By Paul Goldfinger, MD. Editor @Blogfinger
I have come across two worrisome trends at the pharmacy which result in extra trips to get prescriptions and invasion of privacy by pharmacist.
The first is part of a growing trend towards deterioration of customer service in our society. The second is about invading our privacy at the drugstore.
Small potatoes you say? You must watch for small changes and trends in an evolving society. Death can occur by a thousand cuts. (referring to a Chinese torture from 900 AD to 1905)
a. It is becoming common for a customer who arrives at the pharmacy to pick up a new prescription to receive only a one day supply. Then he has to return the next day for the rest. What is the harm? Inconvenience and wasted time is the harm along with exploitation of the consumer.
It is not about your chronic medications which you can call for on Monday and pick up on Wednesday. But if you visit a doctor who prescribes a new medicine, for example an antibiotic for a urine infection, and you go to pick it up, you may only receive enough for the first day. The reason for this is ostensibly because the pharmacy cannot maintain an inventory for all meds, but they certainly could do it for 50 of the most common meds. Did this inventory issue suddenly happen? There has to be more to this story, and it is not about putting the patient first.
b. The next issue is very worrisome. You will find pharmacists interrogating you, at the direction of the insurance or pharmaceutical companies, to find out why you are not taking your medicine the way that they think you should. For example, if you take a BP drug and you skip doses, or if your doctor has reduced your dose (eg take half a pill instead of a whole pill,) you will be interrogated as to why you haven’t been refilling your prescription in a timely manner.
The pharmacist will tell you that this is to make sure you are getting proper treatment, but it is just a sly marketing method in a society which allows more and more invasions of our privacy. It is also intimidation, because you have to wonder what will happen if you refuse to answer these inappropriate questions. The pharmacist I spoke to implied that they have no choice but to engage in this unprofessional behavior. She was uncomfortable about it.
But the pharmacist is an accomplice in depriving us of our rights to privacy, and I find that to be deeply disturbing, and I told her that. We don’t need big Pharma or big government treating us like children and/or asking questions that are none of their business.
Note: This article is based on my experience at one pharmacy in the area. I don’t know how prevalent this is. Consider it a “heads up.”
Thank you for sharing. My pharmacist, who was chagrined that she had to interrogate me said, “You should see what we are going through,” implying that changes are occurring that are not desirable.
We all should keep our guard up when we deal with pharmacies and medications. Some situations can get complicated such as when some of your meds are from mail-order pharmacies while others are from the drug stores. Who’s responsible for considering the drug interactions? Things can fall between the cracks.
There are also shortages of some drugs that have occurred recently for a variety of reasons. Some are even essential in operating rooms and for cancer therapy.
There was a recent incident where a metoprolol generic (a common beta blocker) had too little drug in each pill resulting in blood pressures and heart rhythms going out of whack until the problem was solved.
And don’t forget the complexities that can develop when there are unregulated health food stores that sell medical therapies that can cause side effects and interactions, generics that have been undergoing major price increases, and out-of-control TV gurus like Dr Oz who give “alternative” medical advice. Steve Jobs might be alive today if he hadn’t gone down that complimentary medicine road to treat his cancer.
If you are seeking advice on the Internet, stick to well known sources like Med MD, Mayo Clinic, PDR.net, NIH, etc. You can question your pharmacist, and those answers can be enlightening since doctors often don’t explain medications very well.
But if you get contradictory information ask your doctor to clarify. Don’t put all your confidence in your Internet research.
We have had four unpleasant experiences at a local pharmacy and are so fed up with them that we will be switching pharmacies. But now we wonder if these occurrences are happening not just with this particular pharmacy.
First, my husband got a new prescription and the pharmacy did indeed give him enough for a couple of days citing the same reason, not keeping enough on inventory, He was supposed to return in a couple of days to pick up the rest. Unfortunately this happened over Labor Day weekend so we couldn’t move our car and we also had house guests and didn’t want to have to go to the pharmacy while they were visiting.
The second issue happened just a few weeks ago. The problem occurred when he picked up one of his regular meds and was shorted 15 pills which he didn’t notice until the next day. Upon returning to the pharmacy, he was given the rest of the pills, no questions asked. Good for him, but is that professional?
The third issue was that he is supposed to only get 30 days’ worth of meds and they gave him 90 days’ worth. How will that square with the insurance?
And lastly, he was given a new prescription and after he left it at the pharmacy to be filled, he researched the medication and didn’t like what the side affects could be. So he decided not to pick it up. The pharmacy repeatedly phoned us saying he was obligated to pick it up since they had to special order it. He said he didn’t want it, but they insisted that he was still responsible for the co-pay.
More and more troubles with this place.
About two years ago, I got the question about taking my meds as prescribed directly from my health care insurance company. The actual reason was that the on-line pharmacy had screwed up and sent too many refills, but since they paid those charges, I didn’t feel it was my responsibility to tell them that. Instead I responded that my medications were something that I felt were a private conversation between my doctor and myself, and told them I did not appreciate their interference. They immediately backed off and marked my records so that I would receive no further follow up. We just need to stand up for ourselves.
A patient who cannot afford medicines can seek help in a variety of ways including public assistance, asking the doctor for samples, inquiring about generics or other substitutes, or discussing the problem with the pharmacist.
But that doesn’t mean that the pharmacist should initiate a discussion of a customer’s finances. The patient has a responsibility to ask for help, and the pharmacist-big brother roll is going over the line. I don’t want the pharmacist to be asking me to explain why I am not refilling my medicine. Next time I will refuse to be interrogated.
On delayed refills: Unfortunately, many people can not afford the cost of their medication. They may be self-reducing the dosage to save money. If the pharmacist is proactive in asking, a life may be saved.
Jennifer: Everything you say is true. Of course the pharmacist should look for prescribing errors, adverse interactions or usage mistakes by the patient.
But this is different. This is about proactively questioning patients based on computer monitoring of refill patterns. The pharmacist gets a report from the drug company and then is put into the position of interrogating the patient.
The pharmacist should only question someone if he/she detects a medication issue from speaking to the patient or from the store record. And of course patients may ask advice from the pharmacist, but that is not what we are talking about.
It is none of the pharmacist’s business to routinely question why the patient did not refill a prescription. There are a variety of reasons why a patient might not refill when expected or not at all. Some of those reasons are particularly personal and private, and it is not necessary or appropriate for the pharmacist to investigate those reasons. Thanks for your comment.
Paul
I used to work in a pharmacy as a Pharmacist Tech, many moons ago — about 20 years ago. The pharmacist’s job is to not just fill their customer’s prescriptions and sell them, but it is also for them to take a look at their customer’s medication file, to make sure medications were being administered safely by doctors, while also noticing any history of why your prescription is no being filled timely, as they want to be aware of any changes – so that they can notate the account.
Several times a day, the pharmacist will catch that a customer’s medication was administered incorrectly by their medical doctor, because it conflicted with their other medications on file.
The pharmacist then contacts the customer’s doctor to discuss this with them. Most always, the doctor took the pharmacist’s recommendation and changed the medication accordingly.