Wednesday, December 2, 2009

How Hard Is This To Understand?

Okay. Your epilepsy has been stable for over 20 years. In fact, I only see you once a year for it, and refill your Tegretol while we chat about sports, weather, whatever.

Your medication dose hasn't changed since the 80's, back before I even went to med school.

I write you a new script once a year, that you fax to your mail-order pharmacy.

Normally I see you in January, but you had to move up your appointment since you'll be out of town next month. So you asked me to date your next Tegretol script for January 1, 2010, and you won't send it in until then. Fine. I did just that.

So, after I've given you a post-dated script DON'T FAX IT TO YOUR FREAKING PHARMACY WITHIN AN HOUR OF LEAVING MY OFFICE!!!

Now I've got the pharmacist calling, wondering if I'm demented and don't know the date (not an unreasonable thought). I'm pretty sure he doesn't think you have some sort of special time-traveling fax machine at home.

So don't do it again. Put the script on your refrigerator and don't cash it in until January 1, 2010 LIKE YOU TOLD ME YOU WOULD and we'll all be happy.

Thank you.

18 comments:

Stephanie said...

Next time, just date it today's date and write "do not fill until 1/1/10."

One of the pharmacists I work under, who is admittedly a bit neurotic about details, actually returned a narcotic prescription to a patient after we had already put it on hold because "post-dating is illegal."

Now, I don't yet know my law so I'm not sure how true that is or if it's a state-specific thing (or if my pharmacist is just nuts), so I don't know about legality issues - but, at least it's idiot-proof.

Grumpy, M.D. said...

Thanks, Stephanie, I'll do that next time.

Anonymous said...

From a pharmacist--post dating Rxs is definitely illegal. I wouldn't get too bent out of shape about a post dated Rx for Tegretol, though. For a narcotic, maybe, but not Tegretol...

Jennifer said...

The only issue with that is the script will expire in dec 2010 instead of keeping on the Jan schedule. Not really a big deal unless the pt is absolutely insistent on January refills.

Grumpy, M.D. said...

I wasn't angry at the pharmacist, and certainly Tegretol isn't a C-drug.

It was more that the patient told me he wouldn't fax it in until the new year, and then immediately did so after leaving my office.

ERP said...

I have done what Stephanie recommends. I have put the post date filling requirement on antibiotics that I don't think the patient needs at the moment - but if the symptoms last say a week, they can get it without having to call me or come back.

MCT said...

smart patient.. seriously...

Anonymous said...

Is it possible after he left that he realized it wouldn't be covered under the 2009 deductible?

thegooddrlaura said...

Patients can be like the family dog. You give them your love and attention for years. You think you trust each other. But even the "good" ones can turn on you at any time.

Miss Kismet said...

I don't have the self-control to be a doctor. I would likely smack someone for sheer stupidity and lose my license! I'll stick to writing :)

Anonymous said...

Whatta great blog!!!

...and where did you find the Walter Matthau pic?

N

Vince said...

Hi Grumpy, first time commenting, but I found this comment on a news articles about emergency departments and I just wanted to give you a heads up on a patient who will probably end up referred to you somehow. Enjoy.

"emergency rooms can b frustratin. but i feel lik my primary care doc is even worse. i woke up 1 day cudnt feel the left side of my body n the numbness kept spreadn i call this asshole n he wont c me till december mind it was d beginin of november wen i calld him i xplain my situation n hey tell me 2 go 2 d ER i go spend hours n there only 4 them 2 tell me i have to go 2 my primary asshole 4 a referral neways.all that time wasted n guess wat i mak the appinmnt wit him i was due for it this thursday dec 3rd n they call me 2day an hour ago sayn dat doc asshole's last day was 2day so my appoinment is canceled ALL I NEED IS A FREAKN REFERRAL 2 C A NUEROLOGIST THATS IT!!! my insurance claims i even if i switch my PC i cant c the till next month. dat 2 months wit numbness 2 freakn months cuz of these asshole rules. y must i c his ass wen i need a neurologist. helloo i cud be dead by now"

Anonymous said...

maybe she faxed it early so she wouldn't lose it and thought that the pharmacy would hold off on filling it until 1/1/2010? or maybe she is just that stupid...

Anonymous said...

A real, brick and mortar, walk-in pharmacy could have dealt with this situation easily. It is official policy of mail-order (i.e., fake) pharmacies to make every situation as difficult as possible for both doc and patient.

Anonymous said...

Um, just curious. If he has been taking meds for 2-3 decades without seizure.... How do you know that he still needs it? He was diagnosed 30+ years ago; and taking the same dose for 20+ years...

Oh and pharmacy should call pt; say they can't fill until Jan and put it on hold.

Grumpy, M.D. said...

Based on his past history and test results.

mommy-medic said...

BWAHAHhahahahhahahahah HA ha hardy har hahahahaha

shaking head...... the doc expected the patient to follow simple instructions......

Bwahahahahahahaaa!!!

:)

Anonymous said...

The patient is faxing in scripts? That's against the law here.

 
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