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Wednesday, January 15, 2014

Airing of the Grievances

I have a problem with patients who believe they can bully and scream at pharmacy staff. I take a special kind of offense at other professionals who believe similarly. The following story is true.

Irritable Prescription Writer (a CNP): Isn't Hydrochlorothiazide (HCTZ) on your $4 list?
CP: We do not have a list, but the HCTZ capsules are $4 at many places.
IPW: I sent a prescription to you and the patient called me and said you charged him $20.
CP: <pulling up the original e-script> According to the e-rx you sent me, you selected the tablets.
IPW: I did.
CP: I filled it as you prescribed. For the tablets.
IPW: Why didn't you just switch it?
CP: It's not what you prescribed.
IPW: Don't you believe in customer service?
CP: Don't you believe in using the prescription to tell me exactly what I am to dispense?
IPW: The only reason I sent him there was because it's $4.
CP: Again, only the capsules. Every pharmacy has different products and prices. We are not the same.
IPW: <actual quote> "You don't really expect me to call around and look up the prices at each of the pharmacies where I send prescriptions, do you?"
CP: Actually I do. That would be part of your job. If you're going to send people somewhere expecting something to be a certain price then yes, you should do some fact-checking first.
IPW: Shouldn't you just switch everyone? You knew she didn't have insurance.
CP: But I did not. First, with the new year upon us, many people change plans. I cannot assume she did not get new insurance this year. Second, I cannot assume that her prescriber did not give her directions to take a half tablet on certain days. Filling for capsules would make that impossible. Third, there is this piece of paper called a prescription. It is what the prescriber uses to tell me what to fill. You selected tablets and I filled it as tablets.
IPW: Why didn't you change it when she told you she didn't have insurance?
CP: Let me see if I'm following this: You sent a prescription for a patient which I filled correctly. You told the patient it would be $4 and you were wrong. When the patient came in and we told him it would be $20, should he not have been keen enough to ask why? He could have refused to pay and asked us to change it. Then he goes home and yells at you because you lied to him and now you're yelling at me? I refuse to believe you are trying to blame me.
If you refer a patient with hemorrhoids to a psychiatrist and the patient complains the doctor never checked out his arse whose fault is it? The psychiatrist? Or yours because you didn't check around to see he needed a proctologist. Or the patient's because he didn't open his mouth to ask why he wasn't getting his "O" ring checked?
IPW: <actual quote> "Well I guess I'll have to start steering people away from your pharmacy then."
CP: Okay. First, that's illegal and prescribers have gotten in trouble with their Boards for doing that. Second, I guess I'm going to have to tell my patients to see a REAL doctor then.

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