Anybody who works in pharmacy knows that one sad part of what we do is that not every RX filled goes out the door. We do a lot of unecessary work..filling a prescription (or dozen) only to have it languish on the shelf, ignored by its owner until we finally put it back. To UNDO a prescription is nearly as much work as FILLING the prescription in the first place..and we get nothing out of it. Personally, I’d love to have a Return To Stock fee added to scripts not picked up. If a doctor can charge you $200 for an appoinment you didn’t show up for ( or cancelled too late), then it would seem appropriate that I should be able to do the same..
Yesterday I looked at the daily RTS report and saw nearly 20 entries..a small day for us and nearly every one was auto fill. We wait til the end of the day to do the returns just in case the person will actually come in….because NOTHING brings in a client faster than having JUST put it back. Its really uncanny to be honest. Tech extraordinare put back about 15 of them yesterday with promises from 5 that they will come in THAT day..she called them to tell them their script was about to be returned…and these were some we really didnt’ want to return..expensive rx’s
However, nearly just as irritating as doing the RTS is having all these autofill patients strolling by and asking if they just happen to have anything ready. We have to stop what we are doing to see if there is anything for them…finding nothing…then getting the NEXT inevitable question: “Am I due for anything?..and if so Can I get it while I am here?” Geez people….if you are going to sign up for Auto fill, why dont you just let the thing do what its supposed to?
First of all, every script (auto fill or not) that is ready will cause a generate a call to be delivered to the patient telling them it is ready. Second of all, when I “early fill” an auto fill rx, I have extra steps forced on me so the auto fill sequence is not permanently screwed up. Auto fill is stupid…it does not know I have refilled the script early and re-set the date. It keeps the date exactly as it was. So, if the autofill date was (for instance) the 10th of the month, and I happen to fill it on the 7th, it will try AGAIN to fill it on the 10th. Apparently this is one thing not very well thought out when the program was written.
Lastly, one unintended consequence of auto fill is that the patient has no idea how many prescriptions are waiting for them . Sample conversation: “I am here to get John Smith’s prescriptions..we got a phone call” Ok, how many scripts do you have..I see two (we are supposed to ask how many they are here for) “um I dunno, I just got a call, and Im on auto fill, they just DO them…” Another big WTF moment for the company policy that demands we ask how many prescriptions he patient wants…whatever. They (and we) never know..until they leave and the tech says “Hey wasn’t John Smith just here? we got one for his wife Jane too”.. sigh….
For somebody like myself, where organization is important, this makes me unhappy. we aren’t allowed to bunch rx’s by address. Jane and John smiths RX’s are not bagged or rubberbanded together. Its not allowed. Unless I know them REALLY well, I do not ask if they want the other rx too. HIPAA and all that crap stopped that.
I can’t help but think that pharmacy (and patients) were better served a generation ago when the complications of certain technologies and regulation were absent…when the relationship with the patient, Dr and Pharmacist was uncumbered by the PBM, and when the distance between hard copy and finished script was a much straighter line than the convoluted path it is now.