I often feel like I am lying to patients. I'm a kind of a black and
white guy, no gray areas. Statements are either factual, or lies. An
example from yesterday...

Patient is in a hurry, "Gotta go to work. Can I pay now and my girl
friend can pick it up?" He's very insistant. Now, we know what a
nightmare this could be: what is the copay before you've even entered
it? Do we take that strange card? I suppose some kind of arrangement
could be made to accomodate the patient, but it would be time consuming
and the potential for a bad outcome is large. Eventually I convinced him
to fill at a pharmacy more convenient to him.

I see this all the time. I work in a hospital outpatient setting with a
large Medicaid contingent, and more exceptions than you can shake a
stick at.

Often, to make a patient interaction move more smoothly toward the
desired outcome (MY desired outcome) I may lie: "I can't do that." when
really you can, but it's poor policy, business wise. And we all know, it
IS a business.

It gets tough sometimes. Once a patient really started to squeeze me. I
was obfuscating about something another pharmacist had done, trying to
make the patient accept what had been done. and the patient started
dissecting my semantics. Why why why she was probing for a chink in my
armor. I quickly saw she was not going to accept facile answers. I had
to retreat to rock solid answers and justify what we had done and what
we would do. The little lies wouldn't do.

I'm not sure what any of this means. I guess you had to be there.