If you work in a pharmacy, you will definitely encounter your fair share of them:
- witch doctor – noun
- a physician, dentist, or other medical practitioner that is a real PITA, or otherwise makes working in a pharmacy a living hell
Well I had the honor of talking with a real witch of a doctor this morning. But the story starts yesterday, so I will, too.
Yesterday, a woman (call her Ms. Dill) brought in a prescription for her 91-year-old mother-in-law (I just love hypenation) for Carafate, a liquid medication used to treat, in this case, most likely duodenal ulcer (based on the dosing).
The prescription was written for 10 ml’s, four times daily, dispense 32oz. Surprisingly, we actually had that much in stock, so I filled two 16oz bottles with the chalky pink stuff, and gave them to the pharmacist to check. We sold it to Ms. Dill for $68 (pretty high copay, but she paid it.) Everything was fine.
Or so we thought. Later that night, Ms. Dill called the pharmacy, surprised that the medicine wasn’t in individual dose cups like the doctor had said. (I’ve never seen them outside of hospital pharmacy.) She wanted to return the medicine and exchange it for the kind that comes in dose cups.
Unfortunately, our company has a policy that once medication leaves the pharmacy, it can’t be taken back unless there was a mistake on the pharmacy’s part. Since we dispensed the correct medication, with the correct directions, we hadn’t made a mistake.
So, we told Ms. Dill we could call the doctor and request a refill in order to give her the dose cups, but that she might be required to pay full price ($170), since the insurance had already been billed for one fill. She seemed okay with that, so we left a note to call the doctor the next morning.
Ok, back where we started. Before we had a chance to contact the doctor (call her Dr. Meanie), we got a call from her, in her fake british accent, demanding to know why we wouldn’t take back the medicine when the pharmacy made a mistake.
I told her we didn’t make a mistake. We dispensed the correct medication, in the correct amount, with the right directions.
“But I wanted dose cups! You didn’t give her dose cups.”
“Well, Dr. Meanie, it doesn’t say anywhere on the script that you wanted dose cups.” And I read it back to her.
“And nobody questioned it when the prescription didn’t say that!?”
“No, doctor, we always pour it into a bottle. I’ve never seen dose cups outside of hospital pharmacy. If the patient wants individual dosing, you can either authorize a refill, or we could offer to prefill oral syringes for her.”
Well that set the doctor off. “Don’t you DARE offer her that! Her hands are too week to handle a syringe, that’s why I wanted dose cups!” Ok, doctor, so she can’t hold the bottle (too heavy) and she can’t use a syringe (too small), but she has the dexterity to pull the foil off of a small cup of medicine? (Imagine one of those ketchup containers they used to use at McD’s but even harder to open.)
Well, to make a long story short not quite as long, the pharmacist ended up deciding to just eat the cost of the original medicine (at least we’ll be able to send it away to be destroyed and get some money back) and order the dose cups.
$200 down the drain; and the government’s worried about wasting medicine (google “fraud waste and abuse” or wait for me to complain about it at some point.)
Ugh. I need some Carafate.
