Tuesday, May 13, 2008

A Quick Question For Everyone Who Works In A Doctor's Office.

Why do you think you need a fax from me to renew someone's prescription? You really don't. You can issue a prescription at any time, in any way you like. You can write it down, you can phone it in, you can leave it on the voicemail. Hell, when I was in Ohio the law still said you could transmit it by telegraph.

Yet you'll sit by the fax machine, sometimes for hours, and wait like you need the fax machine's permission to do your job. Sometimes you'll even call me..... tell me what the patient asked you for, and instead of approving or denying the refill request, you'll say something like "WE HAVEN'T GOT A FAX YET!!"

Why do you think you need one? I mean, it's a renewal, and you have a record of what you've prescribed the patient in the past....don't you? I mean, when the doctor issues a prescription, you guys do write it down somewhere, right? All that medical type information necessary to provide proper care.....you do keep track of that.....I hope.....

If not, maybe you should start. Because I bet your office could save a lot of time if the doctor didn't have to re-examine and re-diagnose every patient every time they came in.

Or maybe you do have the information, and would just rather sit on your lazy ass stuffing snacks into your face and talking about the new weight loss fad instead of getting up and finding the chart.

I think you know which one I think it is.

16 comments:

asd said...

It is absolutely terrifying isn't it? The sector of the economy, health care, that has the most direct impact on the safety and health of the public has antique filing systems. Pharmacies and the VA excluded, virtually all health care organizations still rely on paper for patient information record keeping and communication with each other. The backward-ness of it all would be funny if it wasn't so scary and sad.

Anonymous said...

No, they don't keep track...

I get a call once a year from my Dr's office about receiving a request from the pharmacy to renew my presciption... but say I haven't seen the doctor for it or received the meds in over a year which in fact is never the case..

They are either lazy, or dumb... or worse...

antpharm said...

What pisses me off the most about the whole process is the wasting of paper! Let's count it:
- 1 piece of paper from me faxed to the doctors office asking for refill
- 1 piece of paper coming out of doctors fax machine, which doctor signs and faxes back
- 1 piece of paper coming out of my fax machine with refill request approval (or worse yet, denial). Rarely does the doctor call and speak to us in person to approve it.

That's 3 pieces of paper when the process should have taken 1. What a senseless waste.

And the exact same process occurs when we have a question about a prescription (ie. can't read writing, doc wrote for something that doesn't exist, drug interaction, etc). "Just fax it to us and the doctor will look at it". Useless!

mofo said...

We hated the faxes. I would so much rather call in a refill then wait for the fax, pull the chart, wait for a doctor to sign it and call back. Um it takes 2 minutes to call in a refill.

People suck.

Jaded Rx Intern said...

This just reminded me of one time I tried to clear some of our older refill requests. Our protocol is fax when patient requests, repeat in 2 days if no response, then every day thereafter. One day I was running low on the 'to-do' list and we were surprisingly adequately staffed, so I called a couple offices on our oldest (6 or 7 days) Rx's pending refills. The two I remember leaving VMs at the clinic - left pt name, DOB, drug, directions, quantity, last fill date ... everything on the fax. We get a VMs back on both 3 hours later (almost 4pm) saying "Please fax us a request." WTF?!?! I gave you everything you needed to do a refill, short of driving over and pulling the chart for them! Ugh...

Anonymous said...

Dumb waste of time and paper. My favorite is when you call the Dr office to tell them a med needs Prior Auth. and they say "fax it to me". Huh??? Fax you a note stating "so and so needs a PA" after I just told you??? Idiocy, sheer idiocy.

Anonymous said...

Why at my pharmacy does it take 45 minutes from when the doctor sends the fax for us to receive the fax??? Where the fuck does it go? Does it hang out in limbo for three quarters of an hour just to chill? Patients show up all the time and we have nothing, and they say they watched the doc send it. Doctors call too saying they've sent it, but we don't get it for like another 30 mins.... definitely a shitty system

Anonymous said...

We have this lazy Drs office that started a trend among all the drs offices in my small town. Say I am the patient and I am running low on something and I see that there are no refills left (this is a dream patient) and I think to call my DOCTOR to get a refill. That Dr. would say "you need to call your pharmacy and ask them to fax a refill request so we can do it". YES! The office is telling the pt to call the PHARMACY so that we can FAX them the request. Is it so hard to write it down yourself? Does there have to be so many steps? LAZY pre and simple. And I love it when the PATIENT calls after all this and recognizes the laziness themselves. Makes my day.

Sara said...

Silly.. cuz worse yet, the damn patient waits until they are completely out and ask us to call or fax their doc, since you know, they don't know how to use a telephone and call them on their own.

Anonymous said...

That's the sorry assed way nearly all the MDs in this town handle refill requests & have since they got fax machines. I think some of them depend on us to maintain their patients' charts in regards to what meds they're on.

Anonymous said...

Here our health insurance pays md's to renew rx's if requested by the pharmacist but not by the patient - therefore we fax. What I don't get is the md who phones me a script for an antibiotic and then asks me to fax a copy to his office. I thought is was a scam but now I think he's just lazy.

kurt1096 said...

Don't you just love it...and the pt CALLS their dr 5 times, and each time the dr tells them they haven't recieved our fax yet. I guess the only time they want to talk to us is when they are calling in percocet?... you can't?

Anonymous said...

They don't keep track of our meds. Every time I go to the doctor I have to take a list of my meds with me. I always ask them "Don't you know what I take, since you are the one's who precribe them?" they have told me straight out they don't keep track of them.

Anonymous said...

Where I work, I get to handle the non -response Dr's. It's always a pleasure.

10% of the calls are perfect. I call, say I need a verbal, I get one.

10% of the calls would be perfect if the Dr office kept decent records - med names, sigs ...

The rest? Just ... ugh. It scares me to fax a new Rx request to the Dr ... and we get it back ... signed. No sig. No quantity. No Refills.

Or we fax for clarification. We get it back, and they apparently didn't understand what we needed clarified ... Fax says "We need quantity to dispense - sig has prn directions." - response? A check mark on the fax where it asks for quantity.

It is extremely frustrating and, again, scary.

Though, I do think that if Retail Pharmacists would be allowed to automatically adjust sigs and med strengths, life would get a lot easier and the process would go faster. Damnitol doesn't come in 250mg, but does come in 125? Sig written i po bid? Let them change it to 125 ii po bid.

Or maybe it's just my pharmacy that doesn't allow that ... and makes us get the okay from the Dr.

Shalom said...

I don't mind so much sending requests for refills. What urinates me off is when I get a call from the patient, "My doctor wants you to call him so he can give me a new prescription." WTF, does this doctor have a pay phone in his office? I usually tell the patient that on new scripts the doctor has to call me. If they insist, then I'll do it, but it will happen when, as and if I have time for it. If the doctor left the office by then, so be it. Obviously it wasn't important enough to the doctor that the patient get this medication for him to do his end of the job. Laziness, pure and simple.

The worst is when you finally break down and call them for the new Rx, and they say they'll have to call us back. Why the blithering hell did they want us to call them in the first place then?

As for faxes requesting new prescriptions, I just encountered this nonsense for the first time last week. Called someone at a hospital in Philadelphia for one of their patients to get a new prescription, and they said "Fax us a request." How do I do that, the patient never had this med here before? I wound up throwing together a note in Wordpad telling them to send us the prescription and faxed them that.

Back when I used to work night-shift, I would generally clear out the doctor-fax queue starting at about 1:30 AM, after the evening rush had subsided. This involved checking profiles to eliminate those which were filled during the day (sometimes they were called in as new Rxs, in which case the refill request wouldn't clear) and re-faxing the ones that weren't answered. So one night I get a phone call from an irate doctor. "Why the hell are you sending me faxes in the middle of the night?" "Well, this is when we have time to do it, so it'll be on your desk in the morning." "But the fax machine is right next to my bed!"

I was speechless for a moment... thinking, um, like, whose fault is that, doctor? I finally bit my tongue and told her I'd see to it that her fax number was removed from the computer. Unfortunately this didn't remove it from the faxes that were still in the queue, so she got woken up again the next night...

Anonymous said...

Not totally in the same vein, but still about doctors...why do their agents always talk so fast when calling in scripts? And how are these agents so stupid? Today I get a lady calling in both a cream AND a lotion (same medication), lady knows one is .05% and when I ask strength on the other she says "Oh, it doesn't say...hold on" *click* muzak. She comes back and says it's also .05, great. I ask for directions. "Hold on" *click* muzak. She comes back and says "I'll have to call you back."
Um, when you checked on the strength, why didn't you make sure you hadd all of the other info for me?