Can we refill my refill, please?
November 20, 2012 7:02 AM   Subscribe

Doctor's office can't seem to call in refills correctly. These are time-sensitive meds (benzos and anti-depressants) that we shouldn't run out of. Asking for a new nurse didn't change anything. Help?

My boyfriend had been taking bupropion and clonazepam, but has recently stopped use of the bupropion and is only using the clonazepam as needed. Normally, his mother will call the doctor's office for refills. Throughout the summer, she has been fighting with the nurse who does this. The nurse will forget to call it in, will claim she needs to seek approval from the doctor (for the 15th exact same refill in a row) or will call in the wrong quantity. Last month, she got a new nurse in hopes that she wouldn't be jerked around as much. When she went to pick up the most recent refill, where she asked only for the clonazepam, they had called in the bupropion!

What the heck is going on here? Are we getting jerked around by the doctor's office? Are they really that poorly run? What can we do in order to make refilling our RXs less stressful?

It's ridiculous that they're playing with him like this, especially with mood-altering drugs.
posted by kpetrich to Health & Fitness (24 answers total) 3 users marked this as a favorite
Can you ask to speak with the doctor? It may be worth waiting for the doctor to call back directly, or visiting the office in-person.
posted by xingcat at 7:05 AM on November 20, 2012

I'm confused, doesn't the doc write a scrip for X number of refills? I don't understand why this nurse needs to be involved at all, let alone have to call it in monthly.

You take your scrip, with 6 refills or 12 refills and go to CVS. Then they CALL YOU every month when the new refill is ready.

You see your doc after 6 months and he/she does the blood work, or whatever then you get your new scrip.

What you are describing makes NO SENSE. Therefore, change doctors to one who will do it the way that 99% of the US does it.
posted by Ruthless Bunny at 7:07 AM on November 20, 2012 [5 favorites]

Yeah that sounds like a really, really shitty doctor's office. I agree with the "get the scrips in person" thing; if he wants to stick with that doctor, its the only way to make sure.
posted by griphus at 7:07 AM on November 20, 2012 [1 favorite]

I'm confused, doesn't the doc write a scrip for X number of refills?

Depending on the state, you can't get a scrip w/ refills on it for Schedule IV medication like benzopdiazpenes. You have to get a fresh scrip for every order.
posted by griphus at 7:08 AM on November 20, 2012 [8 favorites]

Walgreens calls in refill requests for my recurring prescriptions for me. I just need to contact them a week or so before I run out, and they usually send me email reminders to do this. Maybe see if this is something that your pharmacy can handle, instead of your BF's mom.
posted by donajo at 7:14 AM on November 20, 2012 [4 favorites]

The nurse probably does need at the very least verbal OK from the doctor to authorize a refill.

Why is his mother handling this? Is he a minor? I'm actually a little bit surprised a doctor's office will speak to someone other than the patient.

I would suggest that he make an appointment and go see the doctor and personally talk to the doc about this situation.
posted by something something at 7:15 AM on November 20, 2012

Response by poster: The psychiatrist didn't initially write out an extended scrip for the anti-depressant because my boyfriend was revisiting the doctor every 4-6 weeks to discuss how it was working.

Legally, we have to get a new scrip for his benzos each time.

Asking to speak with the doctor was tried, but we were given the response that we either could talk with the nurse or schedule an appointment to come in and SEE the doctor. It seems ludicrous to have to pay a $30 copay every time he needs to refill his benzos.

His mother handles it for 2 reasons. We live in a different city and visit once or twice a month, so she's local to the doctor and pharmacy. His anxiety makes it difficult for him to try to work with the nurses at the office. They are incredibly short and just not great people and seem to know exactly how to set him off.
posted by kpetrich at 7:15 AM on November 20, 2012

My prescription is non-refillable and my doctor gives me 3 months worth of individual prescriptions when I go in for my quarterly checkups.

Also, yes, it is sort of odd that his mother is handling this for him unless he is a minor.
posted by elizardbits at 7:18 AM on November 20, 2012 [1 favorite]

Best answer: You might want to think about switching doctors. Which, yes, is a giant pain in the ass, but so is this, and you'll be trading a permanent pain in the ass for what is hopefilly a temporary one.
posted by griphus at 7:18 AM on November 20, 2012 [6 favorites]

Clonazepam is a controlled substance in most (all?) states. He DOES need approval from the doctor, and you're lucky that they don't require you to make an appointment every time you want a refill. I am also not sure why your bf's mother is calling the doctor on behalf of your boyfriend who is presumably not a minor. In the future, he should call and fax/email written confirmation of what the ex should read.
posted by acidic at 7:20 AM on November 20, 2012 [2 favorites]

You can ask for the doctor to give you post-dated scrips. We do this all the time for my son's ADHD meds. The doctor will write the date he's making the scrip and then he'll write "to fill on date-one-month-away". Then we give both scrips (the current and the following) to the pharmacy so they know when the next one will be due.
posted by cooker girl at 7:20 AM on November 20, 2012 [1 favorite]

I also walking out of the Dr's office with three Rxs, post dated. Has he asked the office if they can do this?
posted by Ideefixe at 7:21 AM on November 20, 2012

Post-dated scripts are a good idea but please bear in mind this is not something you can at all fight with the doctor about. If the doctor says "no" its "no."
posted by griphus at 7:23 AM on November 20, 2012 [2 favorites]

I never thought about that for ADHD meds, cooker girl. I picked the darn things up every month.

I'd say go to fax while shopping for a new doctor.

I had a similar problem with scrips with my current doctor. This last time I called in and "accidentally" pushed the button to talk to the front desk during a non-busy time and asked them to put me to the nurses' desk (there's a particular mail box for scrips) and they took the message by hand instead (yay!). I'll call the pharmacy next week to make sure it's in process.

If not, I'll start faxing them requests. A LOT harder to ignore fax requests.
posted by tilde at 7:25 AM on November 20, 2012

From the other side, for a doctor's office it is concerning to have the mother of a non-local adult patient calling for scheduled prescriptions. Does he actually follow up with this doctor/intend to follow up with this doctor? Did he decide to stop the bupropion but continue the benzo on his own, or with input of his doctor? Because that sort of med management is what a doctor is for, and most will not be in favor of sole treatment with benzos.

It would probably be most appropriate for him to establish care with a provider in the city where he lives.
posted by maryrussell at 7:26 AM on November 20, 2012 [5 favorites]

I'm confused about why, if refillable prescriptions aren't allowed, verbal refills from the doctor's nurse are. In my state if a prescription isn't refillable, then you also have to have a paper script from the doctor for each new prescription (not a verbal call-in).

You can try putting this in the hands of the pharmacy, asking them to contact the doctor's office. Most pharmacies communicate with doctor's offices via fax, which is more efficient for both the pharmacy and the office personnel.

If that doesn't work, I would think it's time for your BF to get a provider in his location where he can pick up and manage his own scripts.
posted by SweetTeaAndABiscuit at 7:33 AM on November 20, 2012 [1 favorite]

Now that I think of it, if your boyfriend didn't personally say "no more bupropion" then the nurse was in a tough spot having to believe the mother's claim that the meds were no longer needed.
posted by acidic at 7:35 AM on November 20, 2012 [1 favorite]

Your boyfriend should get a doctor in his own city and handle this himself. It can be empowering for anxiety and depression sufferers to take control of their own care, especially as adults.

It can be difficult, as you mention, but it can be done.
posted by sweetkid at 7:36 AM on November 20, 2012 [4 favorites]

I'm confused about why, if refillable prescriptions aren't allowed, verbal refills from the doctor's nurse are.

The doctor's office may be mailing the scrip to the pharmacy. At least in NY, a doctor can call in an order for a Scheduled medication, fax a copy of the scrip, and then mail the scrip shortly after.
posted by griphus at 7:39 AM on November 20, 2012 [2 favorites]

Best answer: People. Doctors' offices allow other people than patients to do everything, including picking up script refills with a signed release. For the love of god, will all of you who are completely ignorant stop broadcasting your ignorance so loudly and in exactly the same way?

Also: switching may be your only option. In my experience if a doctor has terrible staff, the problem never gets any better. And this could be a problem with your doctor being an airhead, not the nurses, or even your guy's mom, since you have only her word that she asked for the right thing. Also, yes, the way to handle this if you're not going to switch, is to get three prescriptions at a time. Good luck. I know how much this sucks, especially when its mentally hard to deal with stuff like this in the first place.
posted by thelastcamel at 7:45 AM on November 20, 2012 [9 favorites]

People. Doctors' offices allow other people than patients to do everything, including picking up script refills with a signed release. For the love of god, will all of you who are completely ignorant stop broadcasting your ignorance so loudly and in exactly the same way?

It might be allowed, but it also leaves room for confusion and complication, which is happening here. I wouldn't assume ignorance on the part of answerers in this thread, many people have personal experience with this sort of thing.
posted by sweetkid at 7:54 AM on November 20, 2012 [7 favorites]

Switch. Clonazepam can be filled via refill in some places, including Washington state and british Columbia. In Washington I filled by mail using Medco. This office is yanking your chain, go elsewhere.
posted by crazycanuck at 9:31 AM on November 20, 2012

You could ask them to write three separate scripts, each one with a "do not fill date" that precludes the pharmacy from filling earlier than one month at a time. This is a common way of dealing with controlled substance prescriptions that preclude automatic refills.
posted by teamnap at 9:45 AM on November 20, 2012

Best answer: Switching docs is the first suggestion I'd try, but in the meantime (because holy heck does it take a lot of effort/time/etc. to switch doctors:)
  • Use a pharmacy that has good customer service procedures - Medco will call my doctor's office, and so will Kroger and Meijer. My compounding pharmacy won't. Mom can ask this question over the phone; pharmacies are used to borderline incompetent administrative staff in doctors' offices.
  • Sign a release for the PHARMACY that spells out Mom can ask questions/make requests/etc. over the phone. That way she can call and say "hey, do you have the script" and there won't be (as much of) an issue with her showing up and picking up the wrong thing. It's best if you can get a power of attorney (you can limit them to just medical stuff, at least in my state,) or a generic HIPAA release, so that when you deal with a new place they're able to cope in a faster way. This is the form for Wal-Mart, to give you a sense of what a typical form looks like.
  • Ask the nursing staff to put a sheet of paper with instructions (who will be picking up the scripts, and on what day of the month, and which scripts are needed on which days) IN YOUR CHART.
  • Hand the doctor a piece of paper every single meeting that spells out exactly what scripts you need and when they'll be picked up. This is not the same note that goes into your chart (which you should hand to a nurse or admin type who is HOLDING YOUR CHART at the moment you hand it to them.)
  • If the benzos are small quantities (I get 10 at a time because they're PRN and there's a risk of dependence/overdose,) talk to the doctor about upping it to 30 and having a loved one hang on to the extras.
  • Get their fax number, and three to five days before the pickup is going to happen, send them a fax that says something like "My name is [whole entire name] and the last four digits of my SSN/patient ID are [numbers]. My prescription for [medication name, dose, quantity] will be picked up at [pharmacy name, pharmacy address, pharmacy phone number, pharmacy fax number] on [DATE]. Please call [mom's name, mom's phone number], who is authorized to receive prescription-related information for this patient, if there are any questions, or concerns."

posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 10:59 AM on November 20, 2012 [1 favorite]

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