While standing in line to pick up a medication at my local pharmacy, a few questions occurred to me, and I just remembered them when I saw the other thread on prescriptions.
What’s the actual proceedure followed when my doctor’s office calls in a prescription for me? Do they have some kind of a “password” they have to give the pharmacy which ensures that they really are legitimate? If not, how does the pharmacy know that it’s not someone just claiming to be from Dr. So-And-So’s office?
For those who have worked in a pharmacy, have you ever had the occasion to get a fake call?
Likewise, how can a pharmacist be sure that a written prescription is genuine? My physician’s signiature is basically a loop with a dot after it-- not hard to fake if someone was interested in doing so. Moreover, how can a pharmacy be sure that the prescrition slips themselves are genuine?
Answering just one of your questions, and in a limited way at that: Here in NJ doctors are required to use a specific form for prescriptions; it has a background that would show if something were erased. I’m sure a determined person could conterfeit it, but it would be non-trivial. In the old days they did use plain paper. It’s the doctor’s job to keep the prescription pads safe from unauthorized use. If he/she doesn’t do so, it’s possible someone could steal them.
If there’s a question of any kind, my pharmacy would call the doctor to verify whatever’s inconsistent. Or if somebody shows up with a prescription for some addicting substance every week. Since the pharm is making the call, they know they’re really reaching the MD.
Major chains also have a central database. This enables them to refill your prescriptions at different physical locations and still check if a new scrip may conflict with something you’re already taking, for example. It would also let them check if you’re filling multiple prescriptions for stuff at different branches. Obviously this could be circumvented by being sure to go to different chains.
Well, I often hear doctors calling in refills to prescriptions. The routine goes something like this:
“This is Doctor Smith, calling in a script for Lizzie Patient, D.O.B. 12/25/82. Zoloft, 100. mg, number 30, 1 at h.s., and refill times five.”
Basically all the doctors I’ve heard use the same pattern, in a brisk rat-a-tat delivery. I think that no-nonsense ‘business as usual’ tone of voice and phrasing is a big part of what tells the pharmacist that he is listening to a real doctor.
At this point there’s most often a brief pause, clearly while the pharmacist asks a question, and then Dr. Smith generally rattles off one (sometimes more than one) of several possible numbers/alphanumeric strings: his state license, his DEA number, his Tax ID number, the medical office phone number, his BC provider number, etc.
My theory is that the druggist asks at random for one of these numbers and mostly just listens to the result – can the Dr. rattle off what sounds like an appropriate number of digits without hesitation or thought? After all, the doctor has been giving out these numbers many times a day for his entire professional life, but would a scamming patient know that the medical license should have five digits, or the DEA number start with two letters and then 7 digits, or whatever? (And, no, they can’t be comparing the answer to match ones they have on file, because I’ve heard many call backs to pharmacies in distant states where a patient just happened to be on a business trip or whatever.)
And, of course, with certain drugs the pharmacist will want a written copy of the script for his records, but he’ll hand out the first refill worth right away so the patient isn’t left hanging.
Interesting question. My last doctor, I heard her say to the front office lady, call this prescription in for Mark. I wonder if the front office lady did it for her. Hmmm…
Also once my doctor told me he was going on vacation for two weeks. He just gave me a new prescription for my blood pressure meds (a beta blocker)…Somehow Osco couldn’t find it. I know I gave it to them but Osco said “Just have the doctor call it in.” Well not wanting to go two weeks without my blood pressure meds (if you stop a beta blocker suddenly it’s uncomfortable as it controls your heart beat. So you got to wean off of it) I called my doctor and he was on his cell. Anyway he was in his car. Then about a minute later he called me back and said it was all set. Osco then called apologized and said it’d be ready in 1/2 hours.
So it must be something doctors have memorized, cause he was in his car and it only took less than a minute.
I apologize if you think my question was innapropriate. I have no nefarious intentions, nor was I wanting answers which got into detailed specifics. I think that StarvingButStrong’s answer of an alphanumeric “code” was a perfect way of answering my question without giving away any information which could be abused. That’s all I was looking for.
Again, I apologize if you feel that I crossed any lines.
Faking any prescription is a felony in my state, and I personally know several people who have went to prison from trying to do it. The pharmacist can call the police while you are waiting.
Often nowdays, they “call in” a prescription by faxing it to the pharmacy. Then the pharmacy has the doctors signature, on the standard prescription form, etc., just like a regular prescription.
Some doctor’s offices even have software that automatically formats the prescription onto the form, inserts the doctors signature, and faxes it to the pharmacy – all without ever actually printing a paper copy.
People who work in doctors’ offices and have access to things like license and DEA numbers can be a danger to themselves. I once had Walgreens call me and tell me my refill was ready; I hadn’t ordered a refill, and in any case it was for narcotic painkillers I’d been prescribed after surgery. (I hate the darn things with a passion, and had most of the original bottle still left, because I’d only taken them for a couple of days.)
Needless to say, I was a little disturbed, so I went over there and explained to the pharmacist what was going on. That was when I realized that my sister might have done it. She was working in an oral surgeon’s office at the time, and she knew the routine pretty well. Plus she was having problems with her knee then, and kept complaining that her doc and/or the insurance company were hassling her about refills on pain medication. (She did have knee surgery a few months later.)
The pharmacist was remarkably unconcerned about possible prescription fraud involving narcotics, and told me that that location hadn’t filled the prescription, but another nearby Walgreens had. I was pissed off, but they told me there was nothing they could do about it. That was when I told both my primary doc and my ortho not to refill any prescriptions for me without talking directly to me first.
Caller ID is ABSOLUTELY WORTHLESS. I know a guy and he can fake ANY NUMBER to show up on your caller ID. So far he has called me and MY NAME and MY NUMBER show up. He put GEORGE W BUSH and the general number to the White House on it once.
As a matter of fact that is how I know it’s him, ridiculous numbers and names show up.
Marxxx is right, and for more reasons that he stated. I work for a private mental health clinic. Because of strict HIPPA confidentiality regulations, we have to make sure that the name and number of our clinic doesn’t show up on someone’s caller ID. A client’s spouse or other family members often are not privy to the fact that their loved one is coming in for counseling or is taking psychotropic medications. Many doctors’ offices are following suit, talking with their phone provider and having a washed-down version of identifying information show up on caller ID.