I Remember When the Pharmacist Was Part of the Team

Every day I receive a phone call, email or text message from at least one of my patients saying they have been trying to refill a prescription at their local chain pharmacy for at least two weeks and they cannot get it done. The pharmacies all claim to have tried to contact “your provider” multiple times and “your provider has not responded.” 

The truth is, my staff and I have never received any of these requests from the pharmacy for a refill. Our office telephone lines are manned by human beings using no automated attendant during business hours when the office is open. After hours phone calls go directly to the physician’s cell phones. Both physicians in this office answer their cell phone calls twenty-four hours a day, seven days per week.

It is common for me to receive an email or text message after hours or on the weekend from a patient requesting a routine refill. If it is a controlled substance, I call it in myself. For nonscheduled prescription medications I will either call it in or send it by the computerized electronic health records software. If it is sent electronically, I receive a receipt for the completion of the transaction.

When I call by phone, I am commonly having to leave a detailed voice mail message because the pharmacy technicians and pharmacists are too busy to answer the phones. When the patient shows up to pick up those prescriptions, they are often told that the physician never called it in. That is usually because the pharmacy staff has not gotten around to listening to their messages on the electronic system they and/or their corporate ownership have set up. When patients are told that the doctor never called the script in, they call the office upset and annoyed that we haven’t honored their requests but, in fact, the prescription had been called in to the pharmacy hours earlier.

Years ago, the chain pharmacies decided to get into the health care business by setting up medical clinics within their pharmacies. They used their power and influence to have legislation and regulations passed to allow them to staff their clinics with nurse practitioners. At the same time, they lobbied heavily to take over and control the routine vaccination business – an important part of most primary care offices that brought patients back to the doctor periodically for a review of their health and preventive care plans.

Having clinics in pharmacies plays well with younger patients who don’t have a personal doctor and wish to perform every health evaluation and diagnosis and treatment over the screen on their smartphone. When they become significantly ill, they are left with running to emergency departments of hospitals or corporate walk-in clinics where typically a short-term solution is provided for a fee because they do not have a physician to guide them or see them.

The pharmacists I trained with were not experts on health insurance and drug benefit management programs. Those pharmacists mixed the medications and placed them in tubes, bottles or capsules. They were not just pill counters transferring pills or tablets from a stock bottle to a smaller bottle with a typed label. They were chemists and scientists. If you called them with a question, they answered your call or called you back. There was a mutual respect for the knowledge and experience they brought to the health care team that has since been lost.

The chain pharmacist is now my competitor, doing their utmost to make physicians in private practice look like inefficient, non-caring buffoons with office staff who are even less competent. There is no short-term solution to the problem.

If you contact your physician for a refill and they say they have called it in, they have done just that. If the pharmacist says the doctor never contacted them, please ask for the manager and ask if they have listened to their recorded messages or checked electronic submissions yet.

Prescription Refills For My Patients

My office staff is instructed to automatically fulfill any refill request for active patients seen within the last six months requesting non-narcotic prescriptions. If your medication bottle says that you no longer have any refills, we ask that you call the office and request a refill rather than calling the pharmacy.

If you have been calling your pharmacy first when you are out of refills, we have most likely not received a message from them.  Pharmacies typically communicate with us electronically and if the transmission does not go through they just keep resending it without recognizing that the message is not going through.

In this scenario, patients have been told by the pharmacy that we have not responded to their request for a refill. We can not respond if we don’t know about it. Please, if you are out of refills please call us first and we will call the pharmacy and renew the medication.  If your prescription bottle shows that you have remaining refills then it is quicker to call the pharmacy directly and give the prescription number.