If Fast Food Was Pharmacy

AKA "Why We Can't Just Get a Z-Pak Off The Shelf and Slap a Label on it"

AKA "Why it Takes 'SO LONG' to Fill Your Prescription"

by Katie Lassiter, Pharm D

So, it is 4:30 am, I can't sleep, and the thoughts from the two previous days at work are running through my head. Sunday at work was the day from you-know-where including every complaining customer you can imagine, not to mention I caught a forgery which is a whole other issue in and of itself. I had the store manager called on us twice with a follow up from my district manager today (or, uh, yesterday?). I am extremely thankful that our managers understand the stress and pressure that we are under and come to inquire as to what actually happened instead of assuming we deliberately did something wrong. Even though my job is not on the line and I am not "in trouble" for said complaints, it is really hard for me to get past when things like this happen because a feel that it is unfair to me. I am not behind the counter watching a movie and having a good ole time and delaying people from getting their medications just for kicks. Contrary to popular belief, I hate it when I have a whole line of customers staring at me and continually checking to see if their prescription is ready. I know it sounds fun, right? Long story short, I have had this little synopsis brewing in my head for a long time in order to fully explain to people " your prescription is not back here sitting on a warmer ready to go" and "this is not fast food" and to ask, "why do you people think you deserve for your medication to be ready in 15 minutes or less?" and "why do you think you are the only customer at the pharmacy when you wouldn't expect this at any other public place such as a restaurant that requires WAITING for a table?" and "why do you think you can walk up to a counter and yell to the pharmacist behind the computer who is diligently checking people's prescriptions for errors and ask 'HEY! Where are the cotton balls?" So, thus brings us the story that follows.....

If Fast Food was Pharmacy

Setting: a fast food burger joint

A customer walks up to the counter with their order in hand. Please keep in mind that the customer ordering the food did not actually pick out what they wanted to eat, someone else wrote it for them. In fact, the customer has no idea what the order is, nor are they familiar with what is on the menu. The customer hands their order to the cashier who proceeds to take down the customer's personal information before scanning in the order. (I could go into a million things here such as, the customer refuses to give their birthday, does not know the birthday, argues about giving the information, or asks 500 questions about what their "order" is because they have no idea what it's for, but that would take all day. Just keep in mind that the "cashier" is delayed from doing other things because the customer is clueless.) Several minutes later, the order has been placed.

Next, the manager (pharmacist) has to check the order and assure that it was put in correctly by the cashier. The manager is the only person in the fast food place who can check orders because of their special knowledge of the menu. So, the manager sees that the customer has been ordered a double cheeseburger and a fry with a medium beverage. Uh OH! The person who wrote the order didn't put WHAT SIZE FRY the customer should have!!! The manager cannot just assume what size of french fry was to be ordered so they must make a phone call to the person who wrote the order. And guess who is the only authorized person to make the phone call??? THE MANAGER.

Oh wait... The Manager has to take a phone call because someone is calling in an order. Who is the only person who is authorized to take order call ins??? THE MANAGER. So, customer number 1's order is being delayed a bit because the manager is tied up on the phone taking orders.

Now, back to the order. The manager calls the person who wrote the order for customer number 1. After pushing 15 different prompts, manager is finally asked to leave a voice mail. Ok. Manager leaves the voice mail and continues to check the rest of customer number 1's order. Now, this may come as a shock to some, but the manager isn't just responsible for making sure the order is put in correctly. The manager must also check to see, does this person always get the double cheese burger or is this a new order? Is this double cheese burger going to cause any issues when eaten with the other things on the order? Is the medium beverage going to contain too much sugar for the customer? Calculations may have to be made.

But before the manager can fully check the order, they have another phone call. It is another burger joint calling to transfer an order. Who is the only person authorized to transfer orders in and out of the burger joint?? The Manager!

Finally, the manager is free to finish checking customer number 1's order.

Oh wait.... the customer's credit card (insurance card) that was stored in the computer that pays for the order is EXPIRED and the customer didn't think to give us the new one. Customer number 1's order is held up yet again. So, the cashier tracks down the customer, the customer digs out the new card for the cashier, and the cashier enters it into the computer. The burger joint submits the order to the credit card for them to pay for it. OH NO! The credit card won't pay for a double cheese burger! They will only pay for a regular cheese burger. So, the cashier informs the customer. The customer gets mad. The Manager then makes another call to the person who wrote the order to inform them of this situation. Customer number one can only get their beverage at this point. The cashier makes the beverage. The Manager checks to make sure that the correct beverage has been served (only the Manager can do this) but before the manager can check this, a customer has come up to ask the manager a question and is telling the manager their life story. The manager clearly has nothing else to do. So, the manager is finally free and can check the beverage. The beverage is good to go. The receipt prints out. The cashier rings up customer number one (we will have to wait for the person who wrote the order to call back before we can continue with the rest of customer number one's order).

Oh wait!!! The customer has a coupon for the beverage that he forgot to give the cashier!! However, these coupons cannot be scanned at the register. They have to be entered into the computer using codes, all of them different, and the whole entire credit card claim has to be redone. OH WAIT!! The customer forgot to "activate" the coupon by calling the number on the coupon that clearly states that the coupon must be activated. The cashier's time has been wasted yet again.

All the while there is a long line of customers waiting to pick up their orders and drop off new orders. All the while other orders are getting faxed in. All the while the phone is constantly ringing. All the while orders are being left on the voice mail. All the while customers are lining up to ask the manager random questions.

Now, that was just one customer's order. Just one! They do hundreds and hundreds of orders a day. Now, say a customer was accidently given a quarter pounder when they had brought in an order for the chicken sandwich.. not a big deal, right? But if a person is actually given medication for diabetes when they were supposed to receive seizure medication, it could be detrimental. That actually happened at a pharmacy (not mine). Or, say a child has been given a prescription for a drug that children are not supposed to take (I have actually seen this before) and the pharmacist doesn't catch it, that could be serious. Or what if the patient brings in a prescription for a drug from one doctor when they are already on a similar or interacting drug from another doctor? These issues are serious. They might not be happening on YOUR prescription, but they very well could be happening on any of the other 300-500 that we are working on that day. We cannot for-see these issues so we give the estimated wait time to the best of our ability. However, you never know what problems will arise. I didn't even touch on half of the things that could actually go wrong.

So please, cut us some slack people. Our job is serious and just because your Z-pak isn't ready in 5 minutes doesn't mean we're back there delaying it just for fun. We don't want you in our faces any more than you want to be in ours.

That being said..... you can expedite the process by calling in your refills 24 hours in advance, not the day (or hour) you need it. Also, make sure your insurance card is up to date. Also, realize that doctors often have no idea how much a medication costs or if it is on your insurance formulary. The pharmacy deals with your insurance as a courtesy to you. It is not our fault if your insurance changes or will not pay for something. The customer is responsible for knowing what medications they should be taking and how they are to be paid for.

Now, I have vented long enough. I am just really down about the issues I had to deal with this past weekend. It can be very discouraging when you are working really hard to do your best and serve people the best you can and people lie and act unfairly (yes, lie). I wanted to be a pharmacist so I could share my knowledge with others because I feel that knowledge is useful and beneficial to people. It is disheartening to find that all many people care about is themselves. I have been shocked and amazed at the types of people and attitudes I have encountered in the last 2 years. If people are treating complete strangers with utter lack of respect and sometimes even hatefulness, how are they treating their family members?

I also have to say that I do encounter some very sweet and gracious people from day to day. I just wish there were more people like them.

AND if you are still reading this, thanks for making it to the end! :)