What patient conflict have you had while working in a pharmacy?

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stu0513

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Hey folks, I just want to know what patient conflicts have people working in a pharmacy encountered and how do they attempted resolve it? What would you do differently now?
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This is a little extreme, but I knew a tech who worked in a pharmacy where a patient threw a glass bottle of mag citrate at another tech :eek:. They called the police.
 
This 80 year old guy once raised his cane and told me, "I should punch u in the nose" (over a Prior auth). That's as bad as it's ever got for me. But now he's cool and I always joke with him about it. Everyone in pharmacy gets one or two 'Zell Miller moments'... Mine was sorta like this:

[youtube]http://www.youtube.com/watch?v=AuBnlNjZq24[/youtube]

Seriously though, it has usually been lack of morale and ethics on the part of coworkers that has made some pharmacies into major dives. The patients are usually good folks.

A Pharmacy's usually only as good as your coworkers and immediate supervisors, and (of course) your own initiative.
 
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If you work in retail, you'll most likely encounter the "I dropped my pills in the toilet" or "my dog ate my pills" scenerio and it always, coincidentally, is a scheduled II.

And once you tell them that you can't dispense them controls without a prescription they'll scream, make a scene, and yell. Then they'll ask for your Manager's phone number. You'll encounter this a lot because they think you're scared to lose your job or get in trouble and will give in.

To shut them up, this is what I do:

"There is nothing I would like to do more than help you but it is illegal to dispense your controlled substance without a valid prescription. It is against the law.

Here is the business card of the Pharmacy Manager. I've also included the Board of Pharmacy phone number. If you are able to obtain a valid prescription from your doctor, I will gladly fill it for you."

Afterwards, they'll fuss and say they're never come here again. And do they ever call the Board of the Manager? No.

Never ever do anything to risk losing your license. If they really make a scene and starting screaming, let them. A lot of time if they're making such a ruckus and won't leave, I'd say loudly in a firm manner "SIR I CANNOT DISPENSE YOU MEDICATION WITHOUT A PRESCRIPTION, IT IS ILLEGAL TO DO SO. I CANNOT BREAK THE LAW"

They'll leave
 
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jasmine0211 said:
If you work in retail, you'll most likely encounter the "I dropped my pills in the toilet" or "my dog ate my pills" scenerio and it always, coincidentally, is a scheduled II.

And once you tell them that you can't dispense them controls without a prescription they'll scream, make a scene, and yell. Then they'll ask for your Manager's phone number. You'll encounter this a lot because they think you're scared to lose your job or get in trouble and will give in.

To shut them up, this is what I do:

"There is nothing I would like to do more than help you but it is illegal to dispense your controlled substance without a valid prescription. It is against the law.

Here is the business card of the Pharmacy Manager. I've also included the Board of Pharmacy phone number. If you are able to obtain a valid prescription from your doctor, I will gladly fill it for you."

Afterwards, they'll fuss and say they're never come here again. And do they ever call the Board of the Manager? No.

Never ever do anything to risk losing your license. If they really make a scene and starting screaming, let them. A lot of time if they're making such a ruckus and won't leave, I'd say loudly in a firm manner "SIR I CANNOT DISPENSE YOU MEDICATION WITHOUT A PRESCRIPTION, IT IS ILLEGAL TO DO SO. I CANNOT BREAK THE LAW"

They'll leave
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My toughest days are not when the patient wants something out of the realm of the law, but when co-workers and managers do. It's always helpful when you have folks backing you up. I have my own standards now, that I would only work at a place that doesn't sacrifice important rules for expediency.
 
I love bringing up the law...haha, it's a nice thing to use.

I've mastered the art of the eyebrow raise and the "suuuuuuure, ******." look upon my face. haha

I think the OP is trying to write an essay or something, or it sounds like it. hahah. We just get pt's who yell about controls, and we just call the police if it gets out of hand.
 
confettiflyer said:
I love bringing up the law...haha, it's a nice thing to use.

I've mastered the art of the eyebrow raise and the "suuuuuuure, ******." look upon my face. haha

I think the OP is trying to write an essay or something, or it sounds like it. hahah. We just get pt's who yell about controls, and we just call the police if it gets out of hand.
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Eyebrow raise works. Also, if you wear glasses, take them off and give them a brooding look when you explain it for the 3rd time.

I've always wondered why banks don't get these same folks walking in saying they've "lost their wallet" and need $100 back. Why is this just a pharmacy phenomenon?!
 
FruitFly said:
I've always wondered why banks don't get these same folks walking in saying they've "lost their wallet" and need $100 back. Why is this just a pharmacy phenomenon?!
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I'm actually waiting for this to happen. I just think that, in general, people can no longer tolerate personal responsibility. If you peruse the pre-pharm thread, you'll see plenty of examples of students blaming EVERYTHING ELSE but their own stupidity for not being able to get in.
 
FruitFly said:
Eyebrow raise works. Also, if you wear glasses, take them off and give them a brooding look when you explain it for the 3rd time.

I've always wondered why banks don't get these same folks walking in saying they've "lost their wallet" and need $100 back. Why is this just a pharmacy phenomenon?!
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That's a REALLY GOOD POINT! How come banks don't have this problem? Maybe because when you think of a bank, you think of cops? I wonder if this phenomenon would still occur if you had a security guard or cop standing there.

I've never used the eyebrow raise before - gotta try it and I love the glasses idea too.:laugh:
 
Ooh I should share this...my favorite line when people ask "blah blah why is it $40?? i only pay $20!!!" is "Ma'am...we only get a number from the insurance company. We get no explanation whatsoever, you'll have to contact them on your own."

Then, if they further bitch and want you to call, someone else posted on here another good line. "We don't negotiate with your insurance."

However, be careful when using this. We get patients where we need to coordinate multiple TP's and sometimes we do screw it up and only bill one.

Also, if it's slow (rarely), and the pt asks nicely (or is a regular), I'll usually look up their history and put in a call if something does look fishy. But this happens once in a blue moon.
 
confettiflyer said:
Ooh I should share this...my favorite line when people ask "blah blah why is it $40?? i only pay $20!!!" is "Ma'am...we only get a number from the insurance company. We get no explanation whatsoever, you'll have to contact them on your own."

Then, if they further bitch and want you to call, someone else posted on here another good line. "We don't negotiate with your insurance."

However, be careful when using this. We get patients where we need to coordinate multiple TP's and sometimes we do screw it up and only bill one.

Also, if it's slow (rarely), and the pt asks nicely (or is a regular), I'll usually look up their history and put in a call if something does look fishy. But this happens once in a blue moon.
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This is absolutly the way to go. I despise more than anything calling insurance companies because of a complaining customer. Its a total waste of the pharmacies time. I always tell patients if they have issues with thier insurance company thet will need to contact them.
 
If you want a good source for stories about patient conflict, read The Angry Pharmacist and the Drug Monkey's blogs. They are hilarious and usually right on target.

I personally love to use the legal excuses when it comes to refills, PSE, etc. I haven't had a chance to use one of the best ones yet, though: If a patient comes in and says that their meds (99.999% controls) were stolen, I want to tell them that I'll call the police and help them fill out a report. I've heard that that sends the patient running. :laugh:
 
You tell a customer that they need to contact their insurance to settle a problem... and they look at you while giving you a "hmmph", "Can't you do that/Isn't that your job?"

What do you say to that especially when it's busy? I absolutely hate calling insurance companies when the patient should be more involved in their own health care.
 
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Haha....I think pt's can't tell the difference between the tech, clerk, and pharmacist. They think EVERYONE'S getting paid $60/hr....so of course it's our job to call the insurance!

And I posted this before....but I love when pt's threaten to transfer their scripts to another pharmacy and expect me to be all gracious and ****.

Bitch, please.

The first thing I say when they threaten that is, "Sure...which pharmacy do you want to transfer them to?" Or... "Sure, just tell the receiving pharmacy to give us a call to transfer them right over."

Hahahha....the look on their faces. What a bunch of ******s. A minimum wage clerk who is most likely not going to be there in 6 months is not going to care about losing business.
 
while i was an intern, i had a patient tell me, on the phone, that she was coming back to the store to kick my a$$ because the generic fiorinal we gave her was going to kill her.

we called the cops, who were waiting to meet her along with myself, my pharmacist and another tech {both were REALLY tough ladies, the kind you don't mess with, say, in a bar} they flanked me on either side and the cops waited in their cruiser.

suffice it to say, the generic seemed to be satisfactory at that point.
 
ethyl said:
You tell a customer that they need to contact their insurance to settle a problem... and they look at you while giving you a "hmmph", "Can't you do that/Isn't that your job?"

What do you say to that especially when it's busy? I absolutely hate calling insurance companies when the patient should be more involved in their own health care.
Click to expand...

As I told a lady the other day who was emphatically pointing at insurance card asking me if i understood what the co-pay amounts on the card meant.

I said "There are thousands of insurance plans and I don't presume to now all the intimate details of each and every one. We processed the claim to YOUR insurance company and that is the co-pay they have directed us to charge you. If you have any questions please call YOUR insurance company and they will be happy to explain YOUR policy to you." Please note the heavy emphasis on YOUR.

I realize this was a bit rude but I was 10 hours into a 12 hour shift and was not in the mood to put up any more crap from anyone. This shut her up but I will darned if she didn't come back the next day and ask the same question to one of my techs. I swear all she had to do was call her insuance company. For what ever reason she was to lazy or ignorant and had to come back to the pharmacy.
 
jasmine0211 said:
"There is nothing I would like to do more than help you but it is illegal to dispense your controlled substance without a valid prescription. It is against the law.
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'

haha.. interesting. I can see a parallel here in nursing. "Some" patients are drug addicts, admitted to hospitals due self-inflicted sickness eg. N&V etc.. I stress that "some".. It sucks because we "have to" call MD to increase her/his pain medicine at 4:00 am in the morning because of course patient have right to have their pain relieved under any circumstance.. Of course, the doctors, knowing the history of pain med abuse and wanting to taper off the dosage, are not going order their favorite type of nacortics..... If they don't get what they want, then it's MY fault for not being able to persuade the doctor to satisfy their needs..

At least, in pharmacy, you can tell the patients to call docs themselves.

Did they ever said " Can you call my doctor for me and told him that I lost my med? I'm in pain...crying...." "Can you call doctor and clarify?? I must have one more refill left.. etc"
 
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Hahah, we get those pt's. Sometimes we give them the phone to call their physician, most of the time the physician gets annoyed.
 
ethyl said:
You tell a customer that they need to contact their insurance to settle a problem... and they look at you while giving you a "hmmph", "Can't you do that/Isn't that your job?"

What do you say to that especially when it's busy? I absolutely hate calling insurance companies when the patient should be more involved in their own health care.
Click to expand...

If the situation truly warrants a call to the insurance company, e.g., drug used to be covered and now it's not or co-pay went up 100%, I will offer to call the insurance company at a later time when it's not so busy. It seems that we always get insurance problems at the drivethru at 5:30 pm when there are 6 cars waiting on the insurance victim. As long as I offer to find out "why" for them and call them back later, even the meanest customers are usually OK with that. Just make sure to CALL THEM BACK!

If they want me to call just because the copay should be $20 and not $30, I'll make up some b.s. about how the insurance company won't discuss their personal plan benefits with me. Or that their benefits coordinator will discuss their plan details with only them personally. Hippa is always a great excuse because nobody really understands what that law covers. :smuggrin: Usually they look at me like "really?" and then just walk off.
 
monsterbrain said:
If the situation truly warrants a call to the insurance company, e.g., drug used to be covered and now it's not or co-pay went up 100%, I will offer to call the insurance company at a later time when it's not so busy. It seems that we always get insurance problems at the drivethru at 5:30 pm when there are 6 cars waiting on the insurance victim. As long as I offer to find out "why" for them and call them back later, even the meanest customers are usually OK with that. Just make sure to CALL THEM BACK!
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For these patients, I'll usually say my name and tell them what time I'm working until. It calms people down a LOT.....but of course, you better do what you say you're gonna do, or they'll come hunting you down.
 
The I'll call you back approach never works at my pharmacy. They want you do find an answer for them now, not after you spend 10 mins on the phone with their insurance.
 
Every single patient conflict here is revolving around insurance and drive-thrus, minus a generic narcotic story.

Perhaps I'm way too conservative, but the _patient's_ insurance is just that; give them the number to their insurance and allow them to vent/obtain info there... I'm not referring to legitimate calls but sometimes I think some pharmacists (if anyone, it should be a tech or clerk) assume the role of insurance agent and waste a huge amount of time dealing with front line people and being on hold... seems very inefficient.
 
Requiem said:
Every single patient conflict here is revolving around insurance and drive-thrus, minus a generic narcotic story.

Perhaps I'm way too conservative, but the _patient's_ insurance is just that; give them the number to their insurance and allow them to vent/obtain info there... I'm not referring to legitimate calls but sometimes I think some pharmacists (if anyone, it should be a tech or clerk) assume the role of insurance agent and waste a huge amount of time dealing with front line people and being on hold... seems very inefficient.
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I couldn't agree more, but sometimes it is hard to determine where our customer service ends and patient responsibility begins. Unfortunately, I usually end up calling insurance companies for the loudest a**holes just to shut them up and get them out of my face.
 
I lot of patient conflicts deal with, yes, insurance. People don't understand their insurance plan. And if I have to explain yes....your insurance needs a prior authorization EVEN though you're on Medicaid, I'll pull my hair out.

Also lots of problems with people using up their narcotic painkillers before their 30 day supply and demanding more. What's worse is there's a pharmacist that will actually release them a couple of days early if they're paying cash for them...but that's a whole other story.

I also hate it when people come through the drive thru and expect me to stop what I'm doing right there and go get them an OTC bottle of Tylenol or Aspirin...then get all huffy when I tell them they have to come inside for it. I had a guy ask me to go get condoms for him, too. That was fun to deal with.
 
pillpharmer said:
I also hate it when people come through the drive thru and expect me to stop what I'm doing right there and go get them an OTC bottle of Tylenol or Aspirin...then get all huffy when I tell them they have to come inside for it. I had a guy ask me to go get condoms for him, too. That was fun to deal with.
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:laugh::laugh::laugh:
Did he ask for a certain size? hahaha

We have a regular "customer" who comes to the drive-thru and gives us her shopping list. She doesn't even have a RX to pick up!!! And can you believe our pharmacy manager ACTUALLY goes and gets the stuff for her.:confused: :mad:
 
monsterbrain said:
:laugh::laugh::laugh:
Did he ask for a certain size? hahaha

We have a regular "customer" who comes to the drive-thru and gives us her shopping list. She doesn't even have a RX to pick up!!! And can you believe our pharmacy manager ACTUALLY goes and gets the stuff for her.:confused: :mad:
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Well the funny thing was...the guy picked up his RX, then kept asking for the condoms...but wouldn't speak loud enough for me to hear. So I had to ask him to repeat it a lot before I finally realized what he was asking for. Seriously...if you're not manly enough to go buy a box of condoms by yourself...you shouldn't be having sex.

There was a pt or two that would come through drive and say they were sick, etc etc...and I wasn't busy...then I'd run out and go grab it. I'd much prefer if somebody called in maybe 30 minutes before hand to ask us to grab them something to give to them through drive. I think that's a lot more courteous.
 
FruitFly said:
Eyebrow raise works. Also, if you wear glasses, take them off and give them a brooding look when you explain it for the 3rd time.

I've always wondered why banks don't get these same folks walking in saying they've "lost their wallet" and need $100 back. Why is this just a pharmacy phenomenon?!
Click to expand...

I was snooping around here and saw this... when I worked at the bank I remember getting a customer who lost $300 cause she left it at the ATM and claiming to sue us because it was lost on the bank's property... these people are idiots and they're everywhere... they love to blame everyone else for their own stupidity. I see this everyday in my bio-class.
 
My pharmacist refused to fill a script for methadone when we found out it was for addiction treatment. The patient called and threatened to kill the pharmacist. We called police... thankfully the pt didn't show up.
 
Chiyo said:
My pharmacist refused to fill a script for methadone when we found out it was for addiction treatment. The patient called and threatened to kill the pharmacist. We called police... thankfully the pt didn't show up.
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I'd probably just take the rest of the day off if that happened.
 
Chiyo said:
My pharmacist refused to fill a script for methadone when we found out it was for addiction treatment.
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I'm confused. :confused:

Isn't that a perfectly legal use of methadone?
 
Gitana said:
I'm confused. :confused:

Isn't that a perfectly legal use of methadone?
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It is a legal use, but it has to be filled at a methadone clinic. Regular pharmacies can only fill methadone for pain indications.
 
Thanks for clarifying.
 
Moxxie said:
If a patient comes in and says that their meds (99.999% controls) were stolen, I want to tell them that I'll call the police and help them fill out a report. I've heard that that sends the patient running. :laugh:
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I've done that a few times, it works! You get the fastest, "uhh, nevermind, bye." ever!
 
Once, when I was working at a hospital Pharmacy, a patient wanted to tell me something privately.
I obliged, patient was insisting that she is perfectly fine, and her family just hates her and want her to go on medications so she can die.
I had to assure her, that the medications arnt meant to kill her lol
 
Yesterday a patient came to the in window to drop off a prescription. When I asked for his date of birth, he freaked out, refused to give it to me, took his script back and told me he was going to Walgreen's. I'm not sure what he thought I would do with his birthdate - throw him a surprise party? Give him an embarrassing "Over the hill" card?
 
FatimaMohamed said:
Once, when I was working at a hospital Pharmacy, a patient wanted to tell me something privately.
I obliged, patient was insisting that she is perfectly fine, and her family just hates her and want her to go on medications so she can die.
I had to assure her, that the medications arnt meant to kill her lol
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Surprisingly, distrust of modern medicine is a huge conflict I've had to deal with...both retail side and working in a hospital (in a field unreleated to pharmacy).

The book, "The Spirit Catches You and You Fall Down," by Anne Fadiman comes to mind.
 
The "transfer" coupons are really annoying. People would drop off their prescription and would give me a "transfer" coupon for a gift card at pick-up. When I tell them that the coupon is only valid for "transfer Rx," they get mad, complains and starts telling me that we need to be more clear on the coupon. The coupon clearly states: "TRANSFER!"

I hate how people expect a $25 gift card whenever they fill a new prescription.
 
anteater07 said:
The "transfer" coupons are really annoying. People would drop off their prescription and would give me a "transfer" coupon for a gift card at pick-up. When I tell them that the coupon is only valid for "transfer Rx," they get mad, complains and starts telling me that we need to be more clear on the coupon. The coupon clearly states: "TRANSFER!"

I hate how people expect a $25 gift card whenever they fill a new prescription.
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haha i like making people feel stupid about not reading them...BUT on the other hand, there are other people who are genuinely confused, since CVS did have "NEW or TRANSFER" coupons not too long ago, and not to mention the new/transfer coupons are still available online.
 
confettiflyer said:
haha i like making people feel stupid about not reading them...BUT on the other hand, there are other people who are genuinely confused, since CVS did have "NEW or TRANSFER" coupons not too long ago, and not to mention the new/transfer coupons are still available online.
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yeah, CVS had the stupid "greeter" promotion last fall...and I was a greeter! hahaha

But, I hate how customers think they should get a $25 gift card just for having a prescription.
 
anteater07 said:
The "transfer" coupons are really annoying. People would drop off their prescription and would give me a "transfer" coupon for a gift card at pick-up. When I tell them that the coupon is only valid for "transfer Rx," they get mad, complains and starts telling me that we need to be more clear on the coupon. The coupon clearly states: "TRANSFER!"

I hate how people expect a $25 gift card whenever they fill a new prescription.
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And some people have tried to rort the system by having their doctor phone in a NEW prescription to another pharmacy, with no intention to pick it up there, but instead have us 'transfer' it from them...
 
pezdispenser said:
And some people have tried to rort the system by having their doctor phone in a NEW prescription to another pharmacy, with no intention to pick it up there, but instead have us 'transfer' it from them...
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When I worked for that company that had all of those coupons, the pharmacists wouldn't consider that a "transfer". Customers would get so mad when they couldn't get their gift card, because they done all of this "work" just to get the gift card!
 
confettiflyer said:
Surprisingly, distrust of modern medicine is a huge conflict I've had to deal with...both retail side and working in a hospital (in a field unreleated to pharmacy).

The book, "The Spirit Catches You and You Fall Down," by Anne Fadiman comes to mind.
Click to expand...


I know right, I guess its just one of the many we have to face :p
 
All the pharmacists in the area kinda know each other, so we usually know when we're dealing with a serial coupon abuser. The same pt's pop up all the time.

I don't fault the pt...technically they are in compliance with the coupon rules as they do not require a good faith effort in the transfer process, a transfer merely has to take place. They are working the system and are getting paid. Sure, I think it's unethical, but eh...oh well.
 
I don't know if this qualifies as a conflict, but I had a pt that thought he was a robot yesterday.. that was interesting lol
 
My favorite conflict at work was a lady who came in for a refill on a medication, which was not one that was life-threatening if she did not receive it, and you had to dispense a whole container. She was out of refills and I told her that she was and that she would have to talk with her doctor about giving her refills. She fussed and yelled and screamed as I told there was nothing I could do. After she left, the pharmacist looked at me and was like "Her husband is a doctor who always calls in her scripts when she needs them, and he was in the front of the store the whole time."
 
Yup..
RxWildcat, robot is 4 next generation..
 
I had a lady tell me she would "come over the counter and lay my *** out". It was right when stupid HIPAA first started and we had get signatures and explain things to every.single.patient and she was mad she had to wait five minutes in the drive-thru. :rolleyes: The first words out of her mouth before "hello" or anything was "why are you so slow?". I told her that being spoken to like that doesn't make me work any faster. She didn't like that, and I really should have kept my mouth shut, but damn when you immediately start in with the yelling, it just doesn't make me feel very charitable. She actually came into the store to yell at me. My pharmacist at the time gave her her RX and tried to placate her. Now that I'm a pharmacist, no one will ever, ever talk to my techs that way and expect to get a damn thing from me except to get banned from the pharmacy. I always tell my techs to let me know if someone is being confrontational and I will handle it; they don't get paid enough for that crap. Well, no one gets paid enough for that, but you know what I mean.

That was the only physical threat I got, but I pretty much have heard some sort of conflict every weekend I worked at Wags this past year, 99% of the time about something over which we have no control (refills, expired RXs, copays). Which is why I am not doing retail because I would certainly die an early death from hypertension. There IS no expectation of patient responsibility and it drives me effing crazy. Everyone gets good care from me and when patients are respectful and nice I will bend over backwards to do everything I can for them. But when they are nasty and rude, they will have to do their own doctor calls and insurance negotiations.
 
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