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- Jun 23, 2003
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So I'm at work, doing my thing, you know, professional tablet slider. It's about 4:30PM
In comes a woman with a script underneath the all too familiar blue piece of oblonged paper everyone on the dole gets. They ask how long and tell me they will come back later. Then the patented "Worst-case-scenario-eva!!" takes place. The infamous "guy on medicaid with a script for non formulary antibiotic that was seen at WVU hospitals by some random PA on a Friday that is just now handing it to you LONG after the prescriber has gone home for the weekend" scenario. The Rx for Widdle Kidd, an infant:
Widdle Kidd - 1/23/05
Ceftin susp 250/5
2.5ml q12h X 10 days
Disp: QS
M. Wacko - P.A.
So using my magical Intern powers, I deduce that she probably has an ear infection based on how flippin' big the dose is for how much I assume she weighs. So I decide to see if Augmentin ES-600 can be billed to medicrap, and, yes, it can. It's about 4:40PM
With my battle plan in order, I call the hospital to start my daunting, epic journey in search of the mythical "competent human being." Oh, they exist, I've talked to them. They are just elusive. Like trying to find an honest used car dealer or a prostitute that isn't really an undercover cop. Trying to find them can lead you down paths of deception and anguish, but when you find a good one, it's like a rush of visceral pleasure. Finding that person that can give you the DEA number of the mystery resident that wrote a Percocet script is equally as rewarding as being named a Rhoades scholor. It's a game. Where's Waldo for the pharmacy set. I just imagine the infectious disease resident I'm probably going to have to talk to wearing a red-and-white striped outfit with a thick pair of black glasses and I'm set. You're mine Waldo.
So I call the number on the PA's script. The first thing I get is the stupid message I have burned into my head I am told they are gone for the day and am directed to the hospitals confusing main telephone system. I've learned that mashing buttons indiscriminately will generally get you a person, so after hitting a combination of 3 and 6 40 times I'm directed to the help line. The person answering the phone is one of those 1st week receptionists. I give her the usual rant and she redirects my call.
After a few rings I get an answer, "Cafeteria. Rob." The ***** redirecting the call obviously screwed that one up. Out of annoyance I acted like I didn't pay attention to his greeting and just started rattling off, "Hi, Mike, Sabraton Pharmacy, I have a script here froma PA down there that I assume is for an otitus media infection, but it isn't formulary on the patients third party, I was wondering if we could discuss a therapeutic substitution." After what I SWEAR was like a solid 10 second pause, the guy just kinda grumbled somthing and hung up. Now it's 4:55 PM.
Square one, nice too see ya again.
I call back and this time I'm connected to the ID resident. After my canned introduction speech I tell her that I'm pretty sure it's otitus and that a good switch would be to Augmentin because it's first line and, more importantly, paid for by my precious tax dollars. She goes to get the chart.
I'm on hold for about 10 minutes counting out Lortab while listening to that damned piano tune they have for their hold music that I can't get out of my frickin head. As I'm waiting one of our 'problem' customers brings in a script for OxyIR and I notice that he is appearently "allergic" to naltrexone because it was added to his profile yesterday. Hahaha. It's 5:10PM
The resident comes back, "The chart just says cough/congestion. I don't know what she has." Using my powers of persuasion (i.e. using big, multi-syllable words) I convince her that it's probably otitus or sinusitis and that she should go with the 90mg/kg Augmentin regimine because it's really awesome......and paid for by medicaid.
So, logically, I ask for a weight. She replies, "I dunno, it's not in here." So I just say, "Ok, fine, how about this, I'll ask the parents the weight, 90 per kg daily over two doses for 10 days, cool?" She then questions me on the otitus being 10 days asserting that it's 5-7. Oi. I'm frickin' looking at my little manual that says 7-10, so without getting into a superiority battle, I just say, "ok, we'll do 7 days, then." I hang up and it's 5:20.
So I'm victorious. I've got a script that will work and all I need is the kid's exact weight.
An hour later, the parents come in to ask me where the medicine is. After getting the kid's weight and confirming it's an ear infection (haha, I was right.), I tell them it's going to be a few more minutes. Then it happened. They just had to say it. That annoying, annoying phrase.
"It's not done yet? I gave it to you two hours ago, how long does it take to put water in a bottle?"
They know they don't have to say, but they do anyway, just because they can. It makes you want to throw a computer monitor at their heads. Or maybe stab them in the carotid with an insulin syringe. Maybe not kill them, but certainly maim them.
I stayed calm. God knows how. I just let my blue coat reconstitute the bottle and ring the guy out. The pharmacist explained that we had to call and get it switched, they didn't really seem it appreciate it. An hour's worth of work and all I get is a bunch of crap. Grrrrrr, I say....grrrrrrr.
In comes a woman with a script underneath the all too familiar blue piece of oblonged paper everyone on the dole gets. They ask how long and tell me they will come back later. Then the patented "Worst-case-scenario-eva!!" takes place. The infamous "guy on medicaid with a script for non formulary antibiotic that was seen at WVU hospitals by some random PA on a Friday that is just now handing it to you LONG after the prescriber has gone home for the weekend" scenario. The Rx for Widdle Kidd, an infant:
Widdle Kidd - 1/23/05
Ceftin susp 250/5
2.5ml q12h X 10 days
Disp: QS
M. Wacko - P.A.
So using my magical Intern powers, I deduce that she probably has an ear infection based on how flippin' big the dose is for how much I assume she weighs. So I decide to see if Augmentin ES-600 can be billed to medicrap, and, yes, it can. It's about 4:40PM
With my battle plan in order, I call the hospital to start my daunting, epic journey in search of the mythical "competent human being." Oh, they exist, I've talked to them. They are just elusive. Like trying to find an honest used car dealer or a prostitute that isn't really an undercover cop. Trying to find them can lead you down paths of deception and anguish, but when you find a good one, it's like a rush of visceral pleasure. Finding that person that can give you the DEA number of the mystery resident that wrote a Percocet script is equally as rewarding as being named a Rhoades scholor. It's a game. Where's Waldo for the pharmacy set. I just imagine the infectious disease resident I'm probably going to have to talk to wearing a red-and-white striped outfit with a thick pair of black glasses and I'm set. You're mine Waldo.
So I call the number on the PA's script. The first thing I get is the stupid message I have burned into my head I am told they are gone for the day and am directed to the hospitals confusing main telephone system. I've learned that mashing buttons indiscriminately will generally get you a person, so after hitting a combination of 3 and 6 40 times I'm directed to the help line. The person answering the phone is one of those 1st week receptionists. I give her the usual rant and she redirects my call.
After a few rings I get an answer, "Cafeteria. Rob." The ***** redirecting the call obviously screwed that one up. Out of annoyance I acted like I didn't pay attention to his greeting and just started rattling off, "Hi, Mike, Sabraton Pharmacy, I have a script here froma PA down there that I assume is for an otitus media infection, but it isn't formulary on the patients third party, I was wondering if we could discuss a therapeutic substitution." After what I SWEAR was like a solid 10 second pause, the guy just kinda grumbled somthing and hung up. Now it's 4:55 PM.
Square one, nice too see ya again.
I call back and this time I'm connected to the ID resident. After my canned introduction speech I tell her that I'm pretty sure it's otitus and that a good switch would be to Augmentin because it's first line and, more importantly, paid for by my precious tax dollars. She goes to get the chart.
I'm on hold for about 10 minutes counting out Lortab while listening to that damned piano tune they have for their hold music that I can't get out of my frickin head. As I'm waiting one of our 'problem' customers brings in a script for OxyIR and I notice that he is appearently "allergic" to naltrexone because it was added to his profile yesterday. Hahaha. It's 5:10PM
The resident comes back, "The chart just says cough/congestion. I don't know what she has." Using my powers of persuasion (i.e. using big, multi-syllable words) I convince her that it's probably otitus or sinusitis and that she should go with the 90mg/kg Augmentin regimine because it's really awesome......and paid for by medicaid.
So, logically, I ask for a weight. She replies, "I dunno, it's not in here." So I just say, "Ok, fine, how about this, I'll ask the parents the weight, 90 per kg daily over two doses for 10 days, cool?" She then questions me on the otitus being 10 days asserting that it's 5-7. Oi. I'm frickin' looking at my little manual that says 7-10, so without getting into a superiority battle, I just say, "ok, we'll do 7 days, then." I hang up and it's 5:20.
So I'm victorious. I've got a script that will work and all I need is the kid's exact weight.
An hour later, the parents come in to ask me where the medicine is. After getting the kid's weight and confirming it's an ear infection (haha, I was right.), I tell them it's going to be a few more minutes. Then it happened. They just had to say it. That annoying, annoying phrase.
"It's not done yet? I gave it to you two hours ago, how long does it take to put water in a bottle?"
They know they don't have to say, but they do anyway, just because they can. It makes you want to throw a computer monitor at their heads. Or maybe stab them in the carotid with an insulin syringe. Maybe not kill them, but certainly maim them.
I stayed calm. God knows how. I just let my blue coat reconstitute the bottle and ring the guy out. The pharmacist explained that we had to call and get it switched, they didn't really seem it appreciate it. An hour's worth of work and all I get is a bunch of crap. Grrrrrr, I say....grrrrrrr.