Wendell,
I will try to explain how my loosely associated remark above pertains to caremark/cvs. Being mandated to eprescribe by the Federal Health care act, is similar as being mandated to change one's clocks twice yearly--as they are both legislative acts (I believe)and in my opinion two legislative acts that are attempting to change entities (not sure if this is the appropriate term) that are not possible to change (in my opinion)-- time itself and the human will. I understand the logic and reasoning for the time change when it occured as the US was more agragarian and was done to make it more feasible to get the crops in (as I understand it in a simplistic fashion)-however the issue for me has more to do with control than reason, especially the Federal mandate of Obama care. I really sympathize with Leslie's frustration, as we are being mandated to eprescribe, and when we comply and "bend our will" to be good citizens, we are the ones to suffer the penalty when unable to achieve the necessary percentage because the CVS/Caremark won't allow us to.
However the basic legislation of Obama care I think pits the will of the Doctor against the will of the patient. Therefore insinuates a third party into the mix, and thus the death of the patient doctor relationship.
I find myself more concerned and worried about meeting all these esoteric goals (pardon the cynicism)than actual patient care.
I think most if not all physicians are a caring bunch and try to make the world a better place, and know where our bread is buttered, and that our allegiance is and will always be to the patient first.
When the essence of my will, as a physician, is in conflict, I will always choose my patient first or I will have to find another profession.
Thus I am all for Leslie carrying on the torch -- I have also decided if a patient wants to continue with CVS/caremark with the Az zip, the one that doesn't play ball, then the patient will get a printed script to get their script (with an explanation why). I agree, I think we have to get the patient involved in the fight.
jimmie
