I need my meds, and I need them NOW!

Many side effects can occur from all these pharmaceuticals and fortunately we happen to be your last defense between them and your health. So how do we do that you ask? Let’s go over some things that happen on a normal day at the pharmacy level.

Drop Off

CUSTOMER VIEW:

This is where you as a customer drop off your scripts. The technician or Pharmacist would ask you for your insurance card, license and couple of questions to help identify you in the system and verify coverage.

REALITY: QUEUE TRIAGE

This is where they are going through thousands of patient names to identify and verify your name matches, demographics are updated and using every last brain cell to descramble the directions or sig the doctor had decided to whip up for this particular medication. While deciphering these hieroglyphics, they are also battling with insurance companies to give you the coverage your paying for. This goes anywhere from plugging in overrides, correcting day supplies and quantities so that they match what the insurance will cover, and trying to have an idea of what alternatives there are in the market and supplying resources for cost reducing discount cards and saving programs to assist patients with expenses. This is also where the technician is using context clues to verify gaps in coverage, next steps into prior authorizations, and contacting insurance companies over discrepancies.

Pick up

CUSTOMER VIEW:

This is where you come whether its at the register inside the store or at the drive-thru window and pick up your medication. The technician scans the bag which contain your medications, they may ask for email and phone number for rewards, clarify any concerns regarding your medication and finalize transactions with a smile.

REALITY: QUEUE PRODUCTION + QUEUE VERIFICATION

Let’s rewind a bit to where the magic happens. After the medication quantity, day supply, and directions match and the patient information and doctor contact information are verified, the script is electronically sent off to the insurance for an approved claim. IF the insurance approves it, within real time, finally the magic can start. The script gets moved to the production portion which is where the technician oversees actually preparing the drug. This entails

  • Retrieving the medication of the shelf
  • Making sure the label properly matches the correct drug
  • Counting the medication if tablets, signing off (if its a controlled substance),
  • Verifying quantity and day supply are also correct from the first step at drop off
  • Answering phones and assisting patients while counting

If these is an issue, it’s up to them to resolve it and have it sent back to the previous step. This part may seem pretty simple but when there’s thousands of pharmaceutical dugs on the market and there’s various forms (brand vs generic), multiple ingredients come in different forms too (tablet, liquid, suspension, powder, etc.), and there’s the fact that many of them even have similar names now (hydroxyzine and hydralazine for instance).

It’s enough to make your head spin. 

Then if that’s not enough the order of medication is a bit like the triage room at an ER. You sign in, you get your information taken, and you wait. Your name and spot in line is put in a type of queue. Some places have early sign ins and appointments even that give you a better indication of when you may be seen. And then there’s emergency cases where certain folk will have something serious like a heart attack and skip all those waiting due to the severity of their issue.

The pharmacy is like that too. All the medications being sent in electronically from the clinics, doctors offices, other pharmacies go into a queue. A sort of list that puts an order to every prescription. Now your particular script goes into the queue for 230pm, that’s an estimate. If it’s 8am and it comes in for 230pm, itll probably be done by that time if not sooner, if all goes well. If the pharmacy becomes slammed then unless there’s some reason to move you up in the list, the technicians will go in the order that the scripts came into the system.

Then after it’s all snug in its red or orange vial, it gets placed in a basket for the pharmacist to verify it. Now to some of you who are unaware of what the pharmacist does, he or she has trained extensively to be aware of how medications work in your body and how they work in correlation with other drugs and factors with your health. Before they throw it in a bag and “simply slap a label on it,” they must

  • Verify the medication will not  interact with other medications you may be consuming
  • Double check the information on the script follows what the medication is intended for
  • Verify the medication order makes sense
  • Verify the medication is within normal limits
  • Verify all points of the script are correct with the doctor’s orders
  • Clarify any gaps in between treatment and counsel if needed
  • Verify the controlled medications follow state and federal regulations

All this while answering phones, tending to patient’s in the store, tending to patient’s in the drive-thru, and overseeing the entire operations within the pharmacy.

This procedure happens with every single medication, every single prescription, and every patient. If you need to update your insurance, its going through it again. If you need less pills of a particular medication? It’s going through it again. If you just want to see if a discount card is cheaper than your copay? It’s in most cases not, but can you guess what’s next? Yup. One. More. Time. Around.

This isn’t to say that we don’t want to help you or does it mean in no way your not entitled to ask questions and make changes as due fit. We here to help and I love to assist my patient’s in anyway that I can but this is just to give you an inkling of what happens behind the scenes to that cold odd place you call pharmacy. This is to give you and whoever’s crazy uncle or impatient mother in law needs to hear it, a better understanding and potentially maybe even a better appreciation to what your local pharmacy team does for you and your family to get them the medications they need.

Published by HonestRambles

Post-grad master's student navigating through the ugly, stressful, and worthwhile moments of being a nontraditional pre-med. Living off good energy, over-priced coffee, and reminding myself why I choose this life everyday.

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