Date: 4/12/2005 3:38:00 PM
From Authorid: 3263
Ooh this is a tough one. I think it is totally inappropriate for a pharmacist to deny contraceptives, but the example you posed isn't so easy. I guess I'd have to say that I hope the pharmacist has proof and wouldn't just go off of a hunch.  |
Date: 4/12/2005 3:45:00 PM
From Authorid: 46527
In the case of a patient filing prescriptions from a number of different doctors then yes, of course they should be able to refuse to safeguard the patient from both overdose and addiction.  |
Date: 4/12/2005 3:47:00 PM ( From Author )
From Authorid: 36704
The person had filled all the prescriptions at the same chain so they have it all on file DC and he had two different Dr.s prescribing a months worth of painkillers and went through those in less than two weeks. Went to the ER and got another prescription, went through that and then went to a different ER and got another prescription.  |
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Date: 4/12/2005 3:48:00 PM ( From Author )
From Authorid: 36704
I would think so LSR but the person disagreed and felt the pharmacist should have filled it without any questions, called the headquarters who did punish the pharmacist for refusing. |
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Date: 4/12/2005 3:48:00 PM
From Authorid: 3263
LSR, I agree, but how would the person be caught, especially in the instance where they don't have insurance? I worked at a clinic for 5 years, we had a few patients who had several different aliases and actually got away with it for awhile. I remember when the one chick got caught, we pulled all five charts. FIVE! Wow. |
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Date: 4/12/2005 3:49:00 PM
From Authorid: 46527
Five! That's dreadful. Over here all our pharmacies are linked by computer system, the patients prescriptions are all recorded. |
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Date: 4/12/2005 3:50:00 PM
From Authorid: 46527
Base, the pharmacist should have been commended for refusing not reprimanded! Just goes to show how money mad the world has gone when profits are worth more than safeguarding a person's health! |
Date: 4/12/2005 3:51:00 PM
From Authorid: 3263
I gotta go back to work, I'll check back when I get home  |
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Date: 4/12/2005 3:52:00 PM ( From Author )
From Authorid: 36704
I kinda think so also LSR, the pharmacist is correct that the person is addicted. |
Date: 4/12/2005 3:56:00 PM
From Authorid: 53052
i know it's pretty easy to go into a walk in clinic and get a perscription from a doc for pain and it's pretty easy a person could do that at 3 different walk in clinics on the same day! i think before they should deny it they should call the doc who wrote it (sorta a "just calling to confirm you wrote this perscription for this person and did you know he is also on this and this what he has filled out recently" i'm all for denying something that contradicts with a drug a person is on.... my friend just recently got her meds upped and they talked to her about how it interacts with her birth control pills and because her pills are a fairly low dose already...  |
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Date: 4/12/2005 3:57:00 PM ( From Author )
From Authorid: 36704
I don't think you can call the person's Dr. here Midnightly, the whole patient confidentiality thing. |
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Date: 4/12/2005 3:58:00 PM ( From Author )
From Authorid: 36704
I don't mean you can't call the Dr. to make sure they prescribed it, but you can't disclose the other prescriptions. |
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Date: 4/12/2005 3:59:00 PM
From Authorid: 46527
That's CRAZY, surely patient protection should PROTECT the patient, not enable them to play the system! |
Date: 4/12/2005 4:02:00 PM
From Authorid: 37843
In this type of case absolutely.  |
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Date: 4/12/2005 4:05:00 PM ( From Author )
From Authorid: 36704
Here's the catch LSR "Courts in [Indiana.sup.2], [Arizona.sup.3] and other states have indicated in recent years that a patient may sue a pharmacist if the pharmacist fails to monitor overuse and potential abuse of prescriptions. In addition, the Drug Enforcement Agency often attempts to hold the pharmacist liable to detect prescriptions for controlled substances that are not for legitimate medical purposes. A pharmacist who fills all such prescriptions without question may face civil, administrative or even criminal liability. Conversely, patients have the right to receive medication prescribed lawfully. Pharmacists are not granted veto power over physicians' right to prescribe." |
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Date: 4/12/2005 4:06:00 PM ( From Author )
From Authorid: 36704
so if they don't fill it they can get in trouble with their employer, if they do fill it they can get in trouble with the DEA |
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Date: 4/12/2005 4:11:00 PM
From Authorid: 53052
i think a pharmacy(these people are trained to fill out perscriptions and spot potential risks to the customer) should be able to call the doctor who wrote the perscription if they think there is a problem |
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Date: 4/12/2005 4:12:00 PM
From Authorid: 53052
i'm not sure if it works that way i just think that's how it should work... |
Date: 4/12/2005 4:29:00 PM
From Authorid: 62752
funny i was gonna make this same post lol... i think no they shouldnt, there job is to fill it, but there have been some who have saved lives because the doctor messed up, i think on birth control and stuff no way, there religious feelings should stay out of it  |
Date: 4/12/2005 4:35:00 PM
From Authorid: 23075
I've had something like this happen to me. I take Imitrex for migrain headaches...I get them bad but not often. My doctor filled out the prescription for me to receive 12 each time the prescription is renewed. HOWEVER, one day my pharmacist said that he didn't think I needed 12 and only gave me six. However it is hard to decided because I also have a freind that has doctored prescriptions to get percodan and oxycontin.....What the pharmacists do here where I live is if you take aprescription in to be filled they call the office to verify the prescription.  |
Date: 4/12/2005 4:37:00 PM
From Authorid: 28946
I agree with LSR and that is the way it's done at our local pharmacies. I don't know the legal aspects of it but shouldn't the pharmacists be the ones to recognise that a client is going through the pain meds too fast and having other docs fill them? Since the new HIPPA law went into effect, a doctor cannot ask another doctor about a former client without permission and that can be scarey in this kind of situation.  |
Date: 4/12/2005 4:38:00 PM
From Authorid: 16671
When it comes to pain meds, yes because too many are abusing pain meds and going to more then one doctor. In the old days, they were not computer connected, they didnt know how many doctors of pharmcies ya went to and my brother had a field day. But when they got connected he could no longer abuse pain pills. NOT that he isnt in pain, he is, bad back and surgery, but if one takes the pain meds as directed by the doctor, rarely does one run out of what they need. If for some reason one does then they need to go to the doctor and tell them the circumstances and usually the doctor *or at least here* will call the drug store and let them know its ok to fill another prescription.  |
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Date: 4/12/2005 4:39:00 PM ( From Author )
From Authorid: 36704
but what about pain medication Kristen? |
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Date: 4/12/2005 4:39:00 PM
From Authorid: 28946
I live in Indiana and just read what you posted about Ind. law. |
Date: 4/12/2005 4:39:00 PM
From Authorid: 11341
In the case of BC, nope they shouldnt but in the case you said up there ^^ YUP! A bartender would get in trouble for serving too much, shouldnt a pharmacist? I think all pharmacies should be linked, and not just chains.  |
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Date: 4/12/2005 4:41:00 PM
From Authorid: 16671
Gee I just read the rest of the comments and base that is crazy, its like they are danged if they do and danged if they dont. |
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Date: 4/12/2005 4:44:00 PM ( From Author )
From Authorid: 36704
lol that pretty much sums it up FB |
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Date: 4/12/2005 4:45:00 PM ( From Author )
From Authorid: 36704
I guess the difference is a bartender doesn't have a Dr. prescribing someone alcohol DMK. |
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Date: 4/12/2005 4:54:00 PM
From Authorid: 11341
Point being Base, they are responsible (or should be) for what they "serve" people. |
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Date: 4/12/2005 4:59:00 PM ( From Author )
From Authorid: 36704
and the DEA agrees with you and the court and most patients who are denied, disagree with you |
Date: 4/12/2005 5:04:00 PM
From Authorid: 27046
I would LOVE to find out where people find their doctors. Maybe it's just a thing here in NY but you have to have some SERIOUS ailments going on to get any kind of narcotic pain killer. In a case like that I think they should be able to refuse to fill the script, that doesn't mean the person won't walk out and get it filled at the next pharmacy, but otherwise and in other cases, they need to just fill the scripts and keep their opinions to themselves. I would be LIVID if I walked into my pharmacy and was refused my birth control script.  |
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Date: 4/12/2005 5:16:00 PM ( From Author )
From Authorid: 36704
maybe you have stricter laws in NY |
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Date: 4/12/2005 5:35:00 PM
From Authorid: 27046
I dunno Base, but I almost fell over when I heard that a 14 year old CHILD was prescribed vicadin by the ER doctor for a freaking sore throat! The problem is so bad in that state that you can walk outside punch a brick wall to bruise your hand pretty good, walk into the ER and get them. They hand them out in that state like they are candy. |
Date: 4/12/2005 5:35:00 PM
From Authorid: 2030
Shopping doctors and pharmacies for medications in excess of the manufacturers recomended dosage is illegal in many states. Rush Limbaugh was busted for doing this very thing, along with buying bootleg medications.  |
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Date: 4/12/2005 5:36:00 PM
From Authorid: 27046
That's in RI by the way^^^^^ |
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Date: 4/12/2005 5:37:00 PM ( From Author )
From Authorid: 36704
it's illegal in some states, yet the pharmacist can get in trouble for following the law |
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Date: 4/12/2005 5:38:00 PM
From Authorid: 27046
Yeah, I'm kind of curious how that happens. Medicaid patients just can't go from doctor to doctor and neither can medicare patients. You have to be referred in order to go to different doctors. Private insurance requires the same thing. I have CDPHP and unless they change the dose, you can't refill your script for the next month more than 3 days in advance from the last one or the insurance company denies it through the computer. These must be uninsured patients getting away with this? |
Date: 4/12/2005 5:42:00 PM
From Authorid: 59876
our pharmacists wouldn't refill my mom's vocoden because they said she was taking too much throughout the month and would be building up too much tylenol in her system, so they called her doctor and he okayed them to fill it anyweay, and then next moth switched her to methadone to avoid the tylenol toxidity. she had been using the vicoden for so long that she built up tolerance and needed more and more of it for it to be effective. i think the pharmacist did the right thing, but the difference is, we have kaiser, which is all inclusive, the pharmacists are the same company and often on the same property as your current doctor. if the pharmacist decided you only needed six of something instead of twwelve, would the actual prescription cost change? that could be a cost factor. what if you need to maximise what your getting and what you were allowed to have by prescription to save costs? or to get the rest, had to see the doc again at additional costs? not really a factor for our family, but could be for others. i'm not sure they should do that, overriding the doctor's prescription without getting in contact with the doctor.  |
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Date: 4/12/2005 6:07:00 PM ( From Author )
From Authorid: 36704
My private insurance doesn't require it Az. only in certain situations and my prescription coverage is a separate company than the medical coverage. |
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Date: 4/12/2005 6:39:00 PM
From Authorid: 27046
I have stood in the pharmacy on several ocassions and heard the pharmacist tell a person that they have to wait another week or another few days to fill their script because it was too close to the last refill. My insurance company is all in one and does the same thing. |
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Date: 4/12/2005 8:06:00 PM ( From Author )
From Authorid: 36704
I've been behind people told to wait, but it was to wait for insurance to pay. The insurance wouldn't cover it for five more days but the person could pay for it out of pocket. |
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Date: 4/12/2005 8:40:00 PM
From Authorid: 27046
Yeah, they could pay for it out of pocket, just not have insurance cover it. Perhaps if I was a pain pill junkie I would pay $100's for the medication, but since I'm not, I wouldn't and I would wait for the insurance company to cover it. I pay them jerks for a reason...LOL |
Date: 4/12/2005 9:18:00 PM
From Authorid: 47218
I see more problems with giving pharmacies the power to do this than not-- many people HAVE to have their medications, if the pharmacy has your prescription you can't just go somwhere else if they turn you down, so you're out of luck till the next day or even the next few days if it's the weekend. How does the pharmacist make the determination that someone is addicted? Wouldn't it be better to consult the doctors directly about the problem to stop it there? Isn't this what they ought to be doing in the first place?  |
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Date: 4/12/2005 9:21:00 PM ( From Author )
From Authorid: 36704
In the situation I described Mollycat, he just drove a few blocks to a different chain who filled it. His point was kind of your point, that the pharmacist didn't know what it was being prescribed for. It was an ER Dr. who prescribed it so I don't know how consulting them would work. He did get the drugs, even though the pharmacist was correct in he is abusing them. |
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Date: 4/12/2005 9:22:00 PM ( From Author )
From Authorid: 36704
Guess that's the difference between you and a junkie Az. they're willing to pay for it and you're not. I'm not saying that every person doesn't need them, but this was a pretty clear sign of abuse and this person has a past history of overdosing. |
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Date: 4/12/2005 9:24:00 PM ( From Author )
From Authorid: 36704
I don't see why our pharmacies can't all be linked like they are in England. |
Date: 4/12/2005 10:08:00 PM
From Authorid: 42945
I would think that the Pharmacist would contact the doctor who supplied the prescription and tell him/her of what he believes the customer is either addicted to it or if the customer is getting the prescriptions off other doctors as well....hugs  |
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Date: 4/12/2005 10:20:00 PM ( From Author )
From Authorid: 36704
Even so Zema, the Dr. can tell the pharmacist to fill it anyway at which point, he seems bound despite his better judgement to fill it. Dr.s do get kickbacks from pharmaceutical companies. |
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Date: 4/12/2005 10:36:00 PM
From Authorid: 59876
even the all inclusive insurance programs have their problems. for instance, my mom has medical through kaiser and she has to use a solano county health insurance card in conjunction with it. the card is limited to our immediate area. most of her prescriptions were for three months at a time except the pain pills but now it seems as if all her scripts are monthly. that means she can't go anywhere for too long if she wants to be able to refill her prescriptions. when my son was born, he was born in walnut creek kaiser, the next county over. he was deathly ill and we were with him constantly. my mom ran out of diabetes medicine and kaiser walnut creek refused to refill the prescription because it wasn't solano county. she was completely out with no way to get back to solano county to refill her prescription. the story had a fine ending, but it wasn't like it was pain pills, but it could have been life or death. i was frustrated and hormonal of course, called all over the place, and the only thing i could get was health and human services which closed at five. there was no help offered beyond that. what i want to know, and it's slightly skewed off topic, is if a bottle had refills listed on it, could we have taken just the bottle to a regular pharmacy and refilled it out of pocket? or do you have to have the actual presciption paper? end of story, finally we got lucky and a pharmacist passed my mother two diabeta to get her through the night bless his heart. |
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Date: 4/12/2005 10:37:00 PM
From Authorid: 59876
lots of people are also filling their prescriptions after office hours when the doctor can't be reached. in that case, should the pharmacist fill it, or wait? |
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Date: 4/12/2005 10:47:00 PM ( From Author )
From Authorid: 36704
sorry to hear about all your problems with the insurance, good question, we have automated refills here that you can call in at any time and they fill them over night. You leave the time that you're going to pick it up so I don't know how that would work, maybe the pharmacist could call and say he needs to speak with a Dr. before filling it? |
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Date: 4/13/2005 5:54:00 AM
From Authorid: 59876
sorry for all the typos, i didn't realize. my keyboard is cordless and if i get it too skewed, it misses letters. |
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Date: 4/13/2005 8:29:00 AM
From Authorid: 27046
I'm not disagreeing with the abuse Base, but rather agreeing that a junkie would pay the money, where someone who isn't would wait it out. |
Date: 4/13/2005 8:52:00 AM
From Authorid: 47162
these are activist pharmacists...........they don't follow the rule of law........they distribute based on subjective personal feelings.....not based on the law...and how wrong it is......we didn't elect them...and some of them serve for life  |
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Date: 4/13/2005 9:48:00 AM
From Authorid: 27046
Resilent One, actually they have the same permission that a doctor has, which is not to perform or practice areas of medicine that they morally oppose or something to that effect. Whatever thing says that a doctor just because he's licensed to do so can't be forced to offer abortion services if he/she is morally opposed to them, the pharmacists have that also. |
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Date: 4/13/2005 9:50:00 AM
From Authorid: 27046
If I am not mistaken, I believe Base is the one that offered that information on a similiar debate when a situation happened where the pharmacist refused to fill a woman's birth control prescription. |
Date: 4/13/2005 11:11:00 AM
From Authorid: 59418
I guess, to protect the patient. But If the patient seriously wants to overdose and kill themselves they'll find the medication somehow...I mean you can buy paracetemol etc easily from supermarkets.  |
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Date: 4/13/2005 1:27:00 PM ( From Author )
From Authorid: 36704
I knew what you were saying Az, sorry if I wasn't clear and yeah it's the conscience clause. |
Date: 4/14/2005 6:43:00 AM
From Authorid: 57225
hmm i dunno, tough call i suppose. i think they have a right to look into it if it looks suspicious, i dunno about refusing service though. i really don't know.  |
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Date: 4/14/2005 10:03:00 PM ( From Author )
From Authorid: 36704
it's a hard one skoola |
Date: 4/16/2005 8:15:00 PM
From Authorid: 22080
no, its discrimination regaurdless  |
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Date: 4/16/2005 8:16:00 PM
From Authorid: 22080
also as for feeling they are addicted, there should be state records of how many times there was a refill on that and then they should be allowed to launch investigations. |
Date: 4/16/2005 8:52:00 PM
From Authorid: 12341
I once had a patient who tried to use my name to call in a script for pain meds, she didn't realize that pharmacists keep track of both first and last names and positions of those who call in for medication. They are just doing their job like everyone else. In the old days, there wasn't the tracking system we now have for those who see multible doctors for multible scripts. It isn't as easy as it used to be for pharmacies to be taken in by forged scripts or multiple scripts. They have every right to refuse service.  |
