Friday, April 24, 2009

It ALL costs money, honey...

Yesterday, I got a call from a doctor. No, not his office assistant, receptionist, or nurse - the doctor himself called. My tech tells me the doctor wants to talk to me so I pick up the phone and say "Thanks for holding, how can I help you?"
"For starters, you can quit sending refill requests to me for John Doe. I already denied them twice!" So I launch into the standard explanation (usually given to a nurse) about our system being automated. When the patient uses the automated system, a fax automatically - hence the term automated - goes to the doctor. When we get denials, we attempt to contact the patient and let them know, but it doesn't always sink in, and they call again.
"It costs MONEY to get someone to pull the chart every time you send me a fax!" I suggest to the doctor that, since the patient obviously doesn't believe that his refills have been denied, maybe one of his staff should call the patient and say "Your refills have been denied until you have an appointment - would you like to schedule one now?" The doctor, whom I will now refer to as jackass, tells me "We don't have time for that. That's why I faxed you a note to tell him!" WTF? Since when did I become his messenger??? And we fill more than 400 scripts a day - we don't have time either! I started wondering if he sees 400 patients a day...
I pull up the profile, and - lo and behold - there are scripts already filled! I look at the scripts and say "Well, Julia authorized these last week. Do you have a Julia at your office?" Jackass pauses and says "Um, I don't know. Maybe. But I didn't approve those, so cancel them." OK. Done. We cordially end our conversation.
Five minutes later, the phone rings, and my tech tells me Dr Jackass is on the phone again. "Uh, yeah.... I just got my message from Julia. Go ahead and let John Doe have those, but remind him he needs an appointment" Here we go with the messenger service again... "I already returned those to stock. Now I have to re-enter them from scratch. That costs MONEY, you know..." I'm chuckling and seething all at once.
So, I process them, and include on the labels "Needs appointment for further refills". I print extra labels, attach them to a fax cover sheet and jot a note to jackass... "This is how we notify patients that they need appointments. If the patient fails to make one and asks for more refills, YOUR staff will have to contact him. I've done my part. Sincerely, SOSP, pharmacy manager"
It made me feel better to send that fax (even though it cost me more MONEY), but Dr Jackass made me pissy the whole day...

4 comments:

"Ms. Mean" said...

Ha ha ha ha...'physician' isn't even remotely close to 'god' in the dictionary - so BITE ME! hee hee hee hee

:-)

Shalom said...

Back when I used to work overnights in the Chain of Verylarge Stores, I used to go through the list of pending refill requests at around 1:30 AM, right after lunch, delete the ones which were completed, and re-send those which hadn't yet been responded to. So one night I get a phone call from an irate doctor. "Why are you sending me faxes in the middle of the night?!" "Well, this is the time when I have the opportunity to do them, and this way it'll be waiting on your desk in the morning." "But the fax machine is right next to my bed!"

God, what I wanted to say to her. All I said was, "Sorry about that, I'll delete your fax number from your profile." Which I did. Unfortunately I didn't know that this didn't remove the fax from the queue, and she didn't respond to it that day either, so the next night she got another fax...

Grumpy, M.D. said...

That's just wrong. He didn't have to treat you like that. I try to treat all other health professionals (pharmacists, nurses, etc) as equals. We are all on the same side of the healthcare trenches.

Bill RPh. said...

Had you in fact contacted the patient about no refills? That isn't always easy to do filling over 400 Rx'x/day. If you hadn't contacted the patient, they may have just forgotten they'd already dialed a refill request (maybe). I'm sure MD's have to deal with many types and ways pharmacy's transmit refill requests. From this point on, though, the MD's behavior is not especially good. Perhaps while you were "launching" into your standard explanation about automation, you could also have explained why your system, though able to generate multiple refill requests for the same medication, can't cross-reference to the newly filled Rx's for the same meds already on the shelf. Things that are obvious to us because we deal with them every day may not be obvious to others. What was learned here? Probably that each of you feels the other is a jerk. Even if your computer can't tell the Rx's were already filled because they have different Rx numbers, this seems more like bad communication (and attitudes) on both parts. When a doctor calls about a patient or has what seems to be a complaint, I get the patient's chart up on the computer so I am better able to explain what might have happened initially. It doesn't always help and I've had my share of misunderstandings with MD'-not trying to be "holier" by any sense.
If I misunderstood something, my apologies.
Bill W. RPh.