Thursday, August 19, 2010

Stop giving it away

Thank you for calling County Memorial Hospital Emergency Department. Please note, by law we are not able to give medical advice over the phone. If you are calling from a physician's office, press one. Pharmacies, press two.....

That's the greeting from the direct line to the local ER. I can't confirm the validity of the statement that it's against the law for them to give advice over the phone. But they are on to something. If you can't make the effort to come in to see us, we're not giving you any information.

They aren't giving it away.

Hmmmm..... we give it away all the time. Why?

Ever call your personal physician with a question about your own medical condition? How many times does the receptionist say that you need to come in to be seen? In my area if you don't pay, the doctor has nothing to say.

Yet we give away information all the time.

Sometimes face-to-face. Sometimes over the phone.


If we are the medication experts, why do we give it away? Because we always have doesn't cut it any more. Experts in other medical fields don't give it away.

We need to change our way of thinking. We are the most accessible health care provider, but that doesn't mean that we need to be the free health care provider.

Several years ago I worked for a company that was toying with the idea of pharmacists billing for our OTC consults. We were going to carry tear-off sheets in our jacket pockets to document the OTC consults and bill for them. The only issue was collecting the insurance information. Asking for an insurance card before dosing Tylenol was odd. The idea didn't survive.

That was then, this is now.

We need to be compensated for each and every time that we utilize our professional skills. I'm going to throw this out there and maybe somebody who is a better position than me can develop this idea.

Each person should have a medical card. Similar to a credit card with the magnetic stripe, but it should contain the person's insurance information. For medical, dental, and prescription purposes there would be no more entering of insurance data. A simple swipe of the card on a card reader would populate the required fields on a computer's insurance screen. (Solves the standardized card format issue right there)

Everybody has one. Even cash customers. You must present the card at each and every transaction surrounding medical care. No card, no care.

For pharmacists, before giving any OTC advice we swipe the card on a PDA. Insurance information is captured. After the consult we record the details of the exchange and submit to the insurance company. Check comes directly to the pharmacist. For the uninsured, we are able to write off the consult on our taxes.

And there you have it. Step one for taking back control of our profession... we don't give away information for free.


Alicia said...

I once read that people only value what they pay for, and when it comes to our expertise, this fits all too well. We don't charge the patient, and thus our advice/counsel is undervalued. It's going to be a necessity that we find a way to change this if we are to survive as a profession.

I heard a PhD Chemist who worked for Merck talk about the need for a medical ID card or chip 12 years ago - why has this idea not taken flight yet?

Sarah G said...

I suggest you push for single-payer health care if you want this.

Eric, RPh said...

Absolutely not.

For years we have griped that insurance cards need a standard format, but it hasn't happened.

Since the health care reform law will basically require everybody to carry insurance or proof of financial responsibility, I propose that the insurance information be stored digitally on a "credit card." No card, no service.

The thought of a single payer scares the crap out of me. Have you seen how government programs have slashed pharmacy reimbursements? A single payer system would kill the market.

Pharmacy, or any medical benefit, would become a line item in the budget. Piss of the executive branch and see your programs eliminated. Kiss MTMs good-bye. Say hello to ACQ - 50% - $3.75 reimbursement rates.

The idea behind this post was to have an easily accessible method to bill the correct insurance company for professional services that we, as pharmacists, current provide at no cost. Period.

Jen said...

My insurance card has always had a magnetic strip on it. It's the only thing I feel United does properly, but only doctors' offices utilize the strip. In Canada, technology is a bit more advanced in terms of portable documenting and charging. They have wireless credit card machines they whip out on the spot at the restaurant. Boom, card charged. We still have everything wired down and that creates a hassle. Something like that would be useful. Also, when is the "open environment" going to go away? I was in a big store, I think a Wal-Mart in Watertown, NY and the pharmacy was enclosed in glass in the middle. You could see everything. I don't know about you, but sometimes I need to go into an unseen area to take care of an unfortunate wedgie. And I'm getting sick of people leaning over the counter and screaming, "WHERE IS THE MILK AND WHY ARE EGGS NOT ON SALE THIS WEEK?!" or "DO YOU HAVE A BATHROOM?!" when I am pouring something expensive and I jump and liquid everywhere. Disaster. I think everyone has complained about this. Why do I want to be a pharmacist again? :P Also, in your store, does everyone just ignore the front store registers? They all come to the pharmacy for refunds or exchanges or to buy everything and they don't have prescriptions. I also blame that on inadequate staffing so the cashiers are always doing planograms and not standing by the registers so people come back to us to complain about not liking their shampoo.