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Is the insurance company telling the truth?

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This is a comment by a “Med Student” to that 4-degree doctor comment. I love getting emails from students.
— Part 1 —

I completely understand what this Dr. is talking about. I always have problems with insurance at the end of year, start of new one. I have chronic pain and also am on a maintenance drug, I take daily for my heart. I went to refill both as I normally do on day 28-29 since the last refill and of course I get the dreaded “It’s too early” from the insurance..but no problem right?

That right there tells me that something is up. Most insurance companies will give a 5 to 7 day window before it kicks back the “refill too soon” error.

Because they tell me to pay cash, and send them the receipt, so I tell this to my pharmacist. Well now, even though I have been going there for over a year, same meds, same amount, same Doctor..she parrots the insurance company (who doesn’t realize there is a HUGE difference between the meaning of THEIR “too early/soon” and a Pharmacies “too early/too soon”) and I ask her, how is it too soon? It’s been 28 days since I last picked up my meds? She wouldn’t answer me. She instead says that she would fill it next week (which btw is at day 33, which means, I’m without my meds for 3 days, which is HUGE, if I miss even one night without my heart med, I start getting some major palpitations..) but it seems she’s made up her mind. She decided to make her OWN medical decision without knowing my complete medical history, as my own personal doctor of over 7 years knows.

To be honest, you are giving me only the information that you wish to give me and I’m sure there is a key bit of information that would make sense that you aren’t giving me. There could of been an ER script in there for a week supply thats throwing everything off, another pharmacy involved, etc. Something however really doesn’t jive with what you are saying. I’m not saying that you are at fault, but with all of the insurance companies I have never heard of one that will kick back a ‘refill too soon’ error when its 2 days remaining on a 30 day supply. Even if you had no coverage, it would say ‘patient not covered’ not ‘refill too soon’.

So, tell me, why is there NO recourse for me for Pharmacists like this when I assure you, I’m no crack addict. I’m a normal person who unfortunately got JRA at 13 with horrible joint damage and chronic pain that I have been living with all my life. Instead of collecting disability like most would, I instead went through school (honors) and now am in my 3rd year of Med school getting my MD/PHD while also working with Congressional members and House members on a daily basis.

Dont take this the wrong way, but if I had a dollar for everyone assured me that they didn’t have a problem as I am looking at their state narcotic report and seeing 4 doctors, 3 ER’s and every Walgreens in town I think I could retire. When everyone and their brother lie to you day in and day out, you tend to not believe everything at face value unless compelling information states otherwise. I hope you would actually read the study on a new drug rather than take at face value what some drug rep tells you, right?
You may think this is bad medicine, but wait until you get out and get a visit from the DEA because you are shoveling vicodin out of the door to everyone who gives you a half-assed sob-story. Its amusing to see new Dr’s backpedal from their ‘we must treat everyones pain’ after I tell them that their patient is going to 3 different pharmacies and 2 other doctors for their narcotics. Its like a real-world shock that there are people who lie and deny to get what they want.
I deal with tons of legitimate pain patients every day, and you know what? I never deny them their pain pills if they are a day or so early. However, this being ‘The Angry Pharmacist’ it doesn’t make for a good read to tell how much I help people. People want to read what pisses pharmacists off, and I know that I have been extremely clear stating this in the past.

There is WAY too much stigma attached to ANY type of pain killer. If it’s for legitimate pain, one shouldn’t be denied healthcare.

Yeah yeah, save me the ‘chicken for every pot’ story. There is no stigma unless you make it a stigma, and in your example above something red-flagged that pharmacist. Vicodin + “Refill Too Soon” = something is going on. Now if your insurance company would not have given that error message back, do you think this would be even an issue? I dont think so. I would also like to hear your definition of ‘legitimate pain’, because last time I checked people don’t go into the doctors office saying “Hey, I need a vicodin Rx to make my car payment or to deal with my bitchy ass wife”.

I do want to point out that:
A. This has never been a “problem” for the Pharmacist before, until insurance denied my claim for a week or so until coverage kicked in
B. The amount, doctor, strength has NOT changed and it IS a legit script, so you cannot argue that she may have denied it on basis of some sort of “suspicion” that it may be fraudulent, etc..

Blame the insurance company, not the pharmacist. They are the ones who threw back a “refill too soon” message. As I said before, if the insurance company wouldn’t of thrown that back, would we even be having this debate now? So, lets break this down a bit more.
Something happens and DEA gets on your case for something. DEA officer comes in and asks to see the hard copies. DEA also has subpoenad your insurance company. DEA asks pharmacist “When you filled this Rx, it came back from the insurance company as ‘refill too soon’. Why did you fill it?” Whats the pharmacist supposed to answer? “Because shes in legit pain and says that she isnt a pillhead?” Yeah, that’ll fly like a turd on a birthday cake.

THOSE are the types of Pharmacists that are trying to practice Medicine without a degree. There should be some sort of consequences. *I* was ticked off at the fact that she “offered” to call my doctor to see if it was ok to “refill early”..MY argument here was, it was NOT early. 28-29 after getting the original fill is NOT early, ESPECIALLY NOT when your on maintenance medication in which you must take it every day.
My doctor is a nice guy, but he REALLY is busy, he spends 12 hours at a busy ER and the rest of the time at the practice, he does NOT have time to get on the phone (which can be backed up by his wife!) to be questioned about nonsense!

I think you should nail your insurance company for practicing medicine without a degree. If the insurance company is kicking back an early fill error, then something else is going on. I would call your insurance company to see who possibly stole your identity or your insurance card and is running up some vicodin scripts with it.
— Part 2 —

I’m sorry, I forgot to add a little more background.
I had been at Walmart Pharmacy last year and the same thing happened then. At the end of year, my insurance changes because that’s what the company forces us to do, they LOVE making life miserable. Well, Aetna has 2 numbers, the business number for customer service and the PHARMACY number the pharmacies are supposed to call. Well, when I needed my refill, the computer denied the claim and the tech called the BUSINESS line, which BTW they are completely useless. All they said was basically it was “too soon”

Wait, so this has happened with 2 pharmacies? Something now is really fishy especially if its coming back ‘refill too soon’ both times.

Well, at THIS point, I had been EXTREMELY busy, I was the campaign manager for a House member and forgot to call in my refill, so I called at day 30! (I almost NEVER do this..or at least try not to..with my luck, something comes up and I forget to pick it I always give myself 2 days wiggle room)

Filling your Rx on day 30 when you have a 30 day supply should go through with no errors. Unless you are getting it filled somewhere else, the Rx was mistakingly put in with a days supply higher than 30 (doubtful with Aetna, it would of gotten rejected), or someone else is using your card.

Well now, I get there and the pharmacist and I literally get into it, she starts screaming that it’s TOO Soon! I KNOW this is wrong, so I sit there and call the CORRECT number for the Pharmacy portion of the insurance and I actually am able to get the DIRECTOR of Aetna on the phone, she tries to speak with the Pharmacist, but the pharmacist will have NONE of it. the director feels bad for me and apologizes and says, I’m sorry, but she just wont listen to me. (The director tried to explain it’s all about the coverage and end of year etc..that it’s NOT too early for the refill)

You got the Director of Aetna? I’m sorry, but I’m having a hard time believing you. The pharmacist has to go by what is on his/her screen, and if Aetna is claiming its too soon then tell them to fix their shit to give back accurate error messages.

So, my DOCTOR calls the pharmacist (keep in mind, Im standing there at the pharmacy for 2 HOURS watching all this) and he tells her, you HAVE to fill this refill! The pharmacist REFUSES, quoting the comment of the clueless wonder at the insurance company the very 1st time, “Insurance is saying it’s too soon” which at THAT time, everyone in line almost faint FOR me because the director actually called and the pharmacist would NOT listen to her. So, my doc calls me on MY cell phone and boy, is he pissed! He’s like, I dont know why she wont listen to me, I’ll go ahead and call a new script at a different Pharmacy because this is ridiculous.
THATS when I go to this new pharmacy, I explain what happened and even though I feel as if I dont HAVE to or need to, I actually go through all my medical conditions, etc. MY thinking is, this is a smaller Pharmacy, I want a more personalized interaction. I want to feel like a person and NOT a refill number, ya know? My Physician even went as far as to stop in and introduce himself! Seriously, we have gone above and beyond here.

Its always good to explain yourself even though you don’t HAVE or need to. You know, we’re just stupid pill dispensers and don’t need to know ANYTHING about you. Give me a fucking break, you must really be a med student with an attitude like that.
Pharmacists tend to get a bit pissed when you withhold information especially when the words “another pharmacy” and “refill too soon” are in the same boat as your narcotic Rx.

So, That is just another reason why I’m sooo ticked that I’m having this problem. Is it so difficult for her to look at the dates?
I’m thinking (in both cases) it’s a matter of their pride, they were wrong and don’t want to admit it. But *I* am paying the price for that while they have absolutely NO consequences for their actions.

Blame Aetna, didnt they give back the refill too soon message that started this whole thing?

After reading quite a few posts of yours, I know you have this thing about thinking everyone is a “pillhead”, but I’m guessing even you would be able to put aside pride or ego and not actually DENY a patient legit care…afterall.. isn’t that why you became a pharmacist? One has to wonder about these pharmacists, is it an ego trip that put them in this field or is it helping people.

No, I dont think everyone is a crackhead or an addict. I however dont take people’s word for anything now days unless I have good and solid evidence that they are being legit with me. Its not pride or ego, its doing our fucking job to control narcotics and to manage the medications that multiple doctors prescribe because its impossible to call each other to see what the others is giving. Amazing how stories change when I get a refill too soon error, ask the patient if they received some at another store about 4 times, call the insurance company to find out what store filled it, then ask the patient point blank if they got it as that store. Then I asked why they fucking lied to me when I have to crowbar out of them that they did get some at another store. Get this done to you (which is a complete waste of my time) about every other day, then you’ll realize that its not “pride” or “ego”.
Lets face it, Aetna probably gave that pharmacist some bum information. If it would have been me, I would of called Aetna and had them give me the pharmacy that last filled it. If you had no idea about this other pharmacy then I’d ask for a copy of the sign-out log and inform the police about narcotic/insurance fraud. You would not believe the amount of shit dropped in pants when I threaten to call the police. Amazingly they manage to remember that they got 30 from an ER doc YESTERDAY. Must of slipped their mind.
However from what you have wrote, you don’t really sound like the easiest person to get along with or work with to get this sorted out. You probably just started screaming at the pharmacist which really doesn’t help anything. Screaming isn’t going to get your pills filled when there is documentation (from the insurance company) that it was too early to be filled (something had to trigger that message).
Of course I will also entertain the fact that you gave me everything and the pharmacist is just being a dick. It happens just like there are asshole doctors in the world who think their shit is worth as much as Zyvox and their farts smell like Warrick Albuterol MDI’s.
So good luck in Med school. When you get out you can rant to me about that mean ole asshole pharmacist who wont fill the Rx’s you write for yourself.

Comments #

Comment by CPhT on 2008-01-08 05:06:48 -0800 #

A few points.

  1. I had a patient with a selective memory like that. He used to get his Darvocet-N 100’s filled the minute the insurance would let him at my store. Finally, it kicked back that it was filled a few days prior at, according to the rejection, an “other pharmacy”. Medco is the best, since if you call their automated line, it tells you what store and their phone number. The fact that this patient claimed he was out when he wasn’t all the time prompted me to call the Other Pharmacy, and I spoke to the pharmacist who both filled the prescription, and rang the man up. He told me exactly what my patient looked like, said he could pull the signature log if the patient still insisted it wasn’t there, and I called the patient. He swears to me he didn’t go there, so I explained my interaction with the other pharmacist. Well, wouldn’t you know it, all of a sudden, he remembers going to get it! That same thing then happened again with the DVN’s, and later, some Lomotil tabs. Surprise, surprise. I don’t know what he’s doing anymore, since I think he got sick of me pointing out that I can’t fill a control, even billed to cash, that was filled 2 days ago somewhere else, but this is a prime example as to why I don’t trust people anymore.
  2. I had another patient who had somebody in California (we’re on the east coast) using her insurance numbers. Every month, I had to call Medco to get them to override her Synthroid being too soon. I kept insisting to the patient she get a new insurance card, but she refused. Finally, I called the store in California, and got them to delete the patient’s ID from the file, and we never had a problem again. People don’t realize that others can steal their information, and should be much more careful. She’s very lucky it was just Synthroid being filled on her plan.
  3. Your point about turning down doctors writing their own prescriptions is dead-on. We, as a policy at my store, don’t accept controls for a doctor from that doctor. Most doctors have some sort of colleagues or doctor friends, at the very least. It’s not hard to get a friend to write for you.

Comment by Hogarth on 2008-01-08 05:54:15 -0800 #

Seems like this guy is reading a lot of judgement and/or intent into refusing to hand over expensive product that the PBM has said they won’t reimburse for. What does he think a pharmacy is, a charity? If the PBM says “we ain’t paying,” why would you EVER just hand out product?

Comment by Pharmacy Mike on 2008-01-08 06:25:38 -0800 #

There is no doubt in my mind that this guy is conveniently forgetting to tell you a little piece of information that makes this all makes sense. Unless he just happened to run into the biggest asshole pharmacist in the entire world, something is up here.
I also have a very very very hard time believing that his incredibly busy doctor, who is too busy to make a phone call to a pharmacy, showed up in person to introduce himself to the staff of the new pharmacy.
This whole story reeks of bullshit.

Comment by Michelle on 2008-01-08 07:14:25 -0800 #

I’m a retail RPh, and have been for years, and the first thing that pops into my head is this “wiggle room” that he claims to give himself EVERY month by filling his Rx a few days early…EVERY month. The rejection is legitimate as far as I can tell, because over a year (let’s do the math since all us pharmacists know how to do it count and pour, right?) at two days early for every fill, he is now 24 days early. It’s a “cumulative refill too soon” edit by the insurance company, not a conspiracy for the pharmacist to yell at you (although in your case it sounds like you deserved any pharmacist’s wrath).
So, MedStudent, before you decide that the pharmacist, pharmacy, and insurance company are denying your precious narcotic just to be assholes, unless you’re stockpiling your Vicodin somewhere, you’re taking more than your doctor has written for.
Your ego needs to be put in check, and I hope that when you become a real doctor and you fuck up BAD on a Rx and a pharmacist saves your ass and keeps you from killing a patient, you get on your knees and beg for forgiveness about thinking “THOSE are the types of Pharmacists that are trying to practice Medicine without a degree”.

Comment by Kelly on 2008-01-08 07:47:18 -0800 #

The dr. was able to *call in* an rx for a pain killer? I have to go to the dr. office and pick up a script for Ultram in person to take to the pharmacy. I experienced this in another state as well. Is this something that varies by state or is there something fishy in the story?
It does sound like any problem in this story is on the insurance side. Changing insurance companies is painful — you have to get preapproval for certain meds done over, etc.

Comment by memphis on 2008-01-08 07:58:31 -0800 #

They really hate it when you call that other pharmacist that deals with them and then busts there ass. I’ve done this twice and it feels good. I also had some crack head attempt to sell her vicodin on our phone before she got them… it was a great feeling to tell her and her pill popping lover to get the hell out.

Comment by everyday miracle on 2008-01-08 08:05:01 -0800 #

Oh glorious med student/politician something is not right here. Having been a pharmacist since 1982 I deduce: insurance companies suck, you are a pompous ass possibly on psych meds,or you are bullying for a $25 gift card. 99% of my customers are great. They bring me cookies and show me pictures of their grandchildren. You are part of the 1% that I wish would go elsewhere, but alas you never do. Believe it or not, we really are trying to help you.

Comment by SCPharm on 2008-01-08 08:09:48 -0800 #

Hmmm…I agree there is limited information here and there’s probably part of the story missing somewhere. Something doesn’t “add up” just listening to the tremendous detail given here about this problem. (What’s that unspoken truth about the overly “chatty” patient?)
It’s interesting that he mentions early on that missing a dose of the heart medication causes major palpitations and it was a MAJOR concern, but the rest of the post only discusses the repeated problems encountered trying to fill the pain medication. I don’t know about you, TAP, but we will gladly GIVE a patient a few days of a heart (or diabetes, seizure etc) if they are out for some reason (early refill, going on vacation, out of refills, they lost it, etc) as long as it’s not $15 bucks a pill and they don’t have this problem every month.
Now controlled substances? We are not covered to do that. I would love to see my DHEC officer’s face if an inventory discrepancy was found during their audits and I said “Oh yeah, I just gave them a few because they said they lost it” or “I filled it early b/c they told me they were out and the insurance was wrong.”
Anyway, I love your blog! The email you get is really crazy sometimes but it is nice to know other people go through the same crap at work!! Keep up the good work!

Comment by Rebecca on 2008-01-08 08:33:44 -0800 #

hi…i love your blog…but i am a grammar nazi as well as a pharmacist…
it is “would HAVE”…not “would OF”…i just thought you might want to know. of course, if you are blogging after a stressful day in the RX box and have slugged down some bourbon you probably don’t care about grammar! keep it real. i had to get out of retail after 15 years or i was going to become a homicidal maniac. i should send you my dramatic resignation tale.

Comment by Jason on 2008-01-08 09:27:39 -0800 #

Ok so this happens twice at two different pharmacies and he still has the nerve to blame the pharmacists?? I call insurances every day with the phone number that pops up on the reject screen and I have never talked to the director of any insurance company. This is a joke right?? I wish we could get the pharmacists side of the story just so we could try and get the real picture, b/c I have never seen an insurance kick back a refill too soon on anything at day 28 or 29. Many insurances will let it go through on day 23. If I was him I wouldn’t be complaining on here I’d be writing to the insurance company or calling everyday. Hell use some of his “political” powers to help get this resolved. What a joke.

Comment by Hogarth on 2008-01-08 11:34:00 -0800 #

Hint to Rebecca –
If you want to be a grammar Nazi, look around your office and see if you can find either of your missing shift keys. LOL

Comment by Crusty Rph on 2008-01-08 11:40:39 -0800 #

Michelle is probably correct — while the ins co will allow early fillings — they do have a cummulative effect. I think our student has some extra tabs he is not telling us about. If not– it is his insurance co. saying they won’t pay not the RPH. The phamacist is not denying the medication he is just stating the fact that the ins will not pay. Pay or palpitate — your choice.

Comment by Prophetess of Doom on 2008-01-08 12:48:31 -0800 #

Okay, “too early”. Maybe filled elsewhere, maybe not. You can’t fight the computer, well… most of the time. After exhausting all plea bargaining with the insurance and the Doctor says “fill it”, this is what we do.
Fill it. Fill it for cash. If the patient wants it, fine. If they don’t want to pay for it, fine. It’s their choice at that point.
No “backdating”, no re-do’s when it’s “okay to fill”. That is the option, take it or leave it. But we don’t deny someone medication. That’s the job of the doctor’s and the insurance.
If the Doctor says “too soon” then so sad, too bad. You don’t get it from us.

Comment by Jeff on 2008-01-08 16:09:26 -0800 #

This “med student” has the mathematical skills of an autistic dog. I quote… “I went to refill both as I normally do on day 28-29…It’s been 28 days since I last picked up my meds? She wouldn’t answer me. She instead says that she would fill it next week (which btw is at day 33, which means, I’m without my meds for 3 days…” Don’t they teach math in med skool? Let’s do a word problem. If you receive a 30 day supply of something on Jan. 1st and get another 30 day supply on Jan. 28th, how many days supply do you have after getting it filled on the 28th… If you said 30, take another soma and try again. The correct answer is 32. Then if you get it refilled 28 days later (Feb. 25), you will have in your possesion 34 days worth of meds. Now extrapolate this out over the course of a year… If you’ve been getting a 30 day supply 28 days after each filling, by the time you get your 12th 30 day supply (on Dec. 1st) you would have a 54 day supply in your possesion. Where did yours go? Either you’ve been throwing away that 2 day supply every time you get it filled(not very likely) or you’ve been taking more than you’re supposed to or selling the excess or some combination of both.
P.S. When you write a page and a half essay complaining about not being able to get your meds EARLY, and then claim not to be a “pillhead”, it’s kind of like a guy taking a cock out of his mouth to tell you that he’s not gay.

Comment by one_angry_tech on 2008-01-08 17:50:44 -0800 #

Ok.. Pharmacist(s): Time for WHAT WOULD YOU DO?
Cash-Patient A comes into your pharmacy with 2 prescriptions, 1 for Vicodin and 1 for Xanax. The prescription for Vicodin is 100 tabs, TID and Xanax is doesn’t matter. Patient inquires as to the price for the Xanax, but not the Vicodin.
Your enterprising tech (me) for some unearthly reason decides to do a central search (which checks all the pharmacies in your chain) and finds that Patient A just filled the same prescription for Vicodin 7 days ago (30 day supply) at the neighboring town store.
What do you do?
When Patient A comes to pick up both RX’s, the Pharmacist in Charge lets patient know we didn’t fill the Vicodin prescription since it was just filled 7 days ago. We have said prescription in the bag.
Patient then remembers that “well.. er someone stole my Vicodin so I went to Dr. Pain Clinic and he wrote me another one.. der der der”
Pharmacist let’s patient know that we will need some kind of proof as to this happening (maybe say a Police Report.. it IS theft after all) and patient angrily walks away and shows us birds.
We then decide it would be a good idea to give neighboring store a call and let them know what happened. They thank us.
They then proceed to fill that prescription the very same night.
I am only a tech, so of course I don’t know shit, but would I be within rights to say WHAT THE FUCK IS WRONG HERE AND WHY THE FUCK WOULD THEY FILL IT??!!??
The only response: “Well, it is the pharmacist license..”
So.. I ask you:
What would you do?

Comment by on 2008-01-08 18:10:20 -0800 #

I too have a really hard time believing this is a med student. He/she has A LOT of time free time on their hands.

Comment by Phathead on 2008-01-08 18:20:10 -0800 #

You know how I smell bullshit?
Who the hell sees a doc for a maintenance meds who works in an ER for 12 hours every day. But maybe thats just me…

Comment by Carolyn on 2008-01-08 18:32:50 -0800 #

Wow… Is anybody else amazed that this guy called into a completely random insurance call centre (probably somewhere in the South Pacific or Canada), and a Director of the company just happened to be touring the site? And willing to take a call that hadn’t gone through the CSR’s Supervisor, the Operation Manager, the Site Manager, etc… No, not likely huh? More likely, somebody wanted to get rid of this annoying person tieing up a line on the phone, and faked a title…
So, not only is this ‘Medical Student’ incompetitent (I am not sure if that’s spelled right, so don’t rip me a new asshole for typos, please) in regards to math (I never want a prescription from him) and a jerk for the entire ‘rant’, but he’s a very big fool… Which bodes well for any druggies in his area…

Comment by RJS on 2008-01-08 19:00:47 -0800 #

This entire thing is horseshit.
His doctor spends 12 hours at an ER plus his outpatient practice?
Bullshit. Emergency Medicine is its own specialty. The days of docs moonlighting at the hospital are just about over. Since this fuck apparently works for a politician, he’s probably in a metro area, which DEFINITELY means there’re no Internists or Family Practice types doing ED work. There’s a reason the metro areas tend to pay worse than suburban and rural areas: there’re more doctors per capita therefore their relative value is less.
And when does this angelic doctor sleep, pray tell? Or is he hooked on modafinil? 12+10+8 > 24, even assuming he needs zero time to mentally unwind from all that doctoring. And needing to drive from one place to the next or shower and shit once in a while.

He’s an MD/PhD student who happens to work for a politician, too?
Bullshit. You’re either an MD/PhD student or you’re an intern for a politician. There isn’t enough time during the day to be an intern, plus do your med school studies AND your research. (That’s what an MD/PhD is — a physician scientist and both degrees have to be earned as though they’re separate.)
Interning and MD/PhD student-ing are both full-time jobs. 16+16+8 > 24. The math just doesn’t work.

No one gets the “Director” of Aetna on the phone. Whatever the fuck that means. (Directors are usually directors of something, otherwise they’re called “President and CEO”) No matter who you are, and how rude you act.

This guy is full of shit at every turn.

Comment by Rebecca on 2008-01-08 19:20:11 -0800 #

To Hogarth
grammar nazi
spelling nazi
not capitalization nor punctuation nazi
i have to stick it to the man somehow – i choose the rogue pathway of lowercase writing.
hehehehe…like i would have an office. you silly. i’m a pharmacist! i’m lucky i get a chair!!!

Comment by Amanda on 2008-01-08 20:29:48 -0800 #

To Rebecca:
You get a chair?
In reguards to the post…if this guy is actually a med student he reminds me of a customer we have. Also a med student (for real) who is always 10 days early on his Norco, yet after a “week in the hospital” with shingles he never came to get his acyclovir. This time last year he was filling Suboxone at another pharmacy. This next generation of doctors sure seems promising.

Comment by rph3664 on 2008-01-08 20:53:42 -0800 #

Actually, I guessed that the “medical student” is a woman. JMHO. I also don’t think she’s a medical student; there aren’t enough hours in her day or her doctor’s day to do all the things she says they do.
As for my old retail pharmacy, refusing to fill a prescription FOR ANY REASON was potentially a firing offense if the store director, who was not a pharmacist, got wind of it. Even forgeries were awfully hard to explain away to him as long as the cash was green.

Comment by limari on 2008-01-08 21:17:56 -0800 #

“Chair”? What’s a “chair”? LOL!!!

Comment by indietech on 2008-01-08 21:25:41 -0800 #

a couple of comments.

  1. for every pompous pharmacist, there are 10 pompous doctors out there.
  2. in my state, there are some state-run insurance companies that require you to wait a full 30 days before refilling a pain killer. so we do occasionally see this happen, since we’re closed sundays at my pharmacy. if the 30 days is up on a sunday, we’ll usually work something out so they can get a few to last them until monday.
  3. if you’re so “buddy-buddy” with these big politicians, how about you tell them your sob-story and make them do something about the country’s crappy health care system?

Comment by Hogarth on 2008-01-09 04:06:26 -0800 #

office? i’m lucky i get a chair!!!
LOL, good point! I’m on the PSAO side, and it’s oh so easy to forget how the other half lives. My sincere apologies!
It’s either “neither capitalization nor punctuation nazi” or “not capitalization or punctuation nazi,” not “not capitalization nor punctuation nazi.”
I’m all three, I’m afraid. It’s a curse, truth be told. My family treats me like a walking spell checker. I can’t sit down and read a book without constant “Honey, how do you spell…” requests.

Comment by Rebecca on 2008-01-09 13:43:55 -0800 #

yup, a chair. i traded my fifteen years in retail for a chair. hehehe…i am doing hospital pharmacy for the department of defense – so i actually traded a competitive salary for a chair. tragically low paycheck – amazing improvement in QOL!!!
for all of you still in the trenches – keep on keepin’ on. my leaky veins and mental health couldn’t take it anymore. it’s your stalwart resolve to help the ambulatory population that makes sure people get their medications.
i might start a not-for-profit organization – A Chair for Every Pharmacist! think anyone would donate? it would be a tax write off!

Comment by Apgad on 2008-01-09 22:39:47 -0800 #

I can’t believe that the “I’ve got a guy on my phone who says I can have my drugs – here, you talk to him” thing didn’t work!

Comment by This is supposed to be anonymous on 2008-01-15 12:29:13 -0800 #

I used to work for a small national PPO. We had a LOT of medical directors. I don’t know how easy it would have been to get one on the phone immediately, but their job was to deal with the medical/claim issues called in by customers.
So I don’t think it’s impossible or even unlikely that the person in your story got a “director” on the line. Some companies have directors like banks have vice presidents – being a director doesn’t you’re on the board of directors. At my former company, director was just above manager and just below assistant vice president (and associate vice president, vice president, executive vice president, president, and CEO).

Comment by Sarah on 2008-01-26 19:54:00 -0800 #

I may have a theory. We have doctors call in Rx’s with “May only fill every 30 days” as part of the directions. I’m thinking that he had this in his directions and the doctor that he claimed to have on the phone was not the doctor on the Rx…? Either way, he’s obviously a drug seeker, and sounds a lot like the guy I “helped” last week, who wanted his heart pills and his pain meds (which he got a 30 day supply 9 days ago and 4 days ago). His story was he was a motocross rider in Germany, though. For sure not the same guy 😉

Comment by on 2008-04-26 00:01:21 -0700 #

Has anyone ever heard of Aetna refusing to pay for Pain control medications? I use Soma, Percocet, Klonopin and Elavil? I was told when I went in to pick up my monthly supply that I had to use mail order for my meds. No warning at all!! I was out of all of my meds! I was told by my pharmacists that it takes 3 weeks for mail order to even start. I have Aetna Insurance (PPO) and had to pay over $280.00 for my meds. What is the since in having insurance if they will not cover me meds. Any suggestions? I am very uncomfortable receiving this type of medication via mail.
Please Help!!

Comment by Raymond Eye on 2009-07-04 10:21:41 -0700 #

Yes, Rebecca, your grammar lesson is well noted. We also have the custom, in the English language, of capatializing the first word in a sentence. If we’re going to allow leinancy for this omission, then shouldn’t we do the same for the Angry fellow?
I often find myself on the recieving end of scrutiny from my local pharmacy. Of course, the medication I’m having filled likely warrants more suspicion than any others at your dsposal. I am a Suboxone paitent. The fact that I am on such a medication has to serve as a red flag for any pharmacist. Suboxone is prescribed for treatment of withdrawal symptoms associated with opiate addiction.
When I come in to the pharmacy, on the first Tuesday of every month, I try to prepare myself for the worst. Through the course of the 2 years that I’ve been on this medication, I can honestly say that I’ve never had a script filled without incident. First, they have to check to see if they even have the drug. Then, they ask if I would like to wait to have it filled, to which I always agree. At this point I am given a time when the script should be available for pickup. I make it a point to look at my watch and confirm the time with the clerk. In over 24 trips to the same pharmacy, my script had NEVER ONCE been ready for pick up at the appointed time. “Well, we got busy”; ‘You didn’t say it wouls be ready in 25 minutes unless you got busy, you said it would be ready in 25 minutes!’. The underlying issue here is; ’25 minutes does not give us ample time to fully scrutinize this transaction and come up with a reason not to fill it’.
This bothers me for 2 primary reasons: It’s representative of a tendency in today’s society for people to not keep their word and do what they say they’re going to do. The other reaason is this; if you’re not going to fill my script, why do I need to wait 25 minutes to find this out? Any issues should be addressed at THIS point, not when the customer comes back expecting to get her med.s!
So far, I’ve been hasseled over a multitude of small, insignificant things such as; the doctor’s script not being written on the proper type of paper, the pharmacy does not have enough pills to fill the order, the medication requires prior authorization, and, naturally, the dreaded Refill Too Soon Edit. Some of these are the fault of the doctor, some the fault of the insureance company, and some are my own fault. Since my pharmacist displays such a propensity for finding these issues, why, then, can’t he ‘find’ them in time to save me a trip back to the store, or notify me before I return? Why is time, from the perspective of the pharmacy, dependant on customer activity, when it merely follows it’s normal outward progression for the rest of us? Next time I get the ‘Refill Too Soon’ line, I’m going to tell the pharmacy tech that I was not very busy during the last month, so it’s actually been the full 30 days.
Angry at the Pharmacist

Comment by Jules on 2011-04-26 19:27:18 -0700 #

What do you say to this? A couple years ago I ran out of my pain meds a day early. I admit I took one day too many pills for the month. I couldn’t get into my pain management doc for another day so I saw an urgent care doctor who I told that I was a day short and afraid of going into withdrawal from 100mg morphine sulphate twice daily. He wrote me a script for ONE PILL. No kidding, that’s all I asked for, one pill.
I went to fill it at a walgreens. The beeyatch there refused to fill it, called pain mgmt, wrote all over the script and gave me a hard time in front of a store full of people.
Tell me that’s acceptable. Go on, tell me that’s fine.
btw, end of story is that pain mgmt doc called me in after 5pm, felt bad and gave me scripts for the next month since it was day 30 anyway. I had NO contract with pain mgmt.

Comment by FormerPharmCurrentMD on 2012-05-25 02:32:07 -0700 #

It’s pharmacists like you that are the reason I became a REAL DOCTOR, you love to make up “rules” and “laws” that don’t fucking exist. You mentioned this Pill Nazi was “Doing their fucking job”, seeing how your job is essentially just to count pills and sell them I don’t know where the fuck people like you thinking you have any right to overrule both the prescribing Dr and the Insurance company blows my mind. You don’t possess the power to prescribe medication or treat patients, maybe that’s part of the reason most of you are control freaks. Everything you know, the average person can learn from the inserts stuck to medication bottles. Back when I was a pharmacist, we actually gave a fuck about our “customers”. “Customer” being the operative word here, not patient. The idea that you know more about a patients needs and how they should be treated than the doctor who has been treating them for 7 years is just absurd. You’re a glorified pharmacy tech with “special privileges”, you need to get that through your head. You’ll never save anyones life, you’ll never perform a surgery, you probably aren’t certified in CPR. You couldn’t intubate a patient to save your life, hell you probably couldn’t even put in an IV. Get off your high horse. The truth is, people like you are at the bottom of the medical food chain, behind RN’s or even LVNs. I’d say you’re about as much of a doctor as a chiropractor, certainly not a dentist (they can actually prescribe medication). I should start a blog called The Angry REAL DOCTOR bitching about all the pathetic control freak pharmacists we have to put up with on a daily basis. The fact that you think you have the right to punish a patient of mine for trying to refill a prescription I wrote early by making them go without for 3 days is fucking ridiculous. Especially if I approve an early refill. You people love to blame the insurance companies for your incompetence.

I know pharmacists don’t take the Hippocratic Oath, but the Oath of a Pharmacist that you allegedly took does say “I will maintain the highest principles of moral, ethical, and legal conduct”… Ha that’s a joke. It should read, “I will judge whether or not to dispense medication prescribed by a real doctor to their patient by how they look, I will make up false laws and regulations to do what I want, if a customer pisses me off I will make their life hell. In fact, I will make their life hell because I can. I will assume anyone and everyone is a junky, including my 85 year old grandmother with cancer, if she asks for a refill on her pain medication, and I swear that maybe some day, not anytime in the near future I will grow the fuck up. God help me if I ever end up on the other side of the counter, because I will surely die before I’m treated with respect.”

You see, I’m not a “med student” and frankly I take offense to you saying “you must be a med student” to another poster. That right there shows the jealousy. That you will never save a life, have a “patient”, or prescribe medication. You’re white coat, that you probably bought yourself, does not make you a doctor. Pharmacists like you are about as much of a doctor as Shaquille O’Neal with his Doctorate.

Now after all my bashing I do have one more thing to say, I personally know a few pharmacists that are great people, caring people that should have become doctors. This post is not directed to the pharmacists running small mom and pops, that really care about their clients. Or the few good pharmacists stuck at big chains doing everything they can to help people, those pharmacists are underpaid. Pharmacists like the one who runs this page, is worth about minimum wage. I heard a few years back that dentists have a high rate of suicide, too bad pill nazis don’t top that list.

With Love,
A REAL Doctor. Bernard Robenowitz, MD

Comment by Dave on 2012-07-11 12:14:50 -0700 #

^ obviously the fakest doctor ever

Comment by Bay Area Resident on 2014-12-05 15:53:22 -0800 #

I doubt that is a fake doctor. Pharmacists have no right to implement any kind of authority when issuing medication prescribed by a MEDICAL DOCTOR. That might be my doctor because their opinion of pharmacists is shared. I love my doctor because he despises pharmacists that attempt to instill their authority on the directives he gives, regarding medication. Pharmacists should simply count the pills, lock the door at night and leave the big decisions to the professionals who know best. Physicians.

Comment by Jim on 2015-03-10 17:16:10 -0700 #

Michele U R an idiot! If U knew anything U would know its up to the doctor, and solely the doc as to how much of his meds R necessary for his health. Its a decision the doc is held accountable 4 not the pharmacy.