I agree with Bert. The pharmacies should call us. I started that about 22 years ago, and there was resistance at first. It used to be that patients would call the office and tell the receptionist they needed "refills" -- and I would get a note to "call in refills." Often, it was unclear what was supposed to be refilled, and especially with elderly and chronically ill people, it wasn't clear that our records and what the pharmacy was dispensing were the same at all. Often required several more phone call to get that straight.
So I changed, and said, if you want a refill, call the pharmacy -- don't call my office. It took a while, but finally everyone came into formation.
I said, if the pharmacy initiates the request, then I know exactly what they are filling, and I know it is a refill, and I can chart it as such.
On the other hand, if I initiate the request, it is a new prescription, I can't really be sure what your pharmacy fills the prescription with (maybe there is an error), and in any case, if I call to pharmacy, it is a NEW prescription and requires you to make an office call (and pay me). If the pharmacy requests it, it can be a REFILL, which we authorize without charge.
So, there are fewer errors and less cost to the patient if the pharmacy initiates the refill request.
Over time, the patients, the pharmacies and my office worked together to make a more workable system -- I tried to avoid power struggles and adversarial relationships. To a large degree it worked, and now most offices around here do it that way.
We are starting to work with pharmacies on e-prescribing, which except for the Long Beach Peninsula -- an out of the way place with a pharmacist who is way ahead of the curve -- the idea is new, and doesn't sink in very fast.
I usually give patients a printed or written Rx even if I send the eRx. I really don't trust the system yet, and if the patient has a piece of paper, they feel more secure. It wastes paper, but avoids phone calls.
Maybe some day everyone will get on board. The increasing complexity of it all, and the increasing number of fingers in the pie make me doubt it. I'm guessing the whole thing will collapse within 5 years, and we will be back to 5x8 index cards for recording office calls and accounts in the same place.
