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Thursday, April 1, 2021

I Want Half!

CPP: What are some things that bother you that shouldn't?
CP: Directions that should change but don't. 
CPP: That's rather basic. 
CP: Here are the two annoyances that came to mind this morning:
Option 1: 
Sig: Take 1/2 tablet by mouth once a day for 30 days. 
Notes: pt states she has been taking 1 tablet a day since May, 2019.

CPP: Yeah. It would be nice if they would fix that. 
CP: Not only is it confusing (is she really still taking one tablet?) but why are you letting the patient determine her therapy on Lasix? When you ask me which providers are on my "never go there" list, lack of attention to detail or not reviewing my therapies with me is right on top. It's been two years! Phix it!
CPP: Of course you called the office, instructed them to fix it then resend it while subsequently deleting this Rx. 
CP: Natch. 

Option 2: 
Sig: Take 1/2 tablet by mouth once a day for 7 days, then increase to 1 tab daily thereafter. 
#30 with 11 refills. 

CPP: I love this one for so many reasons. 
a. what do they do with the extra 1/2 tablet? when do they take it?
2. since there are refills, do they restart this taper each month? 
z. will the office continue this Rx year after year as in Option 1? 
CP: Don't be daft. It's obvious. Since the directions will remain the same on each bottle, the provider wants them to taper it each month and year after year. That extra half tab is the start of the following month's taper.
CPP: You know this will reignite the "professional judgement" vs "I'm afraid. I must call the office" debate. 
CP: Yep. As planned. Should we bring up Chantix Starting vs Continuing Packs refills? 
CPP: Nope. I'm still bothered by the leftover tablet though. Why can't they just write the directions for an even number of days?
CP: Prescribers are sent to school to learn what to think, not how. Simple math and basic handwriting are electives and the rooms sit empty during those lectures. 
CPP: Especially since they have e-scripts to calculate everything. 
CP: Which they still manage to phuck up. "Okay. I want 60 tablets for a 30 days supply and if I write 'bid' that will fix it". <writes directions as "2 bid" instead>
CPP: Right?
CP: But, as with everything else, the pharmacist will phix it. This always reminds me of my favourite John Grisham quote: "If it wasn't for lawyers, we wouldn't need lawyers."
CPP: You mean: "If it wasn't for prescribers, we wouldn't need pharmacists"? 
CP: Something like that.

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