled out by your doctor explaining why he/she chose this medication. We have/will contact them to let them know. We can either wait to hear back or you can purchase the medication out of pocket now." If you just say, "This requires a prior authorization from your doctor" people almost always get pissy thinking that you're telling them it doesn't have refills or something.

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If they wanted to wait by clogging up the drive-thru lane, I'd just tell them to take their prescription somewhere else.


yup...or you can say something like "If you don't move/park your car, i'll have to call security. This is our company's policy. Thank you."
 
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Well, that's pretty much what I did with the lady who wouldn't budge yesterday. I offered to transfer it elsewhere but she really didn't have much choice because we're one of about 3 pharmacies in town open after 6pm on Saturday (the clinic sent it by e-RX to one our other stores and she didn't get there until after they closed, so she was already pissed about that). The front end manager went out there and convinced her to move somehow, and she ended up transferring it to another pharmacy.
 
They key to dealing with difficult patients is to empower them. Let them make the decision.

I'm sorry Mrs A-hole, we are out of your prescription for X. Would you like me order it for tomorrow or call another store so you can get it today? What would be best for you?

I'm sorry Mr. A-hole, your prescription plan requires prior authorization for X. You can pay for it, the price is $649.00 or we can call the doctor to get the authorization started. What would like me to do for you?

Mrs. butt nuggets you are not allowed to wait at the window. We can get your prescription ready ready in about 15 minutes. Did you want to come into the store or if you give me your cell phone number, you can park the car and we will call you as soon as it's ready. What would be best for you?
 
Love the empowerment approach! I will try it tomorrow when people come in waaaay too early for their Ultram after a fun-filled weekend. Access in PA is now also requiring you to phone in for permission to fill rxs that pop up as empowerment will be great! "I'm sorry-you can actually pay for this with your very own cash or come back later as I will be on hold for the next hour waiting for a prior auth code to fill this from da welfare office so you only have to pay a dollar. What works best for you?"
 
Love the empowerment approach! I will try it tomorrow when people come in waaaay too early for their Ultram after a fun-filled weekend. Access in PA is now also requiring you to phone in for permission to fill rxs that pop up as empowerment will be great! "I'm sorry-you can actually pay for this with your very own cash or come back later as I will be on hold for the next hour waiting for a prior auth code to fill this from da welfare office so you only have to pay a dollar. What works best for you?"

I wouldn't let them get Ultram early unless they had a new rx with an increased dose......
 
When people won't move from the drive-thru I tell them it's against the fire code for a car to be parked there and if the fire marshall sees them parked there its a $500 fine. Works like a charm.
 
I wouldn't let them get Ultram early unless they had a new rx with an increased dose......

If the third party covers it, and they look like they might shoot/stab/beat me after work if I don't, I will fill the Ultram early. Ethics and vigilant stewardship of drugs of abuse is important, but I'd like to live to be a good steward another day.
 
They key to dealing with difficult patients is to empower them. Let them make the decision.

I'm sorry Mrs A-hole, we are out of your prescription for X. Would you like me order it for tomorrow or call another store so you can get it today? What would be best for you?

I'm sorry Mr. A-hole, your prescription plan requires prior authorization for X. You can pay for it, the price is $649.00 or we can call the doctor to get the authorization started. What would like me to do for you?

Mrs. butt nuggets you are not allowed to wait at the window. We can get your prescription ready ready in about 15 minutes. Did you want to come into the store or if you give me your cell phone number, you can park the car and we will call you as soon as it's ready. What would be best for you?

Yeah, this is a good approach with toddlers too! Just give them a choice "Do you want carrot sticks for your snack, or apple slices?" and they are less likely to have a tantrum.
 
I typically say "take care" instead of "have a nice day". Sometimes people who are sick or having a bad day get pissed off at the latter. On my second day ever working in a pharmacy a lady went off on me because I told her have a nice day and her husband had just left her for someone else. Obviously, not my fault or my problem, but it made me rethink my send-offs.
 
Empowerment approach - that's a good way to put it. I always think of it as giving them a choice, and it usually works. It's the ones who take your options and scream "NO! I want this (something that was not given as an option and is not going to happen)!" that are just about impossible to deal with, but I guess my empowering choice is going to be "I'm sorry, but that is not feasible/against company policy/unethical/against the law/whatever. You can choose one of the options I just presented, or you can find another pharmacy to fill your prescription? Which will it be?"

And yes, it most definitely works with toddlers. I learned the technique when teaching preschool. Children who still refuse to comply with either option are a little easier to deal with an adults though.
 
my supervisor asked me to give a government subsidized (state medicaid) pt a $25 gift card because my overnight mistakenly only filled 2 of 3 rx's she dropped the night before. The one product was OTC and he didnt realize the state would pay for the product. We politely asked her to pull around while we filled the rx so we could keep the line moving. She wouldnt move and made inappropriate comments to the tech to the point where the tech couldnt take it no more. She just wouldnt move until my partner threatned a call to the police. The sup asked us to apologize and give a $25 gc. Needless to say, her abusive behavior caused that none of us apologized and i did not activate anything for her. I for one am sick and tired of people coming in and knowing that all they need to do is throw a fit and they get what they want. SHe eventually got her gift card for her superior behavior but from the front store. Im tired of the BS.
 
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If the third party covers it, and they look like they might shoot/stab/beat me after work if I don't, I will fill the Ultram early. Ethics and vigilant stewardship of drugs of abuse is important, but I'd like to live to be a good steward another day.

Its pretty sad that our profession has come down to this. and over ultram??
 
Yes, Ultram. Seroquel also can become the DOC for ex-cons, so Seroquel can cause some volatile reactions if the fill is too early and not covered. I don't think it's sad, these incidents are a minor part of the week. Most of the time life is beautiful and pharmacy is a meaningful career.
 
Yes, Ultram. Seroquel also can become the DOC for ex-cons, so Seroquel can cause some volatile reactions if the fill is too early and not covered. I don't think it's sad, these incidents are a minor part of the week. Most of the time life is beautiful and pharmacy is a meaningful career.

...so I guess it's not sad when the bully steals your lunch money every day, since the other 23.5 hours every day are ok.
 
...so I guess it's not sad when the bully steals your lunch money every day, since the other 23.5 hours every day are ok.

If you actually work retail, you understand that if a fill is few days early, it is usually approved by a third party payer. If the fill is early and not covered, the patient pays cash, they just react with some volatility to this situation. Either way, the bully pays my lunch money. All 24 hours are super, but snaps to you for the critical thinking :).
 
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If you actually work retail, you understand that if a fill is few days early, it is usually approved by a third party payer. If the fill is early and not covered, the patient pays cash, they just react with some volatility to this situation. Either way, the bully pays my lunch money. All 24 hours are super, but snaps to you for the critical thinking :).


...and snaps to you for the Sandman/Death avatar. :)
 
Whatever you do, please do not use what school teaches you (i.e Mr Brown, you seem very frustrated. I understand your frustration and *insert solution here*).
 
Just curious but are any of you guys by chance practicing on the West Coast? Lol, i'm an East Coast girl, and a lot of your stories sound familiar. i'm really tired of having a lot of uptight, always in a rush patients. One person today told me he needed his rx ASAP cuz he plays online poker for a living and he's losing thousands of dollars because he's waiting for his prescription (UHH.. OK?!)

One of the reasons I'm actually considering Cali is I hear everyone's pretty laid back (although thats a real general statement) and maybe just MAYBE they're a little more chill? Nice weather perhaps? It might be wishful thinking...
 
One of the reasons I'm actually considering Cali is I hear everyone's pretty laid back (although thats a real general statement) and maybe just MAYBE they're a little more chill? Nice weather perhaps? It might be wishful thinking...

It's definitely not laid back when it comes to prescriptions; but the weather is nice though.
 
NW coast was nice this summer, mellower, but that was in AK, may be too north for you! There definitely was a difference in the population vs. east coast U.S., but I served mostly Native Americans; they were some of the most low-key people.
 
In my best Denis Leary voice:

"Hey idiot--yah you! See the sign there---yah the BIG one that says that this is the drive-THRU, not the drive-WAIT! Move your fat, ugly, stupid carcass out of the drive THRU right now, you eff-ing ***** or I will slap you upside your head for pissing me off!"

That's right---might as well make 'em EARN that gift card...
 
In my best Denis Leary voice:

"Hey idiot--yah you! See the sign there---yah the BIG one that says that this is the drive-THRU, not the drive-WAIT! Move your fat, ugly, stupid carcass out of the drive THRU right now, you eff-ing ***** or I will slap you upside your head for pissing me off!"

That's right---might as well make 'em EARN that gift card...

Once when I was off-duty I actually was in a drive-through line and when they asked me if I could wait in another place I told them "no". I think I'm probably going to hell now...
 
In my best Denis Leary voice:

"Hey idiot--yah you! See the sign there---yah the BIG one that says that this is the drive-THRU, not the drive-WAIT! Move your fat, ugly, stupid carcass out of the drive THRU right now, you eff-ing ***** or I will slap you upside your head for pissing me off!"

That's right---might as well make 'em EARN that gift card...
Ha! :laugh:
 
Once when I was off-duty I actually was in a drive-through line and when they asked me if I could wait in another place I told them "no". I think I'm probably going to hell now...

There's box seats reserved in a SPECIAL h*ll for you, buddy.:)
 
I recommend the book "How to win friends and influence People" of Dale Carnagies. Best classic book in handling those situations.
 
One of the reasons I'm actually considering Cali is I hear everyone's pretty laid back (although thats a real general statement) and maybe just MAYBE they're a little more chill? Nice weather perhaps? It might be wishful thinking...
A few years ago when I was working retail full-time, one of these nice laid back Calis visiting my town (Toronto) screamed obscenities at us because we don't transfer rxs from other countries, and we don't transfer opioid prescriptions at all.

So you've badly broken your arm, and you're in serious pain. Your first step after visiting the ED: hop on an international flight.

One of the important reasons I left retail was I got sick of being a part-time narc.
 
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