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Friday, September 19, 2014

Dear Doctor

...I would like to invite you to visit my pharmacy. I would like to take you on a tour. I have been to your office before. I have seen how it is run. I know how long your wait times are. I know how long you spend with patients. I know how your staff treats their patients, and pharmacists who call them. I wish for you to know the same about me.

The main reason I would like you to visit is to show you how we receive prescriptions from your office, and all the other offices in the area.

It was very nice of you yesterday to see a hurried patient.
It was very nice of you to tell her you would encourage us to quickly fill her prescriptions.
The only problem is the method in which you chose to deliver your message: The Notes Section of an E-Script.
That is SO not the way to deliver an important message to the pharmacy.

(For the record, the message read: "Patient is leaving the office now and would like to pick this up in 30 minutes.")

I didn't see it.
When I check my work queue, I don't see messages. I see names. Patient names and drug names.
If you wish to convey a message with a sense of urgency, please choose a more appropriate, expeditious method. I would go so far as to suggest, and this is only a suggestion, that you personally walk to the phone and call in the prescription to me. I know, it seems ludicrous to think that prescribers can use phones and actually call pharmacies but hear me out on this.
Back in the way way back, this is how it used to work. Short of a patient bringing us a handwritten prescription, offices used the telephone to transmit orders. Guess what? That antiquated technology STILL WORKS! All you had to do was call me, add a sense of urgency to the order, and I would have put her among my waiters.

Instead, your order got lost among the other 35 e-scripts that dropped from 4-4:30pm on a busy Thursday and, get this, the patient got mad...AT ME!

From now on, when patients ask me to send refill requests to your office, I am going to have them stand at my counter and watch me. I am going to send their requests via telegraph. I will input every order in Morse Code and tell them their office will be writing them new prescriptions that will be ready at the front desk when they arrive and they should go now.

Refill Request. Stop. Your Patient. Stop. On Way Now. Stop.

1 comment:

  1. You wanna know what's worse?

    Doctor sends an e-rx for nystatin ointment. The tech types it through, the other tech fills it, you get it at final check only to find a notes field that says "compound w/bactroban & hydrocort 2.5%".

    So now you have to back it out and redo it as a compound, or if you're the type who likes to take shortcuts, you just type through the other two ingredients as separate prescriptions and mix them after the fact. (Not like the PBMs pay you anything extra for compounding these days anyways.) Thus leaving you with a prescription with three numbers, which inevitably causes problems down the line when some moron refills only one of the three numbers and dispenses just the hydrocortisone, for example, leaving you with a compound that has only 2/3 of a refill.

    Not to mention what I got a couple years ago, where this genius of a doctor sent me an e-rx for hydrocortisone 2.5% cream, and then included the following text, verbatim, in the Notes field:

    "If covered Id rathr use 0.1% triamcinolone"

    So if you wanted me to dispense that, then why didn't you prescribe it, huh?!

    Or, back in December. Patient gets a few scripts e-prescribed from the doctor's office. One of them is for omeprazole 20mg. Script gets typed and filled, and as I'm checking the prescription against the hard copy, I happen to notice the following text in the Notes field:

    for treatment of h. pylori with flagyl+biaxin

    So just what does the doctor mean by this?

    Is this merely informing us of what the patient is taking it for? Is it telling us that the doctor has provided the patient with the two stated antibiotics? Or is it the doctor's backhanded way of telling us that he wants us to dispense them? And if the latter, what dosages? (Sure, I know it's clarithromycin 500 BID and metronidazole 250mg QID, but he has to be the one say that, not me. I don't have prescriptive authority in this state.)

    Tried calling the doctor: gone for the day. I left a note for the daytime pharmacist to call the doctor Tuesday morning, and sure enough, it was the latter. He sent us two more e-scripts for the antibiotics.

    Sorry, doc. I can't read minds.