Things I Learn from My Patients.

[loo]

HIPAA dilemma:

If you shout you need your (insert drug name here) at me before I or my tech gets a chance to wait on you, can I be sued ?

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[loo]

It is not a good idea to gargle with undiluted hydrogen peroxide.

Benadryl cream is for EXTERNAL use only.

It is especially not a good idea to use isopropyl alcohol on diaper rash.

If you can see subcutaneous fat, muscle, or bone...then it is NOT a scratch.

Intense, shooting pain is a sign that you need to definitely need to see your doctor, not take ibuprofen or naproxen for the third day.

 

[loo]

No dentist (unless he/she is an OMS) I know writes for duragesic for a toothache.

 

[loo]

If you are going to make your own blanks on the computer, for god's sake please spell the name of the drug correctly!

 

[loo]

If you tell me "kiss my a$$", I will tell you that is physically impossible.

If you ask me if my "head is up my a$$", I will respond "I already looked and it's not there because it is physically impossible". Who's your daddy, now?

 

[Pilot]

When you want to forge a prescription - don't spell the drug "Mophen". (true story).

Be sure to gripe at the pharmacist about how difficult you find the telephone system to use (press 1 if you are a physician).

 

[Pilot]

Be sure to touch-tone your prescription numerous times for refills. That way the doctor gets several auto-faxes and will certainly refill your prescription more quickly.

 

[loo]

When you want to forge a prescription - don't spell the drug "Mophen". (true story).

Be sure to gripe at the pharmacist about how difficult you find the telephone system to use (press 1 if you are a physician).

I nearly peed myself laughing at that one!!!!

 

[scuba_smitty]

how about the individuals that come in and they are on some type of public assistance and say that they dont have enough to pay for their 50 cent prescription yet by just getting near them you feel like you have smoked two packs of cigarettes...


we had one lady bring in some scrips from an er, that particular er just puts labels on the scrips for the patient id (name,d.o.b.,etc), so she just took off the labels and wrote someones name that had real good insurance on them, when we asked her about it, her excuse was that one of them had gotten wet so she just pulled all of them off...

 

[bananaface]

If you are the ex-husband of one of my co-workers, no I do not want you to ask me out for coffee while I ring up your psych meds.

It is not appropriate to open the bags of adult diapers so that you can try them on in the store.

If a pharmacy in another state owes you 6 tablets, you cannot pick it up from my store while you are on vacation.

I will not page the doctor on call to get you Viagara just because you have a date tonight.

 

[loo]

If you are the ex-husband of one of my co-workers, no I do not want you to ask me out for coffee while I ring up your psych meds.

It is not appropriate to open the bags of adult diapers so that you can try them on in the store.

If a pharmacy in another state owes you 6 tablets, you cannot pick it up from my store while you are on vacation.

OMG--this is the BEST !!!!LOTS and LOTS OF GOOD KARMA FOR YOU!!! Doh. I will give you lots of good karma tomorrow--I'm at my limit.
Excuse me. I must clean up after my "laugh incontinence".

 

[loo]

Law of Opposite Attraction?

Why is it that many men seek out the female pharmacist for "man problems" and many women seek out the male pharmacist for "female problems"?

 

[loo]

When we ask you a specific question...say...are you allergic to sulfa drugs. You should then go into a recap of how your day has been, your entire life history, or anything unrelated to the question just asked of you.

Chiggers are not crotch critters. They are summer camping critters.

You should never be embarrassed or ashamed that you have head lice. You should be embarrassed that you used gasoline to treat it.

For the last time...ringworm is not a worm.

 

[Ivorymist]

In a hospital pharmacy, a first year med-intern writes for Zosyn 4.5 q3hrs for a patient. You call him telling him that's too often and suggest q6hrs. He says that "oh that's cool too I guess."

Wow.

 

[Ivorymist]

Wait, that would be "things I learn from my doctors." Let's try this...

Outside a hospital, a guy walks around and sees you. He tugs on your coat and asks you if there's anything you can give him for this radiating chest pain he's feeling right now. I just pointed to the ER.

 

[spacecowgirl]

Ivorymist - maybe we need to start a separate thread for what we've learned from Dr's because I've got those too. That's a hella big dose of Zosyn! Pseudomembranous colitis anyone?

Loo "You should never be embarrassed or ashamed that you have head lice. You should be embarrassed that you used gasoline to treat it." You crack me up to no end!!!!

 

[Ivorymist]

I know! That's a whole lot of Zosyn...

You know what that's a good idea. I'm gonna start a new thread.

 

[MNnaloxone]

Zyprexa is a perfectly fine candidate for prn usage. So is nadolol 40 mg.

"Did my warfarin go through workers comp?" WTF?!

When you complain of ulcers, there is no OTC medication that I will recommend when I discover that you are passing blood in your stool. Honest. You should take my recommendation to go to a doctor. Sooner rather than later.

Super glue works great for repairing broken teeth when you are too cheap to get into your Land Rover and call your dentist on the weekend. However, a hot glue gun just may work better.

If the doctor forgets to write a strength on your Zoloft Rx, and you've never filled it here, it is perfectly ok for me to fill it with the strength you say is correct (20 mg). (BTW-it was 50.)

As for only taking a minute to put pills in a vial, you are certainly correct in your estimation. However, putting the CORRECT pills in the vial is the trick. I'd be happy to grab the first bottle I can reach and fill your RX with it if you'll sign the waiver.

Don't get snippy with me when you are on vacation, forgot your meds, and can't even give me the phone number of your pharmacy or your doctor, or can even give me the physicians complete last name so that I can try to help. I have better things to do (like wait on hold for 45 mins for a copy from Express Scripts mail-order for the idiot waiting behind you).

No, your insurance will not cover meds that you are buying in Canada.

My in-window, although it looks wide and inviting, is not your desk to empty your purse on.

When my in-window is closed because I am short help, and the sign is asking you to go to the next window, do not knock on the glass to get my attention. I will just point to the damn sign.

I went to school for 9 years to get where I am. If I wanted to work in the insurance business and know their MOA, I could have just dropped out early.

When your wife sends you to the pharmacy with a Bactrim or a Diflucan Rx at 10AM, the correct thing to do is wait for them. The incorrect thing to do is tell me that you'll be back around 8PM to pick them up (I'll probably see you back in an hour, anyway).

If your doctor wrote for it, it must be covered by your insurance. If this were true, I'd have my doctor write me a prescription for a 1970 Plymouth Superbird, oral sex, and rocky road ice cream. All three of these things cheer me up when I am depressed, so they are necessary. (BTW-Senna is in aisle 8, and multivitamins with iron are just to my left).

Realization of the week-trying to make a Prevacid suspension more palatable is a nice thing to do. But it probably doesn't matter is the directions include the phrase "G-tube". That was 20 minutes wasted.

Everyday we all can come home and bitch about how horrible retail pharmacy is. However, it is not every job that can give us stories. Retail sure beats anything to do with a forklift or a 10-key numerical pad.

 

[MNnaloxone]

Don't forget "Well, it might have been under my wife's maiden name, and sometimes she uses her middle name as her first name. Of course it could also be under her old married name, and possibly with her middle name as her first for that last name too. Oh, and I think she sometimes hyphenates them.... ...what do you mean you're having trouble finding it?! I think we've been here before!!"

My fiancee is a pharmacist as well. I told her that when me get married, that I wasn't too hung up on her taking my last name. After all, she earned her professional degree and has started her profession with her maiden name. She paused and said she would have to ponder on it. However, she immediately made me promise her one thing-

That our children would not be 'hyphens'. Only from a pharmacist, I tell ya.

 

[LVPharm]

Men have a predilection for ?self-treatment? that defies common sense.

Example:
Patient comes up to the window asking if there is anything he can buy for his painful right ear (he says it "feels full, like it has water in it"). His ear canal is inflamed, it?s almost completely closed, and there is a purulent discharge (looks like otitis externa). I tell him to go see his physician, that it?s infected and there?s nothing we sell OTC that can help him.
30 minutes pass:
He comes back holding up a bottle of a swimmer?s ear product saying that he used it and his ear is now burning. WTF?

 

[jdpharmd?]

If your doctor wrote for it, it must be covered by your insurance. If this were true, I'd have my doctor write me a prescription for a 1970 Plymouth Superbird, oral sex, and rocky road ice cream. All three of these things cheer me up when I am depressed, so they are necessary. (BTW-Senna is in aisle 8, and multivitamins with iron are just to my left).

Everyday we all can come home and bitch about how horrible retail pharmacy is. However, it is not every job that can give us stories. Retail sure beats anything to do with a forklift or a 10-key numerical pad.

To expand on the "if my doctor wrote for it, it must be covered":

JD: Sir, your insurance doesn't cover this particular medication. The cash price is 19.95 if you'd like to pay for it, or you can call your doctor to have your prescription changed to something that your insurance will pay for.

Pt: What's that supposed to mean?

JD: (Ummm, I think that I pretty much covered that )

 

[GravyRPH]

Oh dagnabbit, I have to join in.

If an elderly prison chaplain asks you weekly what's good to kill a large dog, don't help him with the rat poisons, because you may see his picture in the paper for trying help euthanize prisoners.

When asking patients with english as their second language questions, it may help to get a translator or you might not get the answers you'd like. For instance, California med-cal only covers Valium in cerebral palsy or spinal cord degeneration. Me to patient: "Do you have either condition?" Her: "No. I have Medi-cal." *sighs*

It is not necessary to describe the size or consistency of your stools to your pharmacist when filling a laxative prescription.

 

[bananaface]

As for only taking a minute to put pills in a vial, you are certainly correct in your estimation. However, putting the CORRECT pills in the vial is the trick. I'd be happy to grab the first bottle I can reach and fill your RX with it if you'll sign the waiver.

Oooh. The bisacodyl is really close to me......

 

[bananaface]

Why do people as their pharmacists if they can save money by going to mail order or Canada? It's like going to a regular grocery store and asking if you can save money by shopping for groceries at Costco or calling up your long distance company and asking them if it would be cheaper to discontinue service and use calling cards.

And, why do they come to a retail pharamcy without a prescription wanting free drugs when their mail order did not arrive on time?

 

[jdpharmd?]

And, why do they come to a retail pharamcy without a prescription wanting free drugs when their mail order did not arrive on time?

Because we give it to them... because we have a sense of responsibility and provide service to our community. (I think THAT is where we went wrong and the PBMs/drug companies started to make a zillion dollars. )

 

[Pilot]

Yes, I do have an attorney who will defend me if I don't refill your expired Albuterol inhaler prescription on Saturday and you end up in an ER.

Yes, the same attorney will represent me at the Board of Pharmacy for "unprofessional conduct" for refusing to break the law for you.

No, I will not lose sleep over this incident tonight.


PS. I will give a 1 day supply of BP meds if necessary. I don't want a stroke on my conscience.

 

[group_theory]

When you get a new insurance card, make sure you keep it a secret. The pharmacist would rather phone your old company to find out why your Rx is being rejected.

OR

Make sure you save all your old insurance cards. One of pharmacists' favorite games is to guess which one is current.

 

[DocRx]

When you come into the pharmacy don't ask me to order you 100 boxes of cold medicine and expect me not to notify the police.

The next day after he left his name and phone number we "called him" so he could pick them up and the police took him down right in the store. He was making Meth.

Great thread keep it up.

 

[jdpharmd?]

Make sure you deny or lie about any potentially useful informationt that you (could) provide to us:

For instance, the answer to "do you have any allergies to drugs?" is "nahhh", regardless of your real allergies.. after all, you might not get that vicodin if you have a codeine allergy.

If you have new insurance, it's best to maintain that "nothing has changed" and it's "ridiculous" and "happens every time". Continue to re-state that "it's all the same as last moth" until I actually call the insurance company and they tell me that you have switched to COBRA and a different plan as of yesterday. When I ask about this, it's ok to reply "well, yeah I changed that, but I think it's still the same COMPANY"

 

[Sukie]

When you get a new insurance card, make sure you keep it a secret. The pharmacist would rather phone your old company to find out why your Rx is being rejected.

OR

Make sure you save all your old insurance cards. One of pharmacists' favorite games is to guess which one is current.

Haha... SO true!

This thread is so much fun!

 

[loo]

It is not necessary to describe the size or consistency of your stools to your pharmacist when filling a laxative prescription.

Welcome back, Gravy!

 

[loo]

Zyprexa is a perfectly fine candidate for prn usage. So is nadolol 40 mg.

Super glue works great for repairing broken teeth when you are too cheap to get into your Land Rover and call your dentist on the weekend. However, a hot glue gun just may work better.

If the doctor forgets to write a strength on your Zoloft Rx, and you've never filled it here, it is perfectly ok for me to fill it with the strength you say is correct (20 mg). (BTW-it was 50.)

My in-window, although it looks wide and inviting, is not your desk to empty your purse on.


.

HILARIOUS!!!!!!!! Keep it coming! Addendum to the window: It is not a seat for your child with the poopy diaper. laugh:

 

[spacecowgirl]

When you get a new insurance card, make sure you keep it a secret. The pharmacist would rather phone your old company to find out why your Rx is being rejected.

OR

Make sure you save all your old insurance cards. One of pharmacists' favorite games is to guess which one is current.

Yes, yes! this is my favorite game too! In fact, I like to turn them over and try to pick matching pairs like "Memory" hummm....Cigna - BCBS - d'oh! Medco - Medco - score! hey wait...this is an office visit card. damn

I also revel in the time I spend listening to elevator music while waiting for an insurance company to tell me the person's coverage expired in 1998.

 

[spacecowgirl]

Just wondering what a pharm does in a situation like this? Do pharms have the power to confiscate prescriptions from drug-seekers in a situation like this?

Tear 'em up. Or if you don't feel comfortable with that, write your store name, your initials and "refused to fill" and the date with a red Sharpie.

 

[loo]

I also revel in the time I spend listening to elevator music while waiting for an insurance company to tell me the person's coverage expired in 1998.

Yup, I know the world's going to hell in a handbasket when I'm forced to hear the Muzak version of any Bob Marley and the Wailers song or "Loving You--Is Easy Cause Yer Beautiful"

la-la-la-la-la, la-la-la-la-la...*retching noise*

 

[loo]

It is 8:55 PM. The pharmacy closes at 9:00 PM. The phone rings.

Me: So-n-So phamacy, may I help you?
Pt: What time do you close? (8:56 PM)
Me: 9:00 PM.
Pt: Can I still get a prescription filled? (8:57 PM)
Me: If you are here before 9 PM...(8:58 PM)
Pt: My watch says ten of 9... I only live 10 minutes away. Can you wait for me? (8:59 PM)

 

[loo]

If you are a drug-seeking, script forging, lying putz:

Think of me as a teenage girl who's just been told a secret...

By the time you walk into the next pharmacy, the RPh on duty already knows about you!

Word to the wise: Do your "shopping" outside a 25-mile radius of my store. Or better yet, another state.

 

[spacecowgirl]

If you are a drug-seeking, script forging, lying putz:
By the time you walk into the next pharmacy, the RPh on duty already knows about you!

It's called a fax machine - comes in handy for sending out alerts

 

[Apollyon]

It's called a fax machine - comes in handy for sending out alerts

I thought HIPAA had kicked this to the curb.

 

[loo]

ILLEGAL activity (confirmed by MD) doesn't qualify as PHI. I usually call rather than fax, other pharmacies.

 

[bananaface]

It's called a fax machine - comes in handy for sending out alerts

I had a patient who asked me not to tell her PCP that she was getting narcs from 1 of the her other doctors, even though one had a pain contract with the PCP. She tried to use HIPPA as an excuse but got shut down. I told her that I was bound to answer any medically pertinent questions by her PCP - which I am. HIPPA was never meant to block information from those who need it to provide quality medical care.

Preventing a patient from being able to engage in drug-seeking behavior is part of good patient care, regardless of the patient's feeling on it. So out go my hotline reports.

Lesson: Don't expect the me to conspire with you in your drug-seeking scheme. I am not an idiot.

 

[MNnaloxone]

When asking questions about how your insurance co-pay works and you are forced to believe either me, an employee of 5 years, or a "crazy lady" that "I gave a ride home to last month", always choose the crazy lady.

Please, shop your co-pay around. And don't come back.

(Motion to make the 'pimp-slap' a medically acceptable practice. Any seconds?)

 

[loo]

I second that.

 

[Jenita143]

"Sir, I am going to need your original prescription"

"I lost it, but I already faxed it to you"

"Yes, but we still need the original. We cannot process this prescription for you unless we have the original"

"I faxed it to you. See, its right there. I can tell you the phone number of the fax machine"

"I'm sorry, we still need the ORIGINAL prescription"

:Searches through piles of cards in wallet:

"I don't have it!! LET ME TALK TO YOUR MANAGER! GIVE ME HIS BUSINESS CARD. I ALSO WANT THE ALL OF YOUR NAMES! I'M GOING TO SUE YOU GUYS IF MY MOTHER DIES OF A HEART ATTACK!"

:Storms out.......:
:5 minutes later:

"I found the prescription"

(prescription is not even for her heart condition)

 

[jdpharmd?]

Patient: "My friend went to pharmacy school too!"
Pharmacist: "That's great, which school did he graduate from?"
Patient: "Umm, that one on TV where you mail away for everything and you're done in like 8 weeks"
Pharmacist: "Umm, Great"

 

[GravyRPH]

It's impossible to say with a straight face to an insurance company the diagnosis for 8 oxycontin 80's a day is "Radiculitis".

 

[Apollyon]

ILLEGAL activity (confirmed by MD) doesn't qualify as PHI. I usually call rather than fax, other pharmacies.

Ah, I see. I was looking at it from the hospital perspective - you can't fax the name and info of a "professional patient" to all ED's, since they haven't committed a crime yet.

 

[loo]

If I tell you that I do not have Duragesic 50 mcg, please do not ask me what other strengths I have in stock so you can ask your doctor to write for that instead!

 

[Pilot]

If you are a nurse, don't leave a new prescription for Percocet on the voice mail, and forget to give the strength, DEA number, or phone number of the physician. Then, if you are the doctor, don't be mad that I called your answering service to advise you that legally I cannot accept a phone prescription for Percocet (and no, I will not accept an "emergency" C2 prescription).

Another one from a physician - if you wrote the prescription wrong (wrote QD instead of BID) 2 weeks ago and just discovered your error, don't expect me to give the patient the difference because the insurance company will not pay. The doctor actually told me it was my responsibility to insure the patient received the proper amount of medication regardless of who committed the mistake. I told her the patient could receive the difference, as long as someone paid for the remainder. Suprisingly, she didn't offer to do so.

Both of these situations happened to me yesterday.

 

[loo]

Another one from a physician - if you wrote the prescription wrong (wrote QD instead of BID) 2 weeks ago and just discovered your error, don't expect me to give the patient the difference because the insurance company will not pay. The doctor actually told me it was my responsibility to insure the patient received the proper amount of medication regardless of who committed the mistake. I told her the patient could receive the difference, as long as someone paid for the remainder. Suprisingly, she didn't offer to do so.

What a lazy, arrogant, piece of poop! I'd tell the patient that they should go back to that doctor and demand a refund!