Tuesday, September 28, 2010

When A Medical Professional Turns Into The Patient...

I woke up the other morning with pretty badly irritated eye. Apparently I forgot to take my contacts out before going to bed. WHOOPS! I walked into the bathroom and looked into the mirror just to see how seriously red my eye was. I decided to take my contacts out, not sure whether it would make the situation worse or not. It made it worse, much worse! My eyes had a sharp stabbing pain whether it was open or shut. I continued to cover and wipe my eyes of drainage and decided to lay down and see if it passed. This did not help very much so I got the idea to put some contact solution into my eye in hopes it would bring some relief. It only stung more.


I guess I had to go to the pharmacy to see if something like Clear eyes or Visine would help. I figured that if this didn't do the trick, I might have to get some further medical attention that was above my own skill as a pharmacist.

The pharmacy I went to was the one I currently work at. I called a friend and he went with me in case my eye really bugged me. I made it to the pharmacy, picked out the eye drops I had in mind and left. My friend drove me home and stuck around to make sure I was alright. Thank God for good friends. The eye drops burned and did not seem to help much. I waited awhile and tried them again still to no avail. It was time to seek further care.

My friend drove me to an Urgicare which I used to know some nurses at. When we got there I had to fill out 4 forms and give them my insurance and identification. Filling out forms with one hand over your eye is not the most fun, especially after a 20 minute car ride which simply looking out the window makes you nauseated. I turn in the forms and waited to be seen. I waited about an hour and fifteen minutes in the waiting room before being called back to an exam room. Finally!

Once in the exam room the nurses came and asked some basic history and pain questions. They also took my blood pressure and they took it wrong. They raised my arm just over shoulder height and took it. Blood pressure readings should be done at heart level, at least that's what they taught me. I then continued to wait 45 minutes for the physicians to come into the room. He explained what he thought it was (since I gave a very detailed explanation he probably could have diagnosed it without even seeing me) and what he was going to do to examine it. Overall, he was very professional and I was pleased with his work. He then explained he did not see anything serious but was going to give me and antibiotic just to be safe. I then told him I was a pharmacist and wondered what he was thinking for an antibiotic. He said I should have mentioned it earlier and said he was going to write for Vigamox.

Wrong answer.

I knew Vigamox is over $100 a bottle and requires a prior authorization for every insurance I have every dealt with including my own. I suggested tobramycin and explained to him what I knew. He agreed and appreciated my knowledge then left to write the prescription. He came back and gave me follow up instructions if needed, including an ophthalmologist he knew personally, as well as the prescription for tobramycin eye drops, then showed me out to the nursing staff to sign one more item.

When I saw the nurses and signed their document, I asked them to call my prescription into a pharmacy near by that was part of the chain I work for. They were hesitant and said they do not do that.

Wrong asnwer.

I told them I am a pharmacist and that I knew the pharmacist they would be calling it into. They checked with the physician who literally said, "Ya, why wouldn't we call it in?" They agreed and I left with my friend to go to the pharmacy.

We got to the pharmacy 30 minutes prior to close and to no surprise my prescription was not ready. I asked how long and the intern, who I knew, said that the pharmacist did not take it because they were out of stock of it. Personally, I would have still taken it and then offered the patient to transfer it, but to each their own. The pharmacist said the Urgicare was going to call me to call another pharmacy with it or to preferably to pick it up. One problem, my cell phone was dead. Thankfully, my friend let me use his phone to call the Urgicare and call it into the exact pharmacy I work at, to which the Urgicare nurse obliged.

We drove to my pharmacy, speeding a little since we know we would be getting there with in 5 minutes of closing. I called ahead as we pulled off the highway and my pharmacist partner said it was ready and he would stay open until I got there and that he rushed it since he knew it was mine. Again, I am thankful I know how the medical system works and some people in it, which allowed me to get my prescription in a fairly timely manner.



As I was rung out by my cashier, I thought to myself, "What if I wasn't a pharmacist?" This would have meant that the doctor would have written for an expensive prescription which my insurance wouldn't have covered. I would have gotten to the first pharmacy and been pretty frustrated since I had spent 2 hours plus at the Urgicare and still had a sore eye. If the pharmacist would have called the Urgicare to change the prescription, she would than have not had the antibiotic in stock. I then would have to go to another pharmacy to get my prescription. I also would not even be able to stay with the same chain to get my prescription that night since they all would have been closed. I may have even not gotten my prescription that night. On top of all of this the antibiotic I did receive needs to be applied every 3 hours while awake. This is fine by me, since it was $4 instead of over $100, but even as a medical professional applying an eye drop every 3 hours is hard to remember. Imagine if I were a patient again, I would probably be annoyed and not understand why the drop needs to be used so often.

This whole experience really did make me think differently about patients who come in last minute. Ironically enough I had a patient about my age come in with an antibiotic 5 minutes prior to close while I was already busy the night prior to my eye injury. I told him to stick around as I would make sure he got it before he left. The man was grateful for my services and that I took care of him despite being busy. I now fully appreciate his appreciation for me taking care of him despite the fact that I was closing really soon. Thankfully, karma must have paid off and taken care of me when I needed it. I can definitely say I look at the last minute patient with a little bit more respect considering what they might have just been through. If a last minute patient just hurried to make it in, I will definitely take care of them as long as they are in a true urgent need and not just filling a prescription they had for 2 weeks. This is especially true if a patient has an antibiotic or is from an Urgicare!

2 comments:

  1. Sorry about your eye, but it sounds like it gave you a broader perspective on the problems 'regular' patients have (especially with cost and insurance approval issues).

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  2. There will be a follow up to this eventually. The story gets better...

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