How do I get my doctor to use a compliant prescription form?

In My Humble Opinion
1

I like my doctor very much. In fact, my wife and I both go to him and find him to be a knowledgeable and compassionate practitioner. Once, when I asked him about potential drug interactions between an OTC product and the medication he had prescribed for me, he got the PDR out and looked it up in front of me. I found this admission that he didn’t already know all the answers to be somehow reassuring. No matter how much training and experience you have, you still need to do your homework.

However, I have a couple of small problems. I use a Schedule II controlled substance, which (a) can’t be refilled, and (b) for which the prescription blanks are required to have several security features as spelled out in the California Health and Safety Code § 11162.1. The difficulty is that the doctor keeps writing my scripts out on the wrong type of form–and specifying refills! When he hands me the prescription, he says he’s specifying two refills and tells me to continue using the med for three months and then come into the office.

Showing admirable good nature, my pharmacist has been filling these prescriptions, after going through whatever hoops she has to go through to verify it. But after several months of this, she says she won’t fill it anymore unless the doctor uses the right form. I can see her point; I don’t think my doctor is doing anything maliciously, but if he’s writing out these prescriptions on the wrong blanks, then what’s being done with the right blanks?

I don’t want to change doctors or pharmacists now. The pertinent question for me now is, what’s the most diplomatic way to get my doctor to use the right prescription blanks? The pharmacist gave me a copy of a sample form with annotations describing the security requirements yesterday. Should I just write the doc a short letter and include a copy of the sample form together with the relevant statute? I’ve talked about this with him several times already, so sending a letter seems over the top. How do I do this without saying, as it were, “I’ve been telling you and telling you…”

I once had a similar problem with a different doctor, but that was just a one-off. It seems California changes its controlled substance prescription form requirements every couple of years and a lot of people are caught off-guard.

2

He almost surely has an office manager or at least a secretary. I’d call and speak to that person.

3

You could send the letter explaining that your pharmacist requires that particular form. That’d give the doctor some lead time to bone up on the rules and get the forms in stock, assuming he doesn’t have them.

Or you could just take the sample with you next time you see the doctor, and tell him your pharmacist won’t fill the scrip unless it’s on that form. If he refuses, it’s probably a sign that you should switch doctors.

4

I doubt it’s just you. You might ask the pharmacist to give him a call and explain that from here on out any incorrect scripts will be refused. Unfortunately, that’s going to mean the patient making an extra trip back to the doctors office to get the correct one. But it might get the message across.

Beyond that, I think your best bet is going to be just telling the doctor. Next time he hands you a script just say “Hey, the pharmacist said she won’t fill this any more unless it’s on the right form” and see what he says. I know you don’t want to risk pissing off your doctor, but in the end if he doesn’t comply you won’t get your meds, then you’ll HAVE to switch to a new person. Don’t forget, that pharmacist can get into heaps of trouble with the DEA for not having everything filled out properly.

5

The doctor has someone in his office working for him whose job it is to know the laws and keep him compliant, most definitely. I’d be wanting to know why you’re even having this problem- it’s not your doctor, it’s his office person that’s slacking on this.

6

Just point it out nicely!
“I’m not sure you realise, but it appears there has been a problem with my prescription beacuse they were on the wrong form, would you mind sorting it out for me- the pharmacist says it needs to be on form X instead of form Y.”

It might just be that your doc forgot that it was a scheduled drug, or picked up the wrong form in error, or just had a brain fart or “senior moment”.

Nobody’s perfect, and I’m sure your doc would rather have the opportunity to correct their error than have you miss out on your meds or change doctor without an explanation.

7

If he does not use the appropiate form next month, YOU refuse to take it - your pharmacist is sticking her neck out by not having the paper trail required for Sch drugs

8

I used to tell people this when they would ask me to break the law: “If a pharmacist is willing to break the law for YOUR benefit, what might they do for THEIR OWN benefit?”

The laws are there, for the most part, to protect you, the patient, from me, the pharmacist. Most of them are there for very very good reasons. Special forms and no refills on C-II scripts are near the top of my personal list of laws backed by sound reasoning.

miatachris, R.Ph.

9

You’re both grownups. Why not just explain the problem?

10

He’s not a god. Just tell him the next time you need a prescription to put it on the right form. Tell your pharmacist requires it to be on the correct form to be compliant. You already gave an example of him acting humbly in front of you…why are you afraid to just confront him. If he’s not an arrogant ass (most doctors aren’t, just a few) he’ll probably apologize and put it on the right form.

11

The fact that the pharmacist can fill it means there is some wiggle room here.

First of all can the drug be called in or faxed in from the office? I’ve had my doctor office do that. I go to Walmart which is a far trip for me, so I have them fax over the prescriptions to Walmart first

The key thing is when you confront your doctor don’t be a smart guy about it.

Don’t tell him he is doing anything wrong. Yes he is but why make a thing out of something unless you have to. There are enough battles in life you have to fight without asking for another fight.

Just simply say, “Excuse me doctor, but is this the correct prescription form for that kind of drug? I think my pharmacist said it was not correct and I would hate to have to bother you for another prescription form later on.”

The fact is the pharmacist CAN fill it. She’s not breaking a law to do it. If it was illegal she wouldn’t do it at all. She just doesn’t want the extra work of calling the doctor back.

If it was me I’d talk to the store manager and say, “Look your pharmacist just told me to take my business elsewhere.”

Yeah the phramacist is correct, but you don’t chase away business. The thing is the phramacist ISN’T doing something illegal to help the patient. She wouldn’t do that. What she is actually objecting to is going out of her way to make a sale.

It’s like if I walked into a store and paid with pennies and the clerk told me to go away.

Again, I’m not saying the pharmacist is wrong. She’s right, but she’s trying to make out like she’s doing something illegal or underhanded and she’s not. If you had to use a correct form, she would not fill that prescription regardless. The fact she IS filling it means it’s OK to do so as long as she checks and she doesn’t want the extra work.

Again, she’s not wrong, but you don’t chase away business because it’s extra work. And I’d let the manager of the pharmacy know that’s what thay pharmacist is doing.

12

I’m getting here late but I have to comment about him looking up the info in the PDR. This is routine. There’s no way they can know all the drug/prescribing info. That’s exactly what the PDR is for. It’s called the Physician’s Desk Reference.
Especially if he was looking up drug interactions. I would be suspect if he didn’t look something like that up.

As for your schedule II drug problem. I also take a sched II for which I have to pick up every month. It’s a pain to say the least. I’m shocked that the pharm went along with it. If I brought my Adderall script to the pharm w/o the proper script paper or it had 3 refills on it, there’s NO WAY the pharm would take it. (NC doesn’t require a different form, they all have a security id on them) He should know the rules for a sched II drug b/c he is the one they’ll come looking for if it gets snagged by review. He’s being pretty careless about that for sure. Doctors very diligently keep up w/ the changing controlled substance rules as they change frequently everywhere and they are scared as hell of the DEA.

Is he an older doctor? Is he senile? Seriously, some of the older docs just get sort of fast and loose with the rules. You are going to have to be a pain in his ass until he gets it. If my doc writes a mistake on my script then I go back into the office and tell them. I had to wait a few minutes but he fixed it while I waited. Once, I got all the way to the pharm and they caught the error–I had to go back to office for him to fix. They can’t do the sched II over the phone. So from then on I check before I leave the office.

13

I’d bet the pharmacist has been getting the right paperwork, they’re just working back & forth directly with the physician office to do so. My pharmacist has had to do this a few times on my mom’s Sched II stuff, especially when they change the rules.

The pharmacist is no longer willing to spend her staff’s time doing this. That’s reasonable - the problem is at the doctor’s office, and there’s no reason for him not to do the right paperwork the first time.

I’d probably call the office manager and ask them the best way to handle this. If it’s something as simple as getting the right pad of blanks into the doc’s hands every day, this could solve it.

OTOH, some great doctors are…difficult…to get working within the rules, especially changing rules. If that’s the case, I’d address it with the doctor next time he writes the script. “Sorry, Doc, but the pharmacy won’t take these any longer. It’s not the right form.” I’d bet the doctor may gripe, but would rewrite the scrip.