Tuesday, May 13, 2008

My Cousin the Doctor...

There's been a bit of hoo-rah lately about patient/provider relationships...and whether there is one if the patient never really sees the provider but just chats online or via phone. Fortunately Pharmacists have been charged with determining this prior to filling prescriptions (because we have nothing better to do).

This weekend a prescription for an antibiotic was called in from Michigan for a patient residing in Washington. Odd...but maybe they travel back and forth...odd...they also get chronic meds for diabetes, heart disease and some kidney disease from this prescriber...odd...think I'll ask when they come in. The patient professed to be a physician himself (even though he didn't understand difficult jargon like "chronic" vs "acute" conditions). He tells me that he saw this prescriber 2 weeks ago for his ongoing nephritis (hmmm) and that there is a patient/provider relationship. I had left a message for the prescriber and he had never called back so the patient contacted him and asked him to call the pharmacy. Prescriber calls and gets all cranky at me because his patient's medication is not ready and demands to know why...well, I'm having a bad hair day, my pants were not dry when I left that morning and I'm wearing a pair that are too tight (because I've gained a little weight lately) and I'm a little cranky because I'm about to start my period...so I interrogate him unabashedly:

"When was the last time you saw your patient?" (last summer...)...someone is lying.
"What are we treating?" (ongoing nephritis that I saw him for last summer...)
"What is your relationship?" (he is my cousin...and I treat him) ...wasn't where I was going with that question but good information to know!
"How do you monitor his hypertension and diabetes?" (he monitors himself...) ...can I get paid for filling prescriptions and have the patients do it?

You can imagine his delight when I tell him I'm not going to fill his patient's prescription because of failure to establish provider/patient relationship. And you can imagine the patient's delight when I tell him that his cousin/provider contradicted him and said that he hadn't seen him since last summer. I ask the patient why he didn't just write a prescription for himself and he replies that he never ends up taking medication he prescribes himself...what the!!!! Ok, whatever!!!

I have to say that a little confrontation feels good when you're cranky, but it did nothing for my tight jeans or my bad hair...

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