This man comes into the pharmacy with a script for Tegretol. It was his first time. After a bit of counselling, I asked him what he is using it for - he then tells me his life story.
Him: "You know, I think I got it this time. I've been on heaps of meds for the past few years and none of them seemed to work. I searched online and all the symptoms match. Trigeminal Neuralgia. You know what that is??"
Me: "Yes i do. That's nerve pain. Did the doctor say you have that?"
Him: "Well i spoke to the doctor, I printed out all the information and I showed it to him. He thinks it also Trigeminal Neuralgia. So I'm pretty confident that it will work this time after all this research."
Me: "Oh so the doctor didn't really diagnose you with that, his just guessing because you told him so? Errzzz, i think if your GP is not sure, he should at least give you a referral to see a neurologist. At least they can give you a proper diagnosis."
Him: "Trust me I've seen all those specialists. And NONE of them knew what it was. Put me on all these different medicines and none of them work. But after my research, sometimes the internet has all the answers for you."
Me: "You can't always trust the information you find on the internet sir. I mean each person is different. A specialist will give you a proper diagnosis. You're just guessing here.....
Him: "Look you don't know what Trigeminal Neuralgia is!!! You obviously don't see people with that condition here."
Me: "Err actually I do. Nerve pain is a pretty common thing. I can tell you for sure you are not the only person, and usually its not that hard to diagnose. If your GP and specialist couldn't even diagnose nerve pain in the first place then that's pretty unusual. And also Tegretol is NOT the only medicine for nerve pain you know. You know that there are other medications right?"
Him: Oh what other medicines? Anything better than Tegretol?
Me: Possibly. But there's a few on the market. I'm not even sure that you have nerve pain. You and your doctor seems to be just guessing and just trying to see if Tegretol works. So I'm not gonna recommend you something for a condition that you don't even know you have.
Him: I do have trigeminal neuralgia!
Me: Ok if you think so. I guess all i can say is that its unfortunate that your doctor and specialist couldn't help you in the first place that you had to resort to the internet to do your own research.
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Poor guy. Wikipedia is his doctor. And honestly, I find it hard to believe that NO doctor diagnosed him with TN???? Its pretty common. And why would a GP write someone a script for Tegretol based on the papers the patient printed out from the internet? That's a bit unprofessional don't you think? To keep your patients happy? He should at least referred him to a specialist perhaps!
Monday, 29 April 2013
Saturday, 6 April 2013
Trust the doctor but don't trust the pharmacist
This doctor, who we have a good relationship with, wrote Valium 2mg on the prescription. This doctor has previously given us authority to dispense generics with his scripts. He actually prefers the generic brand but doesn't know the name of them, so has told us to just give the generics with his scripts.
Ok so I dispense it and explained to the patient what its for and how to take it. He comes back 20min later saying I gave him a substituted brand without telling him.
I tell him its the same as what the doctor has written. The doctor has given us prior authority to dispense generic brand coz that's what the doctor prefers.
He doesn't believe me. He says I MUST give the brand that the doctor wrote on the script. Farout but lucky me the doctor happened to walk past the pharmacy at the time, I pulled him over and asked him to confirm with the patient that its the same as Valium. Doctor said yes.
Patient was satisfied and accepted it. So after I thanked the doctor, I told the patient there is nothing to worry about because we know the dr and we have given the brand that he prefers. Patient goes I should've told him coz patients won't know. I said I didn't want to confuse him so I said ill tell you next time then.
Trust the doctor but don't trust the pharmacist.
Honestly, the doctor only said yes because I told him to. He didn't actually know what the active ingredient of Antenex is. LOL
I could of given him Alepam and said it was the same as Valium, he would of believed me.
Some doctors trust pharmacists, but not all patients do.
Ok so I dispense it and explained to the patient what its for and how to take it. He comes back 20min later saying I gave him a substituted brand without telling him.
I tell him its the same as what the doctor has written. The doctor has given us prior authority to dispense generic brand coz that's what the doctor prefers.
He doesn't believe me. He says I MUST give the brand that the doctor wrote on the script. Farout but lucky me the doctor happened to walk past the pharmacy at the time, I pulled him over and asked him to confirm with the patient that its the same as Valium. Doctor said yes.
Patient was satisfied and accepted it. So after I thanked the doctor, I told the patient there is nothing to worry about because we know the dr and we have given the brand that he prefers. Patient goes I should've told him coz patients won't know. I said I didn't want to confuse him so I said ill tell you next time then.
Trust the doctor but don't trust the pharmacist.
Honestly, the doctor only said yes because I told him to. He didn't actually know what the active ingredient of Antenex is. LOL
I could of given him Alepam and said it was the same as Valium, he would of believed me.
Some doctors trust pharmacists, but not all patients do.
Boostrix-IPV mate
Patient comes in with script for Boostix-IPV .. which is whooping cough, diphtheria, tetanus and polio vaccine. Price was about $70.... he yelled at me. Then his mother next to him said she got it for $40....."You overcharged me!" I showed her the box and said was that what you bought? "I don't remember."
I explained to the patient it has 4 things in there so that's why its a bit more expensive. The one without the polio is about $40.
He goes back to the doctor and changes it to Boostrix which is about $40.
Now what did I do wrong, got yelled out for overcharging a customer? Boostrix-IPV is more expensive than normal Boostrix coz of the polio component. The doctor prescribed a different one from what your mother got last time, I dispensed it. I'm not gonna question the doctor whether or not you need the polio component or not.
And for the record, no I didn't get an apology.
In some other cases I've had in the past, if the doctor wrote Boostrix-IPV, and I dispensed it, then the patient comes back 2 days later and wants an exchange for the Boostrix because the doctor wrote the wrong one - well then tough cookies, no exchange for fridge items such as vaccines because I can't resell that - how do i know you stored it correctly? its temp-sensitive. and secondly, its not my fault. The fault lies within the doctor. The doctor wrote an incorrect item. We dispense accordingly. Now i know some of these vaccines are quite expensive - what your doctor should've done was think carefully before printing out that prescription from their computer. If you want to recoup your lost money, maybe consider it dealing that with your doctor. You can try and ask him to pay for it. Because the pharmacy is NOT going to suffer the losses for your doctor's mistake.
They get so upset when I say that lol. But its true! We are not responsible for doctors' mistakes! Some doctors just close their eyes and just pick any random name from their list of medicines without realising what it is. Some doctors often mistaken BOOSTRIX-IPV with BOOSTRIX. That's a prescribing error just like how pharmacists have their dispensing errors. Watch out doctors.
I explained to the patient it has 4 things in there so that's why its a bit more expensive. The one without the polio is about $40.
He goes back to the doctor and changes it to Boostrix which is about $40.
Now what did I do wrong, got yelled out for overcharging a customer? Boostrix-IPV is more expensive than normal Boostrix coz of the polio component. The doctor prescribed a different one from what your mother got last time, I dispensed it. I'm not gonna question the doctor whether or not you need the polio component or not.
And for the record, no I didn't get an apology.
In some other cases I've had in the past, if the doctor wrote Boostrix-IPV, and I dispensed it, then the patient comes back 2 days later and wants an exchange for the Boostrix because the doctor wrote the wrong one - well then tough cookies, no exchange for fridge items such as vaccines because I can't resell that - how do i know you stored it correctly? its temp-sensitive. and secondly, its not my fault. The fault lies within the doctor. The doctor wrote an incorrect item. We dispense accordingly. Now i know some of these vaccines are quite expensive - what your doctor should've done was think carefully before printing out that prescription from their computer. If you want to recoup your lost money, maybe consider it dealing that with your doctor. You can try and ask him to pay for it. Because the pharmacy is NOT going to suffer the losses for your doctor's mistake.
They get so upset when I say that lol. But its true! We are not responsible for doctors' mistakes! Some doctors just close their eyes and just pick any random name from their list of medicines without realising what it is. Some doctors often mistaken BOOSTRIX-IPV with BOOSTRIX. That's a prescribing error just like how pharmacists have their dispensing errors. Watch out doctors.
Pharmacist advice or the customer's advice?
I don't understand why people come into the pharmacy and ask for my advice when they don't want to hear it. This guy comes into the pharmacy asking for cold and flu tablets.
symptoms: runny nose, watery eyes, sore throat.
So I give him an antihistamine + anti-inflammatory. He says he has Claratyne at home which hasn't helped so he prefers cold and flu tablets.
He doesn't have a cough or fever.
How is that a cold and flu?
So I explain to him how each product works. He still insists on the cold and flu tablets.
Fine. If that's what you wanted in the first place, then why did you have to ask me for my advice? You could of picked it off the shelf, took it to the counter and paid for it. No questions asked. But you asked me, so I gave you a better option.
Eventually he purchased what I gave him instead.
symptoms: runny nose, watery eyes, sore throat.
So I give him an antihistamine + anti-inflammatory. He says he has Claratyne at home which hasn't helped so he prefers cold and flu tablets.
He doesn't have a cough or fever.
How is that a cold and flu?
So I explain to him how each product works. He still insists on the cold and flu tablets.
Fine. If that's what you wanted in the first place, then why did you have to ask me for my advice? You could of picked it off the shelf, took it to the counter and paid for it. No questions asked. But you asked me, so I gave you a better option.
Eventually he purchased what I gave him instead.
Do not feel threatened by regular customers' unreasonable requests
The problem with pharmacy is you have a big pool of regular customers and you try and help them in all ways possible. You do not want to upset them. But some customers use this to their advantage and threaten the pharmacist to do things they shouldn't do.
Getting Owings
Legally we're not suppose to give the whole box of medications if they patient doesn't have a script. Part supply but for convenience, pharmacies do that. So this man, regular customer, comes in to pick up his meds. We already gave him an owing (owings for 3 medications) last month but he still hasn't returned the script. We seriously can't give him any. We told him he needs to bring a script. He said he will, just give him the meds first and he'll bring the script after.
Now from his records, he hasn't returned scripts yet. We don't trust him to bring the scripts back so no way we're gonna give any more owings.
He gets upset. Threatens to leave the pharmacy and how his been here a long time.
Him: "Don't upset me. If you upset me, you upset the boss."
Woahhh.. don't use the boss's name on me. If I'm the pharmacist-in-charge at the time, I got the final say and is ultimately responsible for those actions.
I rolled my eyes.
Me: "I'll call the doctor and see if he approves it first. Some doctors might not like it if we give too many owings to their patients."
And we called the doctor. And he said to send the patient up to see him, which means no more owings to be given.
We told that patient that the doctor wants to see him first before we give any more meds.
Him: "Oh f***king hell! #@%#^#^#^ " started swearing and being really loud.
But he walked out of the store, made a phone call, and started shouting again. LOL .. good. don't bother us.
He does come back 15min later with new scripts. Calmed down by now. Made sure the doctor wrote repeats for him this time. He did. Good.... That covers us from his insults for another 6 months.
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Never feel OBLIGED or THREATENED to do something a regular customer tells you to do. You as the pharmacist have the last say and whatever action you take, and if you do get in trouble from the authorities, well the fault is not the patient, its not your boss, its you. So as long as you explained everything to the patient and you've did everything in your power to assist him (call the doctor), and if he still can't accept it, well there's nothing else you can do.
So in this case, everything was done. Explained you can't, called the doctor, he says no too. If doctor says no, you're only the pharmacist, you can't do anything. The patient HAS to understand that. If he doesn't, he is being an unreasonable jerk and you'll be better off not having him as your customer coz he is disrespectful and rude.
Getting Owings
Legally we're not suppose to give the whole box of medications if they patient doesn't have a script. Part supply but for convenience, pharmacies do that. So this man, regular customer, comes in to pick up his meds. We already gave him an owing (owings for 3 medications) last month but he still hasn't returned the script. We seriously can't give him any. We told him he needs to bring a script. He said he will, just give him the meds first and he'll bring the script after.
Now from his records, he hasn't returned scripts yet. We don't trust him to bring the scripts back so no way we're gonna give any more owings.
He gets upset. Threatens to leave the pharmacy and how his been here a long time.
Him: "Don't upset me. If you upset me, you upset the boss."
Woahhh.. don't use the boss's name on me. If I'm the pharmacist-in-charge at the time, I got the final say and is ultimately responsible for those actions.
I rolled my eyes.
Me: "I'll call the doctor and see if he approves it first. Some doctors might not like it if we give too many owings to their patients."
And we called the doctor. And he said to send the patient up to see him, which means no more owings to be given.
We told that patient that the doctor wants to see him first before we give any more meds.
Him: "Oh f***king hell! #@%#^#^#^ " started swearing and being really loud.
But he walked out of the store, made a phone call, and started shouting again. LOL .. good. don't bother us.
He does come back 15min later with new scripts. Calmed down by now. Made sure the doctor wrote repeats for him this time. He did. Good.... That covers us from his insults for another 6 months.
--------------
Never feel OBLIGED or THREATENED to do something a regular customer tells you to do. You as the pharmacist have the last say and whatever action you take, and if you do get in trouble from the authorities, well the fault is not the patient, its not your boss, its you. So as long as you explained everything to the patient and you've did everything in your power to assist him (call the doctor), and if he still can't accept it, well there's nothing else you can do.
So in this case, everything was done. Explained you can't, called the doctor, he says no too. If doctor says no, you're only the pharmacist, you can't do anything. The patient HAS to understand that. If he doesn't, he is being an unreasonable jerk and you'll be better off not having him as your customer coz he is disrespectful and rude.
Do not give water to someone with heart attack
This guy comes in with a script for Flucloxacillin 500mg. After I dispense it and counselled him on use and informed him he needs to take it on an empty stomach, he decides he wanted to take the tablets in the pharmacy (don't understand why people do that, you can go and take it at home - its just an antibiotic, it won't hurt if you take it 1 hour later).
Anyway, he asked for a glass of water.
Me: Sorry we don't have glasses here and we don't provide drinking water.
Him: Pfft, that's gonna be a problem if someone has a heart attack.
Me: Well, actually, you definitely wouldn't give someone water if they have a heart attack. Anyway, we're not a restaurant so we don't provide drinking water. You can purchase some water from the café next door.
He leaves after payment. Customer after him heard the conversation and gave him a dirty when he walked away. Customer goes to me: "Geez that man was a bit nasty wasn't he?"
Me: (smiled) "Oh well what can you do? Some people are like that."
Anyway, he asked for a glass of water.
Me: Sorry we don't have glasses here and we don't provide drinking water.
Him: Pfft, that's gonna be a problem if someone has a heart attack.
Me: Well, actually, you definitely wouldn't give someone water if they have a heart attack. Anyway, we're not a restaurant so we don't provide drinking water. You can purchase some water from the café next door.
He leaves after payment. Customer after him heard the conversation and gave him a dirty when he walked away. Customer goes to me: "Geez that man was a bit nasty wasn't he?"
Me: (smiled) "Oh well what can you do? Some people are like that."
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