Once upon a time, in any retail pharmacy you’ve worked at…

I salute retail pharmacists and pharmacist assistants. Full time pharmers. The ones who know how to bite their tongues, keep their hands occupied and suppress the urge to roll their eyes all the while moulding their facial features to an acceptable expression for the ever changing situations they deal with on a daily basis. My colleagues and friends who, as they read the following dramatization, will respond with a knowing smile, which is likely to be followed by a grimace when the realisation hits them that they’ll be due for a visit from their own “Mrs Williams” and “Mr Morris” in the next few days …

A snap shot into the life of a retail pharmacist

You call a medical aid for chronic medication authorisation only to be put on hold for twenty minutes. Upon finally hearing the voice of a living, breathing person after the seemingly endless replay of pre-recorded messages (Please stay on the line, your call is important to us) or tacky phone music, you feel indescribable relief… which is instantly shattered as that living, breathing person informs you that you’ve been put through to the wrong department and will be redirected. Assuming that that dear living, breathing person redirects you correctly, it’s quite possible that you’re in for another long wait which will end with you sorting out the authorisation or hearing the line go dead in your ear. And you will have to start all over again. And when you have completed this soul destroying task, you need to affect a smile and sympathetic tone as you listen to Mrs Williams describe her latest bowel complaint and mutter about the poor quality of bisacodyl the manufacturers are using because it “just doesn’t have the same effect anymore”. Once you’ve ushered her out the store (with a pack of codeine-containing pain killers alongside the bisacodyl suppositories that she insisted upon buying in her bag), you are then told that you need to assist Mr Morris because “only you know what’s going on with his chronic medication”. Mr Morris’s chronic medication consists of the same five drugs he has received for the past three years, a prescription which you usually ask someone else to prepare on the occasions that he phones in the request for a repeat. As you process the repeat and submit the claim to the medical aid, he will regale you with stories about his unbelievably talented and intelligent granddaughter who is a doctor and has recently become engaged to a neurosurgeon. You have never met Mr Morris’s granddaughter. 

If this sounds all too familiar to you, then you’ll probably appreciate the collection of gems that I have compiled for your enjoyment. Some of these are only “argh moments” depending on the scenario – as with everything in life, context is important – and for those where a response is applicable I’ve included a few choice responses (many of which will probably never actually be verbalised). I think I should try work these into a warped form of bingo…

Gem #1

Client: What is the best thing for flu?

Me: Well, you see, most of the cold and flu preparations contain different combinations of the same types of drugs which act on… [I notice a blank expression or that the client is playing with his/her cellphone] What do you normally use?

Client: “Corenza C”

Me: Corenza C it is then.

Gem #2

Scenario 1

Client: I’m just here to collect my chronic meds 

A pretty simple and reasonable request. But not at 18:55 when your pharmacy closes in 5 minutes. And the prescription has ten items on it, at least five of which need to be counted out. And some items are listed as chronic benefits while others need to be claimed as acute.

Scenario 2

Client: “I’m just here to collect my chronic meds” 

On a Sunday morning when the pharmacy is operating on skeleton staff and there’s a queue of acutely ill clients who are desperate to get to their homes. This particular client is a pensioner [or any other person who doesn’t have a full time job which restricts the hours during which one can visit a pharmacy], one who you know isn’t heavily involved in community work or an extremely busy social life. In other words, a person who has the time (and transport) available to them on any given day of the week, but chooses to wait until a weekend to collect the medicine that is keeping him/her alive. If you don’t have stock of the drugs that she/he needs, then you’re probably in for a shit storm because you’ll be told about how she/he has been a client for however many years and you should always have his/her medicine in stock.

Scenario 3

Client: I’m just here to collect my chronic meds 

I prepare the client’s medication and hand it over, expecting to be able to serve the next person…

Client: Thank you. And I’d like some Allergex, Sinutabs, Mybulens and Centrum. On the medical aid. What else was there? Oh ja, I’m looking for the new thing for [insert random condition here] that I saw on TV. The ad said it was available in all leading pharmacies?

And here I thought the client “just” wanted his/her chronic medicine.

Gem #3

Client: Hi, how are you?

Me: I’m fine, thanks. And you?

Client: I’m fine.

Me: How can I help you?

Client: I’m feeling very sick, I’ve got flu.

I thought that you were “fine”… (although that being said, I also have issues with the “Hi, how are you” game).

Gem #4

Client: Hi there, I’m looking for Guronsan C for my flu.

Me: You mean Corenza C?

Client: No, Guronsan C. The fizzy one.

Me: Corenza C is for flu. Guronsan C is for babalas.

Client: Is it?

Gem #5

You’re loading the items from the single or multiple prescriptions that you’ve just processed for a single client, there are quite a few items (let’s say about eight different drugs).

Client: Joh! I’m buying the whole pharmacy. Hahaha

No response is needed. Well, maybe one is, but your hands are full and I don’t know that professional indemnity insurance pays out for incidents involving physical attacks on a client. An eye roll should suffice.  

Gem #6

Scenario 1

Client: Please only give me what’s on the prescription. I don’t believe in generic medications. 

Me: Ok, but are you aware that all of the items that your doctor has prescribed for you are generics of the original products?

Scenario 2

Client: Please only give me what’s on the prescription. I don’t believe in generic medications.

Prescription is processed and submitted to the medical aid. The claim response indicates a high co-payment due by the member.

Me: Your medical aid has accepted the claim, but you’ll need to pay in [insert random figure here] because they only pay for the generic medicine price in full.

Client: Ok, just give me the generic.

Gem #7

The client asks for a whole range of different products, including scheduled items and off-the-shelf preparations, to be claimed from his/her medical aid.

The claim is processed, but a few of the off-the-shelf items are listed exclusions and the client is informed of this detail.

Client: I don’t know why I pay so bloody much for a medical aid. Stupid thing won’t even pay for multivitamins!

Me: Well, I don’t know how much you pay each month. But do you have any idea how much a hospital stay will set you back? Unless you’ve got tens or hundreds of thousands of Rands readily available at the drop of a hat, I’d recommend continuing to pay those ridiculously expensive premiums for your “useless medical aid”.

Gem #8

Client: Hi, I wonder if you can help me. I was sick a few weeks ago and it’s back. Can I get some [antibiotic and/or cortisone].

Me: If you’re needing an antibiotic or cortisone, you’ll need to see a doctor and get a prescription.

Client: Why do I need a prescription if I know what’s wrong? I was sick, I’m feeling the same way now, so why can’t I just get more of the same stuff that I had the last time – it worked?!

In these instances, I often don’t know how I should respond. I will generally simply tell the client what the law has to say on the subject and be done with it. Sometimes I’ll throw in a story about viral infections and how using cortisone can weaken the immune system, leaving them more susceptible to secondary bacterial infection or how taking an antibiotic where it’s not indicated is contributing to the problem of superbugs. But I know that most of the time my opinion is only worth 2 cents when it is not congruent with that of the client.

Gem #9

Client: I normally get my blood pressure medication from another pharmacy, but I’ve run out and I’m here now. Can you give me some?

Me: I can give you an emergency supply if you’re unable to get your medicine from your usual pharmacy and you’ve run out. What medication is it?

Client: I don’t know the name. It’s for blood pressure. The tablet is round and white.

Face. Palm. Enough said.

Gem #10

Client: Please give me the genetic medication.

Genetic medication? Is that something new? Maybe a cure for stupidity?

Gem #11

Client: Can you please give me something. I’ve got chronic ear ache.

Me: What do you normally take?

Client: I don’t know, I’ve never had such chronic pain before.

Me: You don’t know what “chronic” means, do you?

Gem #12

Me: Your prescription is expired, you’ll need to see your doctor and get a new prescription.

Client: I don’t know why I need to go see my doctor and pay him/her hundreds of Rands for a new prescription. I’ve been on this medicine for years. You’ve got the medicine, just give it to me.

Me: So I suppose that there’s no possible way that anything else could be wrong with your body or any chance of your current chronic medication not adequately managing your disease state because your condition hasn’t and won’t ever change. What happened for you to need this medication? Oh, yes, that’s right! You developed hypertension? What caused it? That’s right, you probably don’t know. So you probably won’t know if your condition is actually under control unless you have it checked up. But it’s cool, you can keep on taking the exact same medication and not worry about having a check-up, just please tell your friends and family that you refused to see the doctor when they are in shock over your “sudden” onset of kidney failure due to uncontrolled hypertension.

Alternative ending, Pharmacist’s cut

Client: I don’t know why I need to go see my doctor and pay him/her hundreds of Rands for a new prescription. I’ve been on this medicine for years. You’ve got the medicine, just give it to me. 

Me: You actually don’t need to see your doctor. In actual fact, you don’t even need this medicine. It’s all a conspiracy. A big pharma conspiracy. I’m just a pawn in their game. It’s the government and doctors and your next door neighbour – they’re keeping you controlled by the man.

Gem #13

Client: Can I please get the generic for Xanor?

Me: Do you have a prescription for that?

Client: You don’t need a prescription for generic medication.

I cannot even…

Gem #14

Client: Can I please get my chronicle medication?

Chronicle? Nope, can’t do it.   

Gem #15

Client: I normally get my medicine from this other pharmacy. Can I get it from you? Here’s my medical aid card.

Me: Do you have a prescription here for that medicine?

Client: No, but it’s all loaded on the medical aid.

Me: And all your fast food payments are loaded on your credit card, that doesn’t mean that McDonalds knows that you want a junior chicken burger.

Gem #16

Client: I’m here to collect the repeat for Ritalin for my son.

Me: You don’t get repeat prescriptions for Ritalin, you need to get a new one from your doctor every month.

Client: You people are just out to make money.

Me: How do I get cash from sending a patient to the doctor?

Gem #17

Client: I’m sick, got really bad flu and need an antibiotic. Can you speak to my doctor, he is in [insert random city located somewhere else in the country]?

Me: You do know that the law states that for a telephonic prescription, the prescriber needs to be known to the pharmacist?

Client: Huh? But he’s a doctor.

Me: Yes, I can confirm his qualifications through the phone. And it’s amazing that this doctor knows that you need an antibiotic from examining you through the phone, maybe he should be on the radio…

Gem #18

Client: Can I get a repeat of my antidepressant?

Me: Ok. Ummm. You haven’t had this medication since last year. You’ll need a new prescription.

Client: But I only got 3 of the six repeats.

Me: A prescription is valid for six months. Not six (in actual fact five) repeats. All that aside, you don’t just stop and start antidepressants. Maybe you’re not depressed, maybe you’re just stupid.

Gem #19

Client: I’m feeling sick. Can you give me something?

Me: What symptoms do you have?

Client: I’m just not feeling great, hey. Can I get an antibiotic?

Me: Ah, yes. An antibiotic will fix everything.

Gem #20

Me: Unfortunately I don’t have stock available of that specific medication. Can I give you the generic.

Client: Yes, that’s fine. As long as it doesn’t contain penicillin.

Me: Ah, yes. Penicillin, now lurking in every product at a pharmacy near you.