http://www.facebook.com/photo.php?v=10202475506981845&set=vb.1019746327&type=2&theater¬if_t=like
This WAG’s employee seems a little camera shy… this exchange took place in Florida..
They were willing to fill the pt’s non-controls.. but.. suggested that the pt take the control Rx to another pharmacy – NOT ANOTHER WALGREENS
Does the comment made by the WAG’s staff member ” I’m not comfortable filling the control Rx”… suggest that she either believes the Rx is forged or the pt is a “drug seeker” ?
Has one of WAG’s RPH’s put a note in this pt’s file in their computer system.. that would indicated that this pt is questionable for some reason… Is it WAG’s policy that one RPH can make a decision – based on facts or personal biases – that all other WAG’s Rx dept staff has to honor/follow ?
I think I heard the WAG’s staffer say that “no “filming” on WAG’s property”.. have you ever been around a WAG’s property.. they have video camera all over the friggin building.
I guess it is like all else with corporate America… they will film you from the time you enter their parking lot… through out their store and until you leave their parking lot.. but .. don’t dare document the actions – in-actions of their staff.. might catch the staff doing something illegal… like a HIPAA violation or ADA violation … BUT.. that is just a guess on my part..
Here is a email that I received from this pt:
when their pharmacist chose to discriminate against me and with hold my prescription Medication. After she denied to fillmy medicine that I am dependent upon, she screamed at me to leave the premises and resorted to name calling when I asked her why I was being forced to leave the premises.At no time did I do or say anything to threaten, harass or intimidate her but she did absolutely everything in her power to and did threaten, harass, intimidate, humiliate,and degrade me personally even though she saw my young son sitting in the back seat,of my 2010 Prius, witnessing all of this irradiate unprofessional disrespectful and I firmly believe illegal behavior committed by this pharmacists against me…. This abuse can not betolerated another day, this has to stop, no one deserves to be treated like this when all they are trying to do is fill their medicine that is prescribed to them every month….
Filed under: General Problems
At~least if I die from withdrawals from my medicine because of this discriminatory acts of refusing to fill and blacklisting me from being able to be filled at any other Walgreens Pharmacy, I may travel down the red road in Peace knowing that Steve is fighting this good fight and has my back and that of so many millions of other innocent Chronic Pain Patients being constantly discriminated against and forced into constant barbaric suffering…. Wado Your help to so many Peoples Steve is much sincerely appreciated. Thank you for giving so many hurting peoples a voice.
You can appreciate or not appreciate what you like, but there is no difference in me assuming that there is a possibility that you are on 720 oxycodone 30 a month from a pill mill (which I did not, I stated there was a possibility of the situation) than there is assuming that this pharmacist grossly misused their responsibility (which I won’t do from a single anecdote, seeing as every single post on every single pharmacists blog is from everyone spouting the exact same sob story). I didn’t see a pharmacist screaming and harrassing you in the video, I saw one frustrated and freaked out by you recording her. And I apologize that your young son had to see whatever he saw, but that has no bearing on the situation. In fact, I’ve had people come to my counter with empty strollers with a covered up doll to try to drum up sympathy from me.
If everything that you said is true, then I would have filled your medicine for you. And I’m not the only pharmacist who would. But I would not have if I had been videoed by someone in the drive thru dropping it off. There are thousands of reasons someone could be taping me doing my job, not a single one of them are good, and that’s an excellent way for me to not fill prescriptions for you. Also an excellent way to convince me to put the aforementioned note on your profile that you’re a suspicious patient, because people videotaping me from the drive-thru is incredibly suspicious.
Steve – the first thing I do when I get a script that I deem to look suspicious with an ID is I scan it against our sudafed registry – the register reads the barcode thing on the back of an ID. If that doesn’t scan and match, then I don’t fill the prescription. If it does, I proceed to the next steps.
The system your company using tied into the NPLEx network ? If so, or your system does not validate a Driver’s License against a state’s BMV online database or works like the NPLEx system you may be given a false sense of confidence. To the best of my knowledge.. the NPLEx system just takes whatever data that is input by the first Rx dept to sell the person presenting that license.. and accepted that license as valid.. What I have seen of NPLEx.. is if you put in a driver’s license number entered into that database before.. the screen self populates with the data entered the first time… the NPLEx system doesn’t know if the driver’s license is valid or fake.. all it knows is when that driver’s license number was presented and PSE was purchased and how many mgs. Based on the state laws where the pharmacy is located and the last date purchased and mgs purchased.. it calculates if the necessary days have passed to be legally able to purchase more. If a person is producing valid looking driver’s license with different data points that the NPLEx system will accept.. the person can go from store to store.. using the different ID’s and purchase PSE all day.. day after day … IMO.. many of the systems we use – like driver’s license .. we are still working under a 1960’s mind set that they can’t be duplicated or faked… with today’s technology.. I believe .. if man can make it … man can fake it … We are fighting crooks using 21st century technology against a mid 20th century mindset trying to catch them. IMO.. it is like taking a knife to a gun fight !
Steve, an Indian would take a knife to a Gun fight ((and probably win xD)) haha sorry, given my certain grave circumstances, each laugh is rare but very appreciated, and I thank u for helpin with that 🙂 wado thank you for trying to help many peoples.
Excuse me Georgia RPh, if I may I do not appreciate at all you even remotely suggesting that I take any where near that amount of medicine nor the fact that my Specialist that I go to you also suggest is a “Pill Mill”…. How dare you…. Do you really think people whom have been forced to suffer and have been repeatedly and wrongfully discriminated against should really just sit and do NOTHING to protect themselves and in order to attempt to STOP this blatant horrible discrimination and abuse, humiliation, harassment, embarrassment and degradation that follows as a direct result, Really?! You may Call me Rosa Parks of the Chronic Pain Patients Rights Movement, I simply REFUSE to ride on the back of this bullshit bus any more!!!! This is WRONG and needs to change right now. For your judgmental information I am only prescribed AND I only tried to fill ALL (8) yes count them eight of my medicines ((3 of which are blood pressure prescriptions for my uncontrollable blood pressure which has been high ever since these pharmacy problems, discrimination causing this chronic pain patient crisis, began….)) I am ONLY on 1 per day ((count that out now, “One”)) Long term acting pain medicine making that an entire prescription of 30 tablets per month and ONLY on 3 per day ((yes “three”)) breakthrough pain medicine tablets…. Now, please do continue to throw your stones at me, my character and my Physician rather that to address the true problem here…. It really must be hard for people like you to come to terms with such a nasty truth as this…. Maybe you will help raise My Son when I die because of the constant discrimination which at this point is causing my body permanent physical harm, and my blood pressure alone is proof enough of that. I have never had a chronic problem with my Blood Pressure until now, until all of this Discrimination against us by hateful pharmacists who seem to enjoy creating this Chronic pain patient crisis. I hope each and every one of them loose their licenses and end up in jail for the damage(s) they directly have caused to me, my family and millions of innocent others just like me and mine, out there. Wado
All great points.. i would like to submit that the bureaucrats have done things – or not done things.. that makes our job that much harder.. Do you think that people that will forged a Rx.. doesn’t know how to fake a Driver’s License.. that you put into the PMP.. Why don’t we have the ability to verify the driver’s license number against the state’s BMV online database.. if a pt is giving you a fake ID.. what else are they misrepresenting? I don’t know about FL’s PMP but the states that I am licensed in.. the information goes into the PMP pretty much transparently but try to get a report out.. not so user friendly. Why doesn’t the bureaucrats make the insurance industry to provide a single database that we can use to validate if a person does have insurance.. when they are coming to you with cash. Are we so damn focused on profits that we ignore developing a relationship with chronic pain pts.. Personally, I would make it mandatory.. I get all your business… or I don’t fill anything.. IMO.. way too many RPH’s are looking for ANY reason to say no.. instead of looking for reasons to say YES.. With this new ADA fine to Rite Aid… has potentially created the mother of all cans of worms.. When this can gets open – and IMO – it will happen this year.. many pts and attorneys are going to go “fishing”
For my two cents, if you haven’t been to Florida, don’t talk. Just don’t.
Florida as a state has/had/will continue to have a major prescription drug problems because of the weakness of our pharmacy laws. Compared to other states, we have been pretty much giving controlled substances away and been grateful for the honor.
In the state of Florida, C2 prescriptions are (legally) good for 1 year after being written. C3-5 prescriptions are only good for 5 fills within six months (yeah, you heard me –zolpidem is technically more controlled than Oxycontin).
Until recently, there was no centralized database for pharmacies to report controlled prescription fills to.
Doctors were allowed to dispense controlled medications, up to and including C2s, from the comfort of their offices. How cool would that be?
Prescriptions for controlled substances could be written on the back of an envelope. For real. There were no safeguards in place to prevent forgeries. Do some digging and you will find stories of people buying the ‘good’ (read heavy and high quality) paper from Office Depot to write their own prescriptions at home. Because that is where their doctors were buying their paper for their prescriptions. Talk about a cottage industry…
And, until the really recent recently, most drug-store databases would let you add doctor info willy-nilly. Including unverified DEA numbers. The systems in place in place at most chains will smite you for having the wrong day supplies (well, sometimes) but it is not equipped to verify DEA numbers. Yikes!
Mainly due to public outcry, the state of Florida decided to issue some laws to prevent prescription overdoses. It went something like this:
January 2011 – A law is signed making it mandatory for doctors to use forgery-proof prescription pads to write controlled prescriptions. (The doctors were then given a 3-month grace period because ‘it was really hard to get the correct rx pads’). Two years on and I still have MDs writing controls on white computer paper and giving refills on C2s. Awesome, isn’t it?
September 2011 – The state of Florida takes a hint and starts a PDMP – Prescription Database Monitoring Program. This database requires mandatory reporting of all dispensed controls for those individuals 16 years and older. Granted, the reporting must be done within a week of dispensation, and there is some asinine stupidity in regards to funding (http://www.heraldtribune.com/article/20120930/ARCHIVES/209301032)
but this is a step in the right direction. Right now, it is projected that we will lose funding for the PDMP in Florida by summer 2014. And there are also pending lawsuits about ‘patient privacy’ being violated. Not by pharmacists, mind you, but by law enforcement on fishing expeditions.
Add to this the newly turned out DEA that can’t control illegal drugs, but sure as heck can control legal ones. Ever have a DEA badge placed in front of you and your records seized. Happened to me as a floater. Oh what fun…
And now, factor into that CVS has FORBIDDEN its pharmacists in my area from taking certain doctors’ prescriptions (http://articles.orlandosentinel.com/2012-01-21/health/os-cvs-blacklisted-doctors-20120114_1_cvs-oxycodone-purchasing-doctors-pharmacy-chain). CVS claimed is was a public safety measure, but I really think they saw the writing on the wall and were trying to cover their asses. Is that helping pain patients?
And some independents are refusing to stock certain C2 medications. Maybe because of the DEA, maybe because of the hassle of dealing with so many ‘pain’ patients (In one hour during one shift, I had over 25 requests for Oxycodone and Hydromorphone, all with quantities greater than 120. Is that legitimate practice?).
So, Walgreens not only saw our share of C2 prescriptions increase, but we couldn’t keep up with the demand because of our own stupidity and the new and improved controls implemented by the DEA (I actually had several 222s canceled because it was deemed that my patients didn’t need the medicine). This led us to our current policy headache. It’s not perfect and I’ve seen patients that I’ve deemed legitimate being turned away and denied and those I have denied being accepted at other local Walgreens.
Factor in the ‘Doom of Damocles’ — WAH pharmacists have been told that if we tell a patient that we don’t have the medication when it is in stock and this ‘blatant omission’ is discovered simply to avoid the whole process, disciplinary actions could be taken including termination.
This is what I work under. What else can I say? I don’t know about you, but I had exactly one lecture about pain management in school. One. I know the basics (i.e. a ER formulation with an IR for break through) but I have several patients that are on three Oxycontins a day. Are they out of the scope of practice? And most insurances don’t cover ER meds since they are brand-only. This includes Florida’s Medicaid system. This forces patients into using more IR formulations because they are cheaper if they have to pay out of pocket.
So, until you’ve had to be escorted to your car because of a previous ‘incident’ or know of someone’s tires being slashed, or have had to explain to your DM why 180 each of Oxycodone 30 mg and 15mg along with 300 Methadone 10 mg (oh, and 56 IBU 800 because “I need a non-controll to fill my controls) are not really ‘legitimate,’ don’t talk. Just don’t.
And yes – it is a Walgreens policy that if there is a note under the patient’s profile saying don’t fill THIS PARTICULAR Rx, we all honor it as a sign of professional courtesy, and to prevent every store from having to make the same phone calls and the same lookups. It’s definitely not a perfect system – which is why around here, nobody uses it unless the patient is especially egregious. I can count on my fingers how many times I’ve seen it under patient’s profiles in the past six months, and I’ve input it in exactly once – because I don’t want my judgment to impact another pharmacist’s unless I am absolutely sure that the script is trouble.
Every pill mill in the surrounding area that writes exclusively Oxy30/Xanax2/Soma with maybe a Naproxen and Flexeril thrown in has memorized the diagnosis code for lower back pain with four other codes thrown in, and will happily recite it to you if you ask.
I agree that pharmacists are by and large opiophobic – and I try to give every doctors office that pops up new the benefit of a doubt, until filling one turns into four more people showing up in the next hour.
You don’t know the context of this encounter at all – for all you know she had an Rx from a unscrupulous doctor for 720 oxycodone 30 and 360 oxycodone 15 – and to be quite honest, if I had a customer who was ready to start filming me the second I started talking (as this one quite clearly was, since the phone was turned on video as the pharmacist was explaining that she wouldn’t fill that Rx), I sure as hell wouldn’t be doing anything to make their life easier either.
My personal stance on opioids is that if I take on a new customer with an Rx for 120 oxycodone 30mg from a doctor that isn’t longstanding in the area, they better either a) be filling some sort of extended control pain medicine if they need that much breakthrough pain management, or b) I need to be filling their maintenance meds as well. You said yourself on a previous post that these patients should almost always be on a lot of other disease state medications. These restrictions, which I don’t feel are unreasonable is 80% of cases (I understand that oxycodone is the best therapy a patient who doesn’t have insurance and needs pain management is going to get, and will break that policy occasionally if my professional judgment dictates) still cause me to turn away 4 or 5 scripts a day, and I only fill 120 a day.
And my definition of pill mill is 1) the doctor pops up on every single PDMP report I pull up on patients that I reject for going to multiple pharmacies cash pay every 15 days for 30 day supplies, and 2) The patient without fail pays me in 100 dollar bills.
I don’t feel these are unreasonable standards, and I’d say they’re comparable to those held by 75% of the pharmacists in my area. If there’s a better way to handle it, I’d love to know what it is
Steve, you are doing a great job highlighting this abuse of power by pharmacists. It seems like a displaced reaction against their employer’s stupid policies that the employer’s own policies created a need for. All pharmacists should fill valid scripts. If it’s got a dx code on it, and it’s filled on time, we need to let go of our need to control societal addiction and treat the patient in front of us. Quit punishing patients without cause, or dispense no controls at all.
When I have an issue with that person, I call the doc and document. Write on the hard copy how you checked PDMP and saw multiple prescribers etc.
Document if your employer comments later in any way on any prescription you ever fill.
I love one of the comments on the Facebook site, who do they feel comfortable giving these meds to if not to chronic pain patients?
I am glad that you liked it, for it is the truth. 🙂