There are other kinds of prescriptions besides for drugs: I recently had an eye exam, and my eye doctor gave me a prescription for glasses for driving at night. I took it to the glasses place, where they had great trouble deciphering it. It wasn’t an uncommon prescription, either; he just had horrible handwriting. With a very common prescription like mine (-1.25 is common, right?), you’d think he could have had cards made up and just filled in my name and signed it. Not like bands of marauding Magoos are going to rob ophthalmologists’ offices.
Nah - a couple of foil sheets in a cardboard box are hardly what I’d call “fancy.”
Incidentally, in my experience doctors generally round perscriptions out to the sizes of boxes. I’ll rarely get a perscription of 28 for something boxed by the 30 - doctors will just write 30 and make everyone’s life easier. Dosages are usually pretty standardized, anyway.
You can call in Vicodin (Hydrocodone/APAP). Hydrocodone is a schedule III drug in the United States. Controlled substances that are schedule III through V can be called in or faxed. The only drugs that require an actual Doctor’s original signature (i.e. can’t be called in, faxed, etc) are Schedule II drugs (Morphine, Adderall, Oxycodone, etc).
Hirka T’Bawa
Pharmacist Intern
In the US, a physician cannot send a controlled substance through an e-prescribing system just yet. The DEA has finally released draft rules to allow this, but so far as I know, it has yet to be implemented.
However, as long as the medication is not a C-II, they can call or fax a prescription in, providing it has all of the required information under both state and federal law. And in the case of hospices or long-term care facilities, they can even call/fax in C-IIs, though that doesn’t apply to the general population.
So they can, in fact, call in Vicodin–at least in the US.
RickJay is Canadian, so presumably his doctor doesn’t have a DEA number.
Another former pharmacy tech here.
The reason it takes so long is because your insurer is incompetent and/or its computerized approvals system is arcane and inconsistent. Thus, for any new prescription (and to a lesser degree, refills or renewals) there’s about a 50% chance that your insurance company will decline to cover it, where or not it’s supposed to.
This requires a 20-minute phone call to a call center staffed with people barely intelligent enough to pick their own noses, let alone follow written instructions.
IOW, it’s not the pharmacist (usually) that takes forever to fill your prescription. All the RPh has to do is count the pills and give advice (and sometimes, not even count the pills - he can just sign off on the tech’s count). It’s the tech(s), who spends 50% of his/her working day or more on the phone with Aetna instead of grabbing bottles and such.
[sexist remark]Doctors, traditionally, were men. Most men (yes, not all men, I know!) have bad joined handwriting; if they want to write something clearly, they use print (separate letters). A doctor hasn’t enough time to write each prescription in print, so he uses joined writing.
The few times a female doctor gave me a prescription, it was perfectly legible.[/sexist remark]
But yes, the few times a doc gave me a nearly illegible prescription, I asked what it said. I’m a bit over assertive that way.
FWIW, my dad writes in gorgeous but absolutely illegible script while my mother’s usual handwriting (which her scripts were always written in) is very simple and easy-to-read print. Both physicians.
Me?
Not on purpose, no.
I’ve been embarrassed at times, when the scrip is brought back to me for clarification, and even I can’t read it.
My handwriting is basically legible if I print everything and write slow.
But I literally have to write in over 100 documents a day, sometimes over 200.
I have horrible writing, always have, always will.
I PRINT the drug name and dose as a result.
Quite often my writing is especially bad because I am trying to ask a question, listen to the answer and respond to it while thinking of the next question, all while writing it down as I go. It’s super multi-tasking at speed and penmanship goes out the window.
Nurses are renowned for their beautiful notes, but in my experience they sit down 3 times during a shift and take time to write down what has happened since their last note. I don’t get to do that. If I’m sitting writing in the notes I’m probably telling the nurses the treatment plan, ordering some investigations and possibly on the phone answering a bleep at the same time, uninterrupted note writing just doesn’t happen for me.
I have colleagues with lovely writing, I have colleages with awful writing, but generally they are writing, speaking, thinking and talking more or less simultaneously. You get used to reading other people’s bad writing, or at least recognising who is responsible for the scrawl so you can ask them what they meant to say.
My pharmacy fired the person responsible, and since then prescriptions have been trouble-free.
I really thought they made the pills. How silly do I feel now?
Marc
Me too! First time I got prescription medicine from an American pharmacy, I remember wondering what the hell was taking them so long, and then starting to think that maybe they were sitting in back working frantically with a morter and pestle, beakers bubbling in the background…
Some prescriptions are mixed in the pharmacy - children’s cold suspensions and other liquids, and various creams and ointments.
Also, if your prescription is for a pill strength that isn’t available, your pharmacist may have to chop pills in half.
Prior to about the early 1900s they often did just that.
And that is exactly why my doc and i discuss my medications in great detail, and any time we think that a change is in order for something nontypical I call Aetna and get it preauthorized [like my Byetta, or my indocin and colchicine] so I know ahead of time there will be no problem!
I am oddly anal compulsive about making sure that I go to one pharmacy only, and I keep a list of my meds and dosages [and assorted doctors] on a laminated card in my wallet, a copy is in my bosses desk, one very good friend from work has a copy and there is a copy posted on my fridge at home.
Right now mrAru and I are going through my parents house with a fine toothed comb removing all of my dad’s meds, and sorting out what are my mothers meds … and weeding out all the odds and ends of OTC remedies.
Anybody know a good vodun? I want to have Dad resurrected just so I can kill him again. Dealing with a mother with alzheimers onset while trying to sort through the funeral details, and figuring out where the damned will is [when Mom is crackers enough that she cant remember the name of his lawyer…] just reinforces my requirement to drop dead first and let mrAru deal with the details.
Tell me about docs’ bad handwriting. I am thankful for the electronic medical record insofar as it limits struggles with my colleagues’ scrawls.
As far as prescriptions go, things are getting better, even with written orders. Increasingly, potentially confusing abbreviations and jargon are being discouraged/forbidden by accrediting agencies and hospitals. At my hospital the list of no-no abbreviations for drug orders includes qd (meaning once a day, but it could be confused with qid, or four times a day). You can’t write for MS (morphine sulfate) anymore, as that could be confused with (I suppose) magnesium sulfate, which works just a bit differently.
More on countering prescription errors here.
This seems to have been covered, but what the hell…
Many docs have poor handwriting and most are in a hurry. Poor/ illegible handwriting can and does lead to med errors. As a nurse, I look forward to the day when docs type the scripts in, straight to the pharm. Then again, I’ve caught many a wrong dose/wrong med (ex-pt allergy) that a doc has written. With the nurse out of the equation, that leaves the pharmacist as the sole gatekeeper of correct meds (if the doc has not done so). So, there is a down side. I am referring to acute care here, there usually is no nurse in outpatient med issues (except in same day surgery where I have also caught errors. Docs are human and mistakes happen. These mistakes are rare in SDS, at least so far).
I know plenty of nurses with horrid handwriting, myself among them. My cursive has gotten very bad over the years. Nurses have time to do proper charting upon occasion–I’ve stayed many times after my 12 hour shift to do an hour’s worth of charting and more. But I am no fan of computer charting because it is so hard to read. It’s not illegible; it’s incomprehensible–the grammar and language is very stilted. Most computer charting that I’ve seen relies on drop down menus to add phrases into the narrative. The end result is not cohesive or adequate to the task, which is to provide a clear record of the events. IOW, we have a ways to go.
Don’t forget the Jacob’s Ladder, there’s always a Jacob’s Ladder.
In the case of my father (on whom be peace), I’d lean toward the explanation proffered by GuanoLad’s doctor. When we were cleaning out the ancestral house for sale, we unearthed a file of his notes from med school; and while his handwriting was always crabbed and backhand, there was a noticeable deterioration as time went on. I imagine that the multitasking referred to by Irishgirl played a part as well, as did a familial (benign) tremor that intensified in middle age.
About thirty years ago there was an obscure comic strip called “Doctor Smock” (so obscure that Wikipedia has no listing for it). In one episode, a patient asked the doctor about physicians’ handwriting, and the doctor replied that their penmanship teacher in medical school was a nearsighted chicken who drank a lot. Makes as much sense as any other explanation.