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

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

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

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

"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