Monday 17 September 2012

What is Worse? Newbie Doctor or Annoying Patient?

A patient of mine came in during a busy time and said "I know that the newest Bayer blood glucose machine is out, so I want it now. I brought in a prescription last month and it's on my file". For those who don't know, some of the blood glucose machines are free with a purchase of 100 strips, and some have a cost regardless of whether you buy strips.

I told this customer "Because this machine is very new, I don't think the rep has come by to show me anything about the machine yet. I also do not know if it's free with a strip purchase, so let me call him and ask". I make the phone call and the rep tells me that it is in fact free with purchase. He also informs me that he hasn't been by any stores yet because he himself had only received the demo kit the week before. I asked him what the differences between this one and the old one were. Apparently this machine is more accurate compared to the other ones, and eventually all the meters will be upgraded to these new test strips. I told the customer that I had located this information and that the machine was free and I would now process his test strips. I also mentioned that because these strips were so new, there was no entry in my computer system so I had to manually enter this into the system and figure out how to bill it. I then entered it and had to call his insurance company for a pseudodin # in order to bill the strips, and finally I got it working.

The man also asked to see another blood glucose machine by the same company and started asking more questions like "what is the difference"? (My response: They're practically the same...the newest one that you're getting is supposed to be more accurate.) He then keeps looking at the other machine. I asked him "So which machine do you want? If I give you this one and I open it, you cannot change your mind. I cannot give an open one to someone else". He goes "Okay, I'll take the newest one." I said "Are you 150% sure?" and he says "Yes." After a few more minutes, he's STILL looking at the other machine and I ask him the same thing again. Then this happens one more time, and he looks VERY indecisive. Finally I said "Look sir...are you getting the newest one or not? You need to be 200% sure because once I do it, I'm not changing it. Decide right NOW. If you decide on the newest one, stop looking at the old one." He decided he wanted the newest one. Finally.

At this point in time, it was quite busy, but the most pressing matter on hand was the prescription for an elderly gentleman who had just come out of surgery to remove a lung, for which his daughter had already waited a while. He had a prescription for docusate sodium and Tylenol #3. As soon as I saw the prescription I was like "OMG. This doctor does not know how to write prescriptions." See the following:



What was a huge pain?
1) Any prescription (especially narcotic prescriptions) require a definite quantity if the direction is "as needed". If the patient takes max 2 tablets every 4 hours around the clock for 30 days, assuming his pain is not reduced, then "30 days/1month supply" = 360 tablets which is a pretty huge quantity
2) Narcotic prescriptions cannot be repeated (you must do a part fill - ie. write a large quantity and say to dispense a smaller quantity every X number of days). This means that the repeats are void.
3) This is coming out of a frickin' hospital where you can barely get a response from a doctor especially if they're a resident, or not on call, don't answer pages, or no longer works on the unit that they were on when they wrote that prescription. If you get a call back, it also frequently is not on the same day within a reasonable time. This doctor had the newest license number I'd ever seen. Oh no.

I decided to call the hospital to page the doctor. Thank God they called back within 15 mins. I asked the doctor if they were familiar with writing narcotic prescriptions, and the answer I get was "Well, I guess I'm learning how to do that today!" WHAT. I then proceeded to teach the doctor how to write a prescription, and then to change my prescription. Okay then. I get the quantity verified...so apparently this doctor didn't really care and 360 was fine, haha. I counted and double-counted it by hand. The patient's daughter is pacing like crazy and is saying that she's going to leave soon because she needs to take care of her dad, but she also really needs his medicine as he just got cut open. I run the prescription to the counter. She goes "OMG, why are there SO MANY PILLS?! Last time he got a small amount he threw them out because he was mad at his cancer!". Okay then...now I had to change the number of pills into half.

Cut back into scene 1 with glucometer patient. He apparently walked away and walked back with the merchandiser from the front store after making a huge complaint! So now I was informed that I was mistreating this guy. WHAT?!
Man: You are supposed to be helping me! I GOT HERE FIRST. Why are you helping this woman?! How can you just start helping me and then switch over to someone else?
Me: This woman was here way before you...I think it's possible that she has been waiting for an hour.
Man: She was NOT here for an hour!
Me: Were YOU here for an hour? How would you know?
Man: Well, you should be helping me!
Me: Look, this woman has been waiting for much longer than you, and her father just came out of the hospital after getting cut open and removing an organ and she needs to get this medication to him as soon as possible. I am helping you with your things now.
Man: You're being ridiculous! How can you say you've been helping me when you're wasting your time doing this here and that there and talking to this person on the phone and that person on the phone? You should be working on MY prescription. I SWEAR THAT YOU'RE MAKING ME WAIT ON PURPOSE!
Me: Sir, you have to understand that I WAS working on your prescription! ONE phone call was to the manufacturer of your blood glucose machine to make sure I can give it to you, and to get you the proper details because it's so new that nobody knows. The OTHER phone call was to YOUR insurance company to make sure that it would go through your insurance so that you don't have to pay! I was calling people for YOUR sake! (Thinking: Shouldn't talk to me like that.)
Man: Oh.


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