The "Talkover"...I hate it. It pushes my buttons in the worst possible way and creates a huge mass of human rage, from a fairly easy going, friendly pharmacist...occasionally like me!
So, what am I talking about? Remember? All of us have been victims. It is the person that thoughtlessly ambushes you half way in to a conversation where a cogent thought might be useful...say, counseling a patient on a new medicine. They talk "over" you with a question or a lecture or a whine or a complaint, or a whatever... before the first syllable is out of your mouth. It is like a listening disease! Its symptoms are closed ears and open mouth and usually with a foot in that same mouth, following close behind. Hello...two ears one mouth, ya'll!
Take today. If this patient at the pharmacy counter would have let me finish my thought (and I was fairly confident that I knew what I was talking about) before he popped off as if I was the stupidest guy in a white lab jacket, our verbal exchange wouldn't have escalated to ,"I don't like you Mr. Pharmacist!" and in response, "Quite frankly, Mr. Patient, I am not real fond of your present attitude either!" It didn't end well, but I deftly defused the situation... by what else? I walked away. Oh...that was mature!
So what does this have to do with being a better health care receiver and advocate? Isn't it obvious and yet almost impossible to accomplish? Improve those listening skills, rookie! Get in the game!
Oh, by the way, physicians are not immune to the "Talkover." Neither are pharmacists. In fact, in many ways we can become experts. This is not good. Just for giggles, be your own referee. On your next doctor's visit pay close attention to his or her "doctoring" listening skills. You make the call on the "Talkover" infraction. If you have to, throw the penaly flag! They should be trained listeners, although I have seen some disturbing exceptions on the health care field. Nevertheless, they are trying to dial in to what you are saying with both the verbal and non-verbal signals. Hold them to that standard. Many are very good!
And just for good measure, how about turning the tables on the well educated, highly trained doctors? First, don't do the "Talkover!" Stake your health claim quickly and sit back and listen to the MD's response. Stay on point and you will be enlightened. You will know your provider's level of investment, interest, expertise, etc. My daughter saw nearly 34 physicians before a trip to the Mayo Clinic nailed the diagnosis. THIRTY FOUR! She can immediately tell, within seconds into an appointment whether a doctor is genuinely engaged with her medical care or politely (or sometimes not so politely) dismiss her.
Remember, you are ultimately responsible for your health care and active listening is one of the first steps. It starts with your own body and mind. Trust yourself and act...move and listen...and then act again. Incidentally, follow up questions during these brief but critical moments with your doctor is not and I repeat not the "Talkover!" Just be wise with your timing.
Okay...I'm done, lest you criticize me for the "Talkover" and after today, I just might be very close. Beware of creepy Halloween pranks and of course... the "Talkover." Remember....Take, as directed!
blake
Wednesday, October 19, 2011
Monday, October 17, 2011
Option is not a Failure!
It will happen, especially if a serious or indeed life threatening illness plays a family member like Whack-A-Mole; with the MD holding the Whack! I know what I am talking about, because I saw it first hand on the face of an ER physcian who thought he was option-less in helping my daughter. They won't let us admit her," said he. "What do you mean we are out of options?" I asked, panic stricken.
As you would guess, it is a hopeless feeling, but maybe more disturbing is the newness of that emotion for families experiencing their initial big health care crisis. I was stunned at the response. I had never heard such a thing and certainly this couldn't be happening in the 21st century. Are you telling me that the on-call orthopedic surgeon at the local hospital was not going to admit my daughter because of his hubris, ingorance, a poor judgement? If your remember, the reason was that his colleague instructed him not to do it because he thought my daughter was a drug seeker! Well, on hindsight, he was precise but misguided in his clinical assessment. After all, her femur shattered because of mis-diagnosed bone infection,so I'm guessin' she was looking for some pain relief in a round about way. Sorry, I flew off on an emotional tangent there for a sec...oophs!
So what is my point? As an educated health care recipient (and I mean get educated! Don't be coming in to my pharmacy not knowing what your doctor was supposed to be calling in for that nasty sinus infection!) and a advocate for that sick loved one, NEVER and I mean NEVER believe that you are out of options to get the needed treatment. You think that any doctor would accept that kind of "Sorry, there is nothing I can do?" response from one of his own. Believe me...he would fire the doctor and find a new one. I have done it and it was nothing personal. It was a matter of reminding that health care provider that I pay the bills, or more correctly speaking, my insurance company ponies up and then I disagree on the treatment approach.
And, guess what? You will find plenty of doctors out there that share your sentiments. A fiesty former Army Doc, also on duty that night, gladly shattered protocol, called and end run, and in less than an hour, my daughter was in a hospital bed, Morphine on board, and all vitals good. She was brilliant enough to not accept that woefully outdated argument of "Well, that is the way we have always done it around here!"
It will be a challenge to literally think out of the box and encourage that health care team that surrounds you to do the same. You are in crisis mode, so emotions are high and logic is suffering, Fear not, because those health care providers, like you, are are product of life's experience full of great and not so great ideas. Push 'em a little and ask what they would do if this were their child or mother or wife? If necessary take them to the brink of surrender. It won't be hard, most of them are overworked, sleep deprived, and often pick their battles wisely. I think that the pharmacist and doctors got so weary of me popping off as a pharmacist, they started asking me my insights about pain management to help my daughter and ultimately themselves (figuratively speaking).
Today, after three years. my daughter is thriving under the care of a skilled accupuncturist. And....this conservative, western medicine, trained pharmacist (aka,me) could not be happier. You listen to your intution. It is sometimes as valuable as that skilled surgeon or that new chemotherapy medicine. Even in the most sobering situation where thoughts and actions are so intense, almost surreal, you still have the option of doing NOTHING and leaving the outome to a force much greater that yours and mine. It can be liberating to be in that much control
So remember, if you think your out of options, maybe failure is the one! Just think about it... and of course remember...Take as directed.
blake
As you would guess, it is a hopeless feeling, but maybe more disturbing is the newness of that emotion for families experiencing their initial big health care crisis. I was stunned at the response. I had never heard such a thing and certainly this couldn't be happening in the 21st century. Are you telling me that the on-call orthopedic surgeon at the local hospital was not going to admit my daughter because of his hubris, ingorance, a poor judgement? If your remember, the reason was that his colleague instructed him not to do it because he thought my daughter was a drug seeker! Well, on hindsight, he was precise but misguided in his clinical assessment. After all, her femur shattered because of mis-diagnosed bone infection,so I'm guessin' she was looking for some pain relief in a round about way. Sorry, I flew off on an emotional tangent there for a sec...oophs!
So what is my point? As an educated health care recipient (and I mean get educated! Don't be coming in to my pharmacy not knowing what your doctor was supposed to be calling in for that nasty sinus infection!) and a advocate for that sick loved one, NEVER and I mean NEVER believe that you are out of options to get the needed treatment. You think that any doctor would accept that kind of "Sorry, there is nothing I can do?" response from one of his own. Believe me...he would fire the doctor and find a new one. I have done it and it was nothing personal. It was a matter of reminding that health care provider that I pay the bills, or more correctly speaking, my insurance company ponies up and then I disagree on the treatment approach.
And, guess what? You will find plenty of doctors out there that share your sentiments. A fiesty former Army Doc, also on duty that night, gladly shattered protocol, called and end run, and in less than an hour, my daughter was in a hospital bed, Morphine on board, and all vitals good. She was brilliant enough to not accept that woefully outdated argument of "Well, that is the way we have always done it around here!"
It will be a challenge to literally think out of the box and encourage that health care team that surrounds you to do the same. You are in crisis mode, so emotions are high and logic is suffering, Fear not, because those health care providers, like you, are are product of life's experience full of great and not so great ideas. Push 'em a little and ask what they would do if this were their child or mother or wife? If necessary take them to the brink of surrender. It won't be hard, most of them are overworked, sleep deprived, and often pick their battles wisely. I think that the pharmacist and doctors got so weary of me popping off as a pharmacist, they started asking me my insights about pain management to help my daughter and ultimately themselves (figuratively speaking).
Today, after three years. my daughter is thriving under the care of a skilled accupuncturist. And....this conservative, western medicine, trained pharmacist (aka,me) could not be happier. You listen to your intution. It is sometimes as valuable as that skilled surgeon or that new chemotherapy medicine. Even in the most sobering situation where thoughts and actions are so intense, almost surreal, you still have the option of doing NOTHING and leaving the outome to a force much greater that yours and mine. It can be liberating to be in that much control
So remember, if you think your out of options, maybe failure is the one! Just think about it... and of course remember...Take as directed.
blake
Saturday, October 15, 2011
Is the network picking us up for another season?
Darkness starts its rounds a little earlier each autumn day in the Northwest. It has been over a year since I have found the energy to write and 3 years ago when our family got schooled in the realities of healthcare as we presently know it. As you remember, two of our three children were prized pupils.
The twisted melancholy of the cooler season has drawn me back to pen some thoughts. Tis no big secret blogs evolve, mostly for the writer, since in my case there are few followers, but they are most loyal. I like loyalty. I applaud loyalty!
Moving forward...I think I will continue my/our/your story. Call it an occasional medical theme of sorts, if you like, or think of it as the network gave the go ahead for a few more episodes of "U.S. Healthcare"...without the ratings to justify the quality. It is my little way of sticking it to FACEBOOK social networking crowd, since I don't do facebook. (I do have my reasons and they are obnoxiously dogmatic! A topic for later rants).
I like the idea of helping those individuals facing crisis with medical care. On the self serving front, it will ultimately be cathartic for me. I do get a little PTSD when I visit a hospital at this time of year. Any therapy is good therapy, the way I see it. That is my way of saying that I empathize with the struggles of those care-givers trying to take care of loved ones when they are seriously ill. Wanna here some irony. My daughter Michelle is always telling me, "Dad...get over it!" And I wasn't even the one with ICU time and a couple of surgeries under my belt
So, in the spirit of non linear thought, I shall write of random events surrounding our health education here at the Nelson's. I think you will agree that I have had some time to digest a couple of years of memories. By the way, if your curious regarding the state of health of my "N of 2" (that's statistic talk for my 2 children)they are getting on rather nicely. Let say their progress is directionally correct, but as of yet, not made whole.
I have learned much and committ to staying away from the weary, whining, worried camp with my posts. I will just share a simple narrative of hope and hope people get it. Please remember, I intend to offend nobody and I am not that angry. My perspective still comes from a pharmacist, former big pharma lackey (sic), and a father that watched his kids get sucked into healthcare...for better or worse. In fact, it might be a good idea for you to do a quick review of my older posts, so that when my season opener comes around, you will have a nice little medical history in that fancy "chart" of yours.
If my efforts or hobby or "whatever you would like to call it" is occasionally thought provoking...cool! So, to all my friends, enemies, and frienemies, knock yourself out. Humor me every once in a while and drop in. Remember, "Take...as directed!"
The twisted melancholy of the cooler season has drawn me back to pen some thoughts. Tis no big secret blogs evolve, mostly for the writer, since in my case there are few followers, but they are most loyal. I like loyalty. I applaud loyalty!
Moving forward...I think I will continue my/our/your story. Call it an occasional medical theme of sorts, if you like, or think of it as the network gave the go ahead for a few more episodes of "U.S. Healthcare"...without the ratings to justify the quality. It is my little way of sticking it to FACEBOOK social networking crowd, since I don't do facebook. (I do have my reasons and they are obnoxiously dogmatic! A topic for later rants).
I like the idea of helping those individuals facing crisis with medical care. On the self serving front, it will ultimately be cathartic for me. I do get a little PTSD when I visit a hospital at this time of year. Any therapy is good therapy, the way I see it. That is my way of saying that I empathize with the struggles of those care-givers trying to take care of loved ones when they are seriously ill. Wanna here some irony. My daughter Michelle is always telling me, "Dad...get over it!" And I wasn't even the one with ICU time and a couple of surgeries under my belt
So, in the spirit of non linear thought, I shall write of random events surrounding our health education here at the Nelson's. I think you will agree that I have had some time to digest a couple of years of memories. By the way, if your curious regarding the state of health of my "N of 2" (that's statistic talk for my 2 children)they are getting on rather nicely. Let say their progress is directionally correct, but as of yet, not made whole.
I have learned much and committ to staying away from the weary, whining, worried camp with my posts. I will just share a simple narrative of hope and hope people get it. Please remember, I intend to offend nobody and I am not that angry. My perspective still comes from a pharmacist, former big pharma lackey (sic), and a father that watched his kids get sucked into healthcare...for better or worse. In fact, it might be a good idea for you to do a quick review of my older posts, so that when my season opener comes around, you will have a nice little medical history in that fancy "chart" of yours.
If my efforts or hobby or "whatever you would like to call it" is occasionally thought provoking...cool! So, to all my friends, enemies, and frienemies, knock yourself out. Humor me every once in a while and drop in. Remember, "Take...as directed!"
Wednesday, August 11, 2010
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
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
Friday, July 23, 2010
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
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
Thursday, April 22, 2010
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
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
Monday, March 15, 2010
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
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
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