Thursday, July 7, 2016

Dear Physician: e-Script is NOT a Reminder Service

It was a normal busy pharmacy day. Lots of sick people dropping off prescriptions, phone ringing, etc.

A quick glance at the computer at one point:

"You have 4 new e-Scripts waiting in queue."

So I process them. Two of them were for OTC Zyrtec and Claritin. That's not unusual. We get prescribers send over scripts for these two medications for people on Medicaid because depending on the plan, sometimes they pay for them. Usually we don't see two of them, but allergies have been really horrible this year so I process them and the techs fill the scripts. His insurance doesn't cover them but they're not expensive for cash.

Later in the day the allergy dude shows up for the scripts. I'm checking him out when he stops me. He doesn't want the generic Zyrtec or Claritin. I ask him why. He says that the doctor sent them electronically to REMIND HIM to pick up those medications in the store.


Yes, you read that correctly. The doctor used the e-Script system to send over two prescriptions which we consequently processed and filled NOT so the patient would get them from the pharmacy, but rather just as a "reminder" for the patient to get those medications. We spent time and money for nothing so the doctor could use the system as a reminder service.

Unbelievable. Just jaw-dropping unbelievable.


Anonymous said...

That is ridiculous! Why didn't the doctor just write it down on a piece of paper & give it to the pt? Wait, I know, it's because the doc gets a few cents for every e-script sent, right? One of my pet peeves is when the doctor uses the "note" area on the e-script to tell me to tell the patient that they need labs or an appointment. Sorry, doc, not my job. You want to get a message to the patient? You have their phone number in the chart, call them yourself!

Anonymous said...

This is what drives me nuts.

There are a lot of things I do as a courtesy. Heck, there are things I do simply because no one else is willing to take responsibility to take care of people and most of the time I'm just feel like being nice.

BUT, when it comes to the COURTESY fax refill requests, if it doesn't pertain to a new Rx, I just trash it. Appt reminder from the secretary with no Rx? Garbage. Lab reminder with refill rejection? Screw you, not my job, call YOUR patient on YOUR own time. "Not my patient" written in what looks like crayon? Meh, "Not my problem." PA fax sent back all crossed out with what looks like a few scribbles in the corner as a controlled substance Rx? Oh, hell no.

What's sad is that I'd like to help all these people and I'd like to seem like a 'team player' to all these doctors offices that like to monopolize my time. Then I blink, shake my head a few times and bring myself back to reality where a soccer mom is having an emotional meltdown in front of me because her Xanax Rx is a week too early and hasn't even been sent to us yet while the phone is ringing off the hook with people in line at the register AND dropoff staring daggers at me.

Sorry office-type folks. While you're allowed to close that glass partition and sneak off for breaks and even go to the bathroom when things get crazy (not to mention shutting off your phones for a few hours for 'lunch', gotta say that makes me insanely jealous), my techs and I have no where to hide from open to close. So again, I'm sorry I can't drop everything I'm doing to do YOUR job. So put down your overpriced Starbucks beverage, get cozy in your comfy swivel chair, pick up that phone, give the next person in line 'the look' while raising a finger to indicate just how busy you are and do it yourself.

Anonymous said...

I am a doctor.
I get paid nada for e-scripts, or regular scripts, or phone-in scripts, or any other method of sending a script.
I have also received exactly $0 in my life from drug companies as a kickback for writing a particular drug.
Please do not perpetuate these absolute lies.
Thank you.

Anonymous said...

I will note that from the doctor side, roughly half of the 'courtesy Rx requests' I get from the pharmacy are wrong in same way:
1)script sent in 5 days ago with refills-this happens at least a dozen times a day
2) script changed last month from Drug a->B and noted in NOTES section that this is replacing drug A
3)pt has never been written for this drug by anyone in this practice
4) drug last written 6 years ago
5)not my patient and never been my patient
6) refill requests for 2 drugs from same class from same pharmacy on same day
7) birth control pills for a male(admittedly only once but memorable)-no he was not transitioning gender

Anonymous said...

If a doctor sends in a script just as a courtesy reminder for a patient, not for me to actually fill I calmly tell him that the next time he wastes my time in such a manner I will fax the collecyed works of William Shakespeare to his every single day for a year. If you dont want me to fill it and bill it for the patient, dont send.

In regards to the anonymous doctor above me I would like to let him him know a few things:
pharmacies know most of the cock-ups are due to the idiots you hire to be front end staff, but just as we are responsible for our techs you are responsible for your people too.
Most of the problems listed above are the results of patients' calling in old numbers that you docs have already reauthorized, and the computer sends a refill request before we can stop it OR
Autofill. Mother...bleeping...autofill. Wonderful idea that the idiots who program can never make work right.
Just remember the golden rule of pharmacy-doctor relations: we dont want to fax or call you ever. So its either important or a mistake. Loosen your sphincter and take a breath cause you dudes dont have it any less stressful than we do

Anonymous said...

@anonymous 7:40am
I will note that from the doctor side, roughly half of the 'courtesy Rx requests' I get from the pharmacy are wrong in same way
The problem on the pharmacy end is that customers have full access to sending those damn requests. We as techs and pharmacists have no control over which Rx#'s these morons input on their end. You can thank our MBA corporate overlords for that one.

My problem is that on the doctor's office side, that's not the case. Doctors, RN's and secretaries consciously choose to send bogus replies. I go out of my way to delete crap requests and just throw out passive/aggressive replies to clearly erroneous fax requests from PATIENTS. Because you know what? In the end, it saves me a headache from having to listen to people screeching at me on the phone for whatever lame reason that they chose to completely lose emotional control just so that they can feel a little better about themselves. That would be both patients and office staff.

Anonymous said...

What we need to fix is the root cause of the problem: entitled, spoiled 'Muricans.

You know what I'm talking about. The type of customer that expects people like doctors, pharmacists, techs, nurses and secretaries to cater to their every need regardless of whether or not it is pertinent to level of care they actually need.

These a$$hole$ are the reason that healthcare providers feel the need to attack each other. This needs to stop now. These spoiled pieces of crap need to learn that healthcare is not like their local fast food joint. You are NOT going to get what you want. You are going to get what you NEED. Period. Don't like it? Move the f*ck on.

Ok, sorry, needed to fantasize a bit there. Reality? Reality is that my boss is a MBA-toting, bean-counting, pencil-necked, bean-counting, profiteering parasite as is all of her bosses. Not a single person in the 'chain of command' is a true healthcare provider. Reality? Reality is that those same soul-sucking pieces of crap like Martin Shkreli are making their way into other sectors of healthcare.

We're all on the same team here folks. Grow up.