Paul,
First, I think I have discovered a place in AC to chart the drug specifics....in the Alert section which I use for little if anything.
Secondly, the patients who are taking advantage of this are those who either have no drug insurance, or find it cheaper and easier just to get this or that script locally (rather than through their insurance plan). I do not know of any contractual requirements forcing a patient to go one place or another. I think it has all been monetarily driven.
Third, child-proof containers are not mandatory in my state (don't know about NY) and my patients are generally much older. Like everything though, cautious warnings to the patient about the handling of drugs is given. I know of numerous patients who, because they themselves cannot get into the CRCs, simply leave the caps off...not really any different. The only meds going into pill envelopes are "single event meds
like antibiotics. All others are dispensed via stock bottles.
Apricot, I have not crossed the hurdle of "I can't afford it today, will you bill me" yet. But, I certainly have thought about it. In general, I think it would be safe to assume that, should a patient come into see you, say for a UTI, they would be prepared to go to the pharmacy and pay for a script. I know of none that would bill them. For those wanting their chronic meds I expect I will simply make it a policy of, no cash, no meds (although knowing me I will probably give away meds to some). It is bad enough not to get paid for the office call but then to get snookered also on their meds would be stupid.
Remember, I have not even been at this for a week yet. I have a lot to learn.
Leslie
