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Tuesday, November 27, 2007

Saying 'No' to Counseling

Background:

You don't have to receive a consultation from a Pharmacist when buying a prescription; you may deny consultation. However, Oregon law requires that the patient deny consultation directly to the Pharmacist for any prescription that is not a refill. This means that even though you say "no" you may have wait in line to say "no" to the pharmacist.



Complaints

Last night and tonight, I had patients that flipped out about having to wait to give me their denial. In each case, they only waited half a minute at most and spent more time yelling at my technician, trying to say that she doesn't know the law than it would have taken to talk to me. Actually, I could've given a complete consultation in the time it took tonight's nimrod to finish bitching.


Consequences

If a Pharmacy Technician is caught releasing a non-refill without having the patient speak with the pharmacist, they are assessed a $500 personal fine and the Pharmacist on duty is assessed a $1,000 personal fine. So, getting bitched at is still better than the potential fine. Yet, sometimes, I'm tempted to 'run the red light' and let my technicians just get them out.


Message to the Oregon Board of Pharmacy

Come on, if you can't trust a tech to tell the truth about a denial of consultation, why even allow them to work in the Pharmacy? Oregon (along with most other states) has decided to waste Pharmacist and patient time with an impractical, pointless rule.


Message to Patients

Just, suck it up. It's the law. Our goal is to get you out as fast as possible. Why would we hold you up, if it were not the law? Save yourself and us a huge hassle and just wait patiently and tell the Pharmacist you've had it before and have no questions when it's your turn. Every minute you spend complaining is another minute other patients have to wait.

7 comments:

Bonnie said...

Yeah, but unless the state rep is standing there watching, how is anyone going to know if the patient doesn't say "no" to the pharmacist? Maybe you could have them sign a log saying "I refused consultation," and have the pharmacist initial it every day. That way, you could say, "They refused consultation, and I know about it."

That kind of stuff is ridiculous, but there's ways around it.

Anonymous said...

Signing a log is not the answer--the point is that there was an interaction with the pharmacist that took place i.e. in a 'pharmacy' and not in setting of a 'filling station' setting at the drugstore. At one particular Wal-mart that I did relief, the shop was set up so that before or after the drug inventory was checked out of the pharmacy (don't remember which--but whichever way, it was very convenient for patient and pharmacist) the patient had to pass the 'window' or rather dutch door opening where the very tall pharmacist-in-charge could either make eye contact or ask whether there was anything to discuss. When I was there, as I'm very short, it was more of a deliberate stop for the patient and sometimes the patients had to wait in line to talk to me because I couldn't make that eye contact with 'sotto voce' confidential question...would you like for me to counsel? The shop was run very, very efficiently especially as the tech told the patient up front, 'it's the law'.

Jaded Rx Intern said...

I'm sure it's a frustrating law to work with. It's a little more lax here (Iowa). Techs selling non-refills have to ask "This is a new medication. Do you have time for the pharmacist to counsel you?" Allows the patient to say no to the tech; also allows interns to counsel as well (quite a time-saver), and can ask the patient for counseling directly too.

Best of luck with the law (and the bitching patients...)

Big 'N Tasty RPH said...

I try to temper my "Do you want counseling?" with a little humor. I can usually get a laugh by asking if the patient has any questions beyond the price. That can even get a laugh out of someone angry about a $60 copay. I don't set the prices. Please don't shoot the messenger! Others have asked about sporting event scores, winning lottery numbers, if they can get fries with that, and if I have a husband yet. i have no answers to those questions. I can only speculate...

Un-PC RPh said...

Gez that is crazy. How can you even manage in a very busy, short staffed store? There is just no way a pharmacist could be available all the time with little to no wait. More useless legislation to make people angrier and pharmacist's jobs more difficult. Its a nice idea, but it isn't practical in the current state of pharmacy with increasing volume and pharmacist shortages along with chain's and PBMs trying to squeeze every penny out of pharmacy to maximize profit, yet prmise superior customer service. Something has to give and I believe pharmacists will continue to vote with their feet and leave community pharmacy. Doesn't do any good for community pharmacy, however, but perhaps eventually send the message that something must change.

Anonymous said...

As a tech, I find it easiest to say "The pharmacist will be right with you to discuss your new medication", which allows for the denial on the patient's side and covers my end if there is someone from the state board waiting in line overhearing the exchange. I haven't asked if they need couseling and they can refuse it very easily (my state law doesn't allow for techs to ask if the patient wants counseling).

Anonymous said...

There has to be a better system. I am a RN and had to wait to say No on a routine antibiotic. I kept trying to say, I am a Nurse and the tech kept saying, "It's The Law!" I would rather sign something and go home than stand there waiting to say no...I appreciate the law for those who really need the information, but common sense does need to come into the picture. I am able to make decisions in my own heathcare. I left feeling very grumpy after this experience.