My dog paid off my vet

My dog paid off my vet. Or maybe it was my husband. There is no other explanation.

That's the only conclusion I can draw from my experience with our veterinarian this past weekend.

I have a pomeranian. We never got his AKC papers when we bought him because only after we fell in love with him at the pet store did the guy who sold him to us tell us that they conveniently didn't have his AKC papers. So yes, he's probably a mutt. I've had pomeranians before--but never a pomeranian that weighs 24lbs 6oz. That's right. My pomeranian who is supposed to weigh between 8-12lbs is twice his weight. I don't expect him to be 12lbs, once again due to his mutt status, but he shouldn't be twice his weight either.

So why is he 24+lbs? He eats mainly table food. He'll eat his wet dog food only with sprinkled parmesan cheese on it at the end of the night on occasion if the human food didn't satisfy him. So what human food does he eat? Most of the time it's table scraps but if we eat something that he just won't eat (i.e., anything healthy), my husband will heat up some turkey sausages and give him that or (this next part is embarassing) my husband will get him a small fast food item so that he'll eat (e.g., chicken nuggets, cheeseburger off the value menu).

Anyway, I have been battling with my husband on this issue for a long time and have been threatening to tattletale on him at our annual vet visit. I was counting on the vet to lay down the law and scare him with some lines like, "If he stays at this weight, his life expectancy will surely be cut by 5 years" or "He is very likely to face diabetes in the next year if he continues at this pace" or how about "His small frame cannot carry his current weight for long--his hips or knees will give out".

So the vet and her tech weighed him, felt his frame, checked his teeth and hair, all the usual stuff. They gave him his  rabies shot and we talked about heartworm stuff, yada yada yada. I finally got an opportunity to get back to the discussion about weight since it was dismissed earlier. So I start rattling off all the stuff my husband gives my dog-- bacon, sausages, burgers, beef--and at this point my husband's face is bright red. As I was talking the vet and tech are just holding our dog, giving him his shots, giggling at all the food I listed. Then she turns to us and says "Awe, so what's his favorite fast food?" Okay, just answer, maybe she'll realize how bad he eats if you just answer, I thought to myself. I say, "Portillos." She responds, "Oh, he has good taste! Portillos is good!". My jaw was on the floor. She finishes giving him his shots, cuddling with him, etc and then says to him "You did so good with your shots. Maybe you'll get some Portillos later!". WTF?!

Honestly, I was speechless. My plan to embarass my husband so that he could finally join my mission to improve our dog's health had failed miserably. I had been defeated. When we left the vet, I came up with a theory-- they were purely there for the money and don't aim to improve their patients' health. In fact, they may even hope he comes back in worse shape so that they could charge us some ridiculous fee for hip or knee surgery or diabetic testing and supplies. I was convinced that this is why they don't want to change a darn thing about our dog's diet. So twisted but that's my theory. My husband on the other hand says that they have always been a very passive group and probably avoid confrontation or discipline because they don't want to isolate their customers. Okay, I can kinda see his point, but for goodness sake at least listen to what I had to say and recommend IAMS or an extra walk a day.

We drove away from the vet's and headed home. We hadn't eaten all day and so decided to grab something to go. Our dog had a Taco Supreme for lunch. I shook my head as my dog ate his taco. There he was systematically pulling all the lettuce out of the taco while not leaving a single drop of sour cream or beef behind. My husband's response to my disappointment? "The vet said we should get him Portillo's!"

Sigh.

Being acknowledged and thanked

Every quarter the healthcare company I work for holds a campus-wide forum for everyone to attend- managers from the stores are welcome as well as anyone from corporate (although attendance is so high that you must register to attend so most people watch the event from their computers). Anyway, the purpose of the forum is to talk about hot topic issues, play TV commercials that haven't been released to the public yet, go through Q&As, introduce key executive level additions, etc. Mostly though it's to motivate the entire live and web audience-- the company's employees. There are a lot of thank you's given out by everyone who holds the mic to once again everyone...the field, the DCs, corporate folks, etc...Today, a personal thank you was given to pharmacists as it is Pharmacist Appreciation month. I didn't go to the event and so was left wondering how that really resonated with the pharmacists and non-pharmacist audience members that did attend. My curiosity resides mainly with whether the pharmacists in the room felt truly acknowledged or whether it sounded rehearsed. I personally appreciate the fact that our occupation is celebrated this month, but know that as a pharmacist this is not how I'd prefer to be acknowledged.

This is something our company has struggled with for some time now. The manner in which you thank someone matters. Not thanking pharmacists for their efforts is not an option. If you want to deliver millions of flu shots, meet your KPIs, improve customer satisfaction, etc you need to tell your pharmacists that you 'get it' and that you appreciate them. But how do you convey that message in a genuine manner?

In an effort to demonstrate the value of MTM and at the same time acknowledge select pharmacists for their contributions towards MTM services, MTM vendors put together concise newsletters if you will to describe MTM cases that their contracted MTM pharmacists handled. They are usually not your 'So and so refilled their patient's medication and so compliance was improved' stories-- they are usually cases that show how a pharmacist went above and beyond with an intervention to improve their patient's healthcare. The pharmacist's store is listed, their name is displayed, and the case is described. Once again, this is intended to highlight the pharmacist and their success with this service as well as create interest for pharmacists who don't understand MTM or see the value as well as for pharmacists who may be unaware of how their interventions can make a difference. So, are these 'Look what your peers did!' emails successful? Does the pharmacist highlighted in these briefs even like the fact that their name is published? Do they feel a sense of pride knowing that these emails can trickle down to 7,000+ stores?

We get thank you's in all kinds of ways, from all sorts of people in the company. I get them as automated responses from many people just for responding to an email. I get a more personal thank you and 'good job' at my annual review. I get thanked sometimes by upper management who were made aware of something I excelled at. But whose thank you matters most to me and how do I like to get thanked?

Here's how-- don't thank me only in front of other people. It only shows me that you only care about how you look and if that's the first time I hear it, I know you've been waiting to deliver the thank you in front of a large group because you 'acknowledge your employees'. Don't thank me only at my reviews. I resent you all year long for not acknowledging my efforts just for you to overwhelm me with gratitude this one time a year. Don't thank me only after someone else has acknowledged my accomplishment. You either understood the value of it in the first place or you didn't. And lastly, don't thank me because you have to. The random thank you's at the end of a busy week or emailing our boss to explain why you're so proud of me every so often means something to me. Being thanked by patients for helping them through consultations, product selection, or just answering a simple question is usually good enough for me too. Being thanked by other colleagues via a simple email or call for making their job easier is good for me.

What motivates you to do better? Do you prefer a personal thank you or do you prefer for others to witness gratitude given to you?

Safe Medication Disposal: Do people have the green to be that green?

photo courtesy of Google Images

Last week Walgreens announced their Safe Medication Disposal program for patients who want to dispose of their unused or expired meds safely. For $2.99 patients can purchase an envelope that can be used to ship their unwanted meds to an incinerating facility where medications will be destroyed. By-products are then used for "green" related building materials instead of ending up in a landfill or the ocean.

I get the whole green thing. I get patients wanting to "do the right thing". What I don't get, or rather, what I don't think patients will buy into is having to purchase the envelope to rid their medications in a safe, green way. Patients are already trying to cut corners on their meds. Patients aren't taking their meds because of costs. Do you really think they're going to then pay to make the medications go away when they could just dump them in their trash, or better yet let them sit in their medicine cabinets?

I'd be the first one to advocate for a cleaner earth, specifically for waste not to get dumped into the ocean. (I prefer blue water to the green/brown color that is Lake Michigan). I hate seeing all those documentaries about the damage our waste and harmful medications are having on the wildlife. Nothing brings a tear to my eye faster than watching film on animals trying to remove plastic from their mouths, oil off their feathers, etc. I get it-- we have a very detrimental effect of the livelihood and survival of other species. Dumping our meds in the trash isn't helping. I see crows get into our garbage bags all the time. The last thing I want is a big ass crow picking at some orange vials that smell yummy (mmmm...vanilla scented Biaxin).

Are people literally buying into this program? In a time of national economic stress are people really paying to dispose their medications safely?

Better yet, I have an idea. How about when the patient comes to purchase an envelope, a pharmacist peeks inside to see if it's a long-term med for hypertension/diabetes/hypercholesterolemia/etc. If it is, we counsel the patient on medication adherence, take the envelope back from them but keep the $2.99 for a counseling fee, and send them on their way. They shouldn't be throwing away their meds anyway.