Don't know if I should pit my doctor or my pharmacy...

The BBQ Pit
1

…so I’ll pit them both.

Dr. F,

You’re the one who decided that each refill had to be called in. That puts the responsibility on your staff, to return the pharmacy’s calls and authorize the refill. Perhaps the staff doesn’t think returning these calls is important. Is this happening with all your patients, or just me? Perhaps it is just me; perhaps you’ve decided I don’t need this prescription any longer. Hey, that’s fine with me. I’d be just as glad to stop having to deal with…

My pharmacy,

I called in my refill on Monday night, knowing I wouldn’t run out until Saturday. That gave you four full days to get authorization. Now, last month, you flat-out lied to me and six other customers, three of them senior citizens, telling us our prescriptions were ready when they were not. This time, you were nice enough to tell me that Dr. F’s office had not returned your call. Call, singular. No follow-up. Do you think that I, or any other customer, brings prescriptions to you on a whim? You call once and that’s the end of it?

Yes, I know now that I should have followed up on this earlier. Should have called during the week to make sure the wheels were turning. But the thing is, I had to do that last month as well, and that’s when the pharmacy lied to me, saying they’d heard from Dr. F’s office, when Dr. F’s office claimed to know nothing of this. I can’t quite pin down where the snarl is. All I know is, once that pharmacy on my street gets built and opened, the current pharmacy won’t see me for dust. Except that’s a cure almost worse than the disease; Dr. F’s staff’s heads will probably explode from the strain of calling a different pharmacy.

Fuck you all.

2

Rilchaim–You’ve got my sympathies on dealing with this annoyance. Can you call Dr. F and ask what’s going on?

3

Boy, do I feel your pain. I just don’t understand the lack of communication at pharmacies. Sure, it’s a pain to tell your customer that they’ll have to wait, but why, for the love of all that’s good and holy, can’t you give me a real estimate? Tell me 15 minutes, and I’ll hang around. Tell me two hours, and I’ll come back. But for fuck’s sake, stop telling me 15 minutes and then taking two hours! (Three times. Three times this has happened to me in the last month, and every time I ask, it’s “Just another minute or two!”)

And, when I ask you if my prescriptions have been faxed over from the doctors, that might be a good time to mention you got ONE prescription. The whole “sssss” sound on the end of my query might be a clue that I’m expecting plural, fuckwit.

And, when I’ve waited two hours for you to fill the one prescription you ensured me would be ready in 15 minutes, why the fuck do you think I’m going to believe you when you tell me it will be “just a few minutes” for the others? For fuck’s sake, people!

4

Scribble: Yes, and I will. Not that that will be easy. Dealing with his staff never is; his receptionist in particular. She has the same last name, so she must be his daughter/niece/cousin (I know she’s not his wife) and that seems to be her only qualification. There’s the additional factor of his being at the local hospital half the time. One of the med techs once put this in terms of “has to”, and perhaps that’s so, but it still leaves me up a creek.

And as I said, this is two-pronged. The pharmacy is also a clusterfuck, and this is going to mean a lot of calling one, then the other to tell them what the first said, then calling back the first to tell them the other did too say that, and so forth. All I know is, I’m not leaving the pharmacy tomorrow without at least enough pills to get me through the weekend.

WhyNot: Thank Og I only have one scrip. And I know it’s not an easy job, but it is their job. This is not like getting anchovies on my pizza when I didn’t order them. What do they do back there, anyway? (Seriously, can any pharmaceutically-experienced Dopers clue me in? It might make me feel less jerked around.)

5

Monthly renewals? What med are you on? I only do that for chronic medications if they’re Schedule II narcotics (it’s the law). Otherwise, the chronic med scrips I write for my patients are usually good for 3 months at least, more often 6 months. Rewriting continuing prescriptions is a PITA.

However, I have to call my own damn refills into the pharmacy monthly, since our health plan won’t dispense more than a month’s worth at a time. That’s a pain too. But they don’t have to call the doc each time, only when the original scrip expires. And my own doc and his office are pretty good in getting those renewed pretty quick.

6

It might make some sense to ask Dr. F why it is you can’t get a prescription that you can renew by yourself. Is the medication you’re taking a long-term maintenance thing? If so, there’s no good reason the pharmacy should have to keep getting approval from your doctor each month.

If you’re only supposed to be on the medication for a few months, why doesn’t Dr. F write you a scrip that can be renewed twice? This entire situation strikes me as odd.

7

I didn’t mean to ask if you could renew your medication. I wanted to know if you could refill your medication, with a simple phone call to the pharmacy.

8

It’s Dilantin, for seizures. Long-term, presumably for life. And it has to be authorized every month.

Not sure why. I do remember that early on, I would get blood drawn on a regular basis, after which Dr. F would cluck at me, “You haven’t been taking your Dilantin!” when I most assuredly had been. Perhaps he thinks I’ll slack off if I don’t have to do this? I dunno. All I know is, when I tried to get two refills at once last summer because I was going out of town, he wouldn’t authorize that.

9

That’s wacky. I’ll write scrips for dilantin that are good for 6 months, once the blood levels are stable.

Surely there are other docs in town? You don’t need a neurologist to manage a diagnosed seizure disorder for which meds are effective, most of the time anyway.

10

In cleaning out my e-mail inbox earlier this week, I found a message I had written to a friend about my evening spent in the Emergency Room with my mother after she tried to cut off her finger with a pie server.

At the end of the evening, we had two prescriptions to take in, and my mother wanted them filled at once, so we went to a different chain pharmacy than the usual one she goes to to get them filled. (Her usual is not open 24 hours a day. Has nothing to do with why she picked it, but it isn’t). So anyway, we turned them in, and sat down to wait. We were promised 15 minutes, but it was more like half an hour–not as bad as 2 hours, and judging by the number of people picking up prescriptions, dropping them off, or making phone calls, the people behind the counter filled Mom’s prescriptions about as fast as they could have expected to-- which made me irritated because if it is LIKELY to take a half hour, say so–it wasn’t like we were going anywhere till they got filled anyway.

In another small gripe, my mother has 3 or four things she takes on a regular basis–blood pressure medicine, probalby cholesterol-lowering stuff, and thyroid medicine.

As I understand it, the blood pressure and cholesterol stuff should be taken every day at about the same time, but skipping a day or two doesn’t really matter–at least in comparison to the thyroid stuff where skipping a day is a big deal.

Mom’s health insurance is through my Dad’s employer, who saves money by having people order medication 3 months at a time through the mail. Last summer, Dad ordered the medicines, and two weeks later they hadn’t arrived. Finally, after the date we expected them, they showed up. The Dr.'s office hadn’t called back on the thyroid medicine so it wasn’t included.

Now, due to details that make this different than Rilchiam’s situation, this was perhaps not surprising, or the fault of either pharmacy or Dr.'s office. But what bugged us was that they tried for a week and then used the mail to send the package–without ever even trying to contact us and say “Umm, the doctor’s office isn’t calling us back . . . so we’re not sending the vital, life-saving medicine, so um, maybe you ought to check this out before you run out”. That part, the lack of notification is what pissed us off.

Despite some stress, the situation was taken care of and Mom did not run out of medicine.

11

The one thing we have going for us is a fantastic pharmacy. These people will bend over backwards to help.

A good pharmacy can make a huge difference. I didn’t realize how big until we switched to these people.

12

My current pharmacy isn’t quite as fast as my last one, but they’re very honest with time estimates. They usually say an hour, but the refill is ready in 45 minutes or less. Not that I mind waiting – they have a lovely massage chair in their waiting area, and I go at times where there won’t be a lot of competition for it.

A couple of times, though, they’ve been a few pills short on one of my husband’s medications. They give him as much as they have and tell him to come back for the rest, but if he waits more than 24 hours to come back, they won’t give him the rest of the pills! We can’t figure out what’s going on, but it’s happened three times thus far. Our insurance is paying for the whole scrip; they should give it to us even if it takes more than 24 hours to get back for the last few pills! (It’s for something like Aciphex – not critical, but sure makes a difference in the happiness level of his tummy.)

13

It may be that the monthly refill requirement is an insurance thing which would bring a third party to your pitting.

I have the exact same problem and I can’t for the life of me figure out who is to blame. My insurance has a thing where you can get your meds in the mail and I am going to try that next. Luckily for me, I can miss a couple of days of my meds without serious effects.

14

The pharmacy in my pediatrician’s building is a total pain in the ass.

Now I take my prescriptions to Costco, and I love it. They are fast, honest and try their best to take care of the customer.

Nice change of pace, really.

15

I work in a doctor’s office, and I can tell you one way to make things go much more smoothly:

  1. Ask for the fax number of your doctor’s office.

  2. Write down what you need done. Be certain you include the name of the drug, the dosage instructions(1), plus the voice AND fax number of the pharmacy you use. Also be sure to include YOUR OWN NAME and telephone number, in case there is any question.(2)

If you are efficient and take multiple drugs, create this as a template you can fill in the blanks as needed each time.)

  1. Fax this page to the doctor’s office yourself when it comes time for a refill.

  2. Call the pharmacy the next day to be sure the pills are ready for pickup before going there.
    I assure you this will be much, much easier on you AND the doctor AND the pharmacy.

The thing is, a fax is MUCH less likely to be overlooked than a scribbled down message by the receptionist AND there is way less chance of any mistakes happening.

(1) Sure, all of this information is on file, but your doctor is busy, and if he has to go look through your file, you are much more likely to have to wait until he ‘gets around to it.’ Whereas if he has all the information written down for him, he can make the call and be done in 15 seconds.
(2) It would amaze you how many voice mails go something like, "Hi, doc, I need a refill on my heart medication. <click> Do you really imagine your doctor can recognize all of his patients by their voice, filtered through an answering machine?

16

Well, I’m back. I got four days’ worth of pills. And hajario was right: the insurance company is the third Fate. They only spin out so much thread at a time.

However, I also discovered that the pharmacy didn’t “call” the doctor’s office; they faxed the request. And the fax was ignored. So much for that. So now I’m going to have to lay down the law with Dr. F. I think I’ll go there in person. Thanks to all who replied!

17

Hang on - I’m not sure how this prescription stuff all works over there and it’s making me a bit confused.

Over here, I go to the Dr. and he decides I need a prescription for whatever. So he writes or prints a little slip that says “Siobhan needs blah amount of amoxyoxycillinax for 2 repeats” and off I go. I go to the pharmacy, whichever one I feel like going to and hand over my little slip with my medicare card. The pharmacist assistant says “That’ll be about 15-20 minutes”, I go off to do some shopping or read a book, then come back and they give it to me along with my medicare card and I pay for it. If there’s a repeat they give me that slip back too and tell me when to go and fill it again.

AFAIK, that’s the standard for any prescription medication over here. If it’s signed, and has the Dr.'s name and number on it then the pharmacy fills it. There’s none of this faxing or calling or having to call it in a week in advance that you guys are talking about.

If you’ve got a scrip, why does the Dr. need to fax anything to the pharmacy, or vice versa?

18

Right. But the OP’s doctor isn’t writing the scrip for repeats/refills. Just the one month. But she needs to stay on the drug for longer.

19

In theory, that’s how it works here, too. Except that now, for your “convenience”, your doctor’s office can fax the prescription over to the pharmacy, rather than give you a slip of paper. The pharmacy gets it and I believe has to call the doctor’s office to verify it (so we’re not all printing “prescriptions” from our laptops) before actually filling it.

It sounds like Rilchiam’s doctor, rather than making the prescription refillable X number of times, wants him to check in once a month over the phone at least, and so makes the prescription for a 30 day supply only. The second month’s supply is not technically a “refill”, but a whole new prescription which has to be faxed and verified as if it was new. Or presumably **Rilchiam **could drive to his doctor’s office and get a new little piece of paper each month.

After my experience with the mysterious disappearing faxes, I’ve switched to the old fashioned slip of paper, but my pediatrician’s staff is not happy about it, for some reason. Still, I insist, and they’ll provide it.

However, I did lose a prescription for Vicodin somewhere in the drugstore. Never did find it, and was too embarrassed to get another from the hospital. So I just used OTC Tylenol and ibuprofen instead. Woulda been nice to have that one faxed over since I wasn’t exactly thinking clearly at that point … :smack:

20

I also work in a doctor’s office, and I deal with refill requests a lot. I know that sometimes there can be a few days’ worth of messing around trying to get a refill, and it should definitely not be like that.

I blame Medical Records in our office. They deal with all paperwork coming in, including refill requests faxed in. For some reason, they just don’t make them a priority, I’m not sure why. I know that when I’m assigned to phone calls from patients, I’ll go to MR occasionally and get the requests and find the charts myself, rather than deal with a bunch of irate patients calling.

A good pharmacy, though, can really minimize the hassle- they will keep faxing and start calling, too, if they don’t get a timely response. Certain other pharmacies will only contact us if you pitch a fit with them. Find a pharmacy that cares about customer service and your hassles will decrease.