In the beginning there was a doctor. He wrote prescriptions. There was also a pharmacist. He filled prescriptions. And the world was good. I am not a doctor, nor do I play one at work. However, it seems that we as pharmacists have let the lines blur a little too much in what is each person's role in the whole healthcare dynamic. One of my favourite quotes to customers is "I don't work in your doctor's office and he doesn't work in my pharmacy". I often use this to great effect after a customer is sent directly over from his doctor after being told any or all of the following: "your prescription will be ready by the time you get there", or "it's on their $4 list", or "Augmentin is only a few dollars, don't worry". Well, I can't tell you the last time I saw your doctor here, let alone actually spoke directly with him, so don't believe everything he tells you.
Today I realized it has gotten so out of hand that we pharmacists haven't even noticed we are now employed by every doctor in town. While waiting interminably on hold (pharmacy hold times aren't always better, I concede), to clarify a poorly written prescription, I heard this message: "We are requesting that all refills be faxed. Please contact your pharmacy and they will fax us for you". Another office used the similar "please notify your pharmacy to send a fax to us".
Excuse me? What? When did we allow other people to tell us what our job is? (Oh yeah, when we sold out to mail order and PBM's over the last 10-15 years. But this is different.)
Anyway, I have decided that I need paid. If the doctor requires I fax your refills to her, I am going to send her a bill at the end of each month for every one that I send. Yes, most faxes are generated electronically but I still have to answer your phone call after you have already talked to the office. Since the doctors would like to place the onus on us if a refill is not authorized, I would like to be compensated for this responsibility. We all know that faxes do not get received, doctors ignore them, lose them, forget to sign them, etc. As I have mentioned before, I cannot fill prescriptions I do not have. The patients know we are the only ones they can yell at directly and therefore, since the doctor requires we fax them, we must be the most culpable if the process breaks down somewhere. If the fax number is incorrect or missing or a doctor enters or leaves the practice, I have to track this down for you. A precedent has already been set in other similar situations. Doctors requiring pharmacists do NOT send faxes will charge the pharmacy for each one they receive. Doctors also charge patients a full copay for any refills they require outside of an office visit.
To further support this, my second resolution is to post on my hold message the following script: "Our pharmacy requires that all new, paper prescriptions be sent electronically or faxed. Please contact your doctor and ask her to invest in this new technology and to stop hand writing prescriptions as we will no longer accept these." Perhaps we should charge to fill illegible scratch. I may be on to something here. But that's another story.