I'm dead serious when I suggest this. I also know that it will never happen. However, it will stop prescribers from making stupid mistakes on prescriptions pretty damn quickly.
There should be a law mandating that every single prescription must be written correctly in order for pharmacies to legally fill it. That means every time a doctor doesn't write a quantity, doesn't include directions, doesn't sign his name, doesn't write the patient's full name, writes illegibly or makes any other stupid mistake, pharmacists send the patient right back to the office to get a new prescription. After a dozen or so patients return to the office by lunch to get their scripts rewritten, the prescribers will quickly learn to write them correctly.
I'm so sick of calling to clarify every other prescription I get. The percentage is even higher on e-prescribed scripts. Really... How hard is it to write a fucking prescription correctly? More importantly, how can you just laugh it off when I call to clarify it?
Today, I called the office because I couldn't read whether the doctor wrote felodipine or amlodipine on a prescription. It looked a lot like felodipine, but the patient had amlodipine in the past, so we had to call to clarify it. For one, they couldn't tell me right away. They had to call me back... 6 hours later. Then, the woman on the phone said, "It's for amlodipine, but I have no idea what the rest of the prescription says."
That's great! It's a good thing I could read the rest of his chicken scratch because otherwise, I might have had to wait another day to get the directions clarified.
Then, there was the e-script that came through just like this:
Sig: 2 tabs (1,000mg) three times a day for 7 days
426 Valtrex, huh? So, I called to clarify the quantity just to make sure she really meant 42. Yes, the nurse meant 42 tablets. However, she suddenly realized she made another mistake, saying it was supposed to be for 500 mg, 1 tab 3 times a day for 7 days.
"So, the quantity should be 21 then, right?" I queried with the feeling that she just screwed up.
"No... It's for 42 tablets. She's taking it 3 times a day for 7 days," she answered.
"Three times daily for 7 days would be 21 tablets. Seven times 3 is 21," I informed her.
"Oh.... Well, that's weird because the doctor quite clearly wrote for 42," she responded confused.
I was done playing games with her. "Listen, the original prescription came through for 1,000 mg TID. That's the usual dose for treating shingles (which this patient had). I'm pretty sure the doctor meant her to take two 500 mg tablets or one 1,000 mg tablet TID."
"No... the doctor quite clearly wrote 500mg, 1 tablet TID," she insisted.
I told her that I would feel much more comfortable if she asked the doctor to clarify the dose and get back to me. She begrudgingly agreed.
Ten minutes later, the prescription was e-prescribed again to us with the original directions of 2 tablets TID. She never called to tell me if she got clarification on the script, so I had to call her back. It turned out I had been right. Had I not been insistent about getting the proper directions on the script, it would have been filled incorrectly and those incorrect directions would have been verified with a member of the office staff.
Isn't it comforting to know that often times the doctor's office staff is guessing on prescriptions when they call them in to us? I go through this same speil every freaking day. And are the patients happy that I took the time to make sure the prescription was correct? NO!! They're pissed at me for making them wait.
When they're not pissed, they think it's a big joke. "Oh.. Dr. Whathisname's writing is so terrible. HAHA."
You know... It isn't fucking funny. It wastes my time. It wastes the patient's time. Most importantly, it's DANGEROUS. People get killed because of poor handwriting. People get killed by incorrectly written prescriptions. Pharmacists are fucking awesome at correcting 99.9999% of the mistakes that prescribers make on scripts, but while we just might be the most accurate and obsessive compulsive perfectionists outside of NASA, we do occasionally miss these mistakes. Many of us are working long hours, under high prescriptions volumes, and with little help, so it's hard enough for us to make sure that the right pills go in the right patient's bottle. We don't need the added pressure that comes from poorly written prescriptions... especially when those errors are so freaking easy to eliminate if prescribers would just take 2 extra seconds.
Therefore, I call for pharmacists to revolt and refuse to fill prescriptions unless they are written correctly. We need to stop wasting our precious time bickering and bargaining with the office staff, and let them realize just how often they screw up. Let them waste their OWN time correcting their OWN mistakes.