Pharmacies

The BBQ Pit
81

[QUOTE=Capa84]
I know people fake pain med prescriptions, but do you really believe anyone would slice open their knee, insert a blood drain, and a pain medicine pump, wrap it all up and pop it in an immobilizer, and then come in and try to scam 30 vicodin?
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Maybe they do. I had an extremely similar situation happen to me after ankle surgery. Or are pharmacists so jaded and cynical that they assume no precriptions for painkillers are ever legit? I’ve always had mundane prescriptions (BC pills, antibiotics). I’ve never been treated anything but nicely by pharmacists up until then-- it was an eye-opener. They were kind of assholes about it.

82

My girlfriend has been on a variety of narcotics for back pain for a couple of years now. Duragesic Patch, check. Vicodin, check. Morphine, check. Never once has the pharmacist ever given her the Evil Eye[sup]TM[/sup] or questioned her usage.

I’ve never used those kinds of meds but if I were a legit Rx carrying customer, I would be sooooo pissed off if a pharmacist tried to insinuate that I was trying to milk the system. It wasn’t all that long ago that I read an article about a pharmacist that declined to fill a prescription for birth control for an unmarried woman citing “religious reasons” or some other nutty shit. No one has the right or responsiblity to monitor the morality of the rest of the world.

If the pharmacist was compelled to inquire if my Rx was legit, I would only assume that I would never know about it. A discreet call to the physician done out of earshot of the pharmacy bystanders would be appropriate. A sanctimonious attitude or :dubious: to the customer would be very inappropriate.

83

I’m bemused by the way that health insurance seems to handle drug costs in the US. If I need a prescription filled, I take it to any convenient pharmacy, get it filled and pay for it. When enough have accumulated to make it worth while, I gather up my receipts and mail them off to my health insurance company with a claim form (which I usually fill out on-line and print so they can actually read what I put down), and a couple of weeks later I get a cheque back for their share of the cost.

Admittedly, I have never had any esoteric or hugely expensive drugs, and only a couple of prescriptions that exceeded $100, but if I did, I’d just send my claims more frequently. This business of having to get everything approved up front, only allowing certain pharmacies to fill the prescription, only allowing specific amounts, and so on is strange. For me, if it’s a prescribed drug, it’s covered (with a few clearly specified exceptions), they pay 80%, and the reimbursement process is fast & simple.

84

[QUOTE=Ruby]
My girlfriend has been on a variety of narcotics for back pain for a couple of years now. Duragesic Patch, check. Vicodin, check. Morphine, check. Never once has the pharmacist ever given her the Evil Eye[sup]TM[/sup] or questioned her usage.

I’ve never used those kinds of meds but if I were a legit Rx carrying customer, I would be sooooo pissed off if a pharmacist tried to insinuate that I was trying to milk the system. It wasn’t all that long ago that I read an article about a pharmacist that declined to fill a prescription for birth control for an unmarried woman citing “religious reasons” or some other nutty shit. No one has the right or responsiblity to monitor the morality of the rest of the world.
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Confirming with a prescriber that the prescription is valid is not take responsibility to monitor the morality of the world. I’m pretty sure that NOT confirming the validity of prescriptions for controlled substances when it seems questionable, would have some serious legal ramifications.

I agree - refusing birth control because you feel it’s wrong has no place in the pharmacy. I know the chain I work for does not condone that practice and will take the appropriate measures to discipline in these cases.

Do you think we make these calls on the PA system? All these call are made discreetly as to not embarrass the patient. Some of these calls are not because of the patient, but because the doctor who wrote the script has been known to write excessive amounts for drug seekers. We’re checking the doc too.

85

Regarding Insurance Co-Pays or Drugs Not Covered

The pharmacy has NO CONTROL over what your co-pay is. Your company’s benefits administrator has chosen a Third Party Provider/PMB who sets the cost.

If your insurance doesn’t cover a drug at our store, it’s not going to be covered at one of our competitors.

Please don’t yell at us. We want to help you and get you your medication.
And one last thing:
If the doctor didn’t write for refills, WE CAN’T GIVE YOU REFILLS. IT’S ILLEGAL.

86

[QUOTE=DiosaBellissima]

I have Kaiser for my health insurance, which I’m sure will lead everyone to jump in and say, “Well, there’s your damned problem!” While that’s certainly true for a litany of reasons, it still doesn’t explain their policy to hold the pills for 24 hours. And I’ve been to 6 different Kaiser pharmacies here in town, so it’s certainly not just one that is having this problem. Maybe it’s just a my town thing and if that’s the case, I suppose I’ve got bigger problems (like being from Bakersfield :smiley: ).

And for those of you who don’t know, Kaiser has medical facilities and in each one is a pharmacy. If you want your prescription filled and you want it covered under your insurance, you have to go to their pharmacy-chain and only their pharmacy-chain.
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Here’s a question: Could the 24 hour wait possibly be because they don’t want you to use birth control as emergency contraception? (I’d read somewhere that normal birth control pills can be used in this way.) I have no idea how you’d ever confirm or deny if this is why the policy is in place, so I guess we can only speculate.

87

[QUOTE=Clockwork Jackal]
Here’s a question: Could the 24 hour wait possibly be because they don’t want you to use birth control as emergency contraception? (I’d read somewhere that normal birth control pills can be used in this way.) I have no idea how you’d ever confirm or deny if this is why the policy is in place, so I guess we can only speculate.
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Kaiser’s policy about prescriptions are that they want you to call 24-48 hours in advance for a refill. They don’t like to process them onsite because they get so backed up from the prescriptions that were written that day. The ones from urgent care or ER are priority. It’s a cost issue. Kaiser sends their refills to a factory located in Downey that fills the refill in a white bag. This factory even mails prescriptions for free to Kaiser members. Kaiser will fill your refill if you make a big fuss about it. If you make a scene or whine about it then maybe you’ll get a sympathetic pharmacy assistant or pharmacist and they’ll do it for you, but they always say call in 1-2 days when you see your supply going low. This factory processes about 42,000 prescriptions a day so it’s pretty busy. All So. Cal Kaisers like to send their prescriptions there to take the load off the work for them. I know the 24 hr Kaiser pharmacies do at least 1500 to 2500 prescriptiosn a day so if you do call in your refill over the phone it saves a lot of the workers the trouble.

88

Yup I know all the medications a patient is taking. It’s all on one big medicine kardex. This is a seven page booklet with sections for non injectable medications, stat doses, injectable meds, variable dose meds and PRN meds. A patient does not get a medication unless it is in the kardex. All doctors have to write in the kardex- as nurses have the keys to all the medications on the wards (yup, your doctor cannot get you so much as an aspirin). Nurse don’t give out ANYTHING until they see it written in the kardex.

When I clerk a patient in I get a list of their current medications, either as a prescription list from the patient, that is, an NHS prescription on NHS prescription paper, with a date within the last 2 weeks on it, and the patient’s name, address and date of birth on it, or as a faxed memo from their GP the next working day.

Anything I don’t like, I take off the kardex, anything I need to add gets added. During their stay, everyone else works the same way. By the end of the stay I can see what has been stopped, re-started, increased, decreased, held for a certain period of time…all of it. If the cardiologist stops the aspirin and starts clopidogrel, I can see when they did it and who they are. If the nephrologist stops the Diclofenac and starts paracetamol, I can see that too. If they missed their dose of aspirin this morning…it’s in the kardex.

The discharge letter is taken straight from the kardex, double checked by the computer software used to write the discharge letter, and then triple checked by me and my BNF. If I want to prescribe something a little bit out there I have to fight my way through pull down menus and “did you mean to do this?” prompts. If I prescribe one and a half tablets, it’s because one tablet doesn’t work, and two tablets works too well or makes him sick, not because I can’t read.

I know it has to be double checked by pharmacy, I just don’t see why a script with 75mg aspirin tablets as the only item takes 3 hours to process when the “polypharmacy from hell” script also takes 3 hours. Something is not working properly.

89

I can either say, “Hello, I wanted to know if my medication is ready yet,” or say, “Hello, my name is matt_mcl, my medicare card number is number, and I wanted to know if my medication is ready yet.” In the second case, I will then have to repeat my name and medicare number, because the person was not instantly expecting my name and medicare number as soon as they picked up the phone, since they don’t know what question I’m going to pose or, consequently, what information they’ll need in order to respond to me. That being the case, I’ll save my breath until the person’s ready to receive my information.

90

[QUOTE=matt_mcl]
I can either say, “Hello, I wanted to know if my medication is ready yet,” or say, “Hello, my name is matt_mcl, my medicare card number is number, and I wanted to know if my medication is ready yet.” In the second case, I will then have to repeat my name and medicare number, because the person was not instantly expecting my name and medicare number as soon as they picked up the phone, since they don’t know what question I’m going to pose or, consequently, what information they’ll need in order to respond to me. .
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Right. No use to spout that stuff until they are ready for it.

91

[QUOTE=DrDeth]
Right. No use to spout that stuff until they are ready for it.
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I agree with this. When this used to happen and I answered, I’d say “Let me check for you- please spell your last name for me…” and go from there. No one is asking the tech to be a mind reader.