Wednesday, June 25, 2014

Annie's desk

Annie: "Dr. Grumpy's office, this is Annie."

Mr. Valproate: "I want to know why the doctor won't refill my seizure meds!"

Annie: "Let me see... I don't show that we have a request for that. Did you call your pharmacy?"

Mr. Valproate: "Yes! They told me they've sent it to Dr. Intern 3 times, and all she does is say that she doesn't prescribe my seizure meds. So why won't Dr. Grumpy refill it?"

Annie: "Why are they sending it to Dr. Intern? Did you ask them to fax it to Dr. Grumpy?"

Mr. Valproate: "No. Am I supposed to?"

21 comments:

Mari-Ann said...

Fax it to me. It makes about as much sense!

Mad Jack said...

I think Mr. Valproate has a point. My last doctor (who's office fired me) had a serious prescription refill problem. The staff refused to entertain any and all conversations involving refilling a prescription, stating 'that has to go through your pharmacy'. The thing is, the pharmacy would send a FAX to the doctor's office and call that good enough - and it isn't. How do they know the doctor ever got the fax? There is no follow-up from the pharmacy, as the patient is supposed to provide that if the prescription isn't refilled. And should the doctor's office refuse to refill the prescription, no one calls to inform the patient. Then when the patient calls, the staff refuses to talk to the patient... and on, and on.

My new doctor employs a staff that actually cares about such things and isn't a bit shy about informing the patient what the patient should be doing about prescriptions and refills. Upon hearing my story, one clerical worker told me that the problem was my pharmacy of choice. 'We've had nothing but problems with them, and I know we're not the only office that does.' I switched, and have been good so far.

I'm a computer programmer by trade, and so am a reasonably intelligent, well-read person. I can see the weakness in the system - the exclusive use of the FAX machine - but when I tried explaining this to the pharmacy they feigned ignorance of the English language. Go figure, right?

Anonymous said...

I can call my doc or my pharmacy. They're both great. This one is on the pharmacy for calling the wrong doctor. Don't they check the name on the script?

PediNP said...

I prescribed eye drops last week that are available OTC (with the off chance that the pts insurance would cover them). The pharmacist called and asked if I would prescribe something else, because the drops would have to be special ordered. I asked if they had them OTC, and he told me to hold on while he checked....and came back to tell me yes, the store had them on the shelf. I asked him to direct the patient to the product.

Smh. Shame on me for trying to do the patient a favor...

Anonymous said...

most prescriptions these days are not faxed, but sent electronically through a clearing house. Nobody really looks at it that closely, and while some errors are lessened, the potential for other errors are increased, as a click of the mouse can send strange things into the ether.

Officer Cynical said...

"No. Just continue to do the same thing over and over again, and eventually the outcome will be different."

Anonymous said...

The doctor I see sends prescriptions to the pharmacy electronically and charges me $1.00 for that 'convenience'. The pharmacy never gets the prescription and then has to call the doctor while I stand there and wait. I can't give them a paper script because I never receive one, unless it's for a narcotic like Percocet, and I only had that prescribed when I had surgery. Other than that, I get charged a dollar to stand at the counter at the pharmacy while they call the doctor to see what I'm talking about.

Anonymous said...

Anon @ 1:15: Looks like it is time to find a new doctor :(

Anonymous said...

Anon@1:15, agree that you shouldn't be charged for sending the script, but also bet the pharmacy has it in their computer but just haven't looked at it. Is Walgreen's your pharmacy?
In any case, I agree with finding a new doctor. You'll both be happier.

Anonymous said...

@mad jack.

He'll yeah, I'm gonna send a fax and call it good.....along with the 50+ other refill requests per day. I can't call to check on every fax because a) that is 50 faxes to call on and if I do that no prescriptions will be worked on while I'm calling and b) I don't actually get to talk to anyone at the offices, but rather leave a message or hold for 20 minutes. If the fax fails, that is a different issue and we call then or if it has been more than a week since we faxed.

We had a problem recently with one clinic never getting back to us because the we're THROWING AWAY all faxed requests to try to make pharmacies electronically request refills (which we can't do for IT reasons). No notice they were going to start, either just happened one month.

Packer said...

@ Officer Cynical, That is just insane.

wellillbe said...

mad jack. it is not the pharmacists responsibility to request refills. It is yours. If it improves your life its your job. no one is responsible for you but you. And whoever says the pharmacy has the wrong dr has no clue. Probably dr intern "did her a favor" and ordered one fill to hold her until she could reach dr grumpy and now he is the dr of record for that med on the rx. Pharmacists can't read minds anyb etter than drs can, lol. It is the patient's responsibility to request refills. And any dr who requires the pharmacy call for refills instead of the patient should be charged by the pharmacy for the service they are demanding.

Candida Gomez said...

...this story and others make me so glad I have a marvelous doctor's office and pharmacy. (Target.)

My doctor offers the choice of paper prescription (always with the special paper) or electronic sending. They make it very clear, though, that if you have problems and it's after office hours, you'll have to wait till the next day to have it handled. With five pharmacies in the immediate area, including one on their first floor, it's usually very easy to get things sorted out same day if you hustle.

(Immediate area -less than ten minutes' walk from the office in various directions. Fifteen, tops.)

Jefferson Selvy said...

My Dr. Hates it when I call for refills but if I don't it can take up to two weeks for them to to follow their own processes. With meds for various chronic pain issues that is just not viable.

Anonymous said...

No, it's not a Walgreens, it's a CVS. I don't think the pharmacy ever has it in their computer. It happens with every prescription for any member of the family. It does not happen if the script is from a different doctor. Any other practice and the script shows up in the pharmacy computer right away.

Anonymous said...

We did a survey of faxes we received from pharmacies over the course of a month, and 75% were "invalid:" patient not on that rx any longer, patient already had a rx and hadn't turned it in, patient going to a different pharmacy now, patient dead, patient going to different doc, etc.

As a result we ignore the faxes (yes, we informed the pharmacies) and only respond to requests from the patients. Works great.

Anonymous said...

"it is not the pharmacists responsibility to request refills. It is yours."

Ok? Request it from whom? Every single time I've contacted a doctor's office for refills, they've told me to contact the pharmacy and that the pharmacy will request it from them. Some doctors even have notices to that effect posted prominently in their offices. So if the doctor's office thinks it's the pharmacist's responsibility, then what is the patient to do?

Anonymous said...

Hahaha. I guess it's the pharmacist's turn to laugh (diabolically). With the original comment by the IT guy, one has to wonder why the 'verify fax issued (or received) button hasn't ever been invented. I was just reading over my pharmacist junk mail and came across a mailing promising solutions from this healthcare software service. It identified at least 5 issues that the retail pharmacist tears their hair out daily (beyond the usual) 1. inconsistent electronic health record standards (between various agencies), 2. disparity in ways healthcare workers record and input data, 3. disparate systems attempting to 'marry' data, 4. difficulty integrating buinsess goals with IT processes, and one about insufficient tools in place to comprehensively gather patient data.

I work in a hospital and it is like milking a turnip for blood draw to obtain proper medication information from a patient on their arrival to the hospital. (Do you think you could remember the first letter of the pharmacy where you get your prescriptions filled, dear?) WE consider ourselves striking gold if the patient actually only gets their prescriptions filled at a small independent drugstore or fills at the same national 24-7 pharmacy. Otherwise...

Anonymous said...

As a patient and a health care worker, I get very frustrated with the fact that electronic scripts, referrals, and medical records are taking power and responsibility away from the patient.

We preach that we want patient engagement but then we either encourage lack of engagement or outright prevent engagement (patient needs MRI but can't call to make appointment himself... Instead he must wait for electronic referral to go through and be called by MRI dept).

From a health care/business side of things I understand why it is often easier to do it this way. But then we can't complain that patients don't take any responsibility for their own healthcare. We don't let them...

Anonymous said...

"As a patient and a health care worker, I get very frustrated with the fact that electronic scripts, referrals, and medical records are taking power and responsibility away from the patient."

Over the past few years, because of the MD recommendation for routine radiological procedures, I've called the local hospital to arrange for these procedures for myself or other members of my family at a time when I can take off from work, and often have the scheduling person say, "ask your doctor to schedule it for you", which is a farce because, the doctor's office has to call me back and authorize the time of the appointment per se, if we can or cannot make it at that time. Sometimes there's such a length of phone-tag, that the routine exam in limbo. My husband's colonoscopy is still awaiting scheduling because the hospital gave us ten days to schedule it after the MD office called it into the hospital and we were out of town. That was three months ago. Obviously, we're not in any hurry. Surely our home is not the only one with transportation, family, and work-schedule issues!

Jnepne said...

I work in a very busy pharmacy, and we ended up with over 100 refill requests in our system. Our computer doesn't show us anything past 100, so there's no telling how many there actually were. A fax is good enough, especially when we call most mdo's, if we're lucky enough to get to speak to a person and not a machine, they immediately tell us to fax the request over. We don't get a chance to give them patient or med info, it's just a "well, did you fax us? Send us the fax first." We cannot possibly call on every request. Not when we're also helping customers find the q-tips, taking calls for new prescriptions, handling numerous and ridiculous insurance issues, counseling patients, calling to clarify/verify incomplete rx's or those where the directions are just slightly off, and yeah. Filling your prescriptions. I don't pretend to know how your job works or what you do on a daily basis; Don't pretend to know mine.

 
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