Scrip Joint

After postponing the inevitable, Guido sees her dermatologist about this vicious outbreak of itching eruptions she can’t vanquish. Doctor scrapes a few samples and writes two prescriptions, one for her scalp, other for the rest of her freckled epidermis.

In something of a hurry, we try to deliver the paperwork via the Publix Pharmacy’s Drive-In window, but when nobody answers the summons, Guido runs it inside. She hands both ‘scrips to a counter creature who frowns. “Not sure what this is,” she says, consulting her computer screen. “Oh. Okay. Might be at least an hour.”

They always say this, even if the entire process consists of reaching under the counter and grabbing the correct color-coded container. But we’re not waiting anyway, so they promise to call when they’re ready for pick-up.

Six hours later, still no call, so Guido calls them. Pharmacist says he needs clarification about the medication’s application – that all rhymes —  and is waiting for the dermatologist to call back. This strikes me as peculiar: our dermatologist runs a very tight ship and effective practice, but why should this concern Pharmacist anyway? Just deliver the product.

An entire day goes by and no word yet. Guido’s at work, so I take over. I call the dermatologist’s office and explain the problem to a medical aide. The aide checks the data, doesn’t see a problem, and calls Pharmacist. Then she calls me back to say that whatever the problem might have been (she isn’t certain), the Pharmacist is on it and will call as soon as the medication is ready.

When Pharmo calls, he says he took care of the one problem, alright, but now there’s another: he needs a PA (Prior Authorization) from the dermatologist because it’s an expensive scrip, our insurance won’t cover it, and the doctor didn’t okay a generic or cheaper alternative. I wait politely until he’s finished before I totally lose my shit on him.

First I ask him why the entire fuck he didn’t take care of this problem when he took care of the other problem (whatever it was), or even before. Next I tell him I don’t give a bloody fart how much it costs: we’re talking about health care and a medical condition here, not the price of vegetables, and if I need to I’ll come in an hand him a credit card because in a sane world, the insurance company doesn’t get to override the doctor’s recommended course of treatment. And neither does the goddam Publix Pharm-man who needs to stay in his lane moving pills from big bottles to little bottles without spilling too many on his little white apron.

“It’s $230,” he says.

I reiterate my contention that medical concerns outweigh all else, and if asshats in the health industry like himself can’t grasp this essential Hippocratic component they ought to be sweeping the pharmacy’s floor, not attending to its clientele. He actually says this isn’t about health care, but insurance. When I ask him why my insurance company (Medicare) doesn’t cover it, he suggests it isn’t a very good company.

I explain in easy-to-understand four-letter words at high volume that he’s personally and professionally obstructing the administration of medication to remedy a patient’s medical condition, and that by bumbling around like this he was endangering that patient’s health. He tells me “I’m only trying to help, Sir,” and tops it off by mentioning that in fact, they don’t even have the medication on hand anyway.

And then I wake up in a cold sweat.

No, I don’t. He really said that, and this is actually happening.

I call back the dermatologist’s office, speak to another aide, who can’t quite believe what I relay to her. She asks me for the address and phone number of Pharmo, which I provide, adding that I don’t know his name but if you ask for the guy with the size 28 shoes and big red nose, they’ll know who you mean. Bear in mind it’s almost 5:00 now, so this unrolling horror story is threatening cocktail hour.

A few minutes later the aide calls me, says she spoke to “the clown” (her words), and yes, there really is a problem here, Houston, but she’s going to get the scrip changed to something they already have, so he’ll fill it immediately and call when it’s ready.

Ten minutes later Pharmo calls, so Guido, home from work, goes over to claim it. (Pharmo himself evidently repairs to the latrine to hide when she arrives: he’s not in sight.) She returns with one tube of ointment ($7.00) and the original scrip. So where’s the other med she was prescribed?

This time Guido calls the dermatologist office and provides the update. Now the aide is completely flummoxed. She says she went over both scrips with Pharmo, changed the one that was causing difficulties, and never had to modify the other. “What is going on over there?” she wonders aloud, “Can you take it somewhere else? Is there a Costco nearby?”

At this point we’re better advised taking it to an auto supply outlet. Or maybe there’s a kid in the schoolyard who has a drug connection.

There’s an entire rats’ nest of issues here, the most serious the one about the way patient care is juggled by blind limbless acrobats whose exclusive province is their own 3-ring circus and peanut sales. They are unconcerned for the patient, let alone the Big Picture. They worship Paperwork and Procedures, and if some poor shmenk limps in bleeding from the gills and shitting internal organs, they still need to get a PA or claim they need to call the insurance company first.

Even within these limits, there’s a distinction between competent and incompetent. Many professionals in the field are as upset with the status quo as their clients and patients, and work diligently to expedite care. Evidently, Pharmo isn’t one of them. So he loses our business, slight as it may be, and quite likely any references from our dermatologist’s office.

No skin off my nose. Heh heh. Skin. Dermatologist. Heh heh.