By Amy Hartmann
Editor’s Note: Amy Hartmann is a pharmacist in Oswego, Kansas who read Katelyn O’Leary’s National Pain Report Blog about her frustrations with her pharmacy experiences. Amy’s comments were thorough and sensitive and we asked if we could print some of them as a blog. Happily, she agreed.
As a pharmacist, it makes me sad to hear when any patient (not just a chronic pain patient) is treated poorly by my colleagues. As the daughter of a chronic pain patient, it makes me angry. It’s one of the many reasons why, after spending 7 years in “big box” pharmacy, I defected to a small, independent store.
If the pharmacy says they haven’t received your paperwork, they probably haven’t. If the doctor says they have faxed it, ask your pharmacy to contact your doctor to follow up, but don’t expect them to oblige if it’s been less than 24 hours since your request was made. If it has been at least a day, the doctor says it’s taken care of, and your pharmacy says it isn’t, request follow up by the pharmacy - if they refuse, FIND A NEW PHARMACY!
If you get a monthly prescription and the pharmacy chronically runs out, talk with them and find out what’s going on. There are times in managing inventory that mistakes just get made. I’ve had drugs on my shelf that I haven’t used in MONTHS and then I’ll get prescriptions for 3 patients in the same day –and I run out. Alternatively, I may have someone get the same drug every month, then suddenly we get a new patient on it too - and inevitably they will try to fill it on the same day when I only have enough on hand for one patient. We don’t like not having your drug in stock - it makes you mad, makes us look incompetent, and potentially loses us a sale. In the independent where I am now, we can get an order every business day if need be, so I have more flexibility to take care of my customer. If this “in stock” issues arises time and time again and no one seems to care - OR if you request that the pharmacy call around to find the drug for you and they REFUSE to do so - FIND A NEW PHARMACY!
If your pharmacy EVER tells you they are too busy, dishonest, or lazy to take care of you as a customer or patient - FIND A NEW PHARMACY! If one of my technicians ever told a customer that we lie about our on-hands to potential customers, they would be reprimanded (if not fired) on the spot. If I ever hear someone tell a customer it’s “not my job”, they better be prepared to justify their existence in my pharmacy to me, because everything is their job. With that being said, I don’t think it’s a realistic expectation that your pharmacy call you if there’s a problem with your refill every time. You can call the pharmacy before you make the trip to see if they have your prescription ready - it might mean another phone call but could help to ease your frustration in making the trip only to find out it isn’t ready.
Your insurance company may say they’ll approve your prescription at 28 days, which is possible (and typical). However, you should know many insurance companies also have a rolling window where they count up how early you’ve gotten your prescriptions and how many times - if you are 2 or 3 days early every month for 6 months, that (in theory) gives you 12 to 18 “extra” days of medication. At some point, your insurance company may deny you on that basis alone. In addition, many chain stores also have hard-stops programmed into their systems that will not allow a controlled medication to be filled more than 3 days early. However, if you feel as though you are being arbitrarily denied your medication, and its being done with a lack of respect, I would speak with the pharmacy manager about it - if things don’t improve, FIND A NEW PHARMACY!!!
Talk With Your Pharmacist-Respectfully
If your pharmacist wants to speak with you about your prescription, and is doing so in a respectful and empathetic fashion, be candid with them. Know this. We aren’t your enemy. As you want to be treated with respect, so do we. If I were spoken to by a patient with the hostility that I see related in some of the comments, it might be more difficult for me to maintain an empathetic tone with that person. I went to school for 8 years to get the degree required to do my job - it doesn’t take that long to learn how to count pills. I do have training in disease states, drug interactions, and clinical applications of medications. If I’m taking the time to (respectfully) discuss your medication with you, I promise you I have a good reason. It could be that you’re filling your prescription early on a routine basis, which alerts me to the fact that you might be taking it differently than prescribed. Often, it’s because your doctor has told you to, but the problem is that your insurance doesn’t count “verbal instructions” when they figure up your day supply. Or it could be because you had more pain than usual and had to take a few extra - I get that it happens sometimes. But as part of my education, I have learned different medication combinations that might help. Maybe they will, maybe they won’t - but please don’t be offended if I throw out something like suggesting a long acting medication in combination with a short acting drug for breakthrough pain - many prescribers shy away from prescribing long acting narcotics even when they’re clearly indicated and it might help you. If you show me your pain pump, I will make a note of it, so I don’t make that suggestion to you again in the future. If your pharmacist doesn’t care or doesn’t take the time to talk to you about your therapy, I would seriously consider finding a new pharmacy. If at any time your pharmacist (or their staff) is disrespectful to you, FIND A NEW PHARMACY!!
For the chronic pain patient (my mother is one) I understand that when you are under a pain contract, finding a new pharmacy is a lot easier said than done. But at the end of the day, no patient deserves to be treated with disrespect and no pharmacy, pharmacist, or technician has the right to assume they know everything they need to know about you based on the medication you receive. It saddens me that many of my fellow pharmacists seem to have lacked training in how to communicate, or they have become so cynical and jaded that they just no longer care. I truly hope that if I ever reach that point, I’m able to recognize it and move on from the career that I love.