Let me begin by saying that I have the utmost respect for pharmacists. They go to school as long as I did to become a physician assistant. I know this because I went to the Massachusetts College of Pharmacy and Health Sciences in Boston (Manchester campus). I respect their wealth of knowledge about medications, their interactions, and general advice about over-the-counter products that I may not be familiar with. They are a jack of all trades many times and I use their services readily. However, when a pharmacist decides that he/she or his/her company is going to set up policies or protocols that override what the physician has written on the prescription pad, I begin to take serious offense. I mean intensely, serious offense.
I have been trying to get a drug filled for a long time now. I have been on this medication for years and I take it every month. It used to be that all my medications were delivered to my house by mail and the system was fantastic!! I had everything set up perfectly when I had my last insurance and then they decided to completely eliminate my plan all together at the first of the year so I had to switch pharmacies. In doing that, I cannot seem to find a local pharmacy that will fill this medication. I had this same problem when my insurance switched last time but then after they started giving me a hard time locally, I just went to their mail order system and no questions were asked. They would mail me my medicine like clockwork and I never had to fight for it. Now, here I am again with a new insurance fighting a local pharmacy for the same medication and they won’t fill it regardless of how long I have been on it or how much documentation that I give them of my compliance with the use of the medication or even after they spoke to the doctor’s office and got confirmation of diagnosis codes warranting the need for the medication and knowledge that the prescription had been written!
It is basically this pharmacy’s “policy” to be the drug police of the world and decide who should be given what doses of medication at what quantity that they deem correct. They have taken it upon themselves to cross that line into the exam room with the doctor and actually take the pen out of the hand of the physician when they are going to write a prescription that they feel is not safe, despite the fact that the DOCTOR is the one with the medical degree making the decisions for the patient. You, as the pharmacist, do not know the entire history of what has transpired with each patient and NO you do not have all the records of what has already been tried but the doctor does when she writes that prescription so the decision made by her is far more educated than yours in the first place.
It is her job to worry about tolerance and addiction of her patients, not yours. That will be handled between the physician and the patient. You’re job is to fill the prescription she has written especially after you have been given adequate reasoning and plenty of proof that this person is not pharmacy hopping, physician shopping, the patient IS in chronic pain and what she is currently taking has kept her stable for years.
At what point did it become OK for pharmacists to walk into the exam room and tell the physician I’m not going to fill that prescription just because I don’t believe in your treatment plan? Because that is basically what they are doing here. They are basically saying, we don’t see you making any attempt to take this person off this medicine so we’re going to force you to do it by not filling the prescription and making you find another way to keep her out of pain.
Never mind the fact that, a.) a lot of those other meds are not covered by the lesser insurances, b.) most of us have tried them already if we’ve gotten to the point that we are at now and c.) we don’t want to be on this crap in the first place just to be able to move…. but it is a necessity! We don’t enjoy having to beg for our medication any more, it’s degrading enough to be disabled. We are sick of being treated like street junkies when we are simply chronic pain patients who happen to tolerate high dosages of medication. If the numbers boggle your mind then you, as a pharmacist, should broaden your horizons and go do some more clinical rotations where people are really suffering and try to imagine how it feels to live like that 24 hours a day, 7 days a week.
So, that is my rant on pharmacies today. I was given the run around by this last place for weeks on end. Apparently it was a “floater” pharmacist who didn’t know the rules and she filled my prescription last month so I said, “Great! This is going to be a pharmacy that will work with me every month?” and she reassured me that I could get my meds there so I transferred all of my other medications from other places to that store. When I went in for the refill the following month, a male pharmacist wouldn’t fill it. He told me the female last month had been a “floater” pharmacist and he said that you have to call back to get the manager to do it (first red flag). I spoke to the manager on the phone, explained my situation about having new insurance and having some pretty strong meds so I needed a pharmacy that would work with me and my doctor exclusively to meet all of my needs. He said no problem and the manager filled it. When I went in over the past week or so, I was told that there was a problem and that they would no longer be able to fill this prescription for me at this quantity. Then, I wanted to punch a pharmacist. The first day last week I dropped it off at 2pm they made me come back at 4pm to talk to Ben the manager. I did that. He said, “No problem, we’ll just call your doctor on Monday (it was the weekend, of course) and get some information and you will be all set. We need to know like diagnosis codes, that she knows you’re here, confirm that she wrote the prescription, what she’s treating you for etc. All the pain clinics do it for us.” I figured whatever, I will just pick it up after physical therapy on Tuesday and then I walked into this today. “We’ve spoken to your doctor’s office and we still can’t fill this prescription for you…” AAARRRGGGHHHHHHHHH!!!!!!!
Don’t get me wrong. She was a very nice pharmacist. She completely left the counter, took me over to the seats and quietly talked to me for at least 15 minutes about the policy and how it got to the point that it did which is how I can explain everything that I did above in this blog. I couldn’t punch her. Plus she had glasses on and her name was the same as mine, so that made it kinda tough. She was really nice to me about the whole thing but it doesn’t change the issue that I have one week of medicine left in time to find someone who will fill my prescription.
I walked out of that pharmacy today with my head hung low, totally exhausted from overexertion lately, so much so, that we are gonna cancel my next PT visit and I am going to bed until Wednesday when I have to go to Melbourne Beach to see the doctor then I will be back in bed on Thursday. Sometimes with Lyme Disease you just gotta listen to your body and mine is saying it is time to stop!! Stressful situations like simply the medication issue is exhausting to me never mind all of the PT I’ve done and I even went grocery shopping for myself for the very first time in one of those driving carts! OMG that’s a story for another day…….no one and nothing was safe in the store that day. I was taking out displays, moving tables along with me, I hit a lady while going backwards trying to avoid hitting a wine rack in front of me, people were helping me…..it wasn’t pretty. Those carts are harder to drive than they look! Man, shopping took me like 2 hours. Sheesh. At least I didn’t break anything….well, I don’t know about that lady’s foot that I ran over. Sorry about that.
Alright, I’m gonna go now. Look at it this way, I may not have gotten my medicine but I am sleeping in my own adjustable bed tonight instead of behind bars for punching a pharmacist today! It isn’t all bad. Good Night~