I think that putting the pharmacy between us and the patient is as much a mistake as putting the insurance companies between us and the patient. Patients need to take responsibility for themselves sometimes ("I can't have a flu shot because my insurance won't pay for it"). Sometime those automatic refill requests come in on meds that have been discontinued, changed, etc. If we are willing to address these automatic requests then we wind up chasing our tails and validating/invalidating info that the pharmacies have all in the interest of making things "look" seamless to the patient and making the pharmacy/insurance look good. Not MY agenda.