Monday, May 22, 2017

10 Things NOT to do when Writing a Prescription

Dear Prescriber,

Here's TEN things you should NOT do when writing a prescription:

1. Don't BOLD the last zero

When you do this, it makes it look like the extra zero was added to the prescription and not by you. And you know what that means? Your patient is going to wait while we try to get a hold of you to clarify what you meant.

2. Don't write multiple prescriptions on one blank

We know you're all trying to pinch a penny here and there, but one prescription per prescription blank, please. There's legal requirements on our end that require us to put labels on the back of the prescription. And when you load up the front with multiple medications it makes it harder to read as well. 

3. Don't leave the refill spot blank

If you leave this spot blank, a nefarious patient will be happy to fill it in for you. And if we see 15 refills on a controlled substance prescription, we'll be calling you about it.

4. Don't write 1.0 or .5

After all these years I'm still surprised, but yes, a lot of prescribers are still writing the number 1 as "1.0" which I'm sure you can guess can be misinterpreted as "10." 

The same goes for decimals. If you're writing for 1/2 half of a milligram, please use "0.5" and not ".5" -- in many cases that decimal can be easily overlooked.

5. Don't write illegibly

If you've EVER had a call from a pharmacist asking what you wrote on a prescription... even just one call, then it's time to reevaluate whether you should be physically writing prescriptions. With e-Script technology it's time to stop this nonsense. At the very least, get an assistant or someone with decent handwriting to write for you.

6. Don't write a book

I'm sure you have a novel idea on how prednisone should be tapered, but we've only got about 140 characters on the label. 

7. Don't invent new drugs

We know a lot of you prescribers have a "God" complex, but the reality is that you can't just invent a new medication. Please stick to the already approved and available medications.

8. Don't invent new dosing regimens or indications

Let's stick to the standard dosing with medications unless there's a really odd off-label dosing protocol or another reason why you want the med to be taken the way you've prescribed. If that's the case you should add your reasoning to the prescription. Otherwise, you're either going to get a call from us or your fax machine will be printing out a "prior authorization" request form.

9. Don't give the prescription to the patient until you've proofread what you've written

Just a quick look... 30 seconds at the most, can save oodles and oodles of time at the pharmacy. We're going to check each prescription, and when we find mistakes, we're going to call your office, have you paged, bother your staff, and generally pester you over and over until you clarify the Rx.

10. Don't hand over the prescription without indicating who wrote it

Sounds pretty simple, right? Oh ho ho ho, you'd be amazed how many prescribers sign scripts with an illegible scribble without indicating who they are in any other way. This is especially true for you hospitalists out there. Yeah, you.

If there's multiple physician names on the top, circle your name. Or print your name by your signature, legibly. Don't think for a minute the patient is going to remember. Half the time they don't have any clue who they saw. Don't make us guess who wrote the prescription or... guess what, we'll be calling the office to find out, and that wastes both of our time.

Thank you,

Every pharmacist, everywhere


Anonymous said...

Crazy, I saw this news notice and wondered if you did this on purpose ..

Anonymous said...

And...don't be a dick about it when we do call and talk to you. Remember, we want to talk to you even less than you want to talk to us.

Anonymous said...

Thank you, I love this post and agree with every point!

Anonymous said...

All of this! Another point I'd like to add in regards to controlled substances - put the ICD codes on the prescriptions in a clear and noticeable manner. At least in my state, they're required by law to be on all CS prescriptions, no exceptions. A lot of docs are pretty good at remembering but there are a few repeat offenders. This wastes my time and their staff's time as they're the ones who have to look up the code. However, a lot of the scripts I see are from residents so....