DEAR THYROID^TM

Hello my loves!

This week I am focusing on something central to any chronically ill patients life, the pharmacy experience.  If you use medications on any regular basis, building a relationship with a pharmacy and getting to know the pharmacists within is a great way to ensure your well being.

It took me a few years to realize something important. When we are paying for our medications, just as when we are in our physician’s office, WE ARE NOT CUSTOMERS, we are patients.  This gets confusing as so many pharmacies are located in grocery stores and have chewing gum and candy bars heaped up the sides of their windows.  However, the latin term for patient is “one who suffers,” perhaps from illness, a disease, or from pain. That sums basically ever chronically ill person I know. Customers purchase products and are even sometimes swindled, they are also gamed by marketers. Patients, on the other hand, are involved in HEALTHCARE. Your pharmacist is a healthcare provider and a professional even if they or the world forgets this.

Unfortunately, like ALL medical bullshittery, systems break down in a pharmacy just like they do in hospitals and medical offices and in every aspect of life.  The combination of annoying red-tape clusterfuckery of insurance companies, doctors doing stupid things (like writing prescriptions that might even kill a patient if they are combined), and working with crappy burnt-out colleagues is difficult. Layer that with dealing with people who have classic bad manners, who don’t use common courtesies such as, “please or thank you,” and watching their favorite patients perhaps get sicker, takes the stress even higher. And worse, pharmacists also deal with criminals who try to use stolen prescriptions or try to to scam illegal medications from them.  This makes them often tired, angry, irritated, and snarky when all they wanted was to be a professional.

When we go in with our prescriptions we want a well-oiled machine. We want our drugs and we want them quickly.  However, there is a down side to “fast” medicine. Even pizza companies no longer promise “super dooper fast on time” pizzas because it caused so many accidents and the orders weren’t getting to people correctly.  Oh crap, I wanted double cheese and got triple pepperoni.  If pizza corporations realized that the problems caused by fast pizzas weren’t worth the trouble, how on earth are “fast drugs” that can cause life or death interactions be a good thing for people who are already sick and relying on medications to get healthy or maintain their health?

Yet frequently we’ll see 15 minute promises for drugs, as though pharmacy staff are producing magic tricks instead of quality healthcare. I don’t want “super dooper fast drugs.” I want my medications to be timely, what I was prescribed, and not contraindicated for my current medications or my health. THAT is what your pharmacist is doing in addition to their other professional duties. (I would vehemently warn anyone to stay away from super fast places or places where staff is routinely unprofessional, rude, or dismissive.)

One LR pharmacist said it the best. “Patients shouldn’t receive meds from chaos.”

Years ago I knew I was at the right pharmacy when I went in to procure an over the counter medication (OTC) late at night. I never expected the pharmacist to assist. Until this day I had always received generic, bland, “name, birthdate, here’s your drugs” kind of care.  On this specific day everything changed. A young woman pharmacist in her winter coat, clutching her purse and getting ready to go home for the evening looked at me and said, “What are you looking for?” I was SHOCKED that she would help me with something as trivial as an OTC med ESPECIALLY on her way out the door! I told her and she found a generic equivalent that was much less expensive and told me how to use it effectively.  She was in no rush.  She wasn’t even the boss or the manager! I paid for my medication and home I went.

The next day I went back and transferred all my drugs even though a few of the medications were slightly higher in price (because they weren’t a super store chain discount) I always felt I was getting a great deal in the service because they techs were lovely and both pharmacist who worked gave me individualized attention. When my medications were ready they would give me a personal call. And I had my “own tech” who would deal with my insurance snafus and take care of me. He’d even take me aside and let me paw through my meds bottles individually to make sure they were all there and to make sure they were all accurate as my doses frequently change and sometimes I would catch mistakes.

My favorite pharmacist also caught a huge mistake once by a doctor.  She refused to give me the prescription and said, “This will kill you. This is a deadly combination and I’m surprised he even prescribed this considering he KNOWS you are already on several contraindicated medications.”

She contacted his office. But what she did that day was save my life. It also helped that I used ONE pharmacy for all my drugs. And I kept my pharmacy and all my doctors constantly apprised of all my medications and changes, if something changed, I let each of them know. If she hadn’t known or if I had used multiple pharmacies because of financial issues it would have been doubly important to give her an updated list of all my meds each time I filled my prescriptions.  This solidified in me that good pharmacists are unheralded heroes.

Most retail pharmacists have told me that their job is difficult.  “They don’t prepare you for it in pharmacy school.”

“Pharmacy is the perfect storm of science, customer service, time management, and just tenacity in a sea of sick, anger and red tape.” TAP

Again and again pharmacists and techs repeat that they would simply like a thank you. Most of us would like that. Most of us would like to be recognized for what we’re going through. I’ve said repeatedly that WE ARE ALL IN THIS TOGETHER.  But how can we be in this together if we’re disengaged and not recognizing the people who are on our side?

Granted, if you have an unkind pharmacist and techs who are NOT helping build a relationship and don’t seem to care about you, perhaps it is time to shop for a new pharmacy.  But first, are we willing to do OUR work?  Are we willing to make sure prescriptions are filled, keep track and call in before they run out, act pleasant at the counter even on our shittiest day? Are we willing to use one pharmacy (or if we financially cannot, are we willing to at least take updated medical lists with our birthdate, name listing EVERY medication we are currently prescribed as well as those we MIGHT take as needed (prn), even our vitamins and over the counters at home)?  If we are – we might be shocked at how much work a pharmacist can do for us.

Instead of filling our dozen prescriptions throughout the month, they can often get them sorted to pick up once or twice a month using prior authorizations.  A good tech and pharmacist are like magic.  A bad one is lazy and will lie and tell you there is nothing they can do.  I often say, “I prefer to pick up my meds in one trip or in as few times as possible per month, how can I make this happen?” My current pharmacist got them all moved to ONE trip. Like magic!

My former lazy burnt out pharmacist had me going to the pharmacy 8 times a month. “Sorry, your insurance won’t let me over ride. There’s just nothing can be done. If YOU want to call and deal with it YOU CAN.”

Another pharmacist told me that for NEW medications that you have no experience with you should always consider a consultation. One pharmacist explained, “Consultations catch mistakes. Made by RPh [pharmacist] or MD.” Of this consultation, they explained, “ideally they should be held in a private-ish area that allows some privacy. A consultation should look like a 2 way conversation of patient to professional. It would look less embarrassing and waste of time if more consults happening.” CP

If your pharmacist is acting like a consult is annoying them over NEW medications or simply hands you paper and doesn’t discuss side effects or possible contraindications with you, you might need a NEW pharmacist.  You want to build a good relationship with one who REALLY wants to be a community pharmacist and WORK with you.

The best advice one pharmacist wants you to know is this: I’m surrounded by shell shocked patients when it comes to insurance. Get a copy of their formulary. Insurance companies should provide. Oh, yeah, and give the techs a break as well.” CP

For what it’s worth- I bring my techs chocolate and candy and ask them to call me by my first name because we joke and get along. Working with the techs is some of the best part of the experience for me. I enjoy them even MORE than my pharmacist because they are who I see more often. They are the “go between” between my insurance and me and they tend to know when I’m having a bad day.

Once my favorite tech said, “I know many people who pick up the same drugs you pick up and they are never smiling or joking like you.” I said, “I make the effort for you because you make the effort for me.” And I gave him a fist bump.  It’s the little things. They KNOW how sick we are. They KNOW our diseases because they fill prescriptions for the chronically ill all day. If we go out of the way to lighten their loads a bit, they generally move the sun and stars for us when we need them.  For instance, when I need early re-fills, or if I get opiate meds they don’t think I’m a drug seeker, or if I drop pills like a dork I have NEVER had a problem with them because they KNOW ME.  Building a relationship COUNTS.  With an unknown pharmacy, even if its their job, it is hit or miss.

If patients are cursing and screaming (which happens –stand back- watch), it makes it harder to want to help. Of this CP says, “The pharmacist is your Specialist in drugs. Ask us your questions! Be honest. Be nice. Be patient. It’s YOU we are trying to help. The biggest mistake is NOT taking full advantage of the pharmacist’s expertise.”

However, I also hold them to a far higher standard than most people. I don’t accept anything but the most outstanding treatment from my pharmacy and I also want real relationships and an investment to community health.

What do you think? Do you give much thought to your pharmacist and staff? How has your pharmacy contributed or detracted from your health?  Does having an engaged pharmacist who cares about your health work in your favor?  Do you feel judged by your pharmacist?  Do you hide the drugs you’re on or change pharmacies for coupons or to save money? Is this an investment in your health or because you honestly cannot afford to live otherwise? I’m very interested in this often overlooked aspect of health. Does it matter at all? Tell me! I must know!

I will miss you for one week. I am on a trip to see specialists! I will see you same time in two weeks! Kiss kiss!

-Melissa

Tags: ask your pharmacist questions Experience, chronic illness relationships with pharmacists, Chronic Snarkopolist: A Good Pharmacy, how pharmacists help chronic patients, pharmacists are healthcare providers, pharmacists are helpful

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