We're All Out of a Job

Sunday I posted about my adventures in nabbing several people abusing the system. I neglected to mention, namely because I didn't see it to be relevant, that I was filing in at a store for the day.

I stopped by there today to grab something I left, and while there I explained everything that happened to the techs who normally work there. Their response?

"Why would you do that? That's less prescriptions for us to fill every day which means we could eventually lose our jobs when they close our store for our low numbers."

First off, this place is by far the busiest store I work at, so that's not even a remote possibility.

Second, are you fucking kidding me? I help nab people who are abusing the system (ya know, the system we all pay for through taxes) and are breaking several laws, and you get pissed at me?

Thank freakin' God I will be done working for this company in two short months. Would you put up with that kinda crap on a regular basis?

Advair... In A Provocative Position

Slow day at work today and someone left their Advair diskus here. Naturally I decided to act like a five year old and crack her open to see how she works.

So if you ever wanted to see the innerds of an Advair Diskus... today is your lucky day.

A Good Day In The Pharmacy

I had one helluva of a productive day during my Friday shift. I nabbed four, count them, FOUR seekers in one day, all in separate circumstances.

It had been a rather dreary stretch as I hadn't come across anyone worth busting in about four months now. Personally I like doing a little PI work at work, makes me feel like Matlock... you know because of all the old people and fixodent in the store.

My favorite is I busted someone who has been using three different docs with three pharmacists for at least seven years. I went to bill her fioricet and it came up rejected as an early refill which was weird because she wasn't early at all.

The insurance in question has a knack for giving false rejects, so I figured I'd call them and have them fix whatever the fucked up this time.

Oops.

Turnout one of her pharmacies auto filled her fioricet under her insurance on accident on the sixth. As I inquired more I found out about the other pharmacy and doc.

Ruh oh.

I call pharmacy number one and they talk about what a sweet lady she is and that they hoped she wasn't transferring out. Needless to say they were more than a little surprised when I explained the situation.

Pharmacy number two was a big chain who didn't seem to give a rat's ass, which is somewhat typical around here.

You guys wanna know the best part? She had a narc contract too. With TWO docs.

How the hell she had pulled this off, I have no idea, but I give her props. Sadly, there will be no more fioricet or tramadol or hydrocodone or phentermine or any other fun things.

I suppose the best part is she really has no idea until her appointment next Monday... when there will be a phone conference with three very pissed off docs.

Damn I wish I could be there for that.

And that was just one of the four today. Like I said, it was a bitchin' day all day long. Maybe I should start a secondary business some day.

Phathead, R.Ph. - Private Eye

It's got a nice ring to it, no?

I Want To Be A PBM.... So I Don't Have To Pay Taxes

I can understand why PBMs reimburse us mere pennies above cost. I can, somewhat understand why they refuse to pay fees.

What I do not understand, however, is why they refuse to pay the tax on a drug.

You see in one of the states I have worked in, I keep tabs on my prior employers, many of the PBMs have decided they will not pay for the state tax on the prescriptions we fill. They leave it 'up to the pharmacies' to deal with as one kind PBM rep told an ex-coworker of mine.

The kicker is according to that particular state law, the PBM has to pay the taxes enforced by the state. Yet some how, they're allowed to get away with not paying it.

They are then left with the tax amount and are forced to make the patient pay for it. It is not something that normally I would condone, but seriously what else can you do?

My question is how is this acceptable? Several of the patients who have asked why this has happened have been completely livid with their provider. One of which, apparently, left his work plan and opted to go to a private plan instead.

Apparently if you are a PBM you can get away with no paying taxes. You know what would happen if I chose to not pay my taxes? Well let's just say I may be sharing a tiny room with a guy named Bubba and a lack of Astroglide at night.

So I have decided, on this glorious spring day, that I will now be a PBM instead of a pharmacist. Judging from experience, I will be able to boss everyone around and not have to do anything that I don't want to do. The money I earn will come at the expense of those around me. This, of course, includes when logic stands in my way.

And of course, I will be free of paying taxes. Because, damnit I won't want to. And since I'm a PBM, if I don't want to do something, I don't have to do it.

Right?

Oxycontin is... What?

"So just to clarify, he has a morphine allergy and I want to make sure you're giving him Oxycodone ER instead of Oxycontin because it has less morphine in it"

**Crickets**

Ok, now that you have probably read that three or four times, I will start by saying, What. The. Fuck.

It took me several explanations for me to explain to her that Oxycontin and Oxycodone contain no morphine in it. She kept reiterating that her computer software was telling her that the morphine allergy was triggering a 'big warning' about an allergic problem to Oxycodone. Thus, she said, Oxycontin must contain morphine.

This was from a CNP out of a major hospital working through a major pain clinic.

Ok ok ok, I'll ask the question the rest of you are already asking in your head.

HOW THE FUCK DO YOU FIGURE THAT MORPHINE = OXYCONTIN???

I mean seriously. I can understand maybe not knowing what Kadian is or something because it is relatively obscure, or at least is so in my area. But how in the hell do you not know what Oxycontin is?

I could ask any crackhead on the street what is in Oxycontin and they would answer correctly. It is one of the most used, and probably most abused, C-II narcotic on the market.

And you don't know what's in it? And you PRESCRIBE for it? And you work in a PAIN CLINIC?

Are you fucking kidding me?

To be fair, she was a rather sweet CNP, but I don't think I can excuse something like that. She wasn't new either, she eluded to the fact she hadn't been in school for quite sometime.

I'm just in shock, utter and complete shock. Anyone else see a problem with this?

I'm A Daddy... Kinda

One of the agreements the wife and I came to when discussing moving is how we would move to an apartment that allows pets. Our current apartment does not allow pets, and we both have wanted a dog for some time. Thus, one of our first purchases upon moving would be a dog.

Oops.

Meet River. She is about eight weeks and is half shih tzu, half maltese. Her name comes from the show Firefly (probably the greatest TV series to be canceled after two months) because we're both nerdy like that.

She is also, at this moment, an illegal alien. We did not plan to get a pup this soon, but really, could you turn down a face like this?
So for now she is hiding, every so quietly, in our apartment. I figure if Old MD Girl can show off Boo, I can show off little River.

Maybe we should open a debate over who is cuter. Muhahahahahaha.