Dear Pharmacy Customer

[Sellingmeds]

I work for the pharmacy not your insurance company. I am not your policy holder or your power of attorney therefore I do not know why your copays go up or down. I do not know what your deductible is or what is covered by your insurance company until they either approve or deny it. They won't tell me your personal account information because I am not your power of attorney or your policy holder; they only tell me what I need to know to bill them. I can't correct your information if they have it wrong. At some point you will have to call them yourself. I know that it is unpleasant and that after going through a voice response system that doesn't understand 3/4 of what say you will then end up with a representative in India that also won't understand 3/4 of what you say because I talk them everyday. I feel your pain. By the way, at some time after your enrollment you should get a booklet from the company outlining what is covered, what tiers different brand names are and what they're copays can be and prefered drugs vs. nonprefered. I suggest that you read that before calling us to question why your copay is this and not that. The insurance companies write the rules and set the copays and takes large sums of your money. Truly, you should be informed of what that handbook says. And if you are on Medicaid, then the rules are subject to change mid-month with no warning. Believe me when I say that that irritates us just as much as it does you.

If you want good customer service then HANG UP THE DAMN PHONE! Don't expect me wait on you while you are telling your bff about your latest fight with your boyfriend. Also, don't hand me your greasy nasty cell phone to talk to someone on the other end for you.

Yes, you actually have to have your insurance card with you for us to use it if you've never given it to us before. Shocking I know. If the card says Dental on it, it won't work in the pharmacy. Just saying.

When I give you a price for a medication, it is in American dollars.

No, the doctor's don't listen to us either. I have had a pharmacist refuse to a fill a prescription because the doctor (PA acutally) had grossly overdosed a child and when he was called about it refused to admit his mistake and change the directions. (And it is against the law for the pharmacist to change the prescription without the doctor's consent.)

No, I can not give you a few Percocet, Methadone or Oxycotin to get you through until the doctor writes you a new prescription so don't ask. You are not important enough to go to jail over. Nor is your child so I won't be loaning you a few Concerta or Adderall either.

If you didn't get your prescription filled at my store, don't call me asking why the pill looks different than it did the last time. Seriously, just don't call me.

No, I can't look into the computers of other chain or independent pharmacies to get your insurance information. If I did do so that would be called hacking, and it is frowned upon by law enforcement. Nor can I tell you if your prescription is ready at another store by looking in my computer.

Know your medications and what they are used to treat/prevent. We have access to your profile and can make an educated guess as to what it is you need when you say that you need your little blue pill even if that is all that you know about it. However if you are in the ER at midnight when we are closed, telling them that you take a little blue pill isn't very helpful.

I think that that covers all of the questions that I get asked on a daily basis plus some good advice whether you want it or not.

Good day.

[Just Ace]

Here in OZ most script items are covered by the government but there are a few that aren't. These ones you can claim on your private health insurance - providing you have pharmaceuticals as one of your extras.

Nothing is more annoying then when you ask the customer if they are covered for pharmaceuticals from their private health insurance and all you get back is a blank stare "I don't know????"

WTF

How can you not know what you are paying for everymonth!

What then shits you off even more is that you offer to call the insurance company to find out and you end up sitting on the phone for ages because the insurance company does not have a seperate line for pharmacies/dr/chiro/physio/dentist to call and ask the simple question "Is Mrs. so and so covered?"

People need to take more responsibility and be more aware of things. My word - Its not that hard!

[Trjgul]

No, the doctor's don't listen to us either. I have had a pharmacist refuse to a fill a prescription because the doctor (PA acutally) had grossly overdosed a child and when he was called about it refused to admit his mistake and change the directions. (And it is against the law for the pharmacist to change the prescription without the doctor's consent.)

THAT scares the hell out of me! The clinic on post here is alright, and the pediatricians are excellent, still something good to keep in mind. I hope that pharmacist didn't get in trouble, and that that PA did!

[trailerparkmedic]

Know your medications and what they are used to treat/prevent. We have access to your profile and can make an educated guess as to what it is you need when you say that you need your little blue pill even if that is all that you know about it. However if you are in the ER at midnight when we are closed, telling them that you take a little blue pill isn't very helpful.

THIS THIS THIS THIS THIS THIS

I had a patient recently who had VERY poorly controlled diabetes. "I take some sort of diabetes pill but I don't remember what it looks like or if it is once or twice a day." Well, that explains your blood glucose level of 350 in the ER.

Or, please know what you're allergic to. I went to give a patient an antibiotic and the patient said "I think I'm allergic to that. Well, I'm allergic to some antibiotic and it makes me swell up. But I don't remember which one it is." My professor was with me and I thought the patient was joking at first, like the professor was playing a practical joke on me. The patient was serious.

[Shalom]

THAT scares the hell out of me! The clinic on post here is alright, and the pediatricians are excellent, still something good to keep in mind. I hope that pharmacist didn't get in trouble, and that that PA did!

I've reported such prescribers to their state boards for this kind of shenanigan.

Had one doctor try to give a five-fold overdose of Zantac to a child because he was sure that it was 15 milligrams per teaspoonful, rather than per milliliter. (1tsp = 5ml. Well really 4.93ml, but nobody is ever going to care about that extra 0.07ml, nor be able to measure it outside a lab either.) He wouldn't believe me when I tried to correct him, after all he was a pediatrician, with a whole six weeks of pharmacology under his belt, whereas I was just a lowly pharmacist with three years of it... his tune changed when he finally went and looked it up in his PDR (not my choice of reference for various good reasons, but at least all doctors have one) and found out I was right. He even thanked me (sincerely, not grudgingly) for catching his error, and seemed genuinely relieved that it hadn't gone out as written. If he'd have persisted, though, you bet I'd have blown him in, and not filled the script either.

[Sellingmeds]

My favorite allergy reports are when I'm told that "I'm allergic to those white hydrocodones but not the blue ones." Really? Or I can only take those somas with an M on them.

It's good to know that I'm not the only "drug dealer" on here!

Nothing is more annoying then when you ask the customer if they are covered for pharmaceuticals from their private health insurance and all you get back is a blank stare "I don't know????"

WTF

How can you not know what you are paying for everymonth!

Amen! How do they not know???? The stuff isn't cheap!

[ShinyGreenApple]

My favorite allergy reports are when I'm told that "I'm allergic to those white hydrocodones but not the blue ones." Really? Or I can only take those somas with an M on them.

"I'm allergic to Lortabs and Hyrdrocodone, don't give me those! You can give me Vicodins, though."

Oi.

[KiaKat]

"I'm allergic to Lortabs and Hyrdrocodone, don't give me those! You can give me Vicodins, though."

Oi.

*facedesk*

I'm allergic to opiates. They make me puke, and make my tongue itchy. I'm also allergic to sulfanomides. So I spend half of my first appointments discussing drug sensitivities with docs, and figuring out what else I can take, just in case. *BECAUSE* I'm allergic, I've done the research and I know exactly what alternatives there are. I also know the brand names in addition to the generics.

And I have no sympathy for people who don't have that level of attentiveness to their own health, well-being, and general continued existence.

[Aisling]

In defense of the people in the ER who don't know their medications... being sick and stressed (like most patients of the ER!) does tend to make people confused and forgetful.

This is why everyone in my family has their drug names and dosages listed on cards in their wallet.

[ShinyGreenApple]

The patient in my example had been talking to the pharmacist, and he'd already explained to her three times that Lortabs, Hydrocodone, and Vicodin were the same thing, but she kept telling him that the Vicodin would be ok. I'm sure he wanted to introduce his own face to the counter several times that day.

[Golden Phoenix]

I have an allergy to one particular brand of antihistamines because of an additional ingredient in the pill. (I know what it's called but not if it's a filler, colourant or whatever)

The number of people who have told me i can't possibly be allergic to an antihistamine is downright scary, most of them have been medical professionals prescribing or dispensing them for me.

The reaction to the filler/colour/reservative/whatever is so severe it overrides the (relatively) low dose of antihistamine you find in off the shelf alergy tablets and it will definitely put me in hospital. I dread to think what it would be like if that stuff was in a non-antihistmaine tablet and i took it, the meds must be having at least some effect on the severity of the reaction.

[Shalom]

My favorite allergy reports are when I'm told that "I'm allergic to those white hydrocodones but not the blue ones." Really? Or I can only take those somas with an M on them.

I read about one patient who claimed she was "allergic to generic drugs", so wanted only brand name tablets, and demanded that her insurance company pay for them because she couldn't take the generics. I can see one or two, but every generic drug? Shyeah, right. Every pharmacist around told her she was nuts... until one smart guy finally noticed that every generic drug she'd reacted to, just happened to be blue. Turns out she was allergic to blue dye!

Also, I personally had a customer that wanted us to order in green ferrous sulfate tablets for her, because (she claimed) the red ones we normally stocked gave her a rash. So I started stocking the green tabs instead; what do I care, they're the same price anyway, and nobody ever complained about the green ones.

Regarding the various generics of hydrocodone, if they tell you they want one particular generic, it's usually because they want to sell them. They always want the Watson or Mallinckrodt, because the junkies who buy on the street all recognize the numbers on the tabs and know they're getting what they pay for. (hey, man, you got any 357's?) It was for this reason that in my independent store I would order in uncommon generics like Qualitest or Vintage, because that way the only people who would fill their scripts by me were the ones who were actually taking it for pain relief, and didn't care who manufactured the tablets so long as they worked. (Personally I prefer to avoid Mallinckrodt's tablets because they don't coat them and it tastes awful going down, not to mention the mess of dust they always leave in my counting apparatus, but that's just me.)

Oh yeah, forgot to mention. Generic Darvocet (which was pulled a couple months ago when they finally realized that the only therapeutic effect it ever had was due solely to the acetaminophen content) came in white, pink and orange, all from the same manufacturer. You wouldn't believe how many patients swore that only the pink ones worked. $DEITY help you if the wholesaler was out of that color that week...

Also,

The number of people who have told me i can't possibly be allergic to an antihistamine is downright scary, most of them have been medical professionals prescribing or dispensing them for me.

It is indeed possible to develop an allergy to diphenhydramine itself, if you use it topically; it's a contact sensitizer on prolonged use, somewhat like fabric softeners (to which it's chemically related). This is why I don't recommend Benadryl cream to patients. Use enough of it for long enough, and you might begin to get a rash from it; and then what do you do? Oral diphenhydramine is what you would usually use to relieve such a reaction, but not if you're already allergic to it!

(I also take issue with their advertising, which I believe is misleading. They use the slogan "The Histamine Blocker™", but that's only when taken orally; used topically, it's just another local anæsthetic, no different from benzocaine or pramoxine, and has no antihistaminic effect at all.)

[Setsunaela]

I also am allergic to opiates. Make me puff up and itch.. My little brother has not met an antihistamine he can take, they seem to give him a psychotic breakdown..when he was little he once sat for hours banging his head on the floor and screaming, out of nowhere.

[Sapphire Silk]

I'm allergic to opiates. They make me puke, and make my tongue itchy. I'm also allergic to sulfanomides. <snip>

And I have no sympathy for people who don't have that level of attentiveness to their own health, well-being, and general continued existence.

I'm allergic to hydrocodone (the opiate ingredient in Vicodin, Lortab) and oxycodone (Percocet), as in swelling, rash, tounge swelling, incipient anaphalaxis. I am NOT allergic to any other opiates. I always have to explain this to pharmacists when I fill a prescription for Tylenol #3 (codeine, also an opiate) or when I need Dilaudid in the ER for something (like my kidney stones). I can take Morphine, but it gives me an anxiety reaction (not the same as an allergic reaction).

I makes me uncomfortable sometimes talking to physicians, nurses, and PAs who aren't familiar with me and my weird pharmacological history . . . some of them look at me like I'm a drug seeker.

In defense of the people in the ER who don't know their medications... being sick and stressed (like most patients of the ER!) does tend to make people confused and forgetful.

This is why everyone in my family has their drug names and dosages listed on cards in their wallet.

When I worked in the ER, I encouraged my patients to keep a 3x5 card with all their meds written neatly on it, and to update it at least twice a year. You never know when you might to be able to answer questions about your meds or medical history.

Years ago, my dad got sick with pneumonia and I had to take him to the ER in the middle of the night. I had long since moved out of the house, and happened to be home on a visit when he got sick. He hadn't listened to me when I'd told him earlier to carry a list of his meds in his wallet, so when we made the decision to go to the ER, I had to scoop his med bottles into a bag and run with it. There were a lot of duplicate bottle in there, and Dad had the habit of storing new meds in old bottles. So when the ER doc admitted him, some of the meds were ordered incorrectly, especially his insulin dose (too low). The nurses on the floor had a very difficult time controlling his blood sugar as a result, and the admitting doc wouldn't fix the dose when Dad explained what it was until his regular doctor got back from vacation (he fixed it right away).

After that, Dad kept an up to date med list in his wallet.

I hate it when ER patients hand me a box or bag full of pill bottles. There are so many duplicates and conflicting instructions it can be very difficult to get it all sorted out.

I read about one patient who claimed she was "allergic to generic drugs", <snip> Every pharmacist around told her she was nuts... until one smart guy finally noticed that every generic drug she'd reacted to, just happened to be blue. Turns out she was allergic to blue dye!

I've seen this happen, as well . . . in the hospital, no less. A patient had an allergic reaction to the dye color in the med, which was manufactured by someone other than what they usually got.

Regarding the various generics of hydrocodone, if they tell you they want one particular generic, it's usually because they want to sell them. They always want the Watson or Mallinckrodt, because the junkies who buy on the street all recognize the numbers on the tabs and know they're getting what they pay for. (hey, man, you got any 357's?) It was for this reason that in my independent store I would order in uncommon generics like Qualitest or Vintage, because that way the only people who would fill their scripts by me were the ones who were actually taking it for pain relief, and didn't care who manufactured the tablets so long as they worked. (Personally I prefer to avoid Mallinckrodt's tablets because they don't coat them and it tastes awful going down, not to mention the mess of dust they always leave in my counting apparatus, but that's just me.)

I did not know this! That is very interesting and good to know.

Oh yeah, forgot to mention. Generic Darvocet (which was pulled a couple months ago when they finally realized that the only therapeutic effect it ever had was due solely to the acetaminophen content) came in white, pink and orange, all from the same manufacturer. You wouldn't believe how many patients swore that only the pink ones worked. $DEITY help you if the wholesaler was out of that color that week.

Hmm. I thought they pulled it because of the Tylenol content: 650mg per tablet. Many docs would write for 2 tabs q4-6hrs, which meant each dose would exceed the max safe dose of Tylenol (1 gram) and max daily dose (4 grams).

Brings up an interesting point about the placebo effect, though, doesn't it?

[Jester]

I have been rather lucky with drugs. While I have all kinds of allergies to pollens and stuff like that (though luckily not so much in the warmer climes that I now live in), drugs have never been an issue. I DID once have an allergic reaction to a tetanus shot, but any time I need one, they just give me an alternative (I think) that has the same effect, and everything's fine. (Maybe I had a reaction to something in that brand? I dunno...it was 1986.)

I do have a rather high tolerance to drugs, and that sometimes causes some of them not to work too well. For example, when I shattered my jaw when I was 16, originally they gave me Tylenol with codeine...which had exactly zero effect on me. Seeing clearly the agony I was in, they upped the scrip to Vicodin. And I spent the next three days blissfully looped out of my mind.

On the whole, though, I don't really deal with drugs that much, other than when I'm (rarely) sick. The only drug I take semi-regularly (besides alcohol, of course!) is ibuprofen, for two reasons: hangovers and my jaw, which still occasionally bothers me all these years later, as the doctors at the time told me might happen. So due to the jaw thing, I always have a good-sized bottle of Advil (actually usually generic supermarket versions thereof) in my backpack, and my coworkers often come to me to plead for some if they are hungover or not feeling well. That might sound obnoxious, but I really don't mind, as none of them ever abuses it, and I am happy to make (most of) them feel better.