Difference?

CP: What is the difference between an alternative and a substitute? 

CPP: A substitute is a replacement of like for like while an alternative is a second option?

CP: I'd be happy with that. Here's what my favourite dictionary had to say:

Alternative: (of one or more things) available as another possibility or choice. 

Substitute: A person or thing acting or serving in place of another. 

CPP: Seems right. Why the lexicological lesson?

CP: What about as it pertains to medications? Is there a difference? 

CPP: Yes. Why?

CP: This interaction with Dr. Zoffis:

 

CP: Dear Dr. Zoffis. The medication you prescribed, Doxyxycline 40mg, is not covered. The patient's insurance requires an alternative in order to pay. Please change the medication prescribed to an alternative. 

DZ: <no answer>

Patient Annoyed With Said Doctor: Why can't I get my medication?

CP: Your insurance won't pay for it. It's not on their formulary and they wish for an alternative. Your Dr. Zoffis hasn't replied to our faxes and telegrams yet so it may behoove you to ring them. 

PAWSD: <from pharmacy> My pharmacy won't fill my medication. They said you need to change it and they faxed you. 

<fax arrives> *

CP: I got it. 

PAWSD: They said they clearly indicated on the hard copy that you could substitute this if it's not covered. 

CP: I see that. I learned to read at an early age. Also, they were even nice enough to circle it in Sharpie. 

PAWSD: Then why didn't you substitute it?

CP: Therein lies the rub. I did substitute it, for the generic. However, an alternative therapy is not the same as a substitute therapy. I can substitute from brand to generic and vice versa, but I cannot select another drug or strength as an alternative. Your doctor can check all the boxes they wish, but until they select an alternative therapy for you, they are the ones holding up your therapy, not me.

 

CPP: I see. And how did Dr. Zoffis respond? 

CP: They switched it to 100mg. 

CPP: Let me guess, they didn't select hyclate or monohydrate or tabs vs caps and we had to call?

CP: Yes. That really made their day when I had to inform them it still wasn't correct and the two salts were, technically, alternatives not substitutes. 

CPP: Ass Baggins, a little?

CP: After their initial tirade, they deserved it, a little. 

 

*some of the timeline has been truncated because we all know offices don't work this way/quickly.