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These are the thoughts of a cantankerous ol' gynecologist who remembers when things were a little different. I try to find a little humor in my life and the people I meet along the way. Come meet the characters in my world.
Showing posts with label pharmacist. Show all posts
Showing posts with label pharmacist. Show all posts

Sunday, November 13, 2011

Errors at the Pharmacy

I spend a large portion of my time communicating with pharmacies.  Over the years I have worked with pharmacists that I respect immensely, and a few that I would prefer never to have to call again.  There is also associated staff that may make things interesting.  They are not as highly trained.

Most pharmacists are a wonderful source of information.  They spend their whole day working with drugs and doses.  They have information in their brains that it would take me forever to find.  If they are out of something, they can suggest an alternative.  If my patient is allergic, they can tell me what else we can use.  If something has been discontinued, they can tell me what we the current drug is.  They often know what your insurance will and will not cover (though not always).

Most pharmacies fill hundreds of prescriptions a day.  I know everything is done to minimize errors, but they still happen.  My friend, The Pharmacy Chick (http://pharmacychick.blogpharm.com/) details some of the reasons for this.  You can also refer to the Frantic Pharmacist (http://franticpharmacist.blogspot.com/).  Both good blogs.

I have a name that is unique in our area.  My husband has a more common last name.  [Nobody changed their names when we got married.]  One of my sons shares his first name with several other older men in the area with his last name.  Pharmacies are supposed to check birthdates if the name is similar.  If necessary, they are supposed to check IDs. 

So, when I go to pick up my own prescriptions or those of my family, I have had some of the following issues:

1. My husband was handed medication for another man this week.  Last name same, first name the same as our son.  Wrong medicine. 

2. Our son’s medicine has been billed to this other man.

3. I had issues at one pharmacy when I switched my prescription over because “the doctor’s name and the patient’s name were the same”.  Did they call me back to see what was going on?   No.  They just didn’t bother to fill the prescription until I got there.  For Motrin equivalent.  Sometimes it’s easier to call myself than call my doctor’s office to do this stuff.  I did this because it was on the $4 list and I was switching to the generic.  I checked with my Mom and Pop, and will be going back there next refill. 

4. Pharmacies get very confused because the triplets have the same birthday.  All three of them.  They take the same antibiotic for their acne.  I finally gave up and call the Mom and Pop pharmacy where I’m on a first name basis with the pharmacist.  She knows me, my husband and all the kids.  It makes things much easier.

5. Argued with a pharmacy technician about a generic medication when I specifically asked for brand.  She said the generic is cheaper.  I said I knew that, but the generic didn’t work for me.  I had also had a problem with it.  I now have another medical problem because of it.  I have to take another medication for the rest of my life.  She did not want to let me talk to the pharmacist to get my medication changed. 

6. Argued with another pharmacy tech about an early refill for my autistic son’s inhaler when he was about 5.  He managed to get the thing and pushed it a few extra times.  I got the lecture about how expensive the medication was, etc.  I tried to tell her about autistic kids, but she was having none of it.  I was an irresponsible mother.  This was the first and last time I got an early refill for this reason or any other.  He had gotten quite the lecture when we found out what he had done. 

Do you want to know which pharmacies I patronize and generally refer my patients to?  Guess!

Sunday, September 18, 2011

Medication refills

Please check before you run out

I read a lot of other medical blogs.  This was posted on theangrypharmicist: http://www.theangrypharmacist.com/archives/2011/09/careastatin-0-refills-remaining.html.  She is on the receiving end of people who forget to refill their routine medications until they are out.  Often they are out for days.

Folks, we all know when the bottle is almost empty.  The bottle has the pharmacy number on it.  It has the name of the doctor that prescribed it on it.  If you need to call the doc, call when there is about a weeks worth left so that the process can be done.  If you haven’t been seen for a year, call when the bottle says NO REFILLS.  The doctor is going to need to see you. 

In some offices they will schedule your appointment, then call you in enough medicine to get through until you run out of medicine.  Other offices will want to see the whites of your eyes before you get another prescription.  Most doctors are no longer giving prescriptions after hours or on weekends, because they don’t have access to your records.  We no longer know our patients like your family doctor did 50 years ago.  We also don’t trust people.

I have had patients call for antibiotics and “a few pain pills”.  Then they only get the pain pills.  I have one patient who only calls on the weekend because she has a bladder infection.  I don’t know if she sees anyone else, but she never calls me when she could come to the office.  I finally stopped calling her in medications when I went to chart her weekend call and realized she hadn’t been in for almost two years, and had called me on the weekend about 4 times.

We have an expression: lack of preparation on your part does not constitute an emergency on my part.  Believe it. 

Thursday, September 8, 2011

Electronic Medical Record Rant 1


The Computer is NOT Always Right

The gobment wants us to use the electronic medical record (EMR).  They say it makes everything easier.  They want us to prescribe medications through the computer.  They even pay Medicare providers more if they do this.  We are trying to be good little followers. 

It’s not working.

Yesterday, I checked on a medication I wanted to use.  It is still listed in the computer version of the PDR – or all the drugs that are currently made.  OK.  It is also listed in the formulary in my EMR.  I clicked on it and sent it through the internet. 

This morning promptly at 8 AM, the patient called.  Her husband picked up her prescription.  It wasn’t the medication we talked about.  She had gotten it before.  This looked totally different etc. 

The pharmacy didn’t open until 9 AM.  I called, went through the menu, and spoke to the chipper pharmacy assistant.  She referred me to the equally chipper pharmacist.  I’ll start calling pharmacies at 9:00 from now on.  They are really zippy that early.

The pharmacist told me that the medication was off the market.  That’s why I had checked all those places.  Usually if a medication is discontinued, it is marked that way, both in the formulary and in the drug reference.  I thought it had been discontinued over a year ago, which is why I checked.  I know I can’t trust my brain.  It turns out I can’t trust my computer, either.

Electronic Medical Record – 0

Electronic Prescriptions – 0

Real People – 1

Sometimes the old way is better.

Tuesday, August 16, 2011

Cool, dark place


This is just a reminder about storing medications. I know it says on the bottle to save in a "cool, dry place". Please remember, that does NOT mean the medicine cabinet in your bathroom. Does the mirror fog up when you take a bath or shower? Then it's NOT cool or dry. It doesn't mean the cabinet above the sink, either. This article explains a bit about medicine storage.

If you are on some specific medications like insulin, they actually need to be kept in the refrigerator until opened. So, check with your friendly neighborhood pharmacist about this. And read all those colorful labels they put on the bottles and jars. They go to school for a long time to learn all that stuff.