Not all healthcare professionals and first responders are pulling their weight

Just as accolades should be heaped on those healthcare professionals and first responders that are going above and beyond during this COVID-19 crisis.  Unfortunately, some seem to be in their own little bubble and it is business as usual. No rule should even be considered as having an exception to… no bending the rules in their little bubble.

A couple of years ago, I discovered that a particular medication that Barb takes for her chronic fatigue .. our Part D prgm (Silver Scripts) was requiring a prior authorization and a $600+ copay for a 90 days supply..but there was this Warehouse Club – second largest in the country- was selling this particular medication for $88 CASH for a 90 days supply.

This particular club site is some 30-35 miles from our home, but saving some $500/90 days seemed like it was worth the trip.  You don’t have to become a member to have Rxs filled there, but I joined just the same because I knew that Barb would end up spending $300- $400 each trip.

Last weekend as the COVID-19 crisis was ramping up and there was talk of medication shortages and who knows what the bureaucrats were going to do.  Her Rx had no refills so I knew that our PCP would have to OK it..  We have been seeing the same PCP for some 25 yrs.  His office and the whole hospital system used the EPIC software system and pts have a portal where you can see what is done.

9:30 PM Monday night, our PCP sent this Warehouse Club Rx dept an approval for a refill.  Since the previous Rx had ran out of refills the Pharmacists would have to treat it as a NEW RX.   It is now Tues and our Governor had issued a edict that everyone in the state is to shelter in place for AT LEAST TWO WEEKS.. starting at MIDNIGHT TUESDAY..

I get to pick up Barb’s Rx and the young female pharmacist stated that she had to talk to the PCP – to make sure that he knew “what he is doing with this early refill”. I told her that I was a pharmacist and that she had the professional discretion to fill it early – NOPE…

I pointed out that we were both in our 70’s and were in a HIGH RISK GROUP  – NOPE

I point out that Barb had a auto immune issues which made her more at risk – NOPE

I point out that the CDC had recommended that everyone get a 90 days supply of their medicine – NOPE

I point out that our Governor was telling everyone to shelter in place in about 12 hrs for at least two weeks – NOPE.

The PCP send the order to this Warehouse club THREE TIMES that day…   I forgot what day it was and it was our PCP’s DAY OFF and this pharmacist had been interacting with the PCP’s staff – there are six prescribers in the office.

One of the staff from the office called me and she said that I called her a “nasty woman”… even Barb knows that is not in my vocabulary.  The office calls back again about 3:21PM on Tues and said that the Rx had been approved once again..

The next morning, I called the pharmacy and the pharmacist told me that she had nothing from the office since around noon and I am looking at the EPIC portal and she had been sent a OK TO FILL at 2:41 PM..  She told me that she was NOT GOING TO FILL IT – TAKE YOUR BUSINESS SOMEWHERE ELSE…

Did you know that if you put your IPAD in voice record mode and lay your Iphone on top of it and make a phone call with the speakerphone on..that both sides of the phone conversation will be recorded ?  Indiana is NOT A TWO PARTY RECORDING STATE !!

At our PCP request, we communicate directly with texts… I sent him a letter as a *.pdf attachment to a text..  the letter started out as “I’m confused…”  and I get a text back from him starting as “I’m confused also…”  After a couple of exchanges… he texts get back with me Monday and we will get everything straightened out.  Of course, hell will freeze over before I go back to that club warehouse Rx dept.

I am hoping that the staff made notes in EPIC as this pharmacist called to the office and I am going to try and get a copy of those notes.  My gut is telling me that she was trying her damn best to queer our relationship with our PCP over this early refill.   She would probably have better luck at buying a lottery ticket and expecting to win a big jackpot.

Did you know that it is not that difficult to find the name of the Senior VP of Pharmacy services for this club warehouse ?

As soon as I get all my documentation together, guess who is going to get a certified letter with a couple of cut-up membership cards and letter explaining what great service this particular pharmacist provides at this particular club warehouse of theirs.

 

14 Responses

  1. […] Not all healthcare professionals and first responders are pulling their weight […]

  2. And if there was something new put out saying we can get pain meds early please let me know. My Dr sent mine 2 weeks early and my pharmacy said I can pick it up a week before my usual pickup day and I’m afraid to because of possibly getting in trouble wnmy Dr. And regarding this article… I thought primary care drs are no longer able to even prescribe narcotics for chronic pain?

    • This post was not involving a pain med… all opiates are controlled substances but all controlled substances are not opiates. The DEA permits a prescriber the ability to write up to a 90 days supply. The CDC guidelines were focused on the treating of acute pain. Some states and some insurance companies have rules that override the DEA’s rules.
      Here is four quotes from the CDC opiates guidelines:
      https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm
      “The guideline is intended to ensure that clinicians and patients consider safer and more effective treatment, improve patient outcomes such as reduced pain and improved function.”
      “Clinicians should consider the circumstances and unique needs of each patient when providing care.”
      “Clinical decision making should be based on a relationship between the clinician and patient, and an understanding of the patient’s clinical situation, functioning, and life context.”
      “This guideline provides recommendations for primary care clinicians who are prescribing opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care.”
      The CDC has made a recommendation that pts with chronic diseases get 90 days of their medications because there is anticipated shortages.
      Our country is in “virgin territory” Our state governor first ordered a shelter in place till April 6th… he has now extended it to May 6th. We live in a rural area and the only delivery of product we have available to us is our independent pharmacy and Amazon… we do have the ability to order groceries on line and parking lot pick up from a division of Kroger.. The other day Barb ordered $160 of groceries and the order ended up being abt $60 because of so much out of stock. IMO. healthcare professionals who insist on working on a “business as usual concept ” and pt with chronic health issues get harmed because of med shortages may find themselves in a whole lot of “hot water” after everything gets back to “our country’s normal” Some experts are making educated guesses that the COVID-19 peak may not happen until sometime in MAY. Donald Rumsfeld nailed where we are at years ago https://youtu.be/REWeBzGuzCc

  3. This article makes no sense , there is nothing out by the the dea saying we are to get 90 days of pain meds. 2nd shelter in place doesn’t mean you can’t go to the store or pharmacy. This person sounds like they were trying to do something wrong and maybe addicted.

    • We are both in our 70’s – high risk category for COVID-19 and my wife has auto immune issues – second high risk for being out in the public with COVID-19 running lose and the medication involved treats my wife’s chronic fatigue issues and has nothing to do with opiates, but is a C-IV controlled substance. Our PCP – who we have used for abt 25 yrs… approved the refill… we have had this particular med from this club warehouse for a couple of years.. never early before and has always been written for 90 days supply from the same prescriber. IMO, this pharmacist had no interest – or concerns – why it was asked to be filled early… she had ONE DECISION ISSUE – it was early… She stated that she wanted to talk to the prescriber why he was authorizing it early… he sent the order in electronically THREE TIMES… and she still DENIED FILLING IT… The post may have made no sense to you… but.. any healthcare professional that would look at the “whole picture” they would have filled it… but IMO.. this young pharmacist has a lot of “books smarts” but lacks a corresponding “clinical experiences ” and any healthcare professional that totally relies on a check list to make decisions on providing pt care.. many pts will experience poor clinical outcomes. Many pharmacists are providing “second opinions” based on faulty conclusions based on personal biases, opinions, phobias which has no place in providing medical care to pts.

    • Bob, perhaps you should read slower, all the details were in Steve’s post. If you have read any of his posts, you should know his wife’s name. Your post comes across as very biased, and makes a lot of assumptions even though it was all explained in Steve’s post. Just understand that by you doing that, you may have people do the same thing to you. Meaning put out negativity, you get it back. If that’s the kind of person you want to be, well then you have made your choice. Assuming people are trying to do things wrong or are “addicted” is ridiculous, and those kind of assumptions are why chronic pain patients have to deal with all the grief that they do. Please try to be kinder if you want people to do the same towards you.

      What did Steve’s post sound like to me? Well, it sounded like he was trying to fill his wifes meds and all he got was more problems, and Steve was trying to be a good citizen and stay home and since the pharmacy is quite far away he didn’t want to be driving all around hours away when he was supposed to be sheltering in place. I agree that he can go to the store, but if he doesn’t have proper PPE then he knows he is putting himself and his wife at risk. All the details were in his post.

      Steve, please report that pharmacist. some are kind and some are NOT and it sounds like she is in the not category. I’m very sorry you had to deal with this junk, but very glad Barb has you to help her. We’ve also had problems with costco but it was due to an awful pharmacy manager, once she got kicked out (and she did) things have been so much nicer and now they are great about working with me. But I do stress out every month when my rx is due, have a bit of PTSD about it. I’m guessing that’s normal for a chronic pain patient. Thank you for all that you do! 🙂

  4. Hate to say it, but many of us have been going through this for years. For me, since 2002, nearly every month some snafu between pharmacy, insurer or doctor. It became much worse in 2012, when WA state passed the first anti pain law in the country, and I began getting forced tapered. Every three and a half weeks for 8 to 9 years, extreme stress, hassle and frustraion. Being a former Congressional researcher, Caseworker, legislative worker, etc., I know how to get through red tape. I also have experienced WAY too many times that the red tape was more like it was made out of iron or steel. Well, Steve, you are officially part of our undesirable ‘club’ – not that you weren’t before, but now you’ve been initiated to a higher, more frustrating level. Lucky you and Barb – especially Barb, as she has an educated advocate and a fighter husband who won’t stop til he gets an answer. As always, thanks for doing all that you do, and I’m truly sorry about your hassles, stress, worries and what you have to go through to be a caretaker. I’m really hoping to be able to dismantle and destroy this evil club soon. Valorie, Coalition of 50 State Pain Advocacy Groups, Founder

  5. YES. you go Steve! This is all hickory dickery crock. INEXCUSABLE. UNACCEPTABLE.

    I’m sorry for your nightmare. Grateful you held your ground and prevailed in the end. Fiascos like this nobody needs nor deserves.

  6. @canarensis – it is bullying, plain and simple. Actually has a DSM 5 code – ICD-10-CM Diagnosis Code Z65.8
    * Factors influencing health status and contact with health services
    * Persons with potential health hazards related to socioeconomic and psychosocial circumstances
    * Problems related to other psychosocial circumstances

    • mb;
      Ah…thank you, I hadn’t actually looked at the dsm for a while…tho the actual diagnosis is a teensy bit more polite ‘n’ formal than my made-up one. Probably less inflammatory, too. But bullies do tend to inflame me…!

  7. Dear Pharmacist Steve – you stood your ground. Barb is very blessed to have you as a spouse. Remember! The Pen will always be mightier than the Sword (or whatever weapon). My late husband and I have used Warehouse Club pharmacy services. We discovered that it all depends on location, who the Registered Pharmacist is and the particular Rx medication. So a patient’s mileage may vary (so to speak).

    You go, Steve! We have the Internet in the 21st century and it is very easy to obtain large organizational data from one simple query. Then communicate in writing to the powers that be. Or better yet FAX! Another pointer: since it is Part D you can also write to your US Senator and CMS/Medicare. Our US Congress maintains a Dept of HHS Liason “unit” so to speak. My good wishes to Barb! And you!

    • Since I was going to pay CASH … part D would not come into play.. like many families … I have a multi-function printer – including a fax function – but we no longer have a landline.. I just checked wwww.indeed.com and there is only 23 listings for pharmacists and abt half is for hospitals and if you don’t have at least one residency post PharmD.. lots of luck.. We have a very serious and growing pharmacist surplus. It is claimed that we are graduating 5000 more pharmacists each year than available job slots.. We are on the cusp of the next glut of pharmacists being graduated in May-June and there is a pharmacy school about 3-4 miles from this particular warehouse club. One of two pharmacy schools in the ENTIRE STATE 🙂 Our PCP is about 6-7 yrs younger than me… we have more of a friendship relationship than doctor/pt relationship. some time ago, he gave me his cell phone number.. cause he knows that I won’t abuse it, but if I call… it is damn important !

      • You can fax w/o a landline. I do frequently by using gotfreefax.com.Just scan your documents & submit the file through that site. I believe 3 pages or less are free & they charge per page after that.

  8. So many petty little people just can’t resist the temptation to abuse whatever petty little powers they have…just for the gloaty rush of it. I think that’s an addiction that should also be in the DSM; “Repeated Abuse of Power Just b/c You Can & b/c it gives you a rush, even if it negatively impacts your life/livelihood.” Which, hopefully, will happen to this pathetic tyrant-wannabe.

    You go, Steve!

Leave a Reply to Bob Cancel reply

%d bloggers like this: