Comments on: Shooting from the hip http://onthepharm.net/2007/05/shooting-from-the-hip.html Life on the pharm Sat, 13 Mar 2010 17:06:35 -0800 http://wordpress.org/?v=2.8.6 hourly 1 By: #1Purple http://onthepharm.net/2007/05/shooting-from-the-hip.html/comment-page-1#comment-80853 #1Purple Wed, 23 May 2007 03:20:00 +0000 http://onthepharm.net/2007/05/shooting-from-the-hip.html#comment-80853 I'm a prescriber. Here's my everyday. Patient calls for RF. I fill in our refill form with whatever, and note if the patient needs labs or what have you. (And really, do I care if they have 3 or 6 refills of their Allegra? Not so much.) Meanwhile, patient has ignored recording and signs everywhere requesting 24 hours RF turnaround, and is standing in office 24 seconds after phone call from our parking lot from cell phone wanting script. We give them script because they insist. About the same time the chart shows up AGAIN in my box with one of those automated faxes for the same drug. Turns out the patient called the pharmacy already in the morning. Twice. I scratch my head and wonder if this is a preauth, or clarification, or what? Perhaps some kind of test from God? I kid you not, in my dinky slooow solo practice I'll get 20 requests a day and at least five of those will be duplicates. Throw that in with phone calls about this or that, and actually seeing patients, and frankly, if it's 3 or 5 refills of Lisinopril, I really don't know, as long as I have a recent potassium and creatinine on file. But guess what? The patient saw a cardiologist two weeks ago who changed their dose. Patient didn't tell us or pharmacy, and has been using samples. So the patient goes to the pharmacy to pick up the medication, takes it home, and realizes it's wrong and we start all over again. Would an EMR make a difference? Sometimes, but not often. I'm a prescriber. Here's my everyday. Patient calls for RF. I fill in our refill form with whatever, and note if the patient needs labs or what have you. (And really, do I care if they have 3 or 6 refills of their Allegra? Not so much.) Meanwhile, patient has ignored recording and signs everywhere requesting 24 hours RF turnaround, and is standing in office 24 seconds after phone call from our parking lot from cell phone wanting script. We give them script because they insist.

About the same time the chart shows up AGAIN in my box with one of those automated faxes for the same drug. Turns out the patient called the pharmacy already in the morning. Twice. I scratch my head and wonder if this is a preauth, or clarification, or what? Perhaps some kind of test from God? I kid you not, in my dinky slooow solo practice I'll get 20 requests a day and at least five of those will be duplicates. Throw that in with phone calls about this or that, and actually seeing patients, and frankly, if it's 3 or 5 refills of Lisinopril, I really don't know, as long as I have a recent potassium and creatinine on file.

But guess what? The patient saw a cardiologist two weeks ago who changed their dose. Patient didn't tell us or pharmacy, and has been using samples. So the patient goes to the pharmacy to pick up the medication, takes it home, and realizes it's wrong and we start all over again.

Would an EMR make a difference? Sometimes, but not often.

]]> By: #1 Dinosaur http://onthepharm.net/2007/05/shooting-from-the-hip.html/comment-page-1#comment-79372 #1 Dinosaur Mon, 21 May 2007 22:02:22 +0000 http://onthepharm.net/2007/05/shooting-from-the-hip.html#comment-79372 Re: Order of operations: Gee, that's exactly how we do it in our office. Except that we usually call them in; our fax is getting cantankerous, and I can't replace it because I can't find one that has the same multi-voice-mailbox functionality that lets me use it in lieu of an answering service. Re: Order of operations: Gee, that's exactly how we do it in our office. Except that we usually call them in; our fax is getting cantankerous, and I can't replace it because I can't find one that has the same multi-voice-mailbox functionality that lets me use it in lieu of an answering service.

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