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Thursday, July 27, 2017

Not My Job, Not My Blame

The last thing I heard her say before she slammed down the phone was: "You need an attitude adjustment".

Quick Background: Prescriber sent an e-rx for 60 tablets of Tramadol. The directions were clear (it's an e-script after all) that the patient was to "Take one(1) tablet by mouth UP TO 3 times a day as needed". The prescriber also indicated this was to be a 30 days supply.
All of this is totally normal for a pain clinic. The patient's previous Rx, also electronic, was for 60 tablets as a 30 days supply to be taken "one(1) tablet twice a day as needed".
Many pain clinics want their patients to stick to "as needed".
Again, normal behaviour.

Woman Is Thus Calling Herself: I am calling from Dr. Zoffis about the Tramadol Rx.
CP: Yes?
WITCH: I wanted to make sure you were going to fill the extra 30 tablets we sent over today.
CP: I will.
WITCH: Good.
CP: In 6 days.
WITCH: Why?
CP: It's too soon until then.
WITCH: We wrote the wrong quantity on the Rx. It should have been for 90 tablets to last a month.
CP: But you didn't. Unless the directions change, the insurance won't pay for it for 6 more days. Since I also have to report it to my state's PDMP program, I have to wait until it is due.
WITCH: Why didn't you call?
CP: Excuse me? You wrote a completely valid prescription and now you're telling me it's my phault the patient is out of medication because you can't do math?
WITCH: I've had pharmacists call on this all the time.
CP: You really need to go back and read my post on "Professional Judgement" from last week. Too many people calling on stupid stuff means you don't fix the big stuff. If they're calling you, maybe there's a reason . . .
WITCH: You should have called.
CP: And you should have proofread the prescription. It's a totally valid, normal, understandable prescription we see all the time from pain clinics. Do not try to blame me for your mistake. "It's bad enough you screw up regular prescriptions and I have to call, now you want me to call on ones without errors to make sure there are no errors?"
WITCH: How can the patient get her prescription?
CP: She can wait 6 days or she can pay cash for it today and I will document our discussion.
WITCH:  What if the patient is unwilling to pay cash?
CP: Then I will send her to your office and tell her to ask you for a check to cover her copay, since it was your mistake.
WITCH: That's not very professional.
CP: Neither is blaming the pharmacy for your mistake, which I'm sure is how you presented it to the patient.
WITCH: You need an attitude adjustment.
CP: Yep. I'm no one's bitch and people don't like that.

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