This is an interesting article from
the New York Times about our handwritten prescriptions and the errors
they cause. It is also alarming the carelessness of the medical and
pharmacology professions in not preventing this. I have never
understood how people can have such poor handwriting. If the
handwriting is that poor, I have to wonder about their skills as a
doctor, physician's assistant, nurse, or nurse practitioner.
Generally the two do go hand in hand, but not always.
Is it the fault of
our school system, or the people we allow to be doctors? By any
stretch of the imagination, allowing 37 percent of hand written
prescriptions to have errors says volumes about the quality of the
doctors writing them. Admittedly, seven percent is still poor, but
this will go higher when the careless doctors start using the
computer to click buttons.
I can only say
that patients had better learn to pay closer attention to
prescriptions in the future and become more knowledgeable about many
medications. I have heard pharmacists ask patients if they were
being transferred to a new medication, or ask if they knew what the
medication was for. Many had absolutely no idea, so the pharmacist
had to call for clarification. Many times I could see the
frustration on the face of the pharmacist when the call resulted in
no change or even a medication that could not be deciphered from the
prescription. I felt very sorry for a pharmacist one day that was
trying to do the right thing for a patient and unfortunately the
phone was not muffling the sound of the doctor screaming at the
pharmacist.
On this particular
day, the doctor was changing all of a patient's medications. As I
was waiting for a medication for my wife, the patient came in and
started with foul language at the pharmacist for not having the
prescriptions ready. The pharmacist was doing her best to explain
why she had questioned all the changes. Patient then unleashed a
litany of profanity about the doctor not supposed to have changed any
medications. Pharmacist suggested he talk to the doctor (office at
most 15 minutes away) as the doctor had instructed her to change
every one. More profanity, so I spoke up and said the pharmacist was
attempting to help him and he should be thanking her for that. More
profanity directed at me, telling me to but out. Did I? Not a
chance. I stood up and told the person to apologize to the
pharmacist and get a civil tongue. If he chose not to, I would be
making a phone call and we would see if that changed his tune. I was
surprised that I stood taller than him and he apologized immediately.
He asked what
needed to be done and the pharmacist asked if he was aware of the
changes in his prescription. He stated that he had made it clear to
the doctor he did not want any changes although the doctor had said
he should on two medications. The pharmacist asked if he knew which
two and he answered. The pharmacist said that was understandable as
the one medication had been pulled from the market and for the length
of time he had been on the other, he should consider the change since
the one the doctor prescribed was generic and not a brand name. This
left three other prescriptions and he and the pharmacist discussed
these. He agreed that he could change on two others, but said he had
a allergy to the third one. Pharmacist checked his record and agreed
that the doctor had missed the allergy.
She picked up the
phone and stated she would call him. Even I could hear the doctor on
the phone as he was upset. She handed the phone to the patient and
he said he would be filing a complaint with the medical board unless
he calmed down. He then asked if the doctor was trying to put him in
the hospital as the one medication he was allergic to and would
become very sick. He handed the phone back to the pharmacist and
then she said okay and hung up. Pharmacist asked the patient if he
was satisfied. He agreed and the pharmacist said his order would be
ready in 20 minutes.
Then fellow turned
to me and apologized. I said good as I did not like seeing pharmacy
customers verbally abuse the pharmacists, especially when they were
trying to help the customer. He agreed that he had come in with a
chip on his shoulder and was not intending to be this way. He was
angry at the doctor for changing prescriptions like he did without
discussing the reasons for making the changes. I said that would
make me upset as well, but I would have come directly here and asked
the pharmacist some questions as she would have covered them like she
did. Since two of the medications were for diabetes, I asked if they
were for him. He admitted they were and how did I know what they
were.
I said as a person
with type 2 diabetes, I was fairly familiar with most diabetes
medications. He asked which I was taking and I said insulin. He
looked at me and said you don't look that bad. I laughed and said he
had to be referring to the insulin myth, probably promoted by his
doctor, that this was the medication when nothing else worked. He
looked puzzled and said that this is what he had been taught by his
mother and his doctor. I said that is such a lie and I would never
go back to oral medications.
I stopped him and
asked if he was a veteran? He said he was and I asked him if he was
seeing the Veterans Affairs office for medicines. He said no, but
until a year ago had a good medical insurance policy that covered
most of his medication expense. He continued that he had seven
months left on COBRA and then he would be fully on Medicare and a
supplemental policy. I asked if he would be interested in talking to
the local office and getting his application started. He was, and I
asked if he had time to do it then. He said he was not sure where to
start, but he had some time. I talked to the pharmacist and said we
would both be back later, I was taking him to the VA office and we
would both be back.
After we had been
to the local veterans office, he was even more talkative and asked
why I was promoting this so hard. I said it was still his choice,
but that his medications cost would depend on his income less
qualifying medical expenses (or a means test) and this could save him
some money. He needed to get his DD214 form from the recorders
office and complete his application. He agreed that it could save
him some money especially when he found out some of the other
benefits he probably qualified for.
When we arrive
back at the pharmacy, he again apologized to the pharmacist for his
language, saying he would make sure that it never happened again.
The pharmacist thanked him and asked if he would qualify for VA
assistance and he stated more than likely. She stated that it could
probably save him money and have less business with the pharmacy. I
covered the point that on many generic medications, he could probably
get them more reasonably through the pharmacy and gave him an
example. He asked if that was for real and the pharmacist assured
him that was what he was paying. She also stated that the doctor
would need to send the VA office a list of medications once he was
accepted and he should check with her before letting the VA prescribe
the medications from the central VA pharmacy on most generic
medications.
He had his
prescriptions and then asked me for my phone number and if I had an
email address so we could communicate. We have continued since then
and he is now be waiting for his VA approval.
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