And You Wonder Why Your Pharmacist Never Smile

Parents... the Dumb Ones

2009-09-19T11:07:00.002+08:00

When you work in a paediatric setting long enough you sometimes wonder if Adolf Huxley's Brave New World (sans Soma and orgy) isn't such a bad one to begin with. We allow the bright ones to be sexually productive, and brain-wash the stupid ones into sexually unproductive individuals. Oops... I made an elitist remark, but I am not apologetic about it.

The following conversation happened a few days back when I dispensed a prescription. See if you don't agree with me some parents are really stupid to the extend you wonder if it is such a good thing to let them raise the next generation.

Me: Medicine for XYZ?

Mom: Yes.

Me: Is the address at Blk XXX etc etc?

Mom: No, that's not the correct address?

Me: Was it your old address? This is a common problem, people moved house and they assumed everybody knows they have moved

Mom: No, we've never lived there before.

Me: ?? But your child's name is XYZ?

Mom: Yes.

Me: Then why is the address wrong?

Mom: Er... (at this point the Dad came).

Dad: Oh that's not my child's name. I saw the doctor key under the wrong name just now.

Me: Huh?! Then what's your child's name? And why didn't you tell the doctor on the spot that it is the wrong name?

Dad: (passes me his child's appointment card) Oh I thought it was the doctor's name. in case you think this is an acceptable reason, the wrong patient name clearly belongs to a female (if you disagree, show me a male named Claire), and the doctor is male.

Attitude Problem?

2009-07-17T08:33:00.002+08:00

Okay, I'm officially back to slamming the stupid patients.

I really got to give a hand to the dumb asses of humanity, they really think once they're out of school nobody's going to think they're dumb, or they can get away for being dumb.

Story goes that a stupid husband came to the pharmacy to pick up some medicine for the pregnant wife. I picked up the basket and started dispensing the medicine to the dumb husband. The doctor prescribed lactulose syrup, bisacodyl suppositories, Proctosedyl suppositories, and Flagystatin pessaries. For the sake of the general masses who are not familiar with these medicines, lactulose and bisacodyl are laxatives, Proctosedyl is for piles, and Flagystatin has got an antibiotic and an anti-fungal used for treating vaginal infection.

Lactulose was easy enough, but my torture started when I began counseling the suppositories. The stupid excuse of a human being, kept saying the bisacodyl suppository was for oral taking when I repeated and corrected him multiple times that the suppository is for insertion into the rectum. I even wrote the instructions for him in Chinese together with the phrase "not for oral taking" on the drug label.

When I got to Proctosedyl suppositories, I think his brain has no more memory space left. Wrote out for him in Chinese what the medicine is for and how to use it, and he still asked if it was for oral taking. And he even asked if Proctosedyl and the bisacodyl suppositories are the same. I nearly fainted, but I definitely lost all patience with him. How difficult is it to comprehend that bisacodyl is for constipation and Proctosedyl is for piles?! Even if he cannot remember which is which, surely any normal human being can tell they are not the same!

When he started saying I've got attitude problem, I really felt like telling him I'll give him real attitude problem. Just pretend I didn't hear anything he said and let him tell his wife the pessaries and suppositories are to be taken orally. If I have a attitude problem I would not have bothered correcting his mistakes. After all I've done my job translating (verbally and in writing), counseling, and explaining how to take/ use the medicine.

H1N1

2009-06-26T14:51:00.004+08:00

H1N1, previously known as swine flu, is all the rave now. It's become an international problem and here on the little red dot, things are beginning to spice up with the total counts of people infected rising to 315.

With all this talk of cluster spreading, schools are extending the current school holidays by another week. I thought this is the proper thing to do. However, a significant number of parents apparently seem to think otherwise. Their main concern is their children are missing school and will end up lagging behind in school work. A totally brainless way of thinking. If the school closes, all the students start their lessons one week late. How then, can their children lag behind in school work? Besides, the decision to extend the school holidays by another week is made with the intention of protecting the students' and teachers' health. I wonder if our society's perverse obsession with results and accolades has reached another new height; now a child's education is paramount to his/her health and safety. Are we still treating our children as children, or are we treating them as pets to be groomed then shown-off at some pedigree show?

Anyways, under social pressure (I believe), some schools have decided to start online lessons such that students do not "lag behind" in their studies.
In this whole charade of starting online lessons, we have conveniently forgotten there are families out there who are too poor to even afford new school books, much less computers with internet connections. Now, this is really going to cause some students to lag behind in their studies, and so much for a "democratic society, based on justice and equality"**.

**The phrase "democratic society, based on justice and equality" is taken from Singapore's national pledge.

CPE Points

2009-06-13T08:35:00.005+08:00

After a long haitus I have decided to stop complaining about patients for a bit. Not that I've seen the light, but the current hospital I'm working in does not have a load high enough to make me angsty. Yes I've moved again. Lol!!

Anyways, there is something that I am compelled to bring to light. In case you're wondering, CPE means "continuing professional education". The doctors have it, the nurses have it, and the pharmacy profession (in Singapore) has just joined the bandwagon a couple of years back. Basically, we are expected to accumulate a certain number of points to qualify for renewal of our practising license.

In all frankness, I do not doubt the good intentions of "forcing" us (pharmacists) to get CPE points. Sometimes we need a little push to keep updated with current drug knowledge, else it is in human nature to slack off. However, I have come to realise good intentions are sometimes just not good enough.

Singapore, like all other developed countries, needs more pharmacists to run the pharmaceutical side of the healthcare system. With regards to this, our health minister Mr Khaw Boon Wan already said the ministry will look into hiring more foreign pharmacists to fill the positions. In the last couple of years, retired pharmacists are even encouraged to return to the workforce to help ease the shortage.

Somehow, asking the retirees to return to the workforce does not seem to be such a good idea. There are 3-4 ex-retired pharmacists in the current hospital that I'm in and most of them are just not competent, knowledge-wise. Common reason being they have never practised as a dispensing/ clinical pharmacist prior to this. Heck, there was one who is incompetent even though he worked in my current hospital before retirement.

Perhaps I should elaborate on how incompetent they can get at times. Let's name them TL and TS. TL never practised as a pharmacist prior to this. Always believed he will hate the job, sounds kinda like me, so he joined the drug companies straight out from university. When he continuously "latched" himself to me during dispensing sessions, I found out he was totally incompetent in knowledge. He had (I hope it's past tense now) no idea that aspirin, mefenemic acid, naproxen all belong to the class of painkillers affectionately known as NSAIDs (non-steroidal anti-inflammatory drugs). Heck, he had never even heard of the term NSAIDs. Had no idea Seretide inhaler is used to treat asthma; he claimed the only form of treatment for asthma was oral steroids during his time. He also had no idea that loratadine and ceterizine are anti-histamines, cousins to our all fave yellow pill, chlorpheniramine aka Piriton. What really peeved me during the times he observed me for dispensing was he never picked up any drug knowledge. It's like going for some class and not pay attention such that at the end of the day you have no idea what's been taught by the lecturer.

TS was the one who had worked as a pharmacist in the hospital and remained incompetent. Slowness aside, he has to refer to the pediatric dosing guide given to our technicians who are helping out with dispensing very frequently. There's nothing wrong with referring if you really cannot recall the dosing range, but I most certainly think it will be helpful to commit the dose of commonly used medicines ie painkillers, cough and cold medicines, and anti-biotics to memory. And he frequently uses MIMs as a reference. Any self-respecting pharmacists knows MIMs gives minimal knowledge, heck it doesn't even list all the drugs available in Singapore. He also has no idea what is a Ventolin evohaler although our pharmacy has it.

These are just a few examples. If you sit down and think about it, these are people who are approved by the Singapore Pharmacy Council for renewal of the pharmacy license at 2008. Obviously they met the 50 CPE points requirement. That means they must have accumulated their points through attending talks, conferences, and reading medical journals or articles. How then is it possible they are still so deficient in basic knowledge? I'm perturbed. We really should not be allowing people like them to continue to hold the practising license even if they fulfill the license renewal requirement. Else we can consider "forcing" pharmacists who have not been practising for more than 3-5 years to take a basic competency test before they are given the green light to start practising again.

Different Hosptial, Same Stupid Patients

2008-07-13T08:41:00.004+08:00

Yes, I am currently working in a different hospital. Better working conditions, but still the same stupid patients. Guess if I want to stay in this line I really got to close one eye on human stupidity. Not.

Stupid Incident No. 1

When your doctor tells you to proceed to pharmacy to collect medicine but forgets to send the electronic prescription down, we are trying to be helpful by helping you call up the doctor instead of sending you all the way back to the clinic to get the doctor. Therefore, the least you can do is to let me know which consultation room you went to so I know which doctor to contact. No need to tell me which clinic you went to as your appointment card already tells me that. I need to know which consultation room. It is better if you can remember the doctor's name, but that is just a good-to-have information. Unless you cannot remember which room you went to, then I must know who you saw how else am I suppose to know who to contact to get your prescription.

However, you are most certainly not being helpful by repeatedly telling me which clinic you went to instead of telling me the consultation room number. Also not very helpful when I asked if you recall the name of your doctor instead and you tell me you saw a Chinese male doctor. For your information, majority of the doctors in Singapore are male and Chinese. Since you cannot provide me with the necessary information I have no choice but to send you back to the clinic. So do not whine, make a big fuss, or threaten to complain.

Stupid Incident No. 2
When you come to the receiving counters to get your queue number you asked for the fast queue number. Reason: your dad is an elderly patient. Have you ever used your brain to think about it or for that matter use your eyes to take a look at the crowd in the waiting area and tell me how many of them are elderly patients? This is a semi-geriatric hospital. If I give the expedited queue number to all elderly patients, then how expedited can that be?!

Stupid Incident No. 3
You come to collect your regular medicine, tell me you want the expedited queue number because you are sick. Use your commonsense. Would any person be in the hospital, much less in the pharmacy collecting medicine if they are healthy? Anyone of those in the waiting area would have the same right as you to request for the expedited queue number because they are all sick.

Stupid Incident No. 4
You come to the pharmacy to collect medicine, then tell me the doctor told you there is no medicine prescibed. Nuff said.

A Tiny Flame

2007-11-11T10:58:00.001+08:00

Somebody, obviously too scared to name him/herself, recently left an anonymous comment on my blog saying I am stupid not to help a patient's son. Link to that post is here.

Quoting his/her comment:
i think you are stupid and the customer is right. singaporeans in general cannot think independently and are basically slaves to procedures and have lost the ability to think creatively. i'm wondering why one cannot call the doctor, get him to write a new prescription and fax it if possible? surely it is on his records...furthermore, if it is on his records, then that is all you need to satisfy your records...give the medicine to the patient and pharmacist and doctor can work it out while the patient receives meds. regardless, there is something that collectively can be figured it. so yeah, it is stupid...only stupid on your part. but then again, after living in singapore for a number of years i would expect no more and no less then a scared or uncaring attitude instead of a helpful one...uniquely singapore :)

All this just proves you are as stupid as the patient's son. Good job. Your vocabulary is obviously lacking if you do not even understand the word legal. You also obviously have no aptitude when it comes to comprehension.

Go to this link to understand what it means by legal.

Let's dissect your comment.

"Why one cannot call the doctor, get him to write a new prescription and fax it if possible?" One, you do not call the doctor regarding a patient he saw a few months back. A hospital doctor sees many patients in one day, you do not expect the doctors to remember patients they saw a few months back when they cannot even remember who they saw a couple of days back. Besides, I would not know who wrote the prescription for the patient, we happen to have more than one doctor working in the hospital. Two, a faxed prescription is not legal for obvious reasons such as a high likelihood of forgery etc. But of course you, though not a Singaporean, obviously cannot think creatively as well and I do not expect you to arrive at the above reasonings.

"Surely it is on his records...furthermore, if it is on his records, then that is all you need to satisfy your records...give the medicine to the patient and pharmacist and doctor can work it out while the patient receives meds." I have already mentioned those records are to facilitate work processes. The law does not require us to keep a record of the patient's medicine history, but it does say a copy of the dispensed prescription must be kept in the possession of the pharmacy for 2 years before destruction. The prescription is required to satisfy the law, NOT the records.

"After living in Singapore for a number of years I would expect no more and no less then a scared or uncaring attitude instead of a helpful one." Scared? Nay, you are sorely mistaken. Any pharmacist, in Singapore or overseas, would protect their license, because we need to go through 4 years of grueling university coursework, pass our forensic (law) exam, go through another year of internship before we can qualify to apply for a pharmacist license. After all the time, sweat, and money spent do you think I would do something that blatantly flouts the law, then get my license revoked? I am not the stupid one here. You are. As for "uncaring" and "unhelpful", did I mention earlier you are lacking in your comprehension faculty? It was in my post that I arranged for the clinic to get another doctor to write the prescription. One thing I did not mention was that I offered to arrange for the medicine to be delivered as the patient's son said he did not have the time to wait for the doctor to write the prescription then pick up the medicine. So much for being "uncaring" and "unhelpful".

"Uniquely Singapore." Ain't got anything to do with being uniquely Singapore. More like you and the patient's son are "uniquely stupid". :)

Litter Bugs

2007-10-05T20:34:00.000+08:00

Another act by the Ugly Singaporean. Throwing their unwanted queue tickets at my dispensing counter instead of politely telling me they want to dispose of their tickets.

Today I observed a mother crushing her clinic queue ticket while searching for her credit card to pay for the medicine. Without batting an eyelid, she conveniently left the crushed ticket on my counter top after she signed for the purchase. So tell me what is the point of education? Our education system maybe stellar when it comes to generating "machines" that can spew technical knowledge, but when it comes to creating a civil-minded and genteel society we still have a long long way to go.

不要以为自己有几个臭钱就拽起来。有钱没教养还是老粗一个。

It's About Time

2007-09-29T18:05:00.000+08:00

On the front page of weekend Today was the report on making it a legal offence for a HIV-carrier to have sex with an unknowing victim. The current law only penalises those who are already identified to be HIV-positive but knowingly withold this knowledge from people participating in sexual activities with him/her. With the new clause, anybody who participates in high-risk sexual activities is punishable by law if he/she passes HIV on to another person regardless of the HIV carrier's knowledge or ignorance of his/her HIV status. Person found guilty of breaching the law will be fined $50000 and/or jailed for up to 10 yrs.

I think this is a welcomed change in the law to make people who choose to participate in high-risk sexual activities to be legally responsible for their actions. Why this law was not introduced earlier to protect the innocent I do not understand, but better late than never. With the new law, those who participate in high risk activites will be forced to do more regular blood tests and are no longer allowed to feign ignorance as a means to escape punishment.

Bioterrorism In the Making

2007-09-27T20:58:00.000+08:00

I was chatting with a retail assistant (RA) from the main pharmacy last week when I heard about a horrifying incident. The RA was checking the stocks on the shop floor when she noticed this elderly patient standing near the shelves selling syringes and needles for diabetes use. As the patient looked a little suspicious the RA decided to observe her.

If you were thinking that the patient tried stealing the needles you were wrong. She did something even more terrible. Whilst still keeping the syringes in the packet, the patient twisted off the cap of the syringe to expose the needle and then proceed to poke the needle through the plastic package and then her finger to test the needle. After that she capped the needle and was about to place the packet back on the shelf when the RA approached her, telling her she had to buy the packet of syringes as she had already "tried" one of them. In fact blood was present on the packet and the patient's pricked finger.

According to the RA this was not an isolated incident and one of the cashier actually had a needle stick injury as a result. What I do not understand is why the patients do such things. Have they any idea the implication of trying needles?! If a HIV/ hepatitis B carrier tried the needles and placed them back for another to buy, that person would have become infected and not because he/she is at fault. Rather it is due to the sheer stupidity of a fellow human being.

My take on this: if you ever need to buy needles, buy the full box. Make sure the box is sealed with no tampering. Better to waste the money than to waste your life.

Did Lee Hsien Loong Ever Said Such a Thing?!

2007-09-21T23:27:00.000+08:00

Wanted to blog this sooner, but been getting home quite late and was watching Ghost in the Shell: Stand Alone Complex and playing online games most of the time I was logged in to the internet. Anyway, this incident is but a couple days' old so it is still quite fresh.

What happened was this man came with his maid to collect medicine. Medicine was for the maid so I obviously could not ask her for NRIC number. I did what a person with commonsense would do: ask for the work permit. The employer got huffy and asked why I wanted to check the work permit when the registration counter already checked the work permit. For identification purpose you idiot! Do I look like I am on first name terms with you and your maid?! I need to make sure I am dispensing the correct medication to the correct person.

Anyway to cut the chase, when I requested payment for the medication, the employer told me his maid did not have money. He almost did not want to pay for his maid's medication until I told him flatly that I could not give free medicine because the hospital is not a charitable organisation. I can let them have the medicine and send the bill later, but that does not mean I will do it every time. Correction. I am usually lenient to foreign workers the first time they tell me they do not have sufficient money. I would send the bill to their companies, but I would also remind them to either bring sufficient money or a letter of guarantee from their company the next time. However, should they try to get free medicine from me the second time they are only going to get 3 days' worth of medication. Nothing more until they pay up.

Back to the stupid man. After he grudgingly paid up for the medicine, he asked me if I am going to deny medicine to patients who are poor and have no money for their medicine. If the patients are really poor, there are ways to help them eg. getting their doctors to make a recommendation to see a medical social worker and apply for financial aids, usually Medifund.

It was a poor attempt at trying to draw parallelism between poor citizens and his maid. His maid is holding a work permit, and to hold a work permit means the maid must be holding a job in Singapore. If she does not even have money for medicine that cost less than $10 then he is either not paying her or not giving her a decent enough pay.

After hearing my little explanation on how poor people can get funds to help them with their medicine, he haughtily told me he would bring his maid to see a medical social worker to get the Medifund. This man is really stupid. Medifund is for citizens, not foreign workers! However, that is not to say the government does not care for the foreign workers working in Singapore. Currently foreign workers do enjoy some subsidy from the government when they seek medical treatment at polyclinics, restructured hospitals and some of the private clinics. This unfortunately is not going to last. After all which government does not protect its own citizens first. With limited resources, it is natural for our government to reserve the subsidy for Singaporeans rather than foreign workers. In the process of doing that the government also tries to make sure foreign workers continue to have affordable medical care. And this is why the government is working out a bill to make it compulsory for employers to provide healthcare insurance coverage for foreign workers under their employment.

The twit when told his maid does not qualify for Medifund whined that it is not fair for the foreign workers. He then tried his stupid parallelism trick again. This time he asked me how would I feel if I am overseas on holiday and something happens which resulted in me being hospitalised, and the hospital denies treatment because I have no money, and no passport for identification. Well, that will never happen because I never travel overseas without insurance to cover my arse.

What came next was the most ridiculous thing I had heard thus far, and I am going to quote what transpired between me and him. Words in italics are my thoughts/ comments.

Idiot: You know that who ah, Lee Kuan Yew's son? The prime minister?

Me: Lee Hsien Loong. You call yourself a Singaporean but don't know the name of our current PM?! And you still dare to talk to me in such a haughty attitude?!

Idiot: Yah, Lee Hsien Loong. Two and a half years ago in one of his speeches, he said nothing in this world is free (pause for dramatic effect), except healthcare. And that is according to WHO standards.

Me: (sarcastically) Really. I have not heard of it. Start using your brain if you want to convince me that Lee Hsien Loong, henceforth abbreviated to LHL, would ever say such a stupid thing on national TV. It is because we are now on the issue of healthcare that you claim LHL said healthcare should be free. If you are in NTUC you would claim LHL said nothing in this world is free except food! And don't bring the WHO into this. Anybody with a brain knows that providing free healthcare is the surest way to bring down the whole healthcare system. And unless you don't mind the government increasing the personal income tax by another 10-20 percentage point, and GST to 10% or more, do not even talk to me about free healthcare nor subsidising all medicines for subsidised patients.

Idiot: You never heard of it? He said that. LHL said healthcare should be free. In fact I owe the hospital $300+ in bill. I never paid up. I send all my bills to him.

Me: (raised an eyebrow) You send your bills to LHL? Way to go bugger. Such a typical Singaporean attitude. Throw all the problems to the government instead of taking ownership and solving the problem yourself.

Idiot: (haughtily) Yah. I send all my bills to LHL. I annexed all the bills to him so he can pay them for me.

Me: (Gave a mirthless snigger) Right... I am sure it gets thrown out with the daily trash before it even has a chance to reach LHL's secretary much less LHL.

Luckily i had another prescription to dispense. Gave me the opportunity to walk away without appearing rude.

As a side note:

I know I defended our government a fair bit in this post, but I do not support PAP.

PM Lee, if you ever have the time to surf the net and come across this post, can I make a small request? No not pay my internet and phone bills. Satisfy my curiosity. I want to know if you ever helped the idiot pay his hospital bills. LOL

Back to Slamming the Stupid

2007-09-17T21:17:00.000+08:00

I am back to slamming the ばかもの(idiots).

This stupid patient came to my counter during peak hour and told me he was in a hurry so he needed his medicine right away. Told him to take a queue number and take a seat first while I process the prescription, but he continued standing at my counter, holding on to this prescription, telling me he needed his medicine immediately.

Look you stupid, the medicine is not going to drop from the sky when you pass me the prescription. I. Need. Time. To. Process. The. Prescription. Told him again to take the number and to take a seat first. He then said he is in a hurry and if I cannot give him the medicine then he will not be collecting the medicine. That really pissed me off and I tore off the queue number, gave him back the prescription telling him there is no way I can give him the medicine immediately as I need time to process the prescription.

What came next really made me want to shove the prescription down his throat. He asked me why I could not give him his medicine right away. Just exactly how difficult was it to understand that I NEED TIME TO PROCESS THE PRESCRIPTION?!! Oh, and for your information, this guy is serving national service. Maybe SAF needs to consider grading the IQ of eligible male citizens before drafting them for national service. I have serious doubts that this guy can follow simple orders. He is probably one of those who always gets the whole troop into trouble due to his stupidity, and I shudder to think that we have to rely on such people to protect us in times of war.

Sometimes They Make You Smile

2007-09-13T10:03:00.000+08:00

I'm reflecting on what I have done for the past 3+ yrs as a pharmacist, and thinking back on the patients that I have counseled. Though I mostly ranted and raved about the stupid patients, I never did mention those who made me smile or those whose actions touched me. They do exist, mind you, so this post is dedicated to them.

I thank you when you offered to buy me tea as a sign of appreciation of the effort I put into counseling you on your medication and to write down all the instructions in Chinese so you can understand your medicine better.

I thank you when out of concern you asked me if I had my lunch and looked appalled when I told you I still had not had lunch at 3PM.

I thank you when you patiently waited for me to dispense your child's discharge medicine. When I apologised for making you wait till 2PM, I felt tears in my eyes when you said, "It's okay, I know you are alone in running all the pediatric wards."

I want to laugh when you side with me against the stupid patients and whispered to me as if we were in some conspiracy some gossips about the stupid patients.

I appreciate it when you help us scold the unreasonable patients.

I thank you when you tell me to take my time to process your prescription because there are many items to pack.

I am touched that you always greet me by my name and ask me how my day is or how I have been.

I want to laugh when you tell me your IC number the moment you appear at my counter without me asking for it. You grin from ear to ear feeling triumphant because you have anticipated what I wanted to ask.

All in all, thank you for making my job little more bearable after being tortured by the tons of stupid patients. You keep me sane. :)

Fantasies

2007-08-30T11:37:00.000+08:00

Sometimes I feel the urge to act out my fantasies, but I guess that would earn me an audience with the higher-ups, whom I have no wish to see. So here I am, indulging myself by posting a blog on things that I would have done to the stupid patients that I see everyday.

Scenario 1
I pressed the green button to generate a queue number for the patient, took one of the tickets and told the patient to take the other. Patient looked around and proceed to walk off. Normally, I would call the patient back and repeat what I just told them about the queue ticket.

However, what I really want to say is, "Come back here you stupid, and take the queue number. So stupid till you can't understand simple instructions?!"

Or, "Eh bimbo, will you just take the queue ticket!" If the patient is a young lady.

Scenario 2
Patient asked me if the glucosamine I dispensed to him/her was from animal source. When I told her it is derived from animal sources, they started ranting and raving as if they were possessed by an animal on how we should not be giving him/her glucosamine from animal sources as he/she is a vegetarian. *roll my eyes*

Usually I would give the patient an irritated look and ask if he/she told the doctor that she is a vegetarian. However, there was just once I was so pissed off that I actually asked the patient if the words "I'm a Vegetarian" were carved on her forehead. Got the patient there, and I quickly followed it with a rhetorical question, "If those words aren't on your forehead, then who knows you're a vegetarian?"

Amazing how people simply do not think it important to communicate such information to their doctors and waited till they are at the pharmacy to inform us.

Scenario 3
I am busy dispensing to a patient, and this other patient has to interrupt me just to ask me what he/she needs to do with his/her prescription. Depending on my mood, I may ask the patient to read the instructions or help the patient press the green button for a queue number.

However, what I really want to do is to tell the patient, "Are you stupid or what? The instructions are right in front of you, and don't you have eyes to see that I am busy with another patient here?! If I missed out any information in my counseling and anything happens to this patient, I will come after you with a vengeance."

Scenario 4
I was busy dispensing to a patient, another patient came with the prescription, looked at the instructions, decided it is not worth the time reading them, simply dropped the prescription without a queue ticket attached into the tray then walked off.

After I finished with my first patient I would have to call the patient back and ask the stupid question of whether they took any queue number. Proceed to press the green button and give them a queue ticket.

What I really want to do is just ignore the prescription. It can sit in the tray till the molecules of the paper form a permanent bond with the molecules of the tray. My life is too short to be wasted on such stupid people.

Scenario 5
Patient complained our waiting time was long. I kept my trap shut and continue to dispense as fast as I can.

What I want to do is to tell them if they find our waiting time is long, they can always collect their medicine at the main pharmacy. What I would not tell them is the waiting time at the main pharmacy can be as long as 2 hours, whilst mine is only about 20-25mins on really really busy days.

Your Pharmacist Cringes When You...

2007-08-04T12:32:00.000+08:00

1. Tell me you take medicine for your heart, and when I try to find out more, it just turn up blank stares from you. Telling me you take medicine for your heart problem is not a lot of help. Do you take the meds for your BP? For heart failure? For angina? Tell me the medicine name or at least show me a sample of the medicine you are taking. How else am I suppose to tell you whether the medicine the doctor just gave you has any interaction with the ones you are already taking? I graduated from the school of pharmacy, not the school of divinity. And no, I am not friends with Harry Potter & co so I do not know anything about legilimens.

2. Ask me if the medicine I am dispensing to you has any drug interactions and what drugs you have to avoid. As far as I know, all drugs have interaction with some other drugs. However, I do not think you have the intellectual capacity to handle the information because you cannot even differentiate tramadol from paracetamol; you think everything with a -ol at the end is Panadol. Even if you can differentiate tramadol from paracetamol, it is still useless. You still cannot process the information because you are not a drug expert. The drug names will be jargon to you.

3. Tell me you want the pink/white/orange tablet and the brown/red syrup. *take a deep breath* Tell . Me . The . Medicine . Name. There are many tablets that share the same color, and shape. Ditto for syrups; many cough syrups happen to be of the same color. Do not expect your pharmacist to play guessing games with you. I am very busy.

4. Give stupid answers to my questions. For example, when I dispense loperamide and ask if you have diarrhea, the correct answers would be "yes" or "no", NOT "I don't know"! If "yes" we can both get on with our lives; "no" I will probably have to probe you a little and check with the doctor if he clicked the wrong item from the drop down list, it's just a little more work, but I can handle. "I don't know" will just get you a are-you-a-retard look from me. When I probe and ask you for the reason you came to see the doctor, you tell me you have loose stools...

5. Tell me you had not given your child his epileptic medicine for 2 days because you ran out of medicine. You had not had the time to see the medical social worker to get financial aid nor the time to come down for an appointment with the doctor. The result: your child had a fit right in front of my pharmacy. Have a heart, every time your child goes into a fit, a part of his brain gets damaged.

Any Discounts?

2007-07-09T21:00:00.000+08:00

A parent came and asked my tech if there is any discount given when paying with Diners. Previously another parent also asked me if there is any discount given for any credit cards.

Look you smart alecs, this is not some restaurant, nor some novelty shop, nor some spa etc etc. We do not give discounts unless you are a healthcare professional or a staff of the hospital. *roll my eyes*

Excuse Me, Can I Buy Dry Ice From You?

2007-06-30T07:39:00.000+08:00

Yes, somebody came to my pharmacy asking for dry ice. Stunned my senior and I for awhile before we realised that she may not actually want to buy dry ice. After some clarification, it was a cold compress that she wanted for her son's leg. Sent her to the main pharmacy to pick up the item, but my senior and I had a good laugh after she left.

Why Do I Even Need to be Licensed?

2007-06-27T23:13:00.000+08:00

Somebody sent a pre-registration pharmacist down to the Controlled Drug (CD) store to collect CD. In case you do not know, I am referring to drugs such as morphine, pethidine, and methylphenidate.

Anyways, the procuring of CD is bounded by stringent law. How on earth a principle pharmacist and registered pharmacist can think it is okay for a pre-reg pharmacist to draw CD from the CD store is beyond me. In the first place whoever signs out for the CD is accountable for it; the license is at stake here. Pre-reg pharmacists do not hold licenses, so how are they suppose to be held accountable should there be any loss in the CD?!

As time passes, people happily forget about this sentence in the law which states pre-reg can collect CD only "under the supervision of a registered pharmacist." It is under the supervision. It does not mean you can send the pre-reg to pick up the CD by him/herself. *roll my eyes*

Legal Requirement Vs Work Process

2007-06-10T18:55:00.000+08:00

Another fine example of Singaporean stupidity.

This man's mom lost her prescription, and ran out of medicine. Problem: her next appointment is in half a year's time and under the Poisons Act and Medicines Act we are not allowed to dispense without a prescription. Tried explaining to the son that I cannot give him any medicine without a prescription as it is a legal requirement, but he kept asking me if there is a record on our computer system that showed the balance medicine on her mother's prescription.

Look stupid, I have already said many times that we do have a record, but the record is only to facilitate our work process, ie it cuts down the processing time as we do not have to re-key all the medicine prescribed. It DOES NOT replace the requirement for a legally valid prescription. Besides, if I were to dispense without a prescription, I will probably lose my licence. Much as I hate my job, I do not want to leave it in this manner.

Stupid man kept saying he understood the need for a prescription, but then turned around and say it is essentially the work process that I cannot get around. If I can be flexible with the work process then I can give him the medicine. What a total retard! Essentially he did not understand a single word of what I had said.

The keeping of a record on our computer system is part of a work process. Anybody practising in pharmacy uses a computer system to track their patients' past medicine usage, it does not mean you can just waltz in and start saying stupid things like "Oh you have my record, just give me the medicine." Which program I use, and how I process the prescription is essentially part of the work process. The law does not dictate anything about how I should go about doing it. The actual dispensing and sale of medicine to a patient, this part is controlled by the law. This is not a work process. It is something that is uniformly practised throughout the whole of Singapore by all pharmacists. Without a prescription, you can talk till the cows come home, and nobody would dispense a single thing to you.

To end off, he said, "Do you know from a layman point of view, this whole thing sounds stupid. How do I know that I need a prescription for the purchase of the medicine." I am very sorry if the law sounds stupid to you, but it is for the safety of the masses who are not trained doctors or pharmacists. Medicines are all poisons unless used correctly, and licensed doctors and pharmacists are people who are trained to use the medicine properly. I am bounded by the law, am not above the law, and the only thing I can help it to ask the clinic to get another doctor to write a prescription for the medicine. Other than that do not expect to give you any prescription-only medicine without a prescription!

Singaporeans You Are So Stupid

2007-05-29T08:11:00.000+08:00

Remember my previous rants about patients not reading the instructions to take the queue number... well I sorta gave up on telling them to read the instructions. Guess a large proportion of Singaporeans are possibly illiterate or just plain stupid.

So what I do now is to press the queue button to generate the queue ticket, "snatch" the prescription from the patient, tear off one queue ticket and staple it to the prescription myself. I'll leave the other queue ticket hanging from the machine, and tell the patient to take the queue ticket, but guess what. I think most Singaporeans are simply too retarded to even follow such a simple instruction.

When I tell them to take their copy of the queue ticket, some will show a stupid look on their face, and then walk off without taking the queue ticket. Some will look up at the "serving queue number:" display just above my pharmacy, then proceed to walk off without taking the queue ticket. *Roll my eyes*

You probably want to argue that not all patients are Singaporeans. I agree, but you forgot one pertinent fact. I am looking at their prescriptions with their names, ICs/FIN numbers, and addresses clearly printed on the prescriptions. I can easily tell who is the Singaporean and who is the foreigner.

Let's just face the fact. Singaporeans are stupid. The reason why Singapore is prospering is probably due to the few intelligent people we have running the country and ensuring the rest of the idiots do their job in a clockwork manner.

The O.o and The >_<

2007-05-26T22:53:00.000+08:00

The following rules apply:
1. Anything in brackets are actions.
2. Anything in normal font are speeches.
3. Anything in italics are thoughts.

The O.o

Me: This is chlorpheniramine, it is used for runny nose and allergy symptoms like itch. Take Xml Y times a day when necessary. The medicine may cause drowsiness so your child may sleep a little more than usual.
Parent: What do you mean by when necessary?
Me: (Raise an invisible eyebrow, BP starting to creep) It means to use when the symptoms are present, and stop when your child no longer experiences the symptoms. I am not here to teach you English, buddy.
Parent: What do you mean by symptoms? I am not a doctor how would I know what symptoms to watch out for?
Me: (Brain shoots urgent neurosignals telling my eyes not to roll) I've already said this is used to treat runny nose and allergy symptoms such as itch you retard.

Me: This is panadeine, it is panadol plus codeine. Take X tabs Y times a day when necessary to relieve pain. It already contains paracetamol, which is panadol, so don't take panadol containing products with this medicine. The codeine component may cause a little drowsiness.
Patient: So can this medicine be used for pain?
Me: (Gave the patient a are-you-a-retard look) I just said this is a painkiller. If a painkiller is not used for pain, pray tell me what did you use it for? Poison your estranged husband?

The >_<

My senior: Did the doctor explain why your child need to take Risperidone?
Parent: Yes, she did, but can you tell me more about this medicine? What is the usual dose given? What is the max dose it can go?
(I can smell one those I-think-I-Am-As-Good-As-A-Pharmacist/Doctor parent/patient from miles away and this is one.)
My senior: There isn't actually a straight forward dosing for such medicine. Such medicine usually requires some titration to be done depending on individual patient's response. In addition, in paediatrics dosing is usually based on body weight so there isn't a usual dosing.
Parent: But is there no like common dose that is used.
My senior: Like I said, there isn't such a thing as common dose. It depends on individual response. Usually doctors would start low and then slowly titrate the dose upwards till the symptoms are controlled. Currently, your child is prescribed 0.5mg/day, max dose studied in adults can go up to 6mg/day.
Parent: Do you know why I am asking? I have rejected Dr S for 6 years.
My senior: What do you mean by you rejected Dr S?
Parent: I do not want to start drug treatment for my child. I don't think my child actually needs to start drug treatment, so I rejected Dr S's suggestion.
(I went off to dispense to another patient at this point.)

For the layman reading this, risperidone is an antipsychotic medicine. It is indicated for the treatment of schizophrenia, mania, people whose moods cycle between mania and clinical depression, and behavioral problems in children or teenagers with autistic disorders. What I cannot understand is, if the parent think his son does not need medical treatment then why on earth did he continue to bring his son for consultation? Did he think miracles happen by breathing in the hospital air? None of the conditions mentioned above can be waved away with time or with counselling. Those conditions essentially exist because there are imbalances in the neurotransmitters in the brain. Counselling, scolding or coaxing is not going to put them right, but medicine can. By denying his son the medicine for 6 years, he wasted 6 years of his son's life, because such patients cannot fit into the society with their conditions uncontrolled. He probably cannot go to a normal school and even if he can, will probably have to struggle with keeping up with the other children. This puts a damper on the child's morale and may worsen the condition; it becomes a vicious cycle.

Integrity vs Thievery

2007-05-01T10:00:00.000+08:00

Heard 5 tabs of voriconazole went missing in the wards. According to the pharmacy assistant (PA), who placed the medicine into the medicine trolley, the staff nurse looking after the patient requested for the medicine to be topped up again the next day. Puzzled, the staff went to the ward to search for the medicine in case some stupid nurse misplaced into another patient's medicine compartment. What she found was the blister pack, in a nearby bin, with all the voriconazole removed. When the PA queried the staff nurse looking after the patient, her disinterested reply was to go look for the night staff who was looking after the patient prior to her.

Naturally the PA reported this to the in-patient in-charge who then informed my manager. My manager was understandably angry, after all we are talking about a few hundred dollars that went missing. Nobody was apprehended for the missing tablets, and my manager now wanted all expensive tablets to be stored under lock and key in the control-drug cupboard. All usage of the medicine will also have to be recorded in a book. *roll my eyes*

Crux of the matter is not the location which the medicine is stored, rather it is the integrity of the staff looking after the patient. The tablets were entrusted to the nurses looking after the patient and they simply shrugged their shoulders when queried why the medicine went missing. Sure know how to shirk their responsibilities do they not. The tablets were obviously stolen by a staff of the hospital as we are the only ones with access to the medicine trolley. Narrowing things down, if the tablets went missing in a span of less than half a day, then only 2 groups of people could carry out the act: nurses or doctors. Only these 2 groups still remain in the ward after pharmacy office hours.

Whatever it is, I am surprised no action was done to further investigate or to bring the police into the matter. After all, this is theft, and if you consider the act of pushing a tablet from a blister pack, it is likely to obtain at least one complete print of the thumb. Identifying the culprit is probably easier via this method. Unbelievably, this matter was not raised up to higher authorities either, the thief continues to work amongst us, and the theft was simply glossed over.

These People Should Not Have Children

2007-04-24T23:51:00.000+08:00

You can say I am crass for making such a statement, but I really don't care. This is how I truly feel. Stupid people should not be having children. I don't care if their stupidity harms themselves, but I get angry when I know children who have to rely on adults are harmed as a result of their parents' stupidity.

Case 1:
My patient. Doctor ordered 5mg of medicine C to be taken twice a day. Since there is no 10mg tablet in the market, I told the dad he should give half a tablet twice a day. He left after paying up for the medicine. Came back 10 mins later, claiming I gave the wrong instruction. According to patient's dad, who must have failed primary school Math, 5mg is should be a quarter tablet not half. *roll my eyes*

Told him that 10 divided by 2 is 5, so half a tablet is correct. He then insisted the last time we dispensed 5mg tablets to him and he gave his child half of the "5mg tablet", which I must say again is non-existent in the global market. Guess what, when I checked the history, the patient had always been instructed to take half of the 10mg tablet, so the only conclusion I can draw is the parents have been giving 5mg twice a day, but are hallucinating that they are giving half of the non-existent 5mg tablet.

Anyway, he then argued that we, as in the pharmacist and doctor, were overdosing his son, that the dose should have been 2.5 twice a day and not 5mg twice a day. Kept insisting that he was given the wrong instruction, until I told him to go back and talk to the doctor. That was the last I saw of him on that day. I know the doctor had set him right, but still I wonder what kind of care the parents are giving their son.

Case 2:
My senior's patient. According to my senior, the parents just cannot be bothered and do not understand the severity of their child's condition, and it has been such since the time he was an inpatient pharmacist. As a side note, my senior was an inpatient pharmacist more than 2 years ago.

One of the patient's diurectics need to be specially prepared by the lab into a syrup form for ease of administration. Problem is our lab syrup does not contain preservatives, therefore it is only stable for a month from the day of manufacture. When the parents were reminded that they have to come back monthly to collect the syrup, they never followed the instrutions. According to my senior, they will just let the patient go for weeks without medicine.

In the end, my senior chose to dispense the medicine in the form of tablets; teaching the parents how much water to add to one tablet and then syringing out the required volume for consumption. As the parents look like intellectual low-lives, my senior was sincerely worried the parents will not be doing the dilution properly, but there is only so much we can help the patient.

Something just came to mind. Maybe they are tired of looking after a perpetually sick child, so they decided to slowly "kill" their child by depriving him of the medicines that can stabilise his condition.

Case 3:
A renal patient whose condition has worsened to the extent that the consultant is recommending dialysis. The parents were informed of the consultant's recommendation when the patient was warded, but they told the consultant they needed some time to break the news to their child.

A few months later, they are still deciding whether to let their child go for dialysis despite the consultant telling them their child's condition has worsened. They kept delaying. The reason they gave was this is a major decision so they need to consider and to mentally prepare themselves.

I don't know how long this child is going to last in this world under the care of such stupid parents.

And I Almost Cried

2007-04-17T20:22:00.000+08:00

I don't mean cry as in cry with frustration. I really do mean cry as in sad.

See what happened was this old lady came to collect glucosamine and chondroitin for her joint problems yesterday. Unfortunately, the hospital does not stock any generic versions of it so she had to take the branded one. When informed of the price she was flustered because she did not bring enough money. She calmed down after I explained to her that she can collect the supplement by installments. Maybe just take 1 or 2 bottles first, finish up, then collect the remainder.

She followed my advice and took 2 bottles with the promise that she would return soon to collect the remainder. I reassured her that there is no hurry for her to collect the remainder as 2 bottles will last her 2 months, giving her ample time till the next collection.

To my surprise, she turned up at my counter today to collect the remainder from the prescription. However, she must have misheard me from yesterday with regards to the price. She had thought it was just $200 for the remainder when in fact it was actually $240. Something struck me when she tried to pay me. I at least saw a fifty dollar note yesterday, but today, it is all in ten and two dollar notes, and they look slightly crumpled like those were all her entire possession. When she realised she need to pay another $40, she quietly opened her purse and started pulling out whatever money she has to make up the $40; all in two dollar notes if you care to know.

She did not grumble about the cost, and maintained a cheerful disposition throughout. From her looks I know she cannot be well-off. Having to fork out $200+ at one go must really take some effort. When I received the last $40 I can feel a sting in my eyes. Asked her if she still has enough change to get home, she nodded and gave me a wry smile. I know life is not fair, but knowing somebody like her who can really benefit from some financial help and yet not receiving any really makes me want to cry.

7K 7 Days a Week

2007-04-04T00:16:00.001+08:00

Sometimes it makes you wonder why people just cannot see the little and most commonsense thing that is making them uncomfortable enough that they had to see a doctor. Take this uncle, for example, who came to collect glucosamine from me.

We went through the usual charade of checking for identification and drug allergies before I start explaining to patient what glucosamine is for and how he was suppose to take it. Talk about not judging a book by its cover, uncle obviously had problem understanding me when I tried telling him the glucosamine is to help build up the cartilage in the joints. He went, "Huh?" and asked me what glucosamine is used for. Duh, did I not just explained? If you're thinking he is some ancient who can probably only speak Hokkien, you are so wrong. I am talking about somebody who can speak fluent English, but the word "cartilage" is probably not in his dictionary. Anyway, I went through a slightly longer explanation about the aging process, wear and tear, and "this gel-like thing" that functions like a cushion for our joints whenever we move.

After that he started asking me if glucosamine will give him cramps. It is very important to him that glucosamine should not give him cramps in his legs as he is an avid jogger. "7 klicks 7 days a week," according to the proud declaration from this uncle. Inside of me I went, "Ah... this explains a lot."

7km 7 days a week. Is this uncle crazy?! Any avid jogger knows that jogging is a high impact sport that puts a lot of stress on the joints in the legs. That is why you do not jog everyday, considering your job is not to run a marathon. Man, you got to have days when you just do light jogging of 2-3km or maybe do some other low impact cardio sports eg. swimming or going on an elliptical machine in the gym. Jogging the way he does is going to wear out his cartilage faster than I do when I was playing softball. And he wonders why he needs to take glucosamine... *roll my eyes*

Are You Saying the Doctor is Stupid?!

2007-03-31T23:27:00.000+08:00

Incident happened a few days back. This man came to the pharmacy to collect medicine on his mother's behalf. As usual, people are blind, so he did not see the instructions to press the green button for a queue number, so my tech verbally instructed him to get a queue number.

After that, he started showing this piece of paper with some instructions from the doctor saying he needed the dressing item from the prescription. Politely informed him that the medicine was not written in the prescription so pharmacy cannot supply the item, and he should go back to the doctor to get it written in the prescription or at least check with the doctor if the instructions were meant for him or meant for the wound care nurse. Reason being, sometimes the wound care nurses have their own stocks of dressings and medicines used for wound care so there is no need for patients to procure from pharmacy.

However, I really cannot expect somebody who is too stupid to read instructions to comprehend what I am saying. He raised his voice at us and said he did not care if the medicine is not written in the prescription. The instructions were written on our hospital's form so pharmacy had to supply the med. Told him off that the prescription is the only legal document that pharmacy recognises for any sale of medicine.

That probably riled him because he started shouting at us, asking why then the doctor gave him the hospital form and asking if we were saying the doctor is stupid for not writing the medicine into the prescription. Now that is really "funny", none of us said the word "stupid". He did. Not us. Effectively, he was the one who said the doctor is stupid. So much for trying to be a smart ass. S.T.U.P.I.D.

Check Your Prescription

2007-03-01T09:15:00.000+08:00

Those practising in hospitals would probably come across this problem. When you ask the patient if he is Tan XX, he affirms he is. When you ask for the IC number, you realise it is not the correct number. Ask the patient AGAIN if he is Tan XX, and he realises that he is not Tan XX but Tan YX. Starts getting huffy and will probably raise his voice asking how come the doctor gave him the wrong prescription. *roll my eyes*

Patients, please practise a bit of commonsense. When you receive the prescription, did you even check to make sure the prescription is yours? True, the doctor/ nurse assisting the doctor is at fault to give out the wrong prescription, but you are equally at fault for not doing a quick check. It is the same commonsense you use when you check your bank book after you deposit money with the bank. It is just to make sure the bank returned the correct book and the correct amount of money was credited into the book.

Doing this quick check before you even leave the clinic to proceed to the pharmacy would certainly save us all a lot of time and agony. Time is saved on us having to contact the doctor and waiting for the doctor's reply. Time is also saved on having to wait for the nurse to send the prescription over to the pharmacy. Be thankful if the pharmacist bothered contacting the doctor and arrange for the nurse to send the prescription over, and stop complaining that you had to wait for long. If you are not happy, go back to the clinic yourself to pick up the prescription.

Oh, and did I mention you have to be thankful to the pharmacist? I was referring to my colleagues, because yours truly would just send you straight back to the clinic to retrieve the correct prescription.

Chronic Disease Management Program

2007-02-24T12:12:00.000+08:00

Thought I'll post something useful, for once and maybe the last time, on something that is seriously misunderstood by many Singaporeans.

Chronic Disease Management Program (CDMP): a program intended to shut the mouths of Singaporeans who keep lamenting that their money is growing mould in their Medisave accounts. This program allows the patient to use the money in their Medisave account to pay for part of their medical expenses. However, please note, CDMP is only for diabetes, hypertension (technical name for high blood pressure), hyperlipidemia (technical term for "high cholesterol"), and stroke; data is correct as of 1st Jan 2007. So stop asking if your child's growth hormones etc, or your medicine for osteoporosis treatment can be claimed under Medisave, and DO NOT question me on why your medicine cannot be claimed using Medisave. I do not take too kindly to being blamed for things that are not decided by me. If there is somebody you want to flame, go flame Khaw Boon Wan.

Anyway, if you are a first time participant of this program, a staff will have to sit down and go through with you on all the details of this program. After the explanation, you have to sign on the form affirming that you understand everything that was explained to you. However, past experience tells me people will just sign whether they understood or not. They just want to use their money, pronto. When problem crops up later, they yell at the staff claiming they where not told of this, not told of that. Hmm... maybe a ghost moved the pen to forge a signature on the form...

So how exactly does CDMP work? Every year, you are allowed a $300 withdrawal limit from your Medisave account to pay for your consultation, medicines, and any other diagnostic tests required in the course of the consultation. You whine, "But that is so little. $300 for the whole year?!" So MOH allows you to draw from a max of 10 different Medisave accounts. Here's the catch: you can only use the Medisave accounts of your immediate family members, and by that MOH means your spouse, your child(ren), your parent(s), and your grandchild(ren). No, your "spouse" from extra-marital affairs, love child(ren), cousin(s), uncle(s), and aunt(s) do not count.

Next, let's look at the mathematics part of the program. Before I start, understand that the government is not deviating from its policy of wanting its citizens and permanent residents to be responsible for their health, so CDMP is intended to be a co-payment program. I am not going to explain what is "co-payment", if you have a limited vocabulary please look up a dictionary. Back to the mathematics.

There are 2 main components a participant needs to understand.

1. There is a deductible of $30 + administrative fee for each visit. The $30 is set by MOH, whilst the administrative fee is set by the institution. The $30 deductible simply put is the first $30 of your medical bill for each visit. This, you have to pay upfront whether you like it or not. It also means if your total medical bill for that visit is less than or equals to $30, you basically would not touch a single cent from your Medisave account.

Next, the admin fee. Why pay an admin fee? Because manpower is required in creating a special claims account for the institution to post in your Medisave claim, and CPF board charges the instituition for each claim made. The money has to come from somewhere and since it is the patient who wants to make the claim, then the patient has to fork out the admin fee.

2. This is where the copayment comes in. There is a 15% co-payment, meaning you have to make an upfront payment of 15% of the medical bill, after lessing $30. The remainder 85% will be deducted from the Medisave account. Hold on. Shouldn't it be 15% of the medical bill after lessing $30 + admin fee? No. The admin fee is not part of the medical bill. However, there are times when you have to pay more than the 15%. Remember the annual withdrawal limit of $300? It's annual limit, not per visit limit.

To make things clearer, let's do some actual mathematics.

Assuming the following is the cost for a single visit...
Consultation bill= $30
Medicine bill= $100
Total medical bill = $30 + $100 = $130

To calculate the amount patient has to pay upfront...
Medical bill after lessing the $30 deductible = $100
15% co-payment by patient = $100 x 0.15* = $15
Amt deductible from Medisave = $100 - $15 = $85
Total upfront payment by patient = $30 + $15 + admin fee

This is all very nice if the patient has not exceeded the annual limit and has enough in the Medisave account for deduction. Assuming if this same patient has made prior claims and there is only $80 left of the Medisave annual limit, then the following changes would occur:

Amt deductible from Medisave = $80
Total upfront payment by patient = $30 + $15 + $5 + admin fee

*In case you wonder how I derived the 0.15, 15% = 15/100 = 0.15

Common misunderstandings:

The $30 deductible + admin fee is a once off payment. WRONG! You pay the $30 deductible + admin fee at each visit/ claim. Yes, including the admin fee. Did I not mention CPF board charges the institution for each claim made? That means if you wanted us to do a partial supply of your medicine and wanted to collect the balance on another day, you have to pay the $30 + admin fee again. It is considered as a separate visit/ claim.

I only need to fill in the Medisave forms once and I am in the CDMP forever. WRONG! You need to fill up a new form each year to renew the use of your Medisave account for CDMP. This includes all the other people whose Medisave accounts you are using. If you lapse in doing the necessary paperwork, do not come and blame us for not allowing you to claim through Medisave.

For Goodness Sake, This is A Hospital!

2007-02-15T22:06:00.000+08:00

It started with the new year. Patients came to me asking if the hospital is giving out free calenders. No, of course not! This is a hospital, not some commercial companies trying to woo you into buying their products or using their services. Besides, if the hospital has so much money to print calenders for patients, it should first pay us a fatter year-end bonus.

Now with Chinese New Year round the corner, there are progressively more and more patients coming to the pharmacy asking if we give out complimentary red packets. When I told them the hospital never gives out complimentary red packets, they started asking for the red packets that we used to decorate the pharmacy. Just exactly where do these idiots think they are? The bank?! And what's the big idea asking for the red packets that we used for decoration?! Go buy them yourselves, and stop wasting time asking stupid questions.

Listen To Me!

2007-02-03T20:45:00.000+08:00

I'm not being narcissistic, but I do get irritated when patients are not paying attention to what I am telling them. Do you think I like repeating myself 24/7 on how to take the medicine and what side effects to watch out for? I would love to just collect the money from you and send you on your way without any counseling if you much prefer talking on your cell phone. Or if you prefer to zone out and go on some space adventure give me Scotty's number, I'll get him to beam the medicine to you. However, it is mandatory for pharmacists to provide counseling for the medicine we dispensed, so I am bounded by law. Since I do not have a choice, then the least you can do is to show me some respect by listening to what I have to say about your medicine.

I don't care if it is just the usual cough and cold medicine. You might have forgotten that some of them may cause drowsiness and you really should not be driving, or operating machinery. I've just saved your life or your limbs. I don't care if it is just painkillers. You need to know which is for what level of pain, which are the ones to take after meals, and which ones not to mix. I've just saved you from paracetamol overdose, and experiencing gastric pain. I don't care if it is medicine you have been taking for the past one year. Just listen to me go through your medicine because you might have missed out on any changes in your drug regime during the consultation. Or other times, you remembered the doctor telling you of the changes, but the doctor in his/her hurry did not update the drug regime in the prescription. I've just prevented you from over/underdosing.

If all these still cannot convince you, then let me tell you a real life story, that was related to me by somebody, of how a man from Singapore died. This man was on insulin for his diabetes and was okay until one day he decided to jab himself with insulin just before boarding the plane, and went into a hypoglycemic episode. Stupid. You should know your regular insulin starts working in 15-30 mins' time, and no flights serve meals that soon. And this is not the first time you were traveling on a plane. Stupid. When counseling patients on insulin, we always tell them to carry hard candies, or a juice box where ever they go. Reason: in case of hypoglycemic episodes they can load themselves with sugar and temporarily relief the hypoglycemia, after which it MUST be followed by a proper meal. Stupid. If you were already hypoglycemic, and without your juice box, get help from the flight attendants immediately. Not wait till you were almost going into a coma. Stupid. You already had a close call with death, but you had to go jab yourself with insulin and forget to take your meal. And this time you were at home!

Anyway, the story ends here. This stupid man met his maker, and to be frank, I do not feel sorry for him. All the above things I've mentioned are things we always tell patients on insulin. We teach them the signs and symptoms of a hypoglycemic episode. We teach them what to do if they are hypoglycemic, and we remind them again, and again, that they must remember to take their meals after jabbing themselves with insulin. See all the important things you will miss if you do not pay attention to your pharmacist?

Because You Are Wasting My Time!

2007-01-31T20:31:00.000+08:00

Patient is receiving funds from National Kidney Foundation (NKF) for his medication. The thing about NKF funding is the pharmacy cannot process more than a month's medicine under a single receipt at any one time. This means, if the patient wants to claim 3 months medicine, we have to process it 3 times, all for 1 month's duration of medicine, and charge them under 3 different receipts. Yah, I know this sounds really stupid, but unfortunately, NKF staff cannot do simple mathematics, so they cannot calculate how much the patient is claiming for each month when you lump all the charges under one receipt.

Anyway, I'm not ranting about NKF today. It's the patient's mother that I want to strangle. This is not the first time the patient was collecting his medicine using the NKF fund. Problem comes when he just dropped his Rx at the counter without even letting us photocopy his NKF card (this is another stupid thing, our finance department needs us to submit a copy of the NKF card every time the patient wants to make a claim, and the pharmacy processing program is not able to capture the card's details). Without the card, my tech processed the Rx under a single receipt. The patient only passed me the card when I called his number. Blood pressure started rising. Told the patient he is still underage and I needed his mother to be around before the medicine can be given to him. Also told him to drop his card off with the Rx THE NEXT TIME. My tech was pissed off because it meant she had to reprocess the whole Rx, and it was really busy today.

The poor boy was left to sit forlornly on the sofa for more than an hour while the mother went gallivanting somewhere. Before I started counseling her, I reminded her again that she has to drop off the NKF card with the Rx the next time. She then started to question the patient asking him if he did not show us the card yada yada. Was really pissed off by then. I do not have the time to wait for her to question her son seeing I still have other patients who had to give up their queue for her because she did not turn up when her son's number was called. So, I told her straight off in her face that her son did not show us the card when he dropped off the Rx, and we had to reprocess the Rx. The apology she gave was dripping with sarcasm, and to be frank I really wanted to tell her she was wasting everybody's time.

When I turn away to file the Rx, she actually had the gall to ask why I was angry. Since you are such an inconsiderate retard, let me explain. Because this is not the first time I am reminding you to drop the d*** NKF card with the Rx; the same thing happened the last time. By not doing as you are told, you not only waste the pharmacy staff's time, you also waste other patients' time because while reprocessing your Rx, we cannot process another patient's Rx. Other patients had to wait longer due to your stupidity!

Queue Number Revisited

2007-01-29T23:53:00.000+08:00

This time I'll talk about the patients who DO take their queue numbers. Here is a list of things they do that make me roll my eyeballs until I get a migraine.

1. Stupid patient takes the queue number and walks off with both the prescription (Rx) and queue number. Turns up 15 mins later demanding why it takes so long to process the Rx when it is only one item. Duh, but of course. If you had been smart enough to leave your Rx for us to process in the first place you probably do not have to wait that long. This is not Minority Report where we install machines all over the place to scan the retina to retrieve all information about you from a super mainframe. Without any information as to who the heck you are, how am I suppose to know what medicine was prescribed for you?

2. Stupid patient takes the queue tickets*, leaves the Rx in the tray and walks off with both the queue tickets.

3. Stupid patient takes the queue tickets, staples both queue tickets to the Rx and leaves Rx in the tray.

4. Stupid patient takes one of the queue ticket, leaves the Rx in the tray, and leaves the other ticket hanging from the queue machine.

5. Stupid patient staples one queue ticket to the Rx and leaves the other hanging from the queue machine.

6. Stupid patient presses the queue machine once, staples both the queue tickets to the Rx and presses the queue machine again to take another number.

* Our queue machine issues 2 tickets, one for the patient and one for them to staple onto the Rx.

Common sense tells you when you see 2 tickets of the same number you need to start looking for instructions telling you what to do with them. Not pretend you cannot read the sign then take it out on us, nor pretend this is some bug with the machine.

Medisave Claim

2007-01-24T23:39:00.001+08:00

To all Singaporeans out there who happens to be reading this, pls stop asking your "friendly" pharmacist this stupid question: why can't I claim my medicine under Medisave?

You cannot claim your medicine under Medisave because MOH says so. It is not up to me, nor the hospital to decide what medicine can or cannot be claimed under Medisave. We are not the policy makers. If you want a reason, try writing to the minister of health and ask for a reason. The worse that can happen is that your mail gets lost in the tons of mail the minister receives everyday; at the very least you do not get the "are you a retard" look from me.

If I were to be the policy maker, I could not care less what medicine you are going to purchase using your Medisave. As far as I am concern, if you wipe out your Medisave prematurely then that is YOUR problem. Making sure you have enough dough in your Medisave account to last till you draw your last breath is entirely your responsibility. Not the government's, not the hospital's, and most definitely not my responsibility.

If you haven't any money to pay for the medicine, then kindly go get some before you even come to the pharmacy. Hospitals need money for daily operations and we are not about to do charity work just because you come with some sob story on how you mismanaged your Medisave fund and now has naught from the Medisave or personal savings to pay for the medicine.

Welcome to the real world.

Queue Number

2007-01-20T15:36:00.000+08:00

This is something that annoys me EVERY SINGLE DAY that I am working. Mine is a small outpatient satellite pharmacy serving only the pediatrics and the adult orthopedics. Without fail, everyday, 5-6 out of 10 patients who came to the 2 dispensing counters would stand in front of our queue ticket machines and ask, "Do I have to take a queue number?"

No, you don't have to take a queue number. Let's see... maybe the queue machines are there for show? Or they are there to hog scarce space on my dispensing counters? Or maybe they are there for your kids to play with because they are so amused by the "beep" sound the machines produce and the slips of paper that appear whenever the buttons are pressed? Or maybe they are there to prove what an i**** you are?

Oh, and by the way you can also ignore the sign that is next to the machine telling you to:
1. Press the green button for queue number. (The green button, not the red triangle!)
2. Tear off the queue tickets from the machine. (Tear off the tix, not rip my machine apart!)
3. Staple one of the queue tickets to the prescription.
4. Leave the prescription in the tray. (Just leave your d*** Rx in the tray & stop shoving it under my nose or placing all over my dispensing counter!)

For your information, the sign is attached to the tray so sign and tray are both just next to the queue tix machine. One tray, one sign for each machine. No excuse for not seeing the sign and tray. It's not as if I asked Dr Wayne Szalinski to shrink the signs and trays.

You Chicken Shit of an SAF Man

2007-01-19T21:03:00.000+08:00

I don't usually like to use crude words such as those referring a fowl's faeces in my blog, but this patient really pissed me off and I just had to let off some steam else I'd become even more dysfunctional than I am now. So here goes the story.

It started with this chicken shit of an SAF (Singapore Armed Forces) man, henceforth referred as CSSAFM, who came to the pharmacy to collect medicine last year. He was holding an Identity Memo for Determination of Fitness (IMDF) letter which he passed to the pharmacist when he collected his medicine. No where in the IMDF letter was it stated that it does not cover medicine, therefore the medicine was dispensed to him without upfront payment.

However, when we submitted a copy of the letter to Mindef (Minstry of Defence of Singapore), the hospital was told, much later, that Mindef would only pay for the consultation, and all the tests done in the course of the consultation. Mindef is absolutely not going to cover the medicine. Okay, that is fine. We can always bill the patient. Things get nasty when CSSAFM received the bill, and he called up to complain and declare that he is not going to pay up for the medicine that he had already consumed and poo-ed out.

His claim was, he checked with the pharmacist if the medicine was covered under the IMDF letter, and was told the medicine is covered under the IMDF. Come on, the stupid letter does not state whether it covers or does not cover medicine, how is the hospital staff expected to know? In fact, when we called up and emailed Mindef to clarify the issue recently, we were told that ALL SAF men should know exactly what is covered and what is not covered under their IMDF letters. That means CSSAFM knew all along that medicine is not covered and he delibrately cashed in on the ignorance of the pharmacist who dispensed to him and then hoped he can get away without paying for the medicine.

When I called him up to inform him that he needs to pay for his medicine, he started blah blah-ing about how it is not fair to expect him to pay up for the medicine since he was told by the pharmacist that it can be claimed under the IMDF. Now, pray tell me, just exactly how fair it is that he quietly cashed in on our ignorance instead of being honest and coming clean with us that he knew that the medicine is not covered under the IMDF. Are we suppose to know the Mindef policies better than him?

See, Mindef's reply to us was if CSSAFM is not satisfied as to why medication is not covered, then he needs to contact the IMDF unit which issued the IMDF letter to him and clarify with them why medication is not covered. When I told him to contact his IMDF unit for clarification, his answer was, "You want me to make all the way down to IMDF and then go around asking why they do not cover the medicine!" Well, if you do not want to, there is always the contact number of the Mindef personnel whom we spoke to and she is most willing to "counsel" you on why you need to make your payment. But of course CSSAFM is too chicken to call. His answer to calling the personnel was, "Why should I be making any calls? You know what? I will think about it and maybe I will talk to the press about this."

Go ahead, and be my guest. Everybody knows you are a CSSAFM. If you ever dare to let the whole nation know that an SAF personnel owes the hospital money, and the reason why you got away with not paying the medicine in the first place was due to your lack of honesty, everyone of us in pharmacy will applaud you.

When I told my brother of this incident, he laughed and say CSSAFM is just too scared to contact his superiors to check why the medicine is not covered. Reason being, he'd be a dead piece of meat before any reasons would be given him. In fact, no reasons would probably be given; dead meat needs no reasons.

Know what? I think I will really make him a dead piece of chicken meat. I believe I have grounds to lodge a complain about him. After all, he did threaten me by saying he will talk to the press. Time to slit the chicken neck and drain the blood.

You Stupid Lousy C.H.E.A.T!!

2007-01-18T21:22:00.000+08:00

An Indian lady came by during our peak hours to complain about the glucosamine capsules she obtained from us. In the first place, this was not my first encounter with her and I was seriously pissed off that she came bothering me at the busiest hour. She is the typical rude patient who thinks she is the world and all of us should be groveling at her feet.

First of all, from my previous encounter, I already knew she is a cheat. The previous time she had the same problem with the glucosamine capsules. She claimed that her glucosamine was contaminated with loose silica gel, and that the silica gel was all over the place. You should have listened to the way she hysterically described the silica gel.

"It is all over the place, on the table, on the chair, on the floor and there's a lot of the silica gel on me too!! What to do?! I have already consumed a few capsules. Are they contaminated too? Will anything happen to me?" The way she went about it, you'd think somebody actually sabotaged her glucosamine with anthrax spores rather than silica gel. Anyway, the last time I exchanged a new bottle of glucosamine for her. When I finally had the time to examine the "silica gel" which she had dutifully collected for me in a serviette, I realise it was actually glucosamine powder. How do I know? I opened up a glucosamine capsule, and I opened up the packet of silica gel that came with the "defective" bottle of glucosamine to compare.

So when she came back today, I was ready for her. I promptly opened up a capsule and showed it to her, pointing out that the powder looks the same so it is just glucosamine powder not silica gel. She tried to argue with me that the powder consistency is not the same yada yada. While she was ranting I cut open the packet of silica gel and poured out the silica gel for her to see. Stumped her for a while, then she said the powder I poured out from the capsule is not as yellow as the one she brought over. Of course it is whiter. Any idiot knows there is such a process called oxidation, and if it took her more than a month to bring the exposed glucosamine powder to us, naturally it would appear yellow compared to the one that I just poured out from the capsule!

She argued with me that the powder was not exposed to air and kept repeating the same stupid thing about how after she had spoken to us over the phone she immediately wrapped the powder in the serviette and stuffed the serviette back into the bottle. I really felt like slapping her on her stupid head and telling her to cover her nose with the serviette and see if she can continue breathing through the serviette. Not exposed to air indeed! Try a little harder next time.

Foreign Workers

2007-01-17T23:02:00.000+08:00

My pharmacy serves the orthopedic clinics and we get quite a number of foreign workers, usually Bangladeshi, coming in for consultation after industrial accidents and the likes. What I cannot understand is how they had managed to come into Singapore not knowing how to speak proper English. Okay, to be fair not all Singaporeans speak English anyway, but you have to at least speak one of the 4 major languages in Singapore. Even if I do not understand a single work of Tamil or Berhasa Melayu, at least I know who to get help from. If you only speak Bangla then things get really tough.

It becomes a frustration just trying to get past the routine steps of checking for identification and then checking for drug allergies. I came to realise that less than 50% know what is an "appointment card", but more than 99% know what is a "work permit", so I gave up on asking them for their appointment cards for identification purpose. I'd rather wait a few more seconds for them to dig out their work permit then to mime and think of a synonym for "appointment card" in simpler English, if there is one to begin with.

Checking for drug allergies is like going through some torture routine, for both me and the patient. They do not understand the question, "Do you have any drug allergies?" Most will give me a puzzled look, and I will raise a phantom eyebrow meaning "great, it's time to practise those rusty paraphrasing skills I learned years back when I did general paper at A-levels". So I attempted again. "Any medicine you cannot take?" More puzzled looks; I guess it is just one too many words for them to process. By then, I would given up on those who gave me puzzled looks twice in a row. I would check the computer system in hope that the sometimes not reliable doctors have updated the patient drug allergies info. Then there will be those who attempt to tell me they have "a little allergy" or "allergy have" and then start scratching their skins. When you probe further to find out which drug they are allergic to, they give you the puzzled look again. *roll my eyes*

After getting past the identification and drug allergies checks, the next set of problem comes. For some reasons I do not understand, the orthopedic doctors like to give multiple painkillers for their patients regardless of their capability to understand when they need to use the medicine. Of course, it is my job to educate the patients on when to use which painkiller, but it is hard when the other party is not capable of processing the information due to language barrier. For ages I had problems telling them that paracetamol is only used for mild pain and the NSAIDs or tramadol are used in moderate or severe pain respectively. Well, that was until one of my techs introduced me to the phrase "many many pain". So paracetamol is for pain, and NSAIDs or tramadol are for "many many pain". I cringe whenever I hear myself say that, but the weirdest thing is the foreign workers actually do understand what I mean when I use that phrase. So much for my effort in trying to speak proper English.

What comes after that is something that really annoys me. 6 out of 10 times when I ask for payment, the foreign workers will tell me the company will pay. When you ask for the letter of guarantee (LOG)/ company letter (after paraphrasing) as proof, they will tell you there is no LOG. Then I start giving them the long lecture, which I know they do not understand half its content, on the need for the LOG else I cannot bill the company etc etc. It always end up with me telling them, with a super black face to emphasize the point, I am not giving them any more medicine the next time if they do not present the LOG. And don't even think about cheating. I will always leave a pop-up message in the dispensing program that states the day when I informed the patient to obtain the LOG from their company and not to supply any more medicine if the patient only comes with a song on his company's willingness to pay the medicine bill.

Senna

2007-01-17T00:50:00.000+08:00

Senna or sennoside: laxative.

Wanted to strangle the parent when I was dispensing this medicine to her. This was what I told her, "Take one tablet daily when necessary to relieve constipation. If diarrhea occurs, stop." You would think this instruction is simple enough to follow for any adult who can understand the 3 languages that I speak: English, Chinese and Hokkien, but no. This was how the conversation went.

Me: Take one tablet daily when necessary to relieve constipation. If diarrhea occurs, stop. Total would be $1.50.

Parent paid up and left. Less than 2 mins later...

Parent: Sorry Miss, can I ask you something?

Me: Yes?

Parent: Let's say if my daughter has passed motion, do I still need to give it to her?

Me: No, the medicine is taken only when necessary.

Parent: No, what I mean is if she just passed motion, do I still need to give her the medicine?

Me: No, she only takes the medicine if she is constipated. If her bowel movements are smooth, there is no need for her to take the medicine.

Parent left the pharmacy, and came back in less than a minute's time.

Parent: So you are saying I do not need to give her the medicine if she can pass motion?

Me: (In irritated tone) Yes, she only needs to take WHEN NECESSARY.

Just exactly what is so hard to understand about "take when necessary"?!

Time to Work Those Fingers

2007-01-16T19:19:00.000+08:00

Yah, I know I have not been updating anything on this blog and even considered it defunct, but with a new year, I guess it is time to start working those fingers. One year older now with less angst, but I am sure I can still continue to amaze people with the stupidity of the patients and people I've met.

Small Fry Too

2006-11-18T20:40:00.001+08:00

A staff called up to say he developed allergy to a medicine that he was prescribed and wanted a refund. My tech explained to him he needed to see the doctor and get the doctor to verify in writing that he had developed an allergy before we can do the refund. He then requested for us to print the receipt as he wanted to know the price of the medicine.

My tech explained to him that we were busy serving other patients at that moment and we would print the receipt when we were less busy and contact him again to inform him of the price. He accused my tech of being rude and actually told her that she was not upholding the hospital's mission of putting the patient's first and providing timely patient service. He also said she does not know how to prioritise. What an idiot! We had patients who were physically standing at the counter waiting to be served. Those people had more priority than him. All he wanted was the receipt and to know the price so what was his hurry. As a staff he should know better than to hog scarce services and depriving other patients of receiving timely services.

He asked for my tech's name and position in the pharmacy saying he wanted to lodge a complain. When my tech gave her name and position, he actually had the gall to say, "Oh, you're just a technician." Really made my blood boil when I heard what my tech told me. I took down his name and tried searching for his name in the institutional phone directory to locate the department he is from. Guess what! He is a small fry! His name was not even worth being listed in the phone directory. At least my tech's name is listed.

I will still go ahead and submit my complain letter on Monday even though I do not know which department he is from. My vengeance on the stupid.

The Onus is on You!

2006-11-16T22:18:00.000+08:00

Sometimes I really do not know what goes on in the head of some people. Maybe nothing goes on at all. We were suppose to arrange for the medicine to be delivered to a patient's place, and the parent wanted the charges to be charged straight to his Master card. However, we were not able to take down his Master card details as he told the staff, when placing the order for home delivery, that he will be changing his Master card number and he will call the pharmacy again to inform us of the new number.

So we waited for him to call back. Anyway, my tech had been trying to contact him for the past few days of the week but to no avail. When we finally got him today, he blew his top, saying the pharmacy staff is stupid and had no brains to call him up until so close to the delivery date. Excuse me, the onus is not on us to contact you for the Master card information. You were not able to provide us the information when placing the order, and specifically told us you would call back to give us the information. If you are concerned enough about your child's health you would call back the moment you get your new card. It is not our duty to go chasing after patients or caregivers for such information especially when you HAVE BEEN TOLD to supply the information.

After scolding my tech, he demanded that the medicine be delivered today. Luckily my senior remembered the confirmed delivery date was 17/11/2006 (which is tomorrow *roll my eyes*). What is wrong with this stupid man? Cannot even remember what he said and he had the audacity to demand that we deliver the medicine today. Just exactly who is the stupid one with no brains?!

When my tech reiterated that we will only do the delivery tomorrow as previously agreed, he must be pissed because he made a desperate attempt at getting in the last word. Apparently there were some unauthorised charges made to his Master card that was why he requested for the bank to change the card number. So guess what he said? "For all I know, all those unauthorised charges could have came from you!" Now, I am not a lawyer, but I do believe that is slander. Luckily for him, it was a phone conversation. There was no third party to witness what he said except what my tech told us and the expression we saw on her face when she was told that.

Anyway, he was once again demonstrating his idiocy. All credit card holders know that the bank will send the bill every month requesting for payment. If there is any dispute regarding the amount billed, the card holder can always request for an itemised bill detailing the amount of money paid out to each establishment. He would then be able to know which establishment made the unauthorised charges.

I am once again proven that Darwinian law does not apply to human beings.

What's the Point of Saying "Excuse Me"

2006-11-03T22:23:00.000+08:00

The LRT was super packed this morning, if a student had not forced his way out of the LRT, I would probably not be able to get on. When the LRT arrived at the next station, there was this lady who kept saying "excuse me" to me. Basically she was trying to get in, but I was already trying my best to move in without plastering myself to the man standing in front of me. I mean what is wrong with her. Can she not see we were all squished into sardines formation and there was absolutely no point in saying "excuse me".

The next stupid thing she did was to say "excuse me" when the LRT arrived at the terminal station. What was her hurry?! Everybody's getting out of the LRT, all she needed to do was just to shuffle along and she WILL get out of the LRT. It is not as if by saying "excuse me" we would open a path for her to walk.

S.T.U.P.I.D

Just Go to SGH

2006-10-26T21:38:00.000+08:00

Patient came to my counter asking if my pharmacy keeps the branded form of glucosamine. Told her my pharmacy only keeps the generic brand. Besides, I seriously have no idea what is the original brand of glucosamine; do not think there is one. Okay, I mean it is natural to query about the brands after all there are many different brands of health supplements in Singapore.

What I seriously could not fathom was she asked me to arrange with SGH to send their branded glucosamine to my side so she can pick up the glucosamine from my hospital. I mean if you are so brand conscious why not just see a doctor in SGH and get the branded glucosamine from there? When I told her I am not going to arrange for such thing, she said she will get the doctor to arrange for it. Air head. What can the doctor do when the pharmacy refuses to do the arrangement.

Besides, my guess is this patient is not paying for the medication. Usually the stupid civil servants on pension scheme will make unreasonable requests. If she is a paying class patient she will end up paying much more than the price sold in SGH, and I do not think anybody in the right mind would want to pay 25% more if the taxi fare is going to be cheaper.

Bet she was not able to get the doctor to pressure us into doing the arrangement. Never saw her at my pharmacy for the rest of the day.

No Stock Means No Stock

2006-10-13T20:24:00.000+08:00

Wanted to type this during lunch hour today, but did not have the time.

Anyway, a patient came to collect 6 bottles of Cetaphil wash, but my technician only processed to dispense 2 bottles reason being there were no excess stocks in store or main retail pharmacy. When I told the dad main retail pharmacy only has 3 and they need to reserve for their patients as well, he became upset... okay this is an understatement. He became selfish and stupid. Said it is really important for his son to have the medicine. Hmm... is he insinuating other patients are not important and his son is the all important one? To be frank, his son looks fine. He does not even look eczematous so I cannot understand the reason why it is "important" for him to have the Cetaphil wash. *Roll my eyes* It is just a body wash.

I told him this is a retail item not requiring a doctor's prescription and he can get it over-the-counter at any private pharmacies, but he said he need to claim from the insurance company. Fair enough. I then explained that I would return the prescription back to him so that he can collect the balance of the Cetaphil wash. He refused because he would then have to make an extra trip down. I thought there was something wrong with his brains when he said that. What does he want me to do? Snap my fingers or wriggle my nose or wave my magic wand and make another 4 bottles of Cetaphil wash appear?!

I felt like a broken record, repeating the sentence "We are out of stocks" many many times. Apparently his mustard seed size brain cannot process such a simple statement because he started saying how can such a big hospital not have stocks, and insisted I call the doctor and ask about how to resolve the issue. I did not tell him what the doctor said, but my guess is he would have been really pissed off to hear the doctor saying, "Well, tell the dad it is nobody's fault that the company did not deliver the stocks. He just have to come back another day to get the wash. There is no stock so what can we/he do?" I take back my words about him having a mustard seed size brain, he probably did not even have one in the first place. What can the doctor do when the pharmacy does not have stock? The last I recall, doctors are not warlords nor wizards who can make things appear out of thin air. Insisting that I call the doctor did not help his case at all. Anyway, I am sure he must have flunked his Physics and Chemistry back in school because he did not even understand the basic principles that you cannot create something out of nothing; how can I give him the wash if there is no stock in the hospital.

Anyway, I'm amazed he has not started floating around the clinic with the amount of air in his head. A pity he has already propagated and has passed on his airy property. I pity those who have to deal with the 2 air-heads he produced.

Capsule and Hour

2006-10-10T20:29:00.000+08:00

Patient called up regarding a medicine he collected. He was confused by the following sentences: "Take 1 capsule 2 times a day. Take half an hour or 1 hour before meals." He called up to ask what it meant by half an hour or 1 hour before meals. ?! I mean what do you mean? My techinican tried explaining that he can take 30 mins before meals or 60 mins before meals. Either way is fine, however, he was still confused. He asked if he was suppose to take half a capsule 60 mins before meals and the other half capsule 30 mins before meals. *faint*

Luckily it was my technician answering the phone else I'll be really sarcastic. She again patiently tried to explain that he was suppose to take the whole capsule, not half, either 30 mins before meals or 60 mins before meals. Later his daughter came to the phone and guess what the daughter asked. The exact same stupid question! "Doesn't the instruction mean taking half a capsule 60 mins before meals and the other half capsule 30 mins before meals?" What the @#$!!^

Stupidity apparently is in the genes. Moral of the story, if you are stupid, don't pass on your stupid genes.

It's Called Penile Tip!

2006-10-05T20:21:00.000+08:00

I asked a dad if he knew where the cream was suppose to be applied, he answered yes. When I asked him where exactly was it suppose to be applied, he said, "The doctor says pharmacy side will tell me." Right, I just asked if you knew where to apply, next thing you turn around and tell me I am suppose to tell you where to apply the cream. Smart.

Gave him my are-you-stupid-or-what look and reminded him that he said he knew where to apply the cream earlier on. He then started fidgeting and mumbling something about "that thing" and I half guessed where he was going. It is PENILE TIP, not "that thing". Had to tell him with an irritated look that the cream is to be applied to the penile tip, and the whole purpose is to make it easier to pull down the prepuce or fore skin.

What is there to be shy about? This is the hospital and we deal with human anatomy. The least the parent could do is to trust that we will be professional and not be giggling or blushing when talking about the genitalia. If you think talking about penile tip is something to be shy about, then what about those women who are being counselled on how to insert the pessary into the vagina by male pharmacists?

Why Are You Still Buying Medicine?

2006-10-05T20:09:00.000+08:00

A dad came to buy antibiotics for his child. When he saw the number of bottles he need, for 13 weeks, he protested that he does not need that many bottles as he did not bring enough money. I then asked him how many bottles he needed. His reply was, "I only need 1 or 2 bottles." When I tried clarifying with him if he needed 1, or 2 bottles, his answer was, "Yah lah, 1 or 2 bottles." I mean this man is really thick, how am I suppose to sell him 1 or 2 bottles?!

When I told him to make up his mind as to how many bottles he wanted to take, he then said his child does not need the antibiotics anymore. The prescription was actually dated a couple of months back, and upon review today, the doctor told the dad the patient does not need to continue with the antibiotics. Then what on earth was he doing at my pharmacy buying some medicine that was not required anymore?! Does he think this is some cough syrup that you can just buy a few bottles and keep for standby and then start taking the medicine when the symptoms come? Heck, I bet he's too clueless to even know when he needs to restart the antibiotics.

101 Answers to "What is Your Home Address?"

2006-10-04T19:31:00.000+08:00

The title says it all, though I profess I do not have 101 answers yet. However, human stupidity never fail to amaze me so if I continue in this profession long enough I am sure I will get 101 different answers to "What is your home address?" I will update the list whenever I get a stupid answer from the patients so do check back once in a while. Another thing before I start, I welcome any contributions from fellow pharmacists or people working in healthcare industry.

1. 6767xxxx. ?! Home address pls, not your phone number...

2. Email address?

3. Why you need my address? I stay in HDB lah.

4. 12-01. That's odd. The last I remember Singapore's address also includes the block no. and street name.

5. Er... I don't know. Hello! You don't even know where you live?!

6. Huh? What home address?

Tablets or Syrup?

2006-10-03T23:29:00.000+08:00

The doctor did not write to supply syrup or tablets so I asked the mom if she wanted to collect the medicine in the form of tablets or syrup. The mom told me she does not know if her daughter can swallow tablets. Okay, that is fine, but the odd thing was she turned around and asked me if her daughter can swallow tablets since she is already 6 years old. That is the MOST stupid question I heard today. How on earth should I know if the patient can swallow tablets if even her mother does not know?!

Whether a person can swallow tablets is an individual's preference. There is no hard and fast rule that says, more than 6 years old means the patient can swallow tablets. Heck, I know of adults who cannot swallow tablets. Luckily the husband had more brain, chose the syrup without hesitation.

Do you Come at Night?!

2006-10-03T22:57:00.000+08:00

A mom came to collect medicine for her child today and asked me if her child needs to start taking the anti-epileptic medicine tonight or the next morning.

This was how the conversation went.

Mom: So does she have to start taking the medicine tonight or start tomorrow morning?

Me: Start tonight.

Mom: But the medicine is just enough till her next visit date. If she starts taking tonight, then she'll be short of one dose.

Me: ?! I don't understand.

Mom: If she starts taking tonight, then on the day of the appointment she will only have enough for the morning dose, so she will be short of the night dose.

Me: I still don't understand. You don't come to see the doctor in the night. You come in the morning or afternoon, collect the medicine and then go back and take the night dose. How will she be short of the night dose?

Mom: But she has already missed the morning dose for today so why not just miss the night dose and start tomorrow morning?

Me: (Has this women no brain or what. We are talking about epilepsy medicine, not cough medicine.) Because if you continue to let the drug levels to drop, then a seizure may precipitate.

Conversation ended here with me quickly asking for payment in case another bout of stupid questions start. However, it made me wonder if it is good of the Singaporean government to encourage the citizens to have more children. Makes no logical sense to propagate stupidity.

钱字当头不再糊涂

2006-09-28T23:17:00.000+08:00

Patient's dose was 62.5mcg of medicine X. X comes in 50mcg and 25mcg tablets. Therefore, it is logical to take 1 of the 50mcg tablet plus half of the 25mcg tablet. The less number of tablets, the better, and the cheaper anyway. When the mother of the patient saw the tablets, she complained that it is very confusing for her as both tablets look the same, and wanted everything to be in 25mcg; that means the child has to swallow 2 and half tablets.

I tried explaining to her that the packaging of the 25mcg tablet is dark green in color while the 50mcg tablet is silver. Both are in strip form, with the color coding on the back of the strips therefore it is easy to learn which tablet is 25mcg and which is 50mcg. However, she insisted I change as she claimed she would mix up the 2 tablets. I mean, fine. As long as she gives the correct dose to her child I really could not be bothered.

When I told the parents the total cost of the medicine after making the change, they got a shock. According to dad, he said it was almost double what he usually paid for the medicine. Checked the records and promptly informed him that the increase in cost is due to the increase in number of tablets. Come on, common sense right. You obviously have to pay more if you take more tablets. Nobody's forcing you to take 2 and half tablets when the patient could have taken 1 and half tablets. When the parents realised it is cheaper to take the combination of tablets we packed earlier they requested for us to change back again.

By then I was already fuming. I mean, first you tell me it is confusing, then when you realise the price is cheaper it no longer becomes confusing. It certainly says a lot about these parents.

Why Should We Be Taking the Medicine!

2006-09-27T08:52:00.000+08:00

Patient's caregiver was complaining that the syrup for epilepsy causes a burning sensation in the throat, but seriously speaking, this was the first time I ever heard a patient complained that particular medicine causing a burning sensation in the throat. There is no alcohol content, just medicine and syrup how can that cause a burning sensation?

The caregiver then said pharmacists should try all the medicine, which we were like "Duh!". Why should we try the medicine when we are not ill?! Stupid caregiver. We are not talking about tasting bandung or sunkist orange juice here, it is medicine. Are we suppose to try things like digoxin and go into a cardiac arrest when our heart is working fine? Some people, they talk as if they're only born with the cerebellum.

Ghosts of Pharmacy

2006-09-20T20:54:00.000+08:00

If you ever lingered at the counter after getting the queue no., refusing to go away despite the staff telling you to take a seat, then you are the ghost I am refering to. These ghosts are a real nuisance. They continue lingering at the counter even though you are serving another patient. Some would just stand at the side listening to you counselling another patient's medicine. By doing that they have already infringed on the privacy of another person.

The worse type of ghosts are those who stand right in front of your counter although the next number is not theirs. Sometimes I wonder if they think they're ethreal and people can just walkthrough them, because when the correct patient arrives, they refuse to budge. At least until I black face (being 钟馗 helps) them, and curtly tell them to please move aside.

Ghosts without brains...

Pls Answer to the Question

2006-09-11T20:57:00.000+08:00

Really felt like whacking this parent on the head. Here are the stupid things he said.

1. His queue no. is 65. When I called 64, he came forward and say, "Yah, my son's medicine." When I told him I am calling queue no. 64, he looked blankly at me. I then read out 64's name which happens to be a female name. Continued to give me the blank look. #$@!!*

2. I asked him for home address, he went, "What address?" Home address, home address. You know, the place you go back to rest and sleep?! Unless you're telling me you sleep under a different bridge everyday.

3. I asked if his son has any allergies to medicine, his answer was, "Yah this is my son." *faint*

4. When I told him paracetamol is for fever and is taken only when necessary, he asked, "So when to take?" Had to resort to Tarzan English: Fever, take. No fever, no take. I forgot to "Oh ee oh ee oh" after that.

I really worry for the kid. Can such a clueless parent even look after his kid?

Epitome of Stupid, Rude Singaporean

2006-09-10T10:25:00.000+08:00

If you read the Sunday Times today, you would probably know what I am about to say. If you have not, go get a copy of the Sunday Times, turn to page 4 and read the story on "Customer forced out of restuarant after spat with chef".

Mrs Ang Ai Min is truly the classic example of the stupid, rude Singaporean customer. For starters, all restaurants or food establishments have the right to set their house rules. If you do not agree with the rules, as customers you have the right to just leave quietly and go to another restaurant. Not allowing outside drinks is a common and reasonable house rule. Even if Mrs Ang felt slighted at being told not to consume outside drinks in the restaurant she could still politely inform the restaurant staff her children did not consume the drinks they brought in. There was no need to make a molehill out of an anthill to the extend that even the chef was provoked to force her out of the restaurant.

Her behavior is sending the wrong message to Singaporeans and to the younger generation (who knows what kind of moral values she passes on to her students). In her own words, "I want people to know that such behavior is unacceptable. How can anyone lay his hands on another person, not to mention using brute force on a customer?" True, it is not acceptable for the chef to grab her arm and shove her out of the restaurant, but she is not a saint either. It is equally unacceptable for her to make a big ruckus in the restaurant and disturbing the dining experience of other customers, but she did not apologize for her behavior did she. I am apt to think that it is possibly due to teachers like Mrs Ang that we have youngster like the 2 mentioned in my "A Coffee Bean Story" post.

These 2 incidents serve to remind me that all the talks and campaigns to improve service standards in Singapore are nothing but crock. It is improving slavery industry not service industry. Service is not uni-directional. It involves interaction between 2 or more humans, and if it is an interaction it cannot be about one side giving more and more to the extend of giving in to an obnoxious party, which is the case with service industry in Singapore. Improvements need to be made on both ends in order to truly raise the service standards; boorish customers like the protagonist need to learn to respect others and be empathetic (what am I talking about here, a teacher needs to be taught basic human respect?!), and service providers learn to serve with a heart. In addition, I think it would be good to make it a standard practice to allow service providers the right not to serve rude customers. If UK can tolerate this practice why can't we?

Which is More Important? Health or Opinion?

2006-08-30T21:24:00.000+08:00

Parent came to collect medicine and when I told her the patient need to take half a tablet, she started telling me her child does not take tablets. In consideration that her child is still quite young to be swallowing tablets, I advised her to crush the tablet and mix it with some water. She then started telling me that her child would not take the tablet because it tastes funny. When I told her to mix with syrups, she said her child only drinks water and does not take syrups.

Really pissed me off when she said that and started asking me if there is another medicine that has similar effect but in the syrup form. What is wrong with her. If the child does not take the medicine, the condition would not improve. Which is more important? The health of her child or the child's opinion that the medicine tastes bad? Anyway, even if the medicine tastes bad, I had already suggested mixing it with syrups. If there is a syrup formulation available would I purposely deny her the option to change?!

Note: Parent is an ang moh...

Not All Malays are Called Ahmad

2006-08-29T20:16:00.000+08:00

The bus was super crowded today and when it reached my hospital, I heard this lady saying, "Eh Ahmad, open the front door?" For goodness sake, not all Malays are called Ahmad. Can you imagine people calling you Ah Huay or Ah Lian just because you are a Chinese?

It's the same with this patient who mistook my technician to be a Malay and decided to call her Fatimah without bothering to ask what her name was. She's a Philippino by the way.

A Coffee Bean Story

2006-08-26T18:38:00.000+08:00

Was at Takashimaya's Coffee Bean this afternoon with a friend. Coffee Bean's crowded as usual but I managed to spot a table for two so I went up to it. There was this girl (let's call her Yellow since she was wearing a yellow shirt, doesn't deserve a better name anyway) who took a table for 4 next to mine, but I think the cleaning auntie thought she was alone so she separated her table to make 2 tables for 2.

Okay that's fine except when her friend (Red) came, she was wondering why they cannot have a table for 4, so she wanted to join my table to theirs. Took quite a while for the dense kid to realise that I am occupying the table. Singaporean kids are as stupid as the adults; there's no hope for this country.

After they got themselves settled, they took out their homework to do. The cleaning auntie who was there earlier to separate the tables came back and told them to adjourn if they need a place to revise their homework as this is a cafe for people to eat and drink. Red then shot a disgusted look at the auntie and banged her drink down saying she's a customer there as she had ordered a drink and therefore had the right to be there. Okay, fair enough. However, there was no need to get nasty. Yellow started shouting at the auntie, asking for her name yada yada. The auntie couldn't take it anymore and just told Yellow in her face to go ahead and complain. *Big round of applause for auntie*

Half an hour later, the manager came along and asked them if she could separate their tables as they are only 2 but occupying a table for 4 and there are many people waiting for seats. Those 2 lied through their teeth saying their friend was coming soon. Waited another 15mins, and the manager came back to ask if she can separate the tables. Red repeated the lie about their friend coming soon. The manager repeated that there are many people waiting for seats and patiently asked them to let out 2 seats. Should their "friend" arrive she would arrange for the "friend" to have a seat.

Yellow started getting angry and asked to speak to the manager. She did not realise she WAS speaking to the manager. When she found out who she was speaking to, she started accusing the manager of chasing them out of Coffee Bean, questioning the way Coffee Bean treats their customers and asking the manager if she knows that as customers they have the right to be there etc. Look kiddo, you're totally off tangent here. Nobody's chasing you out. The manager was just telling you to count the no. of butts you have and occupy only the necessary number of seats. *roll my eyes* Do you seriously think people would be scared of you just because you take down their names?

Anyway, after the manager left, Yellow started f***ing everything. Such loose morals and she's still young; to think she can f*** in public for all to see and hear. *blush*

No Refund Means No Refund

2006-08-22T23:52:00.001+08:00

Parent called up to ask if there is a refund for 2 bottles of syrup that she collected for her child as the doctor has stopped the medication and she has no use for the medication anymore. She had called up the main pharmacy and was informed that the hospital has a no refund policy should the doctor discontinue the medication. Nevertheless she must have thought I would give a different answer so she decided to call up my pharmacy, but unfortunately for her I gave the exact same answer. I mean, it is the hospital's policy if different sections of the pharmacy give you different answers then something must be really wrong with us.

Anyway, I tried explaining that there are only 2 conditions for refund:
1. Patient develops known side effects with the medicaiton.
2. Patient develops allergy with the medication.
In both cases, the doctor would still have to examine the patient and write a memo saying they've examined the patient and have concluded it is either case 1 or 2 before we can actually do a refund.

Besides, for patients' safety sake when we take back refunded medicine our hospital chooses not to resell to another patient because we cannot guarantee that the first patient has kept the medicine in good condition. The parent insisted she kept the medicine in good condition, but that is absolutely not the point here. Putting yourself in other people's shoes, how would you feel if you were to receive medicine that another person has brought home for over 6 months, and you really have no idea what kind of condition the medicine is stored in except the words of somebody who is desperate for a refund. As pharmacists we tell patients to keep the medicine away from direct sunlight and heat, but frankly speaking, Singapore's weather is not ideal for storage of medicine no matter how away from direct sunlight and heat you are keeping your medicine unless you're telling me your house is air-conditioned at 21 degrees C 24/7.

Anyway back to the story, she then said she had to write off $300+ worth of medicine which I find puzzling as each bottle only costs $30+. When I told her the price of one bottle, she insisted I got the price wrong. Got really pissed off with her by then, told her to check her receipts and she got snotty and said she had already submitted her receipts for claims. I mean what can I say, I had the computer right in front of me and I was looking at the price from the system. If she chooses not to believe me I am not going to try and convince her; she did not sound like she wanted convincing anyway.

In such cases whereby we cannot do a refund, we usually would offer to help them arrange for their medicine to be donated to needy patients. I have personally encountered parents who generously donated their unused medicine (we are talking about 20+ bottles of medicine NOT just 2 bottles) to needy patients and were really understanding when we explained that there is a no refund policy. This idiotic parent had to distort the whole offer by saying the hospital is doing charity work with public money. That is really funny, I did not recall forcing her to donate the medicine so what was she so uppity about.

I know it is unfair that the doctor had stopped the treatment and patients are left with unused medicine, but hospitals cannot absorb these kind of costs. If the public really wants the hospitals to absorb such costs they can expect healthcare costs to increase tremendously to cover for such loss in income as the hospitals cannot afford to go into the red every financial year. There is no such thing as Progress Package for the hospitals when they go into the red.

She then complain that she had to pay the full price of the medicine and nobody ever asked her if she wanted to only collect part of the medicine nor inform her that there is a no refund policy. Big time lair (that's what I hate about Singaporean patients). She mentioned earlier that she submitted the receipts for claims so how did she suddenly end up paying for the medicine. WE DO NOT FORCE PEOPLE AT KNIFE POINT TO COLLECT ALL THEIR MEDICINE. The choice is always the patient's to collect all, or part of it, or none at all. If you got all the moolah and wanted to collect all the medicine we cannot be wasting time convincing you not to collect the medicine can we. As for no mention of no refund policy, pls read the receipts. It is printed on every single page that there is no refund for medicine. Oh, how forgetful of me, she submitted the receipts for claims hadn't she.

The worse thing was she threatened to write to the papers. Her exact words were, "There are many ways to get to the media okay, and I hope they publish this so that other patients know what it means to collect medicines from your hospital." What can I say, I agree there are many ways to get to the masses, and I am doing it one step ahead of her by publishing on my blog while hers wait in line for approval.

To end this post, I just want to ask the Singaporeans out there:
Do you go to Guardian or Unity pharmacy to buy medicine, use it for a week or two and then go back to the pharmacy to ask for refund for the remaining unused medicine? If you've done it before, be thankful that pharmacies are run by civilised people who do not chase you out with a broom.

So What if You're A Lawyer!

2006-08-20T09:18:00.000+08:00

Doctor ordered a painkiller for a patient in the middle of the night. No problems here except this particular painkiller, let's call it TC, was recently reclassified as a controlled drug (CD). Nurse was unable to obtain TC from A&E pharmacy, and paged the oncall pharmacist (me) for supply at 6AM. Told the nurse this drug is reclassified as CD so there is no way for anybody to supply after office hours because oncall pharmacist does not hold the key to the CD cupboard. Best bet is to ask the oncall doctor to change the order to some other painkiller or for that matter to some other CD that is already available in the ward.

Nurse then started telling me that the patient's husband was barking in the ward; he was not happy why he cannot get the drug and started telling anybody who is interested that he is a lawyer. Excuse me, so what if you are a lawyer. Is a lawyer above the law? How can you be a lawyer and do not know that the use of medicine is controlled by the Poisons Act, Medicines Act, and Misuse of Drugs Act in Singapore. I'm not even asking you to quote me sections or chapters from the acts, but fact is these laws are set in place to protect the public from their own stupidity when it comes to the use of medicines because Singaporeans have a tendency to think they know-all.

CDs, by the way, comes under the Misuse of Drugs Act. This is the very same act that states that if you dare come into Singapore smuggling cocaine, morphine or the likes, you'd be hung especially if the amount brought in exceeds that stated in the law. In the hospital, every single tablet and millilitre of controlled drug has to be accounted for, be it ingested by patients, or accidentally dropped onto the floor. Nurses hate it when accidents with CDs happen cos they have to fill up forms to account for every single step that led to the wastage of the CD. After filling up the forms they have to bag the CD and return to the pharmacy for the Central Narcotics Bureau officers to come and destroy. Everything is official, and has to be documented in black and white. It is that serious. Okay, I've side-tracked.

I am really pissed off when people abuse their positions in society. So what if you are a lawyer, am I suppose to be scared that you may be able to sue me? Can I counter-sue you for threatening me? It's ludicrous how people still live with such an ancient mindset that their profession gets them VIP treatment. Just imagine this, I go to Popular bookstore and the queue is super long, so I use my profession to threaten the cashier, "I'm a pharmacist, and if you don't speed up or don't let me go first, I will first, complain to your management and then make you wait just as long when you come to my pharmacy to collect medicine."

Back to a more serious note, the moment somebody says he/she is a lawyer, you immediately sit straighter, take longer to answer questions (you got to be sure you are not using inappropriate words that would land you in court), and 90% of the time you would acquiesce to their requests (we are just earning our daily bread, no need for bloodshed that is going to be paid with year end promotions and bonuses). As in any argument, usually the more vocal side wins, and these guys are trained to argue with logic. Pit your average stupid Singaporean, who cannot even speak standard English much less talk with logic, against these guys there is no need to guess who get their way in the end.

And the "I'm a lawyer" statement is just a ploy to scare the silly shit out of the average Singaporean so they do not even argue in the first place. Got to conserve the energy to argue with the likes of me who does not give a damn lawyer or not. Got to go catch some sleep. Stupid lawyer barking in the ward and disturbing everybody's sleep...

It is the Same Medicine!

2006-08-15T18:50:00.000+08:00

Patient was prescribed diclofenac 75mg, but upon dispensing she said that that was not the medicine she showed the doctor. She then proceed to show me a strip of medicine. Took a look at the strip of medicine and told the patient it is the same medicine except the one she was holding is a 50mg tablet. Essentially it means when you're in pain, you need to take the medicine more frequently than a 75mg tablet.

Simple concept right? No. She insisted it was a different medicine despite me and her husband trying to explain to her that it is the same medicine, but of a different strength. Just when we thought we had finally gotten through to her, she started asking me if the 2 tablets are the same medicine. This happened about 3-4 times. Really wanted to tell her to shut up and ask her if she was paying attention to what I was telling her. If not for her sensible husband I would have done just that.

What's Ur Hurry?!

2006-08-13T00:24:00.000+08:00

Was alighting from the bus yesterday and there was this lady trying to scan her EZ-link card before me although I was physically standing in front of her at the bus steps. The bus door was already opened, and instead of letting me scan my card and then alight first she had to fight to scan her card first. She still ended up having to wait for me to scan my card and alight before she can alight from the bus since there was no way for me to move aside to let her alight first. She's either being rude/ an air-head*.

*Delete where applicable.

Seats Are Not For Your Feet

2006-08-10T23:36:00.000+08:00

This is an observation. They had done nothing to directly irritate me, but I just cannot stand their behaviour.

Took a bus home from Orchard yesterday, and there was this couple sitting in front of me propping their feet (with shoes and all) on the seats in front of them. (I'm talking about the first 2 rows of seats which usually face one another.) No doubt the bus is not crowded and other passengers probably can get seats elsewhere on the bus, it is still inconsiderate to be propping one's feet on the seats. Seats are intended for the butt. How would you feel about sitting down on a seat which has been dirtied by other people propping their feet on it? Luckily the couple have not stepped on some turd else it'll really cause a nuisance to other passengers and to the driver.

There is No GOVERNMENT Subsidy

2006-07-26T23:42:00.000+08:00

This paragraph isn't really about stupidity, just an observation that many Singaporeans do not know what it entails to be a subsidised patient. Just because you are registered as a subsidised patient does not mean you get all drugs at subsidised rates, as there is a list given by the government as to which medicine is subsidised. Any medicine that falls outside this list means you have to pay the full rate regardless of who you are. Note: it is the government that decides on the list, not the hospitals or polyclinics.

The stupid part comes when a person repeatedly ask why there is no subsidy given even though she has been told her medicine does not come under the list of subsidised medicine. As if it is not enough for her to ask, but she has to get her friends to ask as well. My technician probably repeated herself 3-4 times, explaining why no subsidy was given. Really got on my nerves, that I had to tell the patient bluntly that we are not the ones to decide on the subsidy. No subsidy means no subsidy. The government decides so go ask the government.

It is Still the Same Expiry Date and Price!

2006-07-21T20:23:00.000+08:00

Parent came to collect medicine for his child using an old prescription. I asked him if he wanted to collect the balance of the medicine he said, "Yes, I want a bottle." When I showed him the full bottle he told me the last time we gave him a smaller bottle and he did not want the full bottle as the medicine expires 1 mth after opening. Anyway, from what is left on the prescription he was only entitled to another half bottle. Explained to him that I will have to give him all the 250ml balance from the last time.

He then asked if that is a small bottle. I mimed the size and he said that was not the size he collected the last time; it was smaller. However, from the pharmacy label on the prescription it showed that he collected 250ml of the medicine the previous time. When I told him he actually collected 250ml the last time, he was not convinced. He started asking how much I would charge him for 250ml. When I told him the price, he insisted I was charging him more and wanted me to check how much he was charged the last time. *Roll my eyes* Logic on my side, the system showed he paid the same amount the last time, but he of course argued that he collected other medications that visit as well, which was again proven not to be so. *Bwahaha*

Unable to argue anymore, he then told me to give him a longer expiry date for the medicine as the last bottle we gave him expired within a month from the collection date. Hello... Anybody up there? He just said he did not want the full bottle as the medicine expires 1 mth after opening, so does it make a difference whether I am or he is the one to open the bottle? The medicine still expires in a mth's time even if it was opened in the pharmacy. The pack size for the bottle is 500ml and if I were to dispense 250ml it is logic that I have to open the original bottle and pour out half its content onto another.

After I poured the medicine, I realise the prescription was missing. Asked my in-charge if he saw the prescription, he told me the parent took back the prescription from the counter. I looked at the parent and he took the prescription out from his wallet. I think this man's stupidity is bottomless. You don't go around taking prescriptions while it is being processed and you don't take back the prescription unless it is returned to you!

One Bottle at a Time

2006-07-19T23:13:00.000+08:00

Was counselling a parent on paracetamol (aka Panadol) for his child today. Almost wanted to vomit blood. The child was given 2 bottles of paracetamol and just to inform the parent I told him the 2 bottles contain the same medicine. He then asked me was whether he is to feed the child from both bottles. DUH! SAME MEDICINE! Who in the world with common sense would feed the child from both bottles when you've been told they are the same medicine?! You obviously feed from one bottle first, finish the first bottle then open the next one.

Move Faster!

2006-07-17T20:46:00.000+08:00

I seriously think the girl who was in front of me when entering the MRT this morning has got absolutely no brains at all. The moment she stepped into the train she paused and took her own sweet time to slowly stroll further in. Not only that, she took a long time to decide whether she wanted to move left or right thus blocking the path of everybody who was trying to get into the train. It is peak hour and she does not even have the common sense to move in quickly. The train was relatively empty for peak hours therefore she has no reason to move in slowly.

When Asking for Sponsorship...

2006-07-16T00:23:00.000+08:00

Today's story is contributed by a friend working in the food industry.

There was this guy helping a community association source for sponsorship. (Not sure the sponsorship is for what event.) As he had previously received sponsorship from my friend's company, he contacted the same person he liased with for the previous sponsorship. My friend's colleague was previously working in another branch of the company's business, which is no longer in existence. Hence, he passed the case to my colleague as per protocol.

My friend contacted the guy requesting for sponsorship to find out more details from him, and at the same time to inform him to put in an official request, in writing, to the company. Instead of agreeing to do it, he told my friend he is just the middleman and asked my friend to contact the association for the official request. Anybody with commonsense knows that in the first place when asking for sponsorship you need to supply an official request. Sure, you may call up to just sound out if the company is interested in sponsoring the event, at the end of the day any verbal agreement is not official without documentation to support. Any party can simply turn back on the verbal agreement.

Next, the onus to supply the request in black and white should be on the person/ organisation requesting for the sponsorship. The company giving the sponsorship has no obligations/ responsibilities to go bugging for an official request. No official request, no sponsorship. Simple eh.

The story ended with the guy saying he would get the association to write in for the sponsorship, but that was after my friend gave an incredulous "sure" when she was told to contact the association for the letter.

Cannot Make Up the Mind

2006-07-14T23:22:00.000+08:00

My in-charge's having a fair share of his stupid patients. A patient came to collect effervescent calcium plus vitamin C tablets. As this is the first time she was taking this supplement she made a lot of enquiries such as whether other patients are also taking the supplement. Hello... does it matter if other patients are taking it as well? What matters is the doctor, in his professional judgement, decided that this particular supplement would meet her health needs. When she found out not many patients collect the supplement at our pharmacy, she started wondering if she should collect the whole lot prescribed by the doctor. This was after we went through the trouble to procure the supplement from another pharmacy in the hospital.

Anyway, she basically started telling my in-charge she could not make up her mind as to how many bottles to take and started asking him what she should do. In the end, my in-charge had to tell her to go sit somewhere to think things through before getting back to him as he had other patients to serve. After a long while she came back saying she would just take 1 bottle. Could tell my in-charge was really annoyed by then as we are now stuck with the supplements that she does not want.

You Need to Go Back to School!

2006-07-12T20:04:00.001+08:00

There is a doctor who does not know what is Bactrim and just prescribe it for a patient. Bactrim is a combination antibiotic containing trimethoprim and sulfamethoxazole (both are antibiotics). Thing is the commercial adult tablet contains 80mg of trimethoprim and 400mg of sulfamethoxazole. There are 2 ways to prescribe this drug:
1. Bactrim 480mg BD x 1/52 (meaning 480mg 2 times a for 1 week) OR
2. Bactrim 80mg (TMP) BD x 1/52 (TMP is the short form for trimethoprim)

Either way at pharmacy side we would know immediately that the doctor wants to give 1 adult tablet twice a day. However, the stupid doctor prescribed it as Bactrim 120mg BD, and when I called up to clarify if he is referring to the TMP component, he asked me what is trimethoprim! Naturally I was shocked as it meant the doctor does not know anything about the drug that he prescribed for the patient.

I went into a detailed explanation of what components can be found in Bactrim and after the explanation he still does not get the fact that Bactrim contains 2 antibiotics. Really feel like strangling the doctor. Best is to bludgeon him and make him forget he is a doctor so he will not do more harm to patients.

Pls Answer to the Question

2006-07-12T19:53:00.000+08:00

I asked a patient if he has allergies to medicine today, and he said he is allergic to strong medicine. When I asked him what strong medicine, he got irritated and said he's old so he is allergic to strong medicine. What kind of stupid answer is that. There is no such thing as strong medicine causing allergies, and besides when talking about medicine potency you can only compare within the same class of medication. To do otherwise is something like comparing apples with bananas and then saying a particular brand of apple is better than another brand of bananas.

When I tried to correct his concept of strong medicine causing allergies, he became irritated and said his son is a doctor and he knows that he is allergic to strong medicines. What has the son being a doctor got to do with this?! If the son thinks strong medicines can cause allergies then I think Singaporeans should start worrying about the kind of medical care they are receiving.

Wonderful Imagination

2006-07-11T20:50:00.000+08:00

A parent came to enquire regarding a medication used to control Attention Deficit Hyperactivity Disorder (ADHD). Apparently he has not been giving his child the medication as he is worried that the child is going to rely on the medication for long term to perform well in school. He started going on and on about how it is not worth it for the child to take the medication just to perform well in school. I really wanted to tell him that the medication only helps the child to focus better during lessons, but whether the child eventually performs well in school depends a lot on his intelligence and hardwork. In addition, he will be a burden in class as we're not talking about simply not being able to focus, but the fact that he may be disturbing the class with antics and affecting the study environment.

Then the father started asking about the side effects of the medication, which frankly speaking I was reluctant to let him know as he definitely belongs to the type who believes that a good drug has no side effects. When I told him it may cause dizziness, he started asking if the child will fall down and what do I mean by severe dizziness. I mean, come on if your child is dizzy to the extend that he actually falls down and that is not considered as severe dizziness I really don't know what is considered severe dizziness. Maybe when the child is in a perpetual "drunkened" state?

Introductions

2006-07-10T21:09:00.000+08:00

I realise that I have been writing too much about stupid people I have encountered in my first blog. Therefore I have decided to create another blog simply for me to vent my frustrations about the stupid people; that way I won't have super long posts in my first blog. If you have any encounters with stupid people or stupid things you're most welcomed to vent your frustration on this blog. :D