At this blessed time of the year nothing says "You are so cool and I am such a Loser" better than those truly obnoxius Christmas Letters!!! Now, I know that your intentions are mostly sincere and well meaning, but please, give it a rest!! Your seasonal bundles of joy that clog mailboxes come across as self serving and more nauseating than last week's egg nog! So today, in the true spirit of "Bah Humbug," I have decided these holiday notes just made Blake's "Things I Really Hate" List!! It is truly obnoxious!
Maybe all of the holiday cheer has clouded your judgement during this season of peace and eternal hope. Maybe your forgetting that your fortune of late has allowed you the luxury of jetting off to exotic places with family and friends that are truly happy and healthy!!!
However, let us not forget that most NOT sending our their annual "brag report" are too busy paying for the latest MRIs or that bag full of prescription meds. Merry Christmas to All of You!
I have a dear friend and will always be like a brother to me. Every Christmas he shares his pituresque lifestyle and from all outward appearances, his family hasn't a care in the world. Like many, he lives in a bubble of semi-ignorant bliss, but God bless him! I sincerely hope that the wolf never comes knocking at his door. But if that wiley predator shows teeth, I will empathize with my friend, knowing a bit about life's true struggle. I will fill sad and I will gladly fill his prescriptions for his pain and suffering. Then....I will send him my Christmas Letter!
To my sparse and loyal readers, have a great and meaningful Holiday Season and remember to...take as directed,
Blake
Thursday, December 17, 2009
Saturday, November 21, 2009
What's behind those TV drug ads?
A most warm and generous welcome to my loyal readers of late. I think I am up to 4...5 at the most. Any rate, I have been doing some thinking lately regarding my blog and its contents. As some of you may know, a good old fashion firing from pharmaceutical sales job a year ago (come the day before Thanksgiving) was the catalyst for me to put my thoughts to work. It also has motivated me (...I don't know if that is the right word or not) to write a book about the drug industry. It is an insiders guide, if you will, to what really happens behind those slick drug ads that interrupt an otherwise pleasant evening of watching television. I am approaching the subject as a former drug peddler/pharmacist/MBA kind-of-a-thing.
So, in the spirit of a "customercentric" feedback (that's a big word pharamceutical companies use to show that they are really fulfilling their customers needs), I am looking for some feedback. Would any of you take a little extra time and read over a chapter at each blog posting? I am doing a little of my own market research. If just one of you says, "Blake...knock yourself out!" I will do it. And if you like the content, I will seek a publisher and chase a dream I have had for some time.
Hope to hear from you soon and remember...take as directed!
Blake
So, in the spirit of a "customercentric" feedback (that's a big word pharamceutical companies use to show that they are really fulfilling their customers needs), I am looking for some feedback. Would any of you take a little extra time and read over a chapter at each blog posting? I am doing a little of my own market research. If just one of you says, "Blake...knock yourself out!" I will do it. And if you like the content, I will seek a publisher and chase a dream I have had for some time.
Hope to hear from you soon and remember...take as directed!
Blake
Monday, November 9, 2009
I am a mean old man!
Have you tried to get anything done in health care lately? How did that last doctor's visit work out for you? Our family's experience with a follow up surgical procedure on my daughter last week was disaster. How about this week's wait time at your local pharmacy while Mr. Pharmacist was on the phone with your insurance company regarding a denied claim...for the 5th time?
Fear not, I have got your return ticket for your latest journey of frustration! Unfortunately it is not going to be all that fun when your ticket gets punched. Why? Well, it seems to me of late that if any one of us needs to reach Health Care Happyland, we must get grumpy...maybe even mean, or dare I say obnoxious. Yeah...that's the ticket!
We pharmacists are not programmed like that. Remember...we are usually social folks, accessible, and trustworthy with all that sensitive health information you share with us. So, it pains me (with a pain that oxycodone will not ease) to know that I have turned into a mean old man...dare I say even a jerk! To get my daughter proper pain relief in the hospital, I fired the nurse practioner that was pretendint to take care of her. I told her to stay out of her room and not to touch her...ever again! And it wouldn't hurt for her to work on your bedside manner. I told her that too. I didn't feel one bit guilty about it the confrontation. Of course, for all that trouble, she kicked my daughter out on the street with discharge orders in hand the next morning. We didn't get as much as a "nice havin ya here!"
What has happened to the days of yore when a patient's simple direct request was heard and appreciated and most importantly acted upon? Help me out hear readers with the grump factor or I will end up like those 2 old guy muppet characters yelling from the balcony in Sesame Street! When you have made a pharmacist mad, you know that that is serious stuff!
So as those bafoons in congress continue to debate about a national health care plan, go ahead get a little heated under that white collar of yours. Your advocacy with a little edge on the side will get health care providers attention and there is a good chance you will see results years before the US figures a decent health care plan
...take as directed.
blake and still grumpy
Fear not, I have got your return ticket for your latest journey of frustration! Unfortunately it is not going to be all that fun when your ticket gets punched. Why? Well, it seems to me of late that if any one of us needs to reach Health Care Happyland, we must get grumpy...maybe even mean, or dare I say obnoxious. Yeah...that's the ticket!
We pharmacists are not programmed like that. Remember...we are usually social folks, accessible, and trustworthy with all that sensitive health information you share with us. So, it pains me (with a pain that oxycodone will not ease) to know that I have turned into a mean old man...dare I say even a jerk! To get my daughter proper pain relief in the hospital, I fired the nurse practioner that was pretendint to take care of her. I told her to stay out of her room and not to touch her...ever again! And it wouldn't hurt for her to work on your bedside manner. I told her that too. I didn't feel one bit guilty about it the confrontation. Of course, for all that trouble, she kicked my daughter out on the street with discharge orders in hand the next morning. We didn't get as much as a "nice havin ya here!"
What has happened to the days of yore when a patient's simple direct request was heard and appreciated and most importantly acted upon? Help me out hear readers with the grump factor or I will end up like those 2 old guy muppet characters yelling from the balcony in Sesame Street! When you have made a pharmacist mad, you know that that is serious stuff!
So as those bafoons in congress continue to debate about a national health care plan, go ahead get a little heated under that white collar of yours. Your advocacy with a little edge on the side will get health care providers attention and there is a good chance you will see results years before the US figures a decent health care plan
...take as directed.
blake and still grumpy
Saturday, October 3, 2009
The Big Eye
On my fridge door hangs a magnet that states, "Everyone is entitled to my opinion!" As much as I would like it to be true in my life, the item has become rather iconic and reminds me that one must be careful in looking at the world through their own subjective"Big Eye."
In a bit of an "ah-ha" moment, it seems in my feeble attempt to make health care a little more pleasant via the blogosphere, I came off self serving and hippocritical. I have decided to be...well, let's say...less angry about the whole thing.
Now, thinking about the proposition for a moment, the question that begs to be asked is, "What makes me angry?" My answer: The "Big Eye" theory mentioned above. I know, it is not a particularly clever play on words...but EYE like the imagery. In other words, EYE get mad because most of the time, the world isn't how EYE see it. That patient in the pharmacy, the person in front of me at the bank, my boss, my job, my bank account, a doctor, my latest medical bill, my wife...whatever poison EYE choose invariably makes me angry. You can bank on it.
So, today I will fill your prescription for your "Big Eye." Choose not to be angry, because the world really isn't entitled to my opinion...or yours.
...take as directed,
Blake
In a bit of an "ah-ha" moment, it seems in my feeble attempt to make health care a little more pleasant via the blogosphere, I came off self serving and hippocritical. I have decided to be...well, let's say...less angry about the whole thing.
Now, thinking about the proposition for a moment, the question that begs to be asked is, "What makes me angry?" My answer: The "Big Eye" theory mentioned above. I know, it is not a particularly clever play on words...but EYE like the imagery. In other words, EYE get mad because most of the time, the world isn't how EYE see it. That patient in the pharmacy, the person in front of me at the bank, my boss, my job, my bank account, a doctor, my latest medical bill, my wife...whatever poison EYE choose invariably makes me angry. You can bank on it.
So, today I will fill your prescription for your "Big Eye." Choose not to be angry, because the world really isn't entitled to my opinion...or yours.
...take as directed,
Blake
Friday, September 18, 2009
Compassion? Nah...just lower your expectations
To all of my loyal readers (I think were up to nearly half dozen by now!), it is now surprise that I can be a bit critical of health care...and I am using "care" in the loosest sense of the word. Why?
Well, for starters, as a pharmacist that seems a bit like biting the hand that feeds me. Furthermore, some of my closest friends are physicians, and very good ones at that! I like them and I think they like me, even though eventually, will pull the "doctor card!" Could it be a subtle hint of their constant belief of an inherent superior position?
So today, as you would guess, I am feeling a little cynical. It is my opinion that most doctors don't care much anymore!! Our "tank" of medical compassion is almost empty. And to add insult to injury, my own family members have included me with the ranks of these healers. They have even branded their father and husband as compassionless. I represent what they hate about medicine. Ouch!
Now, before you cry 'What a cynic!" let me explain. Although cynics create little and answer less , I have a simple if not twisted solution: If you feel like you got slighted last visit by your doctor, next time just your lower your expectations. Simple! Although that sounds harsh, it is relatively easy. You expect too much from Dr. Marcus Welby and Dr. Welby can't fix everything that's ailin' ya. He or she might not even have the interpesonal or business skills to communicate that. I have watched my youngest daughter suffer for years. I have seen the disappointment in her eyes so many times when she needed an answer or some compassion and was dismissed in the name of efficiency. It has been painful to watch.
We must understand the limitations of medicine, both on a science and human level. The same obnoxious guy that messed up the curve in your high school chemistry class is now that frazzled doctor that really deserves a knuckle sandwich, stat! I once yanked a friend' s chain about the "jerk" factor. I wanted to know if that attitude was taught in medical school. His answer was ,"Nah...not taught...just reinforced!"
Please...take as directed,
Blake
Well, for starters, as a pharmacist that seems a bit like biting the hand that feeds me. Furthermore, some of my closest friends are physicians, and very good ones at that! I like them and I think they like me, even though eventually, will pull the "doctor card!" Could it be a subtle hint of their constant belief of an inherent superior position?
So today, as you would guess, I am feeling a little cynical. It is my opinion that most doctors don't care much anymore!! Our "tank" of medical compassion is almost empty. And to add insult to injury, my own family members have included me with the ranks of these healers. They have even branded their father and husband as compassionless. I represent what they hate about medicine. Ouch!
Now, before you cry 'What a cynic!" let me explain. Although cynics create little and answer less , I have a simple if not twisted solution: If you feel like you got slighted last visit by your doctor, next time just your lower your expectations. Simple! Although that sounds harsh, it is relatively easy. You expect too much from Dr. Marcus Welby and Dr. Welby can't fix everything that's ailin' ya. He or she might not even have the interpesonal or business skills to communicate that. I have watched my youngest daughter suffer for years. I have seen the disappointment in her eyes so many times when she needed an answer or some compassion and was dismissed in the name of efficiency. It has been painful to watch.
We must understand the limitations of medicine, both on a science and human level. The same obnoxious guy that messed up the curve in your high school chemistry class is now that frazzled doctor that really deserves a knuckle sandwich, stat! I once yanked a friend' s chain about the "jerk" factor. I wanted to know if that attitude was taught in medical school. His answer was ,"Nah...not taught...just reinforced!"
Please...take as directed,
Blake
Saturday, September 12, 2009
"Blow this Whistle!!"
Lately, there has been much in the "pharmaceutical" press regarding corporate "whistleblowers." As a quick review, these are health fraud lawsuits brought forward by ex-company pharmaceutical reps. In fact, several of my old colleauges and friends that I worked with at Eli Lilly and Company are now multi-millionaires because of this very lucrative process. Each snatched a cool 10 million and laughed all the way to the bank. It certainly was much more than I ever made selling Zyprexa and I am not laughing anymore. Why didn't I think of this "bonus" program before being "involuntarily terminated!" Hey guys, give me a call next time around!
So here is a re-enactment of how this usually goes down. The whistleblower is often a long term employee of the pharmaceutical company. Chances are, he or she is top in sales performance and usually trying to do the right thing. However, he becomes "pinched", by an obnoxious district sales manager, backed by a foolish sales/marketing team in the spirit of optimal sales performance. All parties know the score. Drug promotion is based on FDA guidelines of "on label" prescribing (i.e., drugs used only where indicated). The representative is paid to sell "on label," but resents the ole' "wink and nod" surrounding "off label" discussions. The moral compass is checked and the rep to whistleblower transformation is complete! It is classic David and Goliath stuff. Of course, you know how the story ends. The representative quits in disgust and hires a wiley corporate law firm. Years later, we here of big pharma being fined in epic proportions over the fiasco, the former drug salesman is now a millionaire, along with his attorney buddies. Just google: Pfizer, Whistleblower.
So...as interesting or true as this all might be, you ask: What is your point? My point is simply, get energized and start blowing your own whistle at your very own health care game. There is plenty to go around. Here are a half-dozen examples:
1. Blow the whistle when your physician talks more than listens.
2. Blow the whistle when your physician treats lab tests and not you.
3. Blow the whistle when your physician dismisses your intuition. Moms are you listening?
4. Blow the whistle when your physician can't think "out of the box."
5. Blow the whistle when you hear, "Oh, we have always done it that way"
6. Finally, blow the whistle loudest when you see that patient in front of you, on the cell phone, at my pharmacy's pick-up window
...take as directed,
Blake
So here is a re-enactment of how this usually goes down. The whistleblower is often a long term employee of the pharmaceutical company. Chances are, he or she is top in sales performance and usually trying to do the right thing. However, he becomes "pinched", by an obnoxious district sales manager, backed by a foolish sales/marketing team in the spirit of optimal sales performance. All parties know the score. Drug promotion is based on FDA guidelines of "on label" prescribing (i.e., drugs used only where indicated). The representative is paid to sell "on label," but resents the ole' "wink and nod" surrounding "off label" discussions. The moral compass is checked and the rep to whistleblower transformation is complete! It is classic David and Goliath stuff. Of course, you know how the story ends. The representative quits in disgust and hires a wiley corporate law firm. Years later, we here of big pharma being fined in epic proportions over the fiasco, the former drug salesman is now a millionaire, along with his attorney buddies. Just google: Pfizer, Whistleblower.
So...as interesting or true as this all might be, you ask: What is your point? My point is simply, get energized and start blowing your own whistle at your very own health care game. There is plenty to go around. Here are a half-dozen examples:
1. Blow the whistle when your physician talks more than listens.
2. Blow the whistle when your physician treats lab tests and not you.
3. Blow the whistle when your physician dismisses your intuition. Moms are you listening?
4. Blow the whistle when your physician can't think "out of the box."
5. Blow the whistle when you hear, "Oh, we have always done it that way"
6. Finally, blow the whistle loudest when you see that patient in front of you, on the cell phone, at my pharmacy's pick-up window
...take as directed,
Blake
Friday, August 28, 2009
I feel your pain...or do I?
Today's pain management isn't just for the patient! Many doctors struggle with their own comfort level when it comes to prescribing narcotics. I will often hear doctors quip, "Oh, I don't treat chronic pain!" In an earlier post, I related the story of a smug orthopedic surgeon that begrudgingly prescribed my daughter some Vicodin, thinking she was a 15 year old drug seeker! His actions mocked the Hippocratic Oath and created needless suffering for a young woman.
Lest you think I am being overly harsh on the medical community, I get "it" when it comes to balancing the sufferer and the prescriber. On one hand, there is the patient's pain, sometimes chronic and difficult to pinpoint. On the other hand, most doctors have been badly burned by people with ulterior motives. There is no dearth in creativity amongst the Oxycontin junkies! So what is the answer to this dilemma, you ask?
I am no doctor, but here is some prescriptive advice. First and I hate to be master of the obvious: pain is SUBJECTIVE! The only person that knows how much pain exists, is the patient. So, the next time your doc says "Oh...it doesn't hurt that much," kick "em hard in their left shin and then ask them to rate their pain on the 1-10 Faces of Pain Scale. Second, pain control is a little like that annoying squeak in your recently purchased "cash for clunker" vehicle. The problem is hard to find and you are primed for many dealer visits. 'Tis frustrating and it hurts. Third, sometimes the reason for pain cannot be identified. The doctor could be lacking in both diagnostic skills and available technologies. Let's just hope MD empathy outweighs frustration during the process. Finally, be skeptical if your physician bails and chalks up your pain as "depression." It is a sucker's bet! Pain is pain and it doesn't matter whether it is organic or somatic, people just want freedom from the agony. Just ask my friend Doug how that last visit to the gym worked out for him.
...take as directed,
Blake
Lest you think I am being overly harsh on the medical community, I get "it" when it comes to balancing the sufferer and the prescriber. On one hand, there is the patient's pain, sometimes chronic and difficult to pinpoint. On the other hand, most doctors have been badly burned by people with ulterior motives. There is no dearth in creativity amongst the Oxycontin junkies! So what is the answer to this dilemma, you ask?
I am no doctor, but here is some prescriptive advice. First and I hate to be master of the obvious: pain is SUBJECTIVE! The only person that knows how much pain exists, is the patient. So, the next time your doc says "Oh...it doesn't hurt that much," kick "em hard in their left shin and then ask them to rate their pain on the 1-10 Faces of Pain Scale. Second, pain control is a little like that annoying squeak in your recently purchased "cash for clunker" vehicle. The problem is hard to find and you are primed for many dealer visits. 'Tis frustrating and it hurts. Third, sometimes the reason for pain cannot be identified. The doctor could be lacking in both diagnostic skills and available technologies. Let's just hope MD empathy outweighs frustration during the process. Finally, be skeptical if your physician bails and chalks up your pain as "depression." It is a sucker's bet! Pain is pain and it doesn't matter whether it is organic or somatic, people just want freedom from the agony. Just ask my friend Doug how that last visit to the gym worked out for him.
...take as directed,
Blake
Wednesday, August 19, 2009
Everbody needs a win!
This morning, I had breakfast with a great buddy of mine...Jimmy! I never regret the decision in spending time with him;his unbelievable uniqueness makes me happy. He is also brilliant, but would never tip his hand to the fact. Occasionally during the "Early Riser Special" I fool myself thinking our age and experience count for something. However, most of the time I just enjoy the fact that I have met my equal in the "world's greatest audience" category.
My friend wanted a quick review of my family and as I was putting an exclamation mark on my son's challenges of late, I said, "I think he just needs a win once in a while." It was a small milestone in the "I get it" journey for both of us. Don't we all need a win every once in a while?
So today, put a W for win in that pill bottle of yours. This medicine comes without a doctor's order and the prescription is a cinch to fill, with...few side effects! My advice today: Look around and count your blessings, even if the blessing just happens to be that nasty wolf at your door...Jimmy does! Remember...take as directed.
Blake
Monday, August 10, 2009
Somebody is gonna pay!
Over the weekend, I went to a great outdoor concert in Sandpoint, Idaho. In front of me sat a very pleasant couple from Canada and as you would guess, we talked health care. They shared their perspective on Canadian and American approaches to medicine. They seemed well informed about both systems and I had no reason to doubt their opinions, especially since they have lived on each side of the border for some time. Our discussion centered upon, "Who pays when we get sick?"
This week's blog will not tackle the merits of American medicine versus our northern neighbors "evil" socialized medical care...eh? However, I will talk about money and health care. Specifically: Save your money and don't use health care! What's up with that, you ask? Simple: The healthier you are the more money you can keep. And this isn't one of those sales where you spend 20 bucks to save 16...like I did today! And as an added bonus, you don't have to fill out one single form!
Let me be more specific from a pharmacist perspective. You might think you are getting a great deal for that 5 dollar co-pay, but check those premiums, my friend. I am guessing that through a peanut butter costing scam, you are subsidizing other patients with terrible health and many times self inflicted. I am also guessing your premiums don't go down! And...your tax dollars are supporting a group of state assisted patients that often lack the concept that free medicine isn't free at all. You may not have quite thought through this oddity, but health care is one of the few industries where supply actually increases costs. In a way, we have only ourselves to blame. We are not exactly the poster child for health. Just look at the growing incidence of childhood obesity and diabetes. Overweight kids usually turn out to be overweight adults on many medicines.
As health care reform rolls our way, we will soon be asked to value the changes or in other words, how much should your doctor make? That wonderful surgeon that saved my daughter's life was worth every penny. Others during the ordeal, not so much! However, they all got paid based on a billing code and not on outcomes.
So whatever single pay plan congress throws at us, know this. A healthy diet, a lost TV remote, a low dose aspirin, and a brisk walk around the block thinking about fairness in health care, might just save you a few dollars. Maybe you can find a sweet mutual fund for the future....take as directed.
Blake
This week's blog will not tackle the merits of American medicine versus our northern neighbors "evil" socialized medical care...eh? However, I will talk about money and health care. Specifically: Save your money and don't use health care! What's up with that, you ask? Simple: The healthier you are the more money you can keep. And this isn't one of those sales where you spend 20 bucks to save 16...like I did today! And as an added bonus, you don't have to fill out one single form!
Let me be more specific from a pharmacist perspective. You might think you are getting a great deal for that 5 dollar co-pay, but check those premiums, my friend. I am guessing that through a peanut butter costing scam, you are subsidizing other patients with terrible health and many times self inflicted. I am also guessing your premiums don't go down! And...your tax dollars are supporting a group of state assisted patients that often lack the concept that free medicine isn't free at all. You may not have quite thought through this oddity, but health care is one of the few industries where supply actually increases costs. In a way, we have only ourselves to blame. We are not exactly the poster child for health. Just look at the growing incidence of childhood obesity and diabetes. Overweight kids usually turn out to be overweight adults on many medicines.
As health care reform rolls our way, we will soon be asked to value the changes or in other words, how much should your doctor make? That wonderful surgeon that saved my daughter's life was worth every penny. Others during the ordeal, not so much! However, they all got paid based on a billing code and not on outcomes.
So whatever single pay plan congress throws at us, know this. A healthy diet, a lost TV remote, a low dose aspirin, and a brisk walk around the block thinking about fairness in health care, might just save you a few dollars. Maybe you can find a sweet mutual fund for the future....take as directed.
Blake
Wednesday, August 5, 2009
Bonehead Pharmacy 101
When I was freshman in college, the freshman english class was called "bonehead" english 101. The class was designed for students needing the most basic english skill set. It was a good place to start for those of us grammitically challenged.
With that thought in mind, I would like to be of some assistance to those of you destined to visit your local pharmacy in the next few days. Shall we start with the "Top 5 List" of things NOT to do when your waiting for that all important prescription. Now, please don't dismiss this idea. I know what I am talking about and did some extensive research on the process. I simply asked my pharmacy colleagues what most annoys them about their patients. So here goes!
1. Please promptly identify yourself at the counter (or on the phone if you call in). "Is my prescription ready?" is not going to cut it. My local Costco does around 800 prescriptions on any given Monday. Go figure the odds on how well Mr. Pharmacist can guess your name!
2. Please bring your insurance card. I am betting that you had it with you at the doctor's office prior to visiting the drugstore. The trip from the drop-off window to the pick-up window will be much nicer.
3. Oh...and speaking of insurance, did you know if you have prescription benefits, that the price you pay for your prescription is dictated by your insurance company. The final key stroke made by that overworked pharmacy technician is"bill now." Out comes a label with your copay! If you don't like the price, my suggestion is to look at the back of your insurance card and call the 1-800 customer service number. Tell em your ticked!
4. Communication is vital in the pharmacy, so please lose the cell phone when you pick up your medicine. Would you be talking to your realtor while your doctor explains that odd looking rash on the back of your knee? Give those guys behind the glass a break. If your walking up with the phone up to your ear, your being rude and it could be hazardous to your health.
5. Finally, your favorite pharmacy is not McDonald's. In fact, one item on my "top 10 list" of thing Blake hates (which I may visit later on an upcoming blog) is drive thru pharmacies. Other things are mimes and plastic kitchen wrap. Sorry...I digress. My point is, do you want your medicine fast or do you want it correct? We have come a long way in the technology department since the typewriter. However, at the end of the day, mistakes are usually made when someone is in too big of a hurry. And, despite what you think about your favorite pharmacist, they do make mistakes. I will tackle that subject in an upcoming blog episode.
Many thanks to all those that offered their input. I negotiated the terms. They could be in my blog if they would check my blog out! I am not going to lie, I really would to welcome many more visitors to my virtual pharmacy in the blogosphere! May the word spread like the swine flu virus! Who knows, leave a few of your expert comments and I will...take as directed!
Blake
With that thought in mind, I would like to be of some assistance to those of you destined to visit your local pharmacy in the next few days. Shall we start with the "Top 5 List" of things NOT to do when your waiting for that all important prescription. Now, please don't dismiss this idea. I know what I am talking about and did some extensive research on the process. I simply asked my pharmacy colleagues what most annoys them about their patients. So here goes!
1. Please promptly identify yourself at the counter (or on the phone if you call in). "Is my prescription ready?" is not going to cut it. My local Costco does around 800 prescriptions on any given Monday. Go figure the odds on how well Mr. Pharmacist can guess your name!
2. Please bring your insurance card. I am betting that you had it with you at the doctor's office prior to visiting the drugstore. The trip from the drop-off window to the pick-up window will be much nicer.
3. Oh...and speaking of insurance, did you know if you have prescription benefits, that the price you pay for your prescription is dictated by your insurance company. The final key stroke made by that overworked pharmacy technician is"bill now." Out comes a label with your copay! If you don't like the price, my suggestion is to look at the back of your insurance card and call the 1-800 customer service number. Tell em your ticked!
4. Communication is vital in the pharmacy, so please lose the cell phone when you pick up your medicine. Would you be talking to your realtor while your doctor explains that odd looking rash on the back of your knee? Give those guys behind the glass a break. If your walking up with the phone up to your ear, your being rude and it could be hazardous to your health.
5. Finally, your favorite pharmacy is not McDonald's. In fact, one item on my "top 10 list" of thing Blake hates (which I may visit later on an upcoming blog) is drive thru pharmacies. Other things are mimes and plastic kitchen wrap. Sorry...I digress. My point is, do you want your medicine fast or do you want it correct? We have come a long way in the technology department since the typewriter. However, at the end of the day, mistakes are usually made when someone is in too big of a hurry. And, despite what you think about your favorite pharmacist, they do make mistakes. I will tackle that subject in an upcoming blog episode.
Many thanks to all those that offered their input. I negotiated the terms. They could be in my blog if they would check my blog out! I am not going to lie, I really would to welcome many more visitors to my virtual pharmacy in the blogosphere! May the word spread like the swine flu virus! Who knows, leave a few of your expert comments and I will...take as directed!
Blake
Sunday, August 2, 2009
"Me too"
Okay...it's about time to take a shot at the drug companies. Not that I want to bite the hand that fed me so well for nearly 18 years, but maybe just nip at it! My parting from big pharma was not pleasant and certainly some of it was my own doing. However, don't take the following comments as some bitter, ex-drug rep taking a shot at big corporate America! It's just that I have the luxury of saying a few things that many of my friends inside the industry cannot.
So here is an analogy to introduce my point about today's pharmaceutical companies. Hopefully, it will give you some insights from a former drug representative now making a case for drug therapy behind a pharmacy counter.
I greatly appreciate a new idea, novel and pioneering in nature. This is the stuff you talk about at work on Monday mornings. On the flip side, too much of a good thing is too much of a good thing and loses its luster quickly! To put it another way, I am not big on movie sequels or TV spinoffs. "Me too" is another way of saying I am a pathetic "poser." Let's lose the CSI "Scranton!" idea.
In many instances, a launch of a new drug from drug companies is not that much different. In fact, the next time you pick up a prescription for a new drug therapy on that arthritic knee, it might be akin to renting Rocky IV. The question that consumers should ask and the answer that drug companies must give is, "Yes, this new medication is novel and it will improve a patient's quality of live" If this is the case and not some slick brand marketing, then certainly everybody wins. Alas, physicians have a new weapon against disease, patients have hope from a new therapy, shareholders have a reason to celebrate, and last, but not least, drug representatives really do have "something new" to talk about. Now, that's what I call value.
Please, be a smart consumer with regards to the "Me too" phenomenon. Last week, I shook my head in amazement when a lady came into the pharmacy and inquired whether her doctor had called in a new prescription, knowing nothing about her upcoming therapy, not to mention she wasn't all that familiar with any other medicines she was taking. Ask yourself and the physician, "Is this a new therapy or am I being prescribed a commodity to capture market share at my expense?" Now, don't get me wrong, I appreciate choice and if there are significant differences in a drug's efficacy and side effect profile in the same class, prescribe away! This makes us good capitalists in search of optimal health care delivery. However, the road less travelled for drug companies might be the best option. Why don't they blaze a new trail with all that R&D (Research and Development) money instead of bringing to market the 20th NSAID (Non-Steroidal-Anti-Inflammatory Drug) that I mentioned above that you are about to take for that arthritic knee. It might just put to rest that inner conflict every pharmaceutical representative carries along side those drug samples...take as directed, Blake
Tuesday, July 28, 2009
What's the current value of your doctor
Lately, I have been telling my friends that my 401K is now a "101K." In fact, I am not sure why my money was yanked out of my paycheck all these years. Oh well, the upside is that I get to work until I am...say, 82! I hope I can still count to 30 and...inform patients where the hair-care isle is! (Sorry for the dangling participle)
So...as you would guess, lately, I have been thinking about value. It would be wise of you to do the same;not about your 401k or any other financial instrument, but about your doctor. Open up "that statement" every once in a while and peek at the value of your physician. Set up some reasonable expectations, just like the performance of your favorite mutual fund. Remember, his or her past performance, is not an indication of future returns! Or is it?
Physicians like us are to some extent creatures of habit and certainly risk averse! They may not realize it, but they often approach the practice of medicine in 3 interesting ways. Remember, this is my perspective on calling on these guys for nearly 20 years and of course, everyone is entitled to my opionion (...tongue in cheek noted!)
Firstly, they sometimes look at your problem by sheer intution. In other words, they draw upon their education, expertise, and experience where no trails have been blazed. So, it is wise to choose a doctor that at the end of the day, is gifted and trusts himself on some tough calls. (Oh, they have to know when to tag out of the wresting match and bring in somebody that really knows whats going on).
Secondly, he works with the odds...not the kind out here at the Greyhound dog track, but he does have a little info in the white jacket (occasionally shared by a pharmaceutical representative) regarding probabilities. "Hey, let's try this therapy out for size; see if you PROBABLY get better!" The point is, make sure he or she is aware of a reasonable and positive outcome. This is very important, especially if your life has been shattered with the diagnosis of cancer.
Finally, the incredible strides in technology has given your doctor the tremendous gift of precision. In other words, a diagnosis can be indisputable (I think the spelling is correct). Today's imaging procedures correctly diagnose, say a wrist fracture, 99.99999% of the time. Thus, the precision is evaluated, not the ability of the doctor or his intuition...see above.
So please, go ahead. Next time you watch your physician write something on that little prescription pad, ask him how he has made that snap decision. Who knows? YOU might get a little extra time with your doctor! Then come and see me. I will fill the prescription and tell you to...take as directed!
So...as you would guess, lately, I have been thinking about value. It would be wise of you to do the same;not about your 401k or any other financial instrument, but about your doctor. Open up "that statement" every once in a while and peek at the value of your physician. Set up some reasonable expectations, just like the performance of your favorite mutual fund. Remember, his or her past performance, is not an indication of future returns! Or is it?
Physicians like us are to some extent creatures of habit and certainly risk averse! They may not realize it, but they often approach the practice of medicine in 3 interesting ways. Remember, this is my perspective on calling on these guys for nearly 20 years and of course, everyone is entitled to my opionion (...tongue in cheek noted!)
Firstly, they sometimes look at your problem by sheer intution. In other words, they draw upon their education, expertise, and experience where no trails have been blazed. So, it is wise to choose a doctor that at the end of the day, is gifted and trusts himself on some tough calls. (Oh, they have to know when to tag out of the wresting match and bring in somebody that really knows whats going on).
Secondly, he works with the odds...not the kind out here at the Greyhound dog track, but he does have a little info in the white jacket (occasionally shared by a pharmaceutical representative) regarding probabilities. "Hey, let's try this therapy out for size; see if you PROBABLY get better!" The point is, make sure he or she is aware of a reasonable and positive outcome. This is very important, especially if your life has been shattered with the diagnosis of cancer.
Finally, the incredible strides in technology has given your doctor the tremendous gift of precision. In other words, a diagnosis can be indisputable (I think the spelling is correct). Today's imaging procedures correctly diagnose, say a wrist fracture, 99.99999% of the time. Thus, the precision is evaluated, not the ability of the doctor or his intuition...see above.
So please, go ahead. Next time you watch your physician write something on that little prescription pad, ask him how he has made that snap decision. Who knows? YOU might get a little extra time with your doctor! Then come and see me. I will fill the prescription and tell you to...take as directed!
Blake
Monday, July 20, 2009
"Blake...this is a big deal"
"Blake...this is a big deal!" Words I can never erase from my consciousness! That's what the trauma surgeon said after working my daughter up at Sacred Heart Hospital (no, not the one in "Scrubs") in Spokane, Washington, a week prior to Halloween, last year. Silly me...I thought that she was being admitted for a simple arthroscopic procedure on her left hip. As it turned out, the big deal (after CTs and MRIs, and X-rays, and a nuclear bone scan) came down to either Ewing's Sarcoma (bone cancer) or Osteomyelitis of the femur (infection in the thigh bone).
I won't bore you with details of the next 16 days of trauma drama, but neither diagnosis is a picnic in the park and surely the Sarcoma thing (cancer) is a certain death sentence. Oh, did I mention the excruciating pain associated with the diagnosis? (One can't technically die of pain, but most men would have come close in comparison to my unbelievably courageous daughter, Michelle. By the way, she will be 16 years old on August 10th).
So...why all the melodrama? Because there is a point or two here I would like to make with the readers. Remember I eluded to the importance of solid patient advocacy in my 1st ever blog? Okay Moms... please listen up! Never and I mean never let a physician talk you out of your "mother's intuition," when you know something isn't right with your child. Better still, don't let your husband/father off the hook either. Got it? Take that mother's skill set further and start thinking like a doctor or should I say, STOP thinking like a certain doctor that screwed up with my Michelle just prior to getting the "big deal news" previously mentioned.
Tragically, the doctor made 3 critical errors. To this day, this jack-ass (and I use the term in the most literal sense of a stubborn foolish animal) has no idea of the consequences of his actions. Oh sure, my wife informed him at a later date of his unprofessional performance, but his apology over the phone was driven more from the advice of his risk manager than from his heart.
So, you ask what are these errors. The first mistake is termed "search satisfaction" by some. This doctor looked no further than the MRI in front of him. He paid little attention to the pain my daughter was being subjected to during his examination. I would have guessed the sweat left on the examination table might have clued him in. He narrowly connected the pain with a 15 year "actor" looking for a narcotic fix. Secondly, he committed what is called an "attribution error." In short, if a doctor sees 8 drug-seeking patients in a row, then the number 9 must also be a drug seeker. Heaven forbid, if number 9 has legitimate pain. Finally, he was "anchored" to his own ego. Hey Mr. Doctor, "Weigh anchor, look a bit deeper, and diagnose your own 'big deal'!" Instead, he became the deal breaker, and in a cruel twist of irony he later informed his colleague (who happened to be the on-call doctor that night) not to admit Michelle, because the pain "was all in this girls head." Nice...
Well, thanks for letting me fill your prescription on patient advocacy tonight. You might need a refill or two later on. Please, "take as directed"...Blake
Saturday, July 18, 2009
Blake's Inaugural Blog... "Smackdown" style
I am miserably full...and not from the hobo dinners I ate a couple of hours ago. It is from all "the crow" I ate for dessert. As of 2200 hours, I have stepped into the "Blogosphere Portal"
Waiting at the portal's other end was my family's "smackdown". They reminded my that this blog action is not that much different than FaceBook. That hurt and I asked them for some aloe vera gel...stat! They will quickly tell you that "Dad" has nothing good to say about FaceBook and likens the social networking site to a self-serving Christmas Letter on steroids!
So here is the deal! I am willing to take the abuse if my blog accomplishes the following: Firstly, the approach will be well, let's just say, "NOT about me" (see me on Facebook...NOT!) However, It IS about events of late that have had a huge personal and sometime very painful impact on me and my family. I am confident that I have enough material to blog thru oh...I don't know, maybe Arbor Day of 2013. I will re-assess and make an informed decision about the availability of common nonsense.
Now, here is where the whole "self serving" disclaimer that comes into play. The risk in sharing these experiences is that they may come across like the Christmas letter afore mentioned. But, if you stick with me, the blog's subject will hopefully be singular in nature.
The arena will simply be my personal insights into patient health care (see "events of late" above for a clue).
It is my hope that as a parent of children struggling with recent health issues, a washed up drug rep with insights about big pharma, a pharmacist now standing behind the counter, and finally just a guy who is woefully disappointed into the optimal delivery of health care today, I can be your advocate in the blogosphere. If not, I am all open to a book deal!
Your Rx is waiting...Blake
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