Drug costs nothing to sneeze at…

So Obamacare is officially the “law of the land”, and regardless of what you think or what type of “kool-aid” you may drink, health care in America is in deep trouble. In fact, its been spinning out of control for decades, well before the “Affordable Care Act” was passed so we could “See whats in the bill“, quoting congresswomen Nancy Pelosi…

I’ve been opposed to “further” federal intervention into our system of providing health care since I began my career in the industry back in 1989. By that I mean the “Feds” have had their hands in the business of health since the inception of medicare, medicaid, and the little known passage of “D.R.G’s” (Diagnoses Related Groups) in 1983. From reimbursement for hospitals and physicians to “managed care” and “H.M.O’s”, you don’t have to look too far to “Discover” Uncle Sam behind the scene pulling the strings and pushing pills.

Informed Americans have heard the recent horror stories regarding the launch of Obamacare exchanges and the not quite ready for prime-time web site. The proposed budget for the site was $93 million, and there are reports that much more was spent on this massive government project. Shouldn’t come as a surprise to anyone paying attention, as budgets aren’t something our elected officials seem to care about…

With stories of individual health insurance plans increasing dramatically and companies either raising employee contributions or discontinuing coverage completely, my tale pales in comparison. Yet I believe it should be a warning sign that many have simply ignored as millions have become accepting of small “co-pays” for physician visits or prescription drugs at the pharmacy.

You see, I’ve been affected by something very common in my neck of the woods; seasonal allergies. My doctor claims its the trees in the great Adirondacks, as well as the Amazon rain forest like weather in the upstate NY region. I promise you if he had even mentioned “global warming” as a possible cause, I would have wiped my nose on his white coat.

So after my initial visit several months ago, the kind doctor provided several samples of a steroid nasal spray to try. I certainly had no idea what the prescription would cost, but the brand sure does an awful lot of advertising on TV. I followed his instructions to the letter throughout the long and miserable Winter, with a spray here and a nasal irrigation there each and every day…

Finally, my trial samples ran out, and understanding the current state of the health care products industry (both my Brother and myself currently work for medical device companies), I asked for a prescription. It had been awhile since I had entered into the “system” of pharmacies and prescription drugs. Fortunately I’ve been fairly healthy for many years, and try to take proactive measures to keep the doctor away. In this case it took more than an “apple a day”, as my order was called in to the local friendly pharmacist.

It has to be at least 5 years or more since my last experience “filling” and procuring a drug prescription. I Think it was for an antibiotic for yet another allergy attack gone astray, that made it into my bronchial tubes or so they say. As I made my way to the back of the large retail chain drug store, I had no idea what to expect. Currently, I don’t have prescription medication coverage and intended to pay cash for the tiny bottle of nasal spray I’d been using for months. Gosh, it cant cost that much, or so I thought…

Weaving through the aisles of cluttered shelves stocked to eye level with every product known to man it seemed, I approached the sterile looking “Pharmacy”. Staffed by at least 5 busy lab coat wearing females, protected by a massive winding wall of windows and counters, I looked up to find out what “portal” I should access. There were multiple options as most already know, from “consultation” to “Pick up”. A “stage” seemed to be set up in the back portion of the enclosed area, complete with computer screens partially hidden by secondary glass walls. It appeared incredibly cold and complicated, but that’s our American health care system I guess.

My “Pharmacist” made herself known without even looking up and bluntly asked “how can I help you sir”. She was busy typing or something as she made her introduction. I informed her I had a “prescription called in” and gave her my physicians name. Like a robot given a command she seamlessly began “filling” my order. A few quick questions were shot out at me as she moved through what obviously was a habitual routine performed hundreds if not thousands of times. It was as if she was a high tech ticket processor at some futurist movie theater.

Finally she blurts out that “it will take 10 minutes to fill the prescription sir” and quickly disappears behind yet another clinical type wall and off to her shelves of bottles hidden from public view. I guess that was the signal for me to either sit in one of the hard plastic rows of seats by the blood pressure machine (which always seems to conveniently indicate severely high readings), or wander aimlessly around the store…

I decided to browse around the corporate store glancing at the numbing array of lotions, potions and products all neatly arranged on cold metal shelves screaming “buy me”. More than 10 minutes pass and a voice blurts out my full name over the store intercom for all the other patrons wandering around to hear to ” Chris Doster report to the pharmacy”! Yikes, did they find something wrong?

“My” pharmacist (as there were several toiling behind the glass walls moving like really clean zombies on a mission), never looks up from one of her many hidden screens and bluntly asks for my “insurance card”. From her reaction to my response it was obvious she rarely hears “I’m paying for the prescription myself”. Not only did this cause her to actually look at me “directly” for the first time, but several other of her white lab coat wearing workers glanced my way, seemingly annoyed and or surprised by my odd comment.

She gathered herself and in a nano second went back to her typing and the task of “filling my prescription”. It was clear my response had caused an unexpected alteration to her regular pattern of behavior as her facial expression actually seemed to go from robotic to confused. I stood silently at the “pick up” counter not knowing if I should interact with her or just wait for her next request. With 20 years in the medical products marketing industry and having made my way through many a doctors office,  receptionist or office manager, I couldn’t help myself…

“Sorry to have created more work for you but I’m actually looking for a direct primary care practice and the doctor that prescribed this doesn’t offer patients that option”. Whatever I said did not compute as she continued to focus on her task, yet appeared distracted by my comment. I thought I noticed her twitch a bit and perhaps a small bit of smoke rising from her head…

“Excuse me, direct what”, she responded without ever taking her eyes off her screen or keyboard. “Have you heard of concierge medicine or physicians that offer monthly memberships for their patients, it’s quite interesting”, I answered quietly as I sensed I could be asked to leave for violating some type of policy…

Obviously not conditioned or prepared for this type of communication with her “customers”, she was certainly off her game but asked me without looking up;  “direct care, no I’ve never heard of it”. One of her co-workers on the phone actually glanced over wondering what was going on with this no longer routine “prescription”. She appeared ready to call some authority or something…

“Well there’s a practice in Wichita Kansas that has created a program called Atlas MD, quite amazing and receiving a lot interest with all this confusion and conflict over Obamacare”….

Well that must have registered as for the first time since I approached the sterile confines her eyes met mine.  Actually quite attractive yet looking bored and stressed beyond her years, she actually rolled her eyes and under her breath said; “to say the least”…

She obviously was not happy with this new “law of the land” either. “Yes one of the physicians was actually on the nationally syndicated radio show Hannity the other day, as well as several major media outlet articles”, I proclaimed attempting to further the dialog.

She then asked what “it” was called again as I referred her to the Atlas MD web site.  Another “patient” standing silently behind me inquired as well with, “Atlas what”. At this point I was concerned that the other Pharmacists may begin throwing bottles at me if I continued. Fortunately, they were too busy filling their own prescriptions to listen in, but I did look for the nearest exit…

Finally,  my pharmacist made her way down from the white stage and came around from the layers of walls and glass borders keeping her drugs far from the masses and began to “ring me up”. As I could tell she was still thinking about this odd man and his tale of  “AtlasMD”. I added; “yes it’s pretty neat I actually spoke with one of the founding physicians a while back and they also provide physician prescription dispensing at their practice”…

That did it as her once typical day of “filling prescriptions” had been moved off its “axis” as she appeared to lose her balance. Looking up again from the latest screen at the register she shot back with; “doctors can’t offer prescription medications from their office”, in a rather high pitched voice laced with disdain…

Having been involved in the past with a “physician dispensing program” when I lived down South, I knew well that many states do indeed allow such. I responded, “Yes in New York State it’s not allowed but in Kansas and quite a few other less regulated areas of the country it’s becoming popular”….

This stressed-out New York State pharmacist was threatened, “well that would jeopardize my career” she exclaimed as her eyes widened. Trying to calm her obvious fear and yet appeal to her critical thinking skills I countered with my stock reply to every and any bad law passed by government. “Well elections have consequences and there will always be a place for your profession I’m sure, but the AtlasMD concept is in response to decades of dysfunction throughout the healthcare system”

As her mind was far from filling my prescription she again made eye contact and quickly shifted back to the corporate pharmacist and years of training. Her question came with no remorse or regard;

“Are you aware of the cost without insurance sir, with no co-pay”? Thinking this tiny spray bottle for allergy relief can’t be more than $40 or maybe less, heck the doctors office had provided at least 3 samples thus far?…

“That will be $165 sir”, said my new pharmacist service provider who probably wanted me out of the store faster than she can count out pills…

I asked if a generic version was available and was informed with a quick “no”, but for $65 I could buy a competitors steroidal nasal spray. I apologized for the inconvenience and told her I would have to consult with my doctor.  As my nasal passages began to swell, I’m quite sure that the Pharmacist wanted to forget about me and the story I had to tell…

Stunned by the experience I sent an email to Dr. Josh and confirmed as I sneezed, that his revolutionary practice could provide the prescription directly through his office in a breeze, for a fraction of the cost! Now I just have to move to Wichita, or find an Atlas MD doctor near me!