Claim Checkers

Getting back to my post of 9th April last about claim checkers.  I had a phone call from the PCRS about the disappeared prescription this morning. Apparently it did appear on my reject list.  The entire claim was rejected because of one item.  However it only appeared on the reject list as the one item and not seven items that were actually rejected.  When I asked why the other items were not paid for I was told that if one item is rejected then the whole prescription is rejected.  “That’s just the way it has always been.”  As a stop gap they have now agreed to pay for the other six items (2 months late) and I have to chase up the prescriber for another prescription for the rejected item.

The claim checker paid for itself in that I was made aware and able to chase it up.  However I think that it is a disgrace that pharmacists have to pay for these programs just so we can deal with arbitrary decisions by the PCRS. Ultimately it would be nice if the PCRS were subject to the Ombudsman and we could have somebody to ensure fair play.


A Question For The PSI

There is still no mention on the PSI’s website about Garda vetting despite it being a requirement to practice as a pharmacist.  So I decided to email them and ask why they decided not to become involved.  Here is the email that I sent.

I note that from 1st May it is a requirement that all pharmacists and qualified assistants in a patient facing role will needed to be Garda vetted. I would like to know why the PSI has chosen not to involve itself in this process given that other regulatory bodies such as the Teaching Council have taken this task upon themselves.

Surely overseeing Garda vetting for pharmacists and qualified assistants falls within the PSI’s role to protect the public. It would also ease the administrative burden on individuals who now require vetting every time that they change jobs and an inordinate burden on locums who now require vetting for each pharmacy that they provide cover for. Given that there is now a difficulty in obtaining locums particularly at short notice is there not now a case to be made for the PSI to become the authorised administrative body for vetting pharmacists and qualified assistants meaning that each individual would only need to be vetted once.

It would also reduce the administrative burden on the Garda’s vetting office as presently they have to duplicate the process for a large number of individuals.

I’ll keep you update when i get any reply.


Garda Vetting For Pharmacists

Is it just me or does it strike anybody else as being odd that the PSI want nothing to do with Garda vetting for pharmacists and qualified assistants?  All the more so when their primary purpose is to protect the public.  It’s probably because there’s no money in it for them.

Let’s leave aside that all this has been sprung on us at less than 3 weeks notice and that most of the other regulatory bodies see it as part of their role.  Anybody who has been involved with Garda vetting in any other situation knows that a 3 week time frame is ridiculous. Also because of the PSI’s action any pharmacist who works in more than one pharmacy will have to obtain clearance for each pharmacy.  Every time that a pharmacist or Qualified Assistant changes job they will have to obtain clearance.  A once off vetting managed by the PSI could prevent a lot of this messing around.

This also throws up an interesting anomaly. What if a pharmacists for whatever reason cannot obtain clearance.  Is their employer now obliged to sack them?  And as up to now very few if any pharmacists would have it in their contract of employment that they must have Garda vetting could they then sue for unfair dismissal?

For now kudos to the IPU for stepping up to the mark at short notice but why did the PSI shirk their responsibility to the public?  Even as I write their is zero mention of it on their website.  It would be nice for them to even acknowledge that the issue even existed.

The Price Of Claim Checkers

Any pharmacy that doesn’t do this yet should consider getting some form of software to check their GMS claims.  I have one and often wondered was it worth the price I pay for it.  I am fairly rigorous in chasing up on my rejects so I thought “what do I need this for?”  Well today it paid for itself.

There is now a new type of reject.  The ones that they don’t tell you about.  My software highlighted a prescription that did not appear in either the paid or rejected lists.  It just disappeared into the ether. The amounts involved more than cover the cost of the software.

I think that it is deplorable that a government body such as the PCRS can behave in this fashion.  If they behaved in this manner to members of the public the media and public representatives would be jumping up and down.  But it seems as if pharmacists are not worthy of even the most basic level of respect.  I challenge any public representatives reading this to contact me and say if they think that this is acceptable and what they might do about it.  I don’t expect to be inundated with replies.

I have written to the PCRS asking them to pay me for the disappeared prescription ASAP and to explain how it could have gone missing in the first place.  I eagerly await their reply.

Over half of community pharmacists considered leaving the profession.

From the Pharmacy Journal.

It’s a UK survey and has its limitations but it’s frightening to see that 56% of community pharmacists there had considered leaving the profession in the last year.  I wonder what the equivalent survey here might show.

Pharmacy Has Enemies In High Places

Not much I can add to this really.

The political and PR challenge for pharmacy is convincing institutions like the International Monetary Fund that they are wrong, says Peter Kelly

If you were Christine Lagarde, the managing director of the International Monetary Fund, and you were considering reforms for a bankrupt country such as Greece, which of the following would you feel was in most urgent need of reform:

(a) The irresponsible, corrupt and frankly criminal financial sector.

(b) The accountants and lawyers of the thriving tax avoidance sector.

(c) The small family-owned pharmacies.

That’s right you guessed it – the pharmacies that played no part in bankrupting Greece had to be reformed first. This is the medical equivalent of looking at a patient with lung cancer and deciding to operate on their colon.

And when the patient asks if it is still ok to smoke, telling them ‘yeah sure, everything will be fine when we remove half your cancer-free colon.’

In a fascinating book by Yanis Varoufakis, the former Greek finance minister – ‘Adults in the Room – My Battle with Europe’s Deep Establishment’ – there is an extraordinary passage where Yanis invites Christine Lagarde to a serious discussion about possible reforms for the Greek economy and the first area she wants to discuss is pharmacies.

She is then astonished that Yanis has the gall to defend pharmacies. People outside pharmacy might find this passage in the book extremely surprising but pharmacists in the UK and Ireland will not. (My emphasis)

Since the financial meltdown of 2008, pharmacy sectors in the UK and Ireland have been attacked by the powers that be with such consistency you would be forgiven for thinking that pharmacies had caused the crash.

Pharmacy has a major PR problem. The political establishments’ view of pharmacy is this; pharmacy takes much more than it gives.The government gives pharmacy massive amounts of money and gets very little for it.

Most of the money the pharmacy sector receives comes from government, therefore pharmacy is really just an extension of government – as an extension of government it would be much easier to deal with one or two large organisations than lots of little ones.

This perception is not based on reality or evidence but that doesn’t matter because in politics, perception is more important than reality. The political and PR challenge for pharmacy is convincing institutions like the IMF that they are wrong.

This will be extremely hard to do and won’t be achieved by presenting evidence. We will need to be more creative and be under no illusions this will be a real David and Goliath battle. The pharmacy profession needs to invest seriously in sophisticated PR and lobbying.

Peter Kelly is a community pharmacist based in London.


The customer is always right, not necessarily.

This comes from the airline industry but could easily be applied to any business where you have to deal with the public.

One woman who frequently flew on Southwest was constantly disappointed with every aspect of the company’s operation. In fact, she became known as the “Pen Pal” because after every flight she wrote in with a complaint.
She didn’t like the fact that the company didn’t assign seats; she didn’t like the absence of a first-class section; she didn’t like not having a meal in flight; she didn’t like Southwest’s boarding procedure; she didn’t like the flight attendants’ sporty uniforms and the casual atmosphere.
Her last letter, reciting a litany of complaints, momentarily stumped Southwest’s customer relations people. They bumped it up to Herb’s [Kelleher, CEO of Southwest at the time] desk, with a note: ‘This one’s yours.’
In sixty seconds Kelleher wrote back and said, ‘Dear Mrs. Crabapple, We will miss you. Love, Herb.'”
The phrase “The customer is always right” was originally coined in 1909 by Harry Gordon Selfridge, the founder of Selfridge’s department store in London, and is typically used by businesses to convince customers that they will get good service at this company and convince employees to give customers good service.

However, I think businesses should abandon this phrase once and for all — ironically, because it leads to worse customer service.

Here are the top five reasons why “The Customer Is Always Right” is wrong.

1: It Makes Employees Unhappy

Gordon Bethune is a brash Texan (as is Herb Kelleher, coincidentally) who is best known for turning Continental Airlines around “From Worst to First,” a story told in his book of the same title from 1998. He wanted to make sure that both customers and employees liked the way Continental treated them, so he made it very clear that the maxim “the customer is always right” didn’t hold sway at Continental.

In conflicts between employees and unruly customers he would consistently side with his people. Here’s how he put it:

When we run into customers that we can’t reel back in, our loyalty is with our employees. They have to put up with this stuff every day. Just because you buy a ticket does not give you the right to abuse our employees …
We run more than 3 million people through our books every month. One or two of those people are going to be unreasonable, demanding jerks. When it’s a choice between supporting your employees, who work with you every day and make your product what it is, or some irate jerk who demands a free ticket to Paris because you ran out of peanuts, whose side are you going to be on?
You can’t treat your employees like serfs. You have to value them … If they think that you won’t support them when a customer is out of line, even the smallest problem can cause resentment.
So Bethune trusted his people over unreasonable customers. What I like about this attitude is that it balances employees and customers. The “always right” maxim squarely favors the customer which is a bad idea, because, as Bethune says, it causes resentment among employees.

Of course, there are plenty of examples of bad employees giving lousy customer service but trying to solve this by declaring the customer “always right” is counter-productive.

2: It Gives Abrasive Customers an Unfair Advantage

Using the slogan “The customer is always right,” abusive customers can demand just about anything — they’re right by definition, aren’t they? This makes the employees’ jobs that much harder when trying to rein them in.

Also, it means that abusive people get better treatment and conditions than nice people. That always seemed wrong to me, and it makes much more sense to be nice to the nice customers to keep them coming back.

3: Some Customers Are Bad for Business

Most businesses think that “the more customers the better”. But some customers are quite simply bad for business.

Danish IT service provider ServiceGruppen proudly tell this story:

One of our service technicians arrived at a customer’s site for a maintenance task, and to his great shock was treated very rudely by the customer.
When he’d finished the task and returned to the office, he told management about his experience. They promptly cancelled the customer’s contract.
Just like Kelleher dismissed the irate lady who kept complaining (but somehow also kept flying on Southwest), ServiceGruppen fired a bad customer. Note that it was not even a matter of a financial calculation — not a question of whether either company would make or lose money on that customer in the long run. It was a simple matter of respect and dignity and of treating their employees right.

4: It Results in Worse Customer Service

Rosenbluth International, a corporate travel agency since bought by American Express, took it even further. CEO Hal Rosenbluth wrote an excellent book about their approach called Put The Customer Second – Put your people first and watch’em kick butt.

Rosenbluth argues that when you put the employees first, they put the customers first. Put employees first and they will be happy at work. Employees who are happy at work give better customer service because:

They care more about other people, including customers
They have more energy
They are happy, meaning they are more fun to talk to and interact with
They are more motivated
On the other hand, when the company and management consistently side with customers instead of with employees, it sends a clear message that:

Employees are not valued
Treating employees fairly is not important
Employees have no right to respect from customers
Employees have to put up with everything from customers
When this attitude prevails, employees stop caring about service. At that point, genuinely good service is almost impossible — the best customers can hope for is fake good service. You know the kind I mean: courteous on the surface only.

5: Some Customers Are Just Plain Wrong

Herb Kelleher agrees, as this passage From Nuts! the excellent book about Southwest Airlines shows:

Herb Kelleher […] makes it clear that his employees come first — even if it means dismissing customers. But aren’t customers always right? “No, they are not,” Kelleher snaps. “And I think that’s one of the biggest betrayals of employees a boss can possibly commit. The customer is sometimes wrong. We don’t carry those sorts of customers. We write to them and say, ‘Fly somebody else. Don’t abuse our people.'”
If you still think that the customer is always right, read this story from Bethune’s book From Worst to First:

A Continental flight attendant once was offended by a passenger’s child wearing a hat with Nazi and KKK emblems on it. It was pretty offensive stuff, so the attendant went to the kid’s father and asked him to put away the hat. “No,” the guy said. “My kid can wear what he wants, and I don’t care who likes it.”
The flight attendant went into the cockpit and got the first officer, who explained to the passenger the FAA regulation that makes it a crime to interfere with the duties of a crew member. The hat was causing other passengers and the crew discomfort, and that interfered with the flight attendant’s duties. The guy better put away the hat.
He did, but he didn’t like it. He wrote many nasty letters. We made every effort to explain our policy and the federal air regulations, but he wasn’t hearing it. He even showed up in our executive suite to discuss the matter with me. I let him sit out there. I didn’t want to see him and I didn’t want to listen to him. He bought a ticket on our airplane, and that means we’ll take him where he wants to go. But if he’s going to be rude and offensive, he’s welcome to fly another airline.
The fact is that some customers are just plain wrong, that businesses are better of without them, and that managers siding with unreasonable customers over employees is a very bad idea, that results in worse customer service.
So any business needs to put its people first — and watch them put the customers first.