"Well, the pharmacist there does it for me all the time!"

[Aristus]

I'm on call this weekend. Just got a call from a medical Karen demanding that I refill her son's ADHD medication, which is a controlled substance and can't be called in. It requires a printed prescription and presented in-person to the pharmacist. I informed her of this fact, and I got the huffy reply posted in the header.

I called the pharmacy to refill the two non-controlled medications she also requested, and then told her what the patient's mother had said.

"Yeah, we totally don't."

"I didn't think so."

It's going to be a long weekend. And not in the good way...

[elleng]

1. ;-(

[keithbvadu2]

2. Karen, what is the pharmacist's name?

Karen, what is the pharmacist's name?

Or description.

[CaliforniaPeggy]

3. I'm so sorry, my dear Aristus...I wish things were better for you.

[SheltieLover]

4. So sorry you are plagued with idiots

Surely she knows this about ADHD meds!

Who calls for rx refills after hours anyway?

Stay chill! ✌😷

[Aristus]

6. Who calls for refills after hours?

A lot of the patients of my medical organization. I've tried telling them that the out-patient call line is for emergencies only. But they never listen.

There are times when I'm driving home from work, and eight minutes or so after the clinic closes, I'll get a call from a patient wanting a medication refill. I really dislike being at the beck and call of irresponsible people. I once got a call at three in the morning (on a work-night!) from someone who didn't have an emergency, but only "Oh, I just had some questions about the COVID-19 vaccine..." At three in the morning...

I get paid a certain sum over and above my salary for pulling out-patient call. On my next contract negotiation, I'm considering telling Admin to keep the money; it's not worth it to pull call when I'm already exhausted from a day of clinic.

[SheltieLover]

7. Ridiculous!

I'd tell them to call the clinic during business hours!

Maybe negotiate for a change of policy consistent with the above. Or have answering service screen calls & have them.tell patients to call during office hours.

[Aristus]

9. The service isn't allowed to do that.

They just pass the calls on to me. What we really need is 24-hour nurse triage. Pay somebody to be awake at the stupid hours of the morning when stupid people are awake wanting answers to their stupid questions.

That way, I don't have to have my sleep interrupted when I need to be fresh for clinic the next morning...

[SheltieLover]

10. Crazy!

How can you be at your best wigh these inconsiderate people calling at all hours?

Stay chill. ✌

[csziggy]

16. My doctor's group has a voice menu that lets you leave a message after hours

In fact they have a tier of options - first off they tell you "If this is an emergency, hang up and call 911." Then it goes into a menu. Among the selections are a nurse message line - the nurses listen and call back during business hours, sometimes the next morning. There is also a selection if you need a prescription refill. Both of those, you leave your name, date of birth, telephone number, and a "short message."

The voice menu is shorter at night - during the day you can select an option for making appointments and for which doctor. But after hours, it has just the essentials. I like it because I take my meds in the evening and sometimes haven't realized I'm out of refills. I can call in, leave a message and often by the time I get going the next day I've gotten a message from the pharmacy there's a prescription waiting to be picked up.

The nurse message is basically a triage - I've called that when I've had a recurrence of something and need to get word to the office after hours. That way when I call for an appointment first thing the next morning I am already flagged as a priority rather than being sloughed off to a day or two later.

[hlthe2b]

5. I think the pharmacist (or you, if you have access) should check the PDMPS*

to see if she is seeking throughout the area (for herself via her son)... I would not be surprised if that were the case. Perhaps the pharmacist will do so regardless. It isn't just opiates being abused (and resold).

*Prescription Drug Monitoring System

[SheltieLover]

8. Great idea!

👍

[Diamond_Dog]

11. A doctor I used to see some time ago didn't even want to be bothered

Refilling prescriptions during office hours!

He had his staff play this recording if you called their office for any reason....

“You have reached the office of Dr. XXX. To schedule an appointment, please press one. If you have a question about your bill, please press two ...”. etc. etc. Then she would say in a rather snotty voice, “For prescription refills, we strongly remind you to take care of this during your office visit.” Really made you feel like you were a big bother asking for someone to call your pharmacy to refill your prescription!

[Aristus]

12. I'm actually the opposite.

My medical organization has a policy that patients have to have a clinic visit for medication refills. And while the reasoning behind this is medically sound, (patients who require close-monitoring for conditions like diabetes, high blood pressure, high cholesterol, etc can get updated vital signs and lab levels) patients can't always drop everything to rush over to the clinic for a refill, And that can hurt compliance with treatment.

So I tell my patients to ignore that policy and that if they need medications refilled but can't come in for a visit, just call me (during office hours, it is implied), and I'll get their refills done same-day, so they don't have to worry about running out.

I will say the patients who call after hours or in the middle of the night are always some other provider's patients, not mine. Most of my patients like me enough that they would never call at 3am or sometime.

[Diamond_Dog]

13. I totally get it about clinic visits being required

for prescription refills in many situations

But ..... when the doctor’s office calls you to reschedule your appointment ahead a few weeks because “he won’t be in the office that day” then they get all snotty about refilling your prescription ....because it ran out before you are scheduled for your next appt. .... that happened to me a couple times and it really burned my ass. Glad I don’t go there any more.

[Aristus]

14. I also don't do bridge prescriptions. I think it's petty.

"Here. Here are ten tablets. Come see me as soon as you can." It seems small.

If a patient needs a refill in-between visits, I just give them a full prescription, usually a month's-worth and a couple of refills. So many of my patients are homeless; clinic follow-up can be difficult for them; transportation issues, maybe they're looking for a job, or, you know, doing a job, other reasons. No need to make compliance difficult, as well.

[Diamond_Dog]

15. I always appreciate it

When my doctor understands my personal challenges, like you do with your homeless patients who may have transportation issues.

For a few years we only had one car (that my husband took to work)and I had small children at home and no one else available to watch my kids. It wasn’t very easy for me to just pop in for doctor visits or much of anything else at any old time.

I have to tell you ... I was at a doctor’s office for a visit one time ... this was a few years ago ....and I was discussing my insurance problems with him (I was without insurance for about half a year). So we were talking about Medicaid.

He asked me if I saw the woman in the waiting room sitting there chatting away on her cell phone. I said, yes. He told me she’s on Medicaid, and she was sitting there yakking on her FREE phone after she called for a taxi cab for a FREE ride home, after her FREE doctor visit, also paid for “by the taxpayers”. For some reason the fact that HIS taxes were paying for this woman to get a taxi ride to the doctor really irked him. I said, feeling that it was pretty obvious, “Maybe she cannot afford a car?” “Well, yeah, maybe,” he said. “But why can’t she take a bus?” (not even aware there was no bus stop within miles of his office.)

I just said that it really wasn’t such a huge expense, the taxi ride, if it ensured that she kept her appointments? And wouldn’t she need a phone to call for appointments and rides to get to and from her appointments? He kind of grumbled, “I suppose so.” I really didn’t like him much after that, even though I had been his patient for about ten years. And I thought it very unprofessional for him to talk like that about another patient.

[Aristus]

17. Medicine has been in the past, and still is, very conservative.

But I don't like it when right-wingers practice clinical medicine. Caring for people is pretty much against their whole world outlook.



Keep cool. Diamond Dogs rule...

[Diamond_Dog]

18. That's why the Doc I see now is 100% Democrat!

Happy accident....

You and all hardworking medical professionals rock,Aristus!

[Aristus]

19. Anecdotally, I would say the Physician Assistant profession is about 70% Democratic.

It’s encouraging…

[3catwoman3]

20. It was annoyingly common for parents to call about 10-15 minutes after...

…office hours ended on a Friday afternoon, just after phones had been routed to the after-hours answering service, with an “urgent” complaint about symptoms the child had had all week long, wanting an antibiotic prescription over the phone. Not good health care, and I would typically say, “I need you to know that the very best I can do over the phone is to guess what is wrong with your child, and I sure would hate to guess wrong.”

Years ago, a mom who was in the hospital with pneumonia called at 3 AM, wanting to make an appointment for her child to be seen. I told her I was returning her call from my bedroom and did not have access to the appointment template at home. We really did think that some folks thought that whoever was on call was sitting up, awake, AT the office, just waiting to talk to them.

As to ADHD meds, if you are giving you child a medication every day, all the time, don’t you notice when you are down to the last 5 pills in the bottle? Why wait until they are all gone?

Do tell your practice to keep the extra money.