Medical Rant #2: Pharmacies

The BBQ Pit
1

As I related (at really great length) in Medical Rant #1: Doctors, we are in the midst of a medical adventure concerning our new son, HS2.

Before we were discharged from the hospital, we were given a prescription for heart medication for HS2. Because the pediatric cardiologist was singularly uncommunicative, we didn’t know much about this medication, how important it was, etc. All we knew was “heart medication,” so we’re thinking “pretty damn important.”

While MrsSponte and HS2 were still at the hospital, awaiting discharge, I drove to the pharmacy closest to the hospital and dropped off the prescription. (The hospital, BTW, is about 1/2 hour from our house). I was told two things at the pharmacy. First, the pharmacy would have to compound the medication - convert it from a solid into a liquid suspension solution so that a newborn could take it. That would take about an hour, I was told. Second, our insurance company could balk at paying because our newborn wasn’t yet on our insurance policy.

OK, no problem. This was at 4:30 p.m., and HS2 had to take it at 8:00. As for the insurance company, of course I’d pay, and then fight with the insurer if necessary.

Anyway, I head back to the hospital. HS2 is discharged around 6:00 p.m., and we drive back to the pharmacy. When we get there, were are told the following
[ol]
[li]They have just gotten off the phone with the insurance company, who refused to cover the prescription; and[/li][li]Because compounding the medicine made it unsellable if we refused to pay for it, they hadn’t started the compounding until we confirmed we would pay for it. The compounding process would, again take about an hour.[/li][/ol]
So now, we are 1/2 hour from home, with a newborn in our car. We can’t go into the pharmacy - newborns should be in crowds. We can’t sit in the parking lot of the pharmacy for an hour with HS2.
We decide to go home. I would drop off MrsSponte and HS2, and drive back to the pharmacy to pick up the meds. If all went well, I would be back home with the medication at 7:30 p.m.

Of course, things don’t go well. I get back to the pharmacy around 7:15 p.m. I ask for the drug, and am told that the pharmacist was “just finishing up.” Of course, that really means “she is just starting.” I finally make it home with the drug around 8:15. HS2 was, of course, just fine - I had the panic attack.

I don’t blame the pharmacy for its policy of not compounding a drug until it was sure of payment - while I was waiting there, I saw several persons refuse to accept prescriptions as too expensive. What I do blame it for is not confirming payment when, as in this case, it was aware that there might be a problem with insurance. Hell, take a credit card imprint to cover your ass. Don’t simply not fill the prescription for a life-sustaining medication.

And, of course, once you are ensured of payment, make the damn stuff. Don’t wait until I actually get back to the pharmacy to start.

Sua

2

I ran into a similar thing the other day and I was sort of shocked that it happened. Of course, it wasn’t a life-saving medication for my newborn, but id did peeve me a tiny bit.

I dropped off a new script at the pharmacy in the grocery store (where I always get them filled) then told them I’d be shopping. They said cool, see you in 45 mins.

So I came back in an hour, and they’re obviously slammed (as usual). The one clerk calls me over and says she didn’t filly my script yet because I needed 60 pills and they only had 10, and they wanted to ask me first if this was ok before filling it. They waited an hour to ask me, when they could have called my cell? Or paged me at the store? (ok maybe not, cuz of privacy). It wasn’t even a life-or-death question - they said they’d have more in 3 days and gave me 10 days worth.

So I said it was cool, please fill it. Then the clerk goes on her break for 15 mins.

I’m standing there with all my groceries in the cart, like an idiot, because no one told me it’d be another 40 mins. It took that long because of the break and because the pharmacist was busy formulating something for an infant (ironically, I guess) so he couldn’t sign off on it. If someone woulda taken a second to let me know, I’d have happily gone to check out, loaded up my car, and came back instead of standing there getting crabby.

I dunno why the pharm doesn’t ask for “instant contact” info - cell phone numbers - when you drop something off. Don’t they want to get stuff answered right away when there’s a question?

I think a good bit of the problem, at least at my pharmacy, is that they are woefully understaffed.

Anyway, glad that your sprout got his meds and the 15 minute delay wasn’t as dire as you probably felt it was at the moment. Hope it goes more smoothly from now on!

3

If you need your insurance right away, talk to your insurance company about an emergency enrollment for your newborn. If they give you a hassle, go directly to the HR department at whichever of your jobs which provides the insurance. Tha’ll avoid any further problems with pharmacies or with new docotrs or whatever. It is an entirely normal request that insurance companies deal with daily.

4

Zipper, I’ve dealt with pharmacies that use the same kind of pager they use at restaurants. When the prescription is ready, or if they have a question, they page you while you shop.

Robin

5

I get my prescriptions filled at Target. They are very good about paging you to the pharmacy if there’s any issues at all.

6

Actually, the kid is automatically covered for the first 30 days under the mom’s policy. In fact, the insurance company had already paid the hospital. It just usually takes two calls to get the insurance company straight.

As it happened, when I finally did pay for the drugs, the pharmacy had apparently straightened things out with the insurance company, as I only had to pay the co-pay amount.

Sua

7

Sua I’m not surprised that you experienced a doc with poor communication skills, or a pharmacy staffed with the less than the brightest we just follow our rules kind of folk, but I am a bit surprised that the intensive care nursery nursing staff dropped the ball so. Usually they are excellent at reviewing the meds and what each does. They are generally good at knowing which ones may not be readily available at a local outside pharmacy and offering the option of having the first fill completed at the hospital pharmacy for those meds. That you had nurses who didn’t step up to the plate is unusual.

8

My rant…

WalGreens…other people in other areas seem to think WalGreens is great…but here in the Twin Cities MN…they suck. Slower than molasses in January after having been put into liquid hydrogen for a year then said molasses put at the bottom of a hill and prgress measured as how much it goes up the hill.

Bad…freakin bad. The kind of place where if you go in to pick a prescription you’ve already been told is ready and there is even ONE person in line in front of you then you might as well leave and come back later.

So…I pull into the new drivethrough (which makes me laugh…a drive through at THIS place? hahahahahahaha)

Sure enough, I sit and sit and sit. So…I get out my cell phone. I try to find the phone number of the Walgreens. No dice…not listed. I call corporate…get passed around from person to person until I get someone willing to give me the number (we usually don’t do this but…)

I then call the number…request the pharmacy…get it and I ask them to go to the window.

My God…and ALL the Walgreens are like this! I’ve tried 3 of THEM!!!

Thank heavens CVS opened up stores here. They are much, much faster.

9

That is what I was going to say. Why didn’t they send you away with a bottle of meds plus a script?

10

Yes and no. Some insurance companies don’t cover take-home prescriptions, and the patient is responsible for the full cost. Nurses are aware of this, but I can’t understand why the script wasn’t called in to the pharmacy.

Robin

11

I think 90% of my customer service frustrations center around this issue right here.

You do your job every single day. You don’t have any questions about how things work; you just assume that all customers who walk through your door, what, automatically know by osmosis what the process is that you use daily?

Most of the time, if the monkey behind the counter would actually say things out loud, I would find myself far less frustrated when I find “what to do, where to go, who to see, which line to be in” is less than immediately obvious.

12

I did this once in my doctor’s office. I was in respiratory distress, having my very first asthma attack (and did not know what it was, other than I couldn’t breathe). After waiting around 2.5 hours to be seen, I called the front desk from the waiting room and asked if they were going to see me for my 10 a.m. appointment before or after lunch.

They hung up on me.

But they did call me in about five minutes later.

13

Why pharmacies in the US operate like this? In Europe meds are prepacked in blister packages. You simply go to the pharmacy with the prescription and they hand you the package, end of story.

Is there an advantage doing it the US way?

14

Dog80, the medication the OP’s child needs has to be a liquid because the child can’t swallow pills. The pharmacy didn’t have the liquid form available, so the pharmacist had to make it.

Robin

15

While I definitely agree that the nurse should have reviewed the baby’s prescriptions with the parents before discharge, I don’t understand how the nursing staff is supposed to know what meds are readily available at what outside pharmacies. I’m a nurse at a hospital, and if a parent asked me if they had Medication A at Kroger Pharmacy down the street, my face would look like this :confused: That’s just not something I know or feel like I need to know.

I definitely understand your frustration, SuaSponte. I’ve been discharging patients who have meds that need to compounded at the hospital pharmacy, and it takes for-freaking-ever, even without all the insurance bullshit.

16

I’m really surprised that they didn’t have the hospital pharmacy compound some for you to take home and then send you with a script. When things are less crazy, I would also speak to the pharmacy manager where you had it compounded regarding the issue- while I understand the need to make sure a medication is paid for before mixing it, a phone call would have taken seconds. Any pharmacy I’ve worked in, hospital or retail, would have taken 10 minutes out of the day to compound that for you on the spot and save you the hassle, especially with a newborn.

This is a great example too for everyone who bitches “why does it take 30 minutes to fill my rx? You just count out 30 and slap on a label!!” Not everyone has a simple prescription and you gotta wait your turn.

17

Why Does My Prescription Take So Damn Long To Fill?

18

Absolutely. It’s something I try to pound into any new hire I work with. Most people don’t particularly mind waiting for a while if you just keep them informed on why they’re waiting and where they are in the process. Even if you have to make an extra trip up to the lobby just to talk to them, it takes a whole 45 seconds, and the vast majority of the time you have to go up there for something else anyway, so it’s no extra hassle at all. And dealing with people who are fairly relaxed and understanding is infinitely more pleasant than dealing with ones who are impatient and cranky.

19

Slightly off topic (as it’s not prescription-related) but I’m NOT surprised at the NICU staff dropping the ball.

When Moon Unit was discharged after 17 days in NICU, I was told - the day before - by a nurse I’d never seen before. All the regulars were off that day. Ditto the day she was actually discharged. There were no medical people there, no counselling on what to do, just a single sheet with nothing more informative than how much to feed and how often. We didn’t even see a doctor, just a nurse - and again, nobody we knew, and nobody who knew our child.

20

They told us that the hospital’s pharmacy does not fill outpatient prescriptions. Don’t know if that is true, or if that is unusual.

Sua