Katherine Katsivalis, PharmD, BCPPS

Medical Science Liaison | Views are my own 🧠💊🇬🇷

[Katherine Katsivalis, PharmD, BCPPS @KKatsivalis]

“You’re the best pharmacist, ever!” — 8 year old patient within the first two minutes of meeting me and learning my job title. THIS is the energy you’ll find in #pedspharm 💕💊

[Katherine Katsivalis, PharmD, BCPPS @KKatsivalis]

This is why I ask if every medication copay, no matter how “small,” is affordable.

Not “expected.” Not “usual.” Not “ok.” Affordable. Medication access is financial access.

[Dr. Glaucomflecken @DGlaucomflecken]

A lot of people are dragging this person. The knee jerk reaction of “92% coverage?! That’s amazing! Why are you complaining. Leave the country.” This shows how low the bar has been set for health insurance coverage in the US. Let’s put on our empathy hats for a moment.

Imagine paying a ~$1k per month premium for the privilege of having health insurance. It was $750 last year, but the company you work for had a lot of employees use their health insurance in 2023, so Blue Cross decided to hike up the premiums to defray the cost of actually paying for their customer’s healthcare. You’re annoyed but fortunately, are still able to pay the monthly premium.

Over the course of the year, you seek preventative medical care like you’re supposed to, paying a $20 co pay for every visit. Maybe you have a few extra visits to your PCP or the emergency room. These bills go entirely to your deductible, which means you pay for 100%. The high deductible plan was all you could afford due to the rising premiums. Again, you’re annoyed but you can manage.

Finally you reach your deductible, thinking “great, I won’t have to pay anything the rest of the year.” At least that’s what it sounded like from the intro pamphlet you received from HR at the beginning of the year. It was all pretty confusing.

With your deductible met, you finally schedule that procedure your doctor has been nagging you to get that will prevent further health care issues down the road. However, you didn’t realize co-insurance charges still apply until you reach your out of pocket maximum (~$12,000 for the plan you chose. Again, the only plan you could afford). You are frustrated, but fortunately still able to cover the estimated cost.

Then, while recovering from major surgery, you receive a bill for $4,457 that you can’t pay. This is more than you were quoted by your doctor’s medical office. Turns out Blue Cross thought some of the medication you received during the procedure was unneccesary, so they refused to pay for it.

You’re angry. You have done everything right. You paid your premiums, you did everything your doctors suggested to keep yourself as healthy as possible, and yet, you still end up with a bill that will take months, if not years, to pay off. If you don’t, you will be sent to collections, wrecking your credit, and making life an even harder uphill climb. Does all of this apply to the OP here? Maybe, maybe not. But it does apply to millions of other people in the US every year.

Does this person not have a right to be angry? Should we just be ok with a health care system that is death by a thousand cuts? Or should we strive for a system in which a person can access health care without risk of financial distress? Unfortunately, many people can’t understand this point of view until they are on the receiving end of those medical bills. Health insurance companies don’t care about you. They are evil. Don’t settle for slightly less evil.

[Zed Zha, MD, FAAFP @DrZedZha]

I’m not the smartest. I don’t have the most resources. I’m frequently wrong. I admit “I don’t know” often.

But one thing I can promise my patients is that I WILL fight hard to get them the medications they need.

“Don’t lose heart when you get a denial letter from your insurance,” I say, “because if you get it, I’ve got it, too. And chances are, I’m already fighting them.”

Some days, I lose more than I win. Maybe it’s even most days. But on the scale of good and evil, I am good, today.

Good night. ❤️

[Panagis Galiatsatos, MD, MHS @panagis21]

Office: Hi, is this Dr Galiatsatos

Me: Yes

Office: We are calling about a patient and she asked us to call her “Greek Doctor” before she makes decisions. She also said she taught you Sunday school? Not sure that was relevant but she was adamant we know.

❤️My Greektown patients

[Katherine Katsivalis, PharmD, BCPPS @KKatsivalis]

Chicagoans are built different. 38 degrees after a polar vortex feels so warm, some dude was just chillin at the bus stop in flip flops. And like…I get it.

[Katherine Katsivalis, PharmD, BCPPS @KKatsivalis]

@KaceeGould Think about converting to doing a white elephant exchange. That way, everyone gets to bring a gift, but they’re only responsible for one.

[Katherine Katsivalis, PharmD, BCPPS @KKatsivalis]

@KaceeGould *Calls Penn Badgley* “Listen, as a pharmacist…”

[Katherine Katsivalis, PharmD, BCPPS @KKatsivalis]

@KaceeGould Which ones?!

[Katherine Katsivalis, PharmD, BCPPS @KKatsivalis]

@shivenbh Lol! Neuro-related but for epilepsy!

[Katherine Katsivalis, PharmD, BCPPS @KKatsivalis]

“Don’t cite the review article, cite the original trial.” But what happens when all roads lead back to the same consensus review…and there is no additional source cited? 🧐

[Katherine Katsivalis, PharmD, BCPPS @KKatsivalis]

“Patient has tried and failed multiple medications and has treatment refractory headaches. Peer-to-peer has been rescheduled with @UHC AT LEAST FIVE TIMES due to failure of the UHC MD to contact us at the scheduled time of call.” @KaceeGould

[Katherine Katsivalis, PharmD, BCPPS @KKatsivalis]

@cefDANIr Decided to leave because it was a dream job. I wanted Gen Peds/Epilepsy. It was the only job in the country offering Gen Peds/Epilepsy. If it weren’t for that, I felt no obligation to leave. Came home 1 yr later for family. No right/wrong approach.

[Katherine Katsivalis, PharmD, BCPPS @KKatsivalis]

@KaceeGould I get very petty and highlight, “this is for prevention.”

[Katherine Katsivalis, PharmD, BCPPS @KKatsivalis]

@jtrebach Infectious disease would be grape for all the pseudomonas that’s treated

[Katherine Katsivalis, PharmD, BCPPS @KKatsivalis]

@LGlaucomflecken @DGlaucomflecken Ma Glaucomflecken is the light and example we all need in our lives. Thank you for sharing your beautiful spirit 💕

[Katherine Katsivalis, PharmD, BCPPS @KKatsivalis]

A small counseling point that can be impactful: When appropriate, tell your patients their disease is not their fault. Tell them medicines are a tool, not a failure. Tell them they did nothing to cause this, and they couldn’t have done anything to prevent it.

[Lexi Thumann, PharmD, BCIDP, AAHIVP @LexRX]

Had to share the cookies we got for #USAAW22! Giving these to providers tomorrow along with antibiotic “facts and myths” to promote #Antimicrobialawarenessweek. We may give unsolicited advice but at least it comes with cookies, right?! 🤣🍪

[The Readiatrician- not here anymore @readiatrician]

I said goodbye to a patient a few years ago. She didn’t die, she just got old. I treat patients to age 21 and they move on. When they do, I joke, “well, I did my job! I kept you alive until adulthood!”

With this kid, it was not a joke. 1/

[Katherine Katsivalis, PharmD, BCPPS @KKatsivalis]

@cefDANIr No no! You're right on track! There's just *something* about *specifically* October. You're feeling all the right feels, and come research week, they too shall pass <3

[Panagis Galiatsatos, MD, MHS @panagis21]

I’d like to submit a new vital sign for warning of clinical concern:

Presence of a komboloi 😬

[Andy Webb @AJWPharm]

Lamotrigine can be a tricky drug to get started in the setting of drug interactions, and sometimes it's hard to tell how much an offending drug will impact lamotrigine's PK

Here's a nifty chart showing what some meds will do to lamotrigine's clearance:

https://t.co/UAXtlFCy1N