Nowadays, most people have the necessary software to create fraudulent prescriptions, or to edit legitimate ones. So I’m wondering . . . Before filling a prescription, do pharmacists check back with the doctor, or do they just assume that every prescription is legitimate?
My primary care physician never gives me written prescriptions any more. He just types the prescriptions into his computer, and sends it over to my preferred pharmacy. This is partially to prevent prescription fraud, but it’s also helpful when I tell him that I received a powder when he prescribed a cream. I bring in the bottle of powder, and then he calls up the pharmacy and tears them a new one. Usually my office visits aren’t nearly this entertaining, though.
At any rate, my PCP said that he really likes this new method. I think that we might see this as a default method of providing prescriptions.
I know that in the past, pharmacists inspected certain types of prescriptions more closely than others…a prescription for a yeast infection would almost certainly not be given a second glance, but one for Valium or a powerful painkiller would be closely looked at.
I’ve noticed that when I get a prescription for something remotely abusable, it’s written on special prescription paper that can’t be faked. There’s a watermark on it that fades if you breathe on it. I’ve gotten prescriptions on that paper for Ritalin and Vicodin, though I’ve also received Vicodin prescriptions on regular prescription papers.
I suspect that the pharmacists also keep their eyes open for likely fraud.
There are certain drugs that get forged a lot, and the people forging always ask for certain drugs. When we get a script for Hydrocodone/APAP 10/500 #120 Take 1 tab four times a day with 5 refills, we double check it. When we get a script for a z-pack, we don’t.
When you work in a pharmacy for awhile, you get a sorta sixth sense when it comes to prescriptions. Forgeries normally have something that gives them away, be it the drug/quantity asked for, or the script is just too perfect, or they just make a mistake.
Oh, and when they ask if we have the Watson 349’s to fill their Vicodin script, that’s a dead giveaway.
Slight hijack…
How does a doctor identify themselves when they call in a script over the phone? Is this more or less secure than written prescriptions?
Well, most of the time the doctor themselves do not call, they have their “agent” call (normally a nurse, but sometimes just a receptionist). Most of the time they just leave a voicemail, but if they speak to the pharmacist, normally they just say they are calling in a script for a patient.
As for how secure, well, anyone could leave a voice mail. However, if the message seems weird for some reason (drug, dose, frequency, or just not leaving the message “normally”) we will double check it, just like we would a written script.
Most criminals who forge prescriptions, be it written or oral, are stupid, and do something that gets them caught. Also, a pharmacist gets used to the doctors around them, start to recognize their hand writing or the agents who call for them.
Two questions to supplement this thread: First, when a doctor emails a Rx, is it instantly filled? Is there some stop-gap where a pharmacist must wait for you to ask, or does s/he fill it automatically? Second, about traditional scripts…how can the pharmacists read the doctor’s writing esp. eb assured a scribbled signature is legit?
When my doctor sends a prescription to the pharmacy electronically, it’s usually filled by the time I get from the doctor’s office to the pharmacy. This always takes me at least half an hour and sometimes longer, depending on the time of day and traffic and such. This is about as long as the pharmacy will normally take to fill a prescription that I drop off…that is, it usually takes them at least half an hour and sometimes quite a bit longer once I’ve dropped off the physical prescription. I find it very handy to have the prescription ready and waiting for me when I get to the drugstore.
How do you know this? How do you know you’re not just catching the stupid ones, and the smart ones are getting away with it?
At my pharmacy, when a doctor sends an e-prescription, it just appears into our queue just like if you called in a refill. How long it takes to actually fill depends on the workflow, the backlog at the pharmacy, and if the doctor actually sent the e-script correctly (It is rarer then you think! Doctors almost always make some sort of mistake on them).
As for the Doctor Hand writing… Actually, sometimes we have trouble reading their hand writing. However, normally we can make out the drug and the sig without a problem, though part of that is knowing around what it should be saying. The hardest thing to read on a script is normally the patients name. The only time we need to read the signature is when the doctor’s name isn’t elsewhere on the script (normally only happens with an ER), or there are multiple doctors and they didn’t circle their name. In the first case, if we can’t read the name, a lot of time we will just put the script under the main doctor at that ER. In the 2nd case, we normally only have to read the first letter to know which of the doctors to use. If it is a controlled substance, then a lot of times we can just look up their DEA number, which is a lot more readable.
It is possible, but most do make some sort of mistake… even if their only mistake is to keep forging a script after they succeed once. I remember there was one person who was passing forged scripts in my area for over 6 months. He was finally caught because a pharmacist was doing overtime at another store, and recognized him from their own store. Peaked her curiosity, so she pulled the scripts he filled at her store and called to verify them. So, his only mistake was to repeat the same crime, with the same M.O., and the bad luck of going into a different store which had the same pharmacist working… But he was still caught.