Does everyone want to “play doctor” ?

This showed up as a comment  https://www.pharmaciststeve.com/?p=6260#comment-2293

Do you want to talk about mixed messages?

When it (PMP) works, I can tell you as a WAG pharmacist when and if I can fill your medication. We try to keep to the 28-day rule for all our patients. And I say ‘try to fill your medication’ because I am required to check you out by the corporate honchos and sometimes the damn thing (PMP ) is on the fritz. But some insurances will actually allow a week early refill of any and all controls. Should I let it go early because the insurance will pay? On the other hand, the new insurance game is that, in order to fill your medicine, I have to call the insurance EVERY. SINGLE. TIME. for an override to state that I am ‘comfortable’ filling the script. WTF? Keep in mind that I am doing this while actually filling other prescriptions for other patients that were here before you and I will help you out. It is going to be longer than 15 minutes. And no, I don’t care if there is ice cream in the car. Don’t be an asshole because you are a pain patient. If you keep insisting that your pain trumps the little girl with an E. coli infection in her blood who can’t keep her medication down or the cute little Spanish lady with dementia who thinks I am her daughter, you are wrong. Let me work and I can help you.

Within the last three months I have personally been called by my DM for cutting my C2 order and for filling too many C2 prescriptions. My point on the first is that if I have 15 bottles of Oxy 30 in stock I really don’t need another 15. My point on the second it basically ‘What the hell?” And by C2s my DM means everything from a percocet 30 count for the man with tamsulosin and bacterium ds (kidney stone) to the nice lady crying because her RA is now so bad that she has to try morphine (15 mg, IR, 90 pills for 15 day supply because the doctor is trying to assess her threshold. Good doctor!) to my regular who has been on the same dose for years and years. This is the same DM that wants me to assess doctors based on the criteria ‘Would I send my parents to them.’ Really? How am I to make that call?

Lastly, I am apparently the only WAGs in the area tries to keep enough meds on hand for the regulars and will actually order new meds for changing therapies (if you don’t see the irony, re-read the above paragraph). It doesn’t help that my fellow stores are not keeping up with their patients and actually tell their patients that I will order medicine for them. Every time I fill for the cancer patient they don’t have enough meds for, I have to make a mental note to make sure that I will have enough for my MS patient. If you bring in a prescription for a new C2 and take the time to explain to me what is going on (I currently have 3 patients trying new therapies) and the requests are not too out of line with normal treatment guidelines (I did have one joker tell me that he was on 240 count of Oxycontin 40 mg a day in the hospital (yeah, while hooked up to a respirator maybe)), I will order for you. But I always warn people that I have been limited in the past by the damn DEA as to what I can order. I try, but sometimes my hands are tied.

Is the only one not being able to practice medicine is the PRESCRIBER ? When did pt care become a function of a committee ?

2 Responses

  1. I cannot imagine any pharmacist would refuse a legimate patient in need. The first thing needed is to establish a rapport with the pharmacist and staff. Secondly, pick a time when the pic is not busy and explain your medication needs. Thirdly, give the RPh plenty of time to order your medication if it is not in stock. Do not play pharmacy roulette, going from pharmacy to pharmacy to save a few pennies or dollars. If you want loyalty, expect to be loyal to the pharmacy.

    Also, you need to understand that RPhs have a fear of armed robberies by people who want the same drugs you want. Unless you know what it is like to have a gun pointed at your body, (I have 4 times), show compassion to the problems faced by the pharmacy staff. They are controlled by corporate policies that could care a rats ass about their life.

  2. Well your one good Walgreens pharmacist amongst the other thousands, I hope your customers appreciate you. I have 3 Walgreens stores around me that will not even look me in the eye when asking if they will fill my long acting opioid. That’s pretty rotten and I will not be treated like crap by any Walgreens pharmacist. Something needs to change with Walgreens because I pass right by them when I need a script filled. I know this isn’t your fault but many other chronic pain sufferers say the same thing. Its not that we get inpatient we just know the way most Wags pharmacist are like their better than us that suffer from chronic pain or hold this power over us because we need a certain medication filled.
    That’s all I have to say about this, its no way to treat customers in need.

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