Humor Me after I pay the bill!

My youngest daughter just completed her latest surgery; a mere tune-up of sorts compared to her past dramatic health history. However, this rant has nothing to do with her oral surgery... rather it is all about another form of inflicted pain: Payment of Services Rendered.

Of nothing else, my experience has taught me the value of due diligence when it comes to insurance coverage. It is an extremely arcane world, understood only by its sordid designers. They talk of "EOBs,In Network versus Out of Network, co-insurance,co-payments, and maximum out of pocket costs." And...those are the things that I understand! I was confident in my prepratory efforts and expected all players in this health care game to claim victory. Fat Chance!

Regretfully, the pain I referenced earlier came from a most unexpected site. The female keepers of the finances! Oh sure, it is all fun and games at the front office and in the back exam room. In fact, one couldn't help thinking that the oral surgeon might be akin to Captain America. The supporting cast was also accomodating, professional, and slapped on their best patient advocacy faces,(which included dazzling-white bleached teeth). And why? Simple...the money for service deal hadn't gone down yet. Make no mistake, they WERE helpful in the "I will show you HOW to get the money so I can quickly take if from YOU and then get GRUMPY" category. Well...maybe grumpy is a tad severe. How about: deliberate indifference! That ticket is even worse...at least, grumpiness takes a little forethought! You see, my daughter had a little post-op complication requiring attention. Their response, "I am sorry, what did you say her name was again?" Seriously...

So next time your scheduled for a some time "under the knife", enjoy the joyous preliminaries, because after your cash will soon be parted, you will continue be sliced up! Tragically...typical!

Remember...take as directed

blake

Tell me where it really hurts?

I can no longer bear listening to Jesse Jackson, President Obama, or the occasional NPR pundit. It is just too painful! Why, you may ask? The reason, the discussion thread is all scripted. Where is the emotion, the spontaniety, and cutting to the chase? Give me some Hydrocodone and fast! Oh wait, that might prove to be too difficult!

To that end, I am throwing away my well thought out communicative approach and write from my cold, calculating heart about this subject. You see... me, a Dad, a pharmacist, can't get a prescription to ease my pain to save my life or better still, my daughter's life!!! Check out previous blogs and you will see, pain management is a big deal with her. And yet, last week after her 5th surgery in the past 24 months, she is still dismissed as a Hyrdocodone seeker and worst, her concerned mother, treated as white trash on the score. Seriously, Haven't we seen this movie before?

So...here is my solution. I have discovered after standing behind the pharmacy counter for years, our family is going to fulfill the expectations of those indifferent surgeons (who by the way, have rarely had surgery and thus, poor pain advocates). I am quitting my job, applying for state assistance, move into a "van down by the river." That will give me plenty of time to focus on clever reasons on why I should get my Hydrocodone for that pesky "skin condition." Those are the people that seem to get the prescription without a hiccup.

In short...I know pain managment is going to be looking good around the old homestead. I now know where it really hurts!

And remember...take as directed

Blake...your future un-employed pharmacist

You can't have it both ways!

As a pharmacist, there is not a day that goes by where I don't here from my patients about the big, bad, and very rich pharmaceutical companies. Regardless of my past life in pharma, I will not play an apologist role. Hey, despite what you might think of me as a former drug salesperson, I agree with most of their arguments, even if their facts are a little emotionally whacked! It is not like I am feeling any love from the drug companies.

However, this is where I don't get it. If patients are so concerned over the oft obscene price charged on their last prescription, then doesn't it follow that they should know something about the medicine that they are whining about....SERIOUSLY!

I can't even count the number of times in a week where I hear, "Ah, just fill whatever I'm due!" or "My doctor just called something in for me...have know idea what it is, but...hey, go ahead and fill it!" or my new best favorite, "I think I am supposed to refill the 3 DOLLAR prescription!" Are you kidding me? This level of communication almost frightens me as much as a misfilled Rx.

I am sure on of one thing today. If I coughed up 40K for some new wheels, you can bet your next Advil Coupon I would know at minimum, the make and model of the car that my credit union will soon own! See my point? So, please tell me in painful detail which medicine you need me to refill and then we can discuss the strategy of going short on pharameucitcal stocks.

Remember...take as directed,

Blake

It is RPh not MD

We all like free advice and given the recent economic slump, even bad advice might be worth something. But...there is a limit. A couple of weeks ago, an elderly gentlemen snuck up on me at the pharmacy counter. I looked away for just a second and BAM...there he was! Now, that might not sound all that frightening to you, especially if you are a pharmacist. It is all in a days work.

But hey... you didn't see this guy's left eye. The color was a ghastly deep, dark, blood red. The reason: A large wood chip from his favorite chain saw just happened to find his eye. The hemmorhage was breath taking. And as you would guess, chunks of wood moving at bullet speed tend to do that. It was horrible and I was certain that any minute that eye would be violently erupting on my recently cleaned pharmacy counter. I am sure you can feel the angst. Then, it happened, and it was not the pop of bodily fluid. It was something more scarier than the impressive injury at hand. It was his unbelievable question, "Do you think Visine will help?"

Now, I think I was the one in semi-shock state. Look, as pharmacists, we are secretly flattered by the trust given to us by all of you loyal patients. Many confide in us at a deeper level than their physician, pastor, bishop, or for that matter, wife! I have even heard on occasions people ask, "Well...aren't you a guys doctors?"

But serious medical emergencies like this are way out of our league and please understand our limitations. As a result, I will quickly point you to the nearest emergency room or urgent-care clinic. I will then remind you that RPh stand for registered pharmacist, not medical doctor. So next time, you have a serious health problem, ask yourself, "Will Visine will help me?" Then, go see a doctor..stat!

and remember...take as directed,

Blake

I want their insurance plan

My daughter's bill from last month's trip to the Mayo Clinic finally arrived...high anxiety, as you would guess. I had to sit down after glancing at the charges. And...it is not what you think. Unbelievable...the bottom line literally showed that we CAN have great health care in America at a very reasonable cost. 7 frigid days in Rochester, Minnesota and I am not medically broke! Indeed, I was lightheaded with "Explaination of Benefits" euphoria!

And then...I had to go and ruin it all! A rookie mistake at best, as are many decisions made with high emotional value. In a lapse of judgement, driven by my civic duty, I tuned into President Obama's live health care "summit." What was I thinking? It took only seconds for the torture to begin as I listened to the same ole' roster of congressional leaders pandering to the tv camera, heavy on the partisan baffoonery!

Seriously...do these clowns think those of us serious about health care reform look at this type of media event as nothing more than really bad television. So...I got thinking and thought to myself, "If I were in that room, what would I want?" (besides that sweet meal they had at mid-day). The answer was easy and I think I may have even solved the hotly debated issue of a one payor health plan. This one is free on me, boys and girls!

In short, I want the same health care plan that every member of that room enjoys as a public servant! All those old guys looked pretty healthy and spry to me. It appears that they are getting the "best health care in the world" that we here about, ad nauseum. Instead of McCain and Obama re-bashing big bad pharma, or re-hashing old campaign promises, I would have liked to see the President's and the former Wanna-be-President's insurance plan specifics. Let's debate your present monthly premiums, annual deductibles, maximum out of pocket expenses, pharmacy benefits, and the like.

So...all of you smug Democrats and selfish Republicans in Washington, please get back to work and start over on that 2700 page health care juggernaut. Maybe you can lighten the text and go for: Blake's Number 1 Payor Plan....YOURS!

Remember...take as directed. Oh yeah, Beltway...I'm not kidding on this one.

Blake

Ahhh...satisfaction

Yup...here comes curve number two! Some of you have heard the term "search satisfaction." It is a common malady amongst the human condition and simply put...it is the trap we all fall in when we desperately grasp the first solution for our problem; even if it isn't the optimal one. A case in point is when you quickly jumped on that "perfect" job and soon found out that there was a "perfecter" job a week later. Ouch!

The best of physicians are not above this sometimes fatal error, so please make sure that you help them steer clear of the consequences. After all, satisfy your health first! My point is that next time you see your favorite doctor and it seems your problem is too quickly remedied, it just might be.

In previous blogs, I made mention of my daughter's osteomyelitis (big name for bone infection) being brushed aside in favor of a doctor's own short sighted diagnosis of his personal satisfaction. It was a rookie mistake and I asure you that in the past, he has "dressed down" many residents for making the same gross error. He did come clean and I never erased his apology from my answering machinge. I am sure those past residents and present "big boy" doctors might enjoy listening to the message. I am also guessing they would get a little satisfaction of their own, at their past mentor's expense! Ahhh...payback!

And remember...take as directed...it will help the pain...some!

Blake

Trust but Verify!

As promised in the last blog posting, here comes the first of many sharp curves on our health care road trip.

Most of us have grown up trusting modern medicine unconditionally. However, my experience of late with modern medicine has caused me to pause and reevaluate. Therefore, I am now adopting a not-so-new mantra popularized by a couple of past U.S. Presidential Aministrations: Trust but Verify!

How appropriate is this approach when it comes to the "buy in" on a physician's diagnosis. Let me give you a quick illustration and hopefully it will be instructive the next time you are handed a prescription.

For over two years, my youngest daugther was mis-diagnosed as clinically depressed. She went through more antidepressants than you can shake a stick at...and that deal truly was depressing. The upside is that this first of many comedies of error in her health care has transformed me into a better pharmacist and is "good copy" for many antecdotes to come. (By the way, all this will make sense when we talk about her real diagnosis made at the Mayo Clinic a few weeks ago. If interested, Google: POTS for more information).

So, to make a long story short, it wasn't depression, it was HYPOTHYROIDISM!!! Somebody neglected to do a simple lab test. Furthermore, you don't have to be a pharmacist to know that thyroid medicine is the BEST ANTIDEPRESSANT. It is the gas that run's our body's engine. Without it we bloat and put on weight, we get sluggish, our hair falls out, our nails are brittle, we are cold all the time, we sleep too much, and yes we actually become...depressed.

The names of the medicines needed for this type of depression are not Prozac or Paxil or Pristiq. Instead, they go by Synthroid or L-Thyroxine or Levoxyl or good ole' Armour Thyroid. I have a good idea of what I am talking about here. I sold Prozac for years and rubbed shoulders with some of the foremost experts in clinical depression that could be found anywhere. They taught me that it is as important to know what depression IS NOT as it is to know what IT IS!... I think that came out okay. Despite what you see on every direct to consumer on the latest and greatest antidepressant, everyone does NOT have depression.

So...go ahead, trust and verify that your doctor can reach for either a sample of Pristiq...or maybe better still, Synthroid. And remember...take as directed


Blake

"The pet monkey seemed like a good idea at the time"

That phrase probably means little to you. However, the words are of some significance when used around our house. In essence, it is symbolic that somebody amongst us made a bad decision and let us learn the all-important principle of of non-repitition when it comes to future said opportunities. The point is, what a great thing it is to be able to change direction, even in mid-stream on many of our intentions, even those on my little portion of the "Blogosphere River!"

The initial catalyst for my posts was my daughter, Michelle, as she has made her ghastly journey through the health care system...and regretfully there is nothing systematic about it. Last count, she has seen over 30 physicians over the past few years before finally getting a diagnosis (see previous blog post). If that wasn't enough, my son soon followed with his brutal share of health problems. Understandably, I wanted to land a punch on the cheek of medicine thru tongue in cheek verbage. It was random and emotional and soon, 3 followers were gracious enough to flatter me with their loyalty. Life is good!!! But all those good things must come to an end.

So, in the spirit of excellence in journalism (not that I would know), I want to change things up a bit and personally share in some of the highlights and mostly lowlights of our trip through the perfect storm...only in reverse. Please join us as we go backwards so we can do better forward...if that makes any sense. What is this prescription supposed to do for me, you ask? I have enough "tough pills to swallow" in life as it is...(notice the self promo tact here!)

Regretfully, the answer is not so obvious. Yes there will be stories. However, there is more to it. I am just not sure what that "more" is...yet. All I can ask is for you to stick with me in the next few months and I can help you becoming a better navigator when it comes to getting medical help. Not only Michelle, but our entire family is the vehicle to assist you in finding an alternate route when heading toward the doctor. So...please, get in, buckle up, and enjoy the ride! The first curve is coming up soon!

remember...take as directed.

Blake

I'll have Mayo on the side!

" Oh...This is how medicine is supposed to roll!" This is my departing thought as I leave frigid Rochester, Minnesota and the world renowned Mayo Clinic. Now that my daughter's 6 year health nightmare has ended, it might as well be 85 and sunny outside.

A week ago, we came here desperate and anxious knowing that this was the end of the line for family answers. There were no options remaining. We have despised the endless and brutal perfect storm for years. Without faith and hope (and not always present, I assure you) it nearly destroyed an otherwise very happy family unit. Never underestimate on how ghastly chronic illness can be...and it does not affect just the patient.

However, there are very few moments in life where expecations will not only be met, but exceeded. It happened here and the experience has been epic! We now have a very personal and real life example of the fact. We have answers.

I have stared at this page for days, knowing that I have no skill package that can adequately articulate our journey and more importantly our deepest feelings. I can only tell you that the weather cleared and we are happy with the forecast.

So...let me cut to the chase. If the "health wolf" is at the door, you do not have to answer it. You can move and answer it elsewhere. What I am trying to say is physicians really do care (You have to come to southeast Minnesota find them, though), they actually are good capitalists and put patients first and profits second...hope that didn't sound too cliche;they set politics and egos aside. And most of all...they can communicate with another doctor who might see things different or is better and smarter about what is going on with the patient. They even team up!The Nelson's woke up and now realize that the health care we have been receiving for years (with few exceptions) has been incredibly mediocre. None of us can afford this harsh reality.

Why, I ask myself, can't US medicine clue in on the Mayo method of integrated medicine. Integration...a big word for were are all on the same page on how to take care of a patient. It starts with listening...no bias approaches...no dismissive attitudes...I am not crazy or depressed...and no first question of "What insurance are we billing?"

Ok already, I will step off the soap box, before someones knocks me off. But...one more thought from the pharmacist filter. There was no talk of drug therapy until the last day of a week of appointments seeing a number of medical sub-specialty. How refreshing was that and how odd is that statement coming from a druggist? Now don't get me wrong, your prescription should include life changing medicine. Just don't forget to get an accurate diagnosis of what is wrong and what is NOT wrong with the you before the trip to the pharmacy. And...if your serious about your health, come to the Mayo Clinic and get your prescription filled!

Remember...take as directed and thanks to all at the Mayo

Blake