Thursday, October 28, 2010

"We Made the Mistake. You fix it."

At least that's what one medical assistant wanted us to do today.

Two weeks ago, the office called in a prescription for the wrong dose of Metoprolol. The patient was supposed to get 50 mg, but the office called in 100 mg. By the time the patient realized the mistake, he had already picked up the medication and started taking it.

Today a medical assistant called up and informed us of the mix up. She told us that it was supposed to be for 50 mg. Then she stated that the patient will be returning the 100 mg tablets and exchanging them for the correct ones.

I quickly corrected her by saying, "we won't be exchanging the prescription. It's against federal law to take back medication once it has left the pharmacy. It's been 2 weeks. The patient will have to pay another copay."

"You won't take it back?" she exasperatedly asked. "Other pharmacies have taken medication back before. You're going to force her to pay another copy?"

Now, I was a little pissed off. "Is that how it works?" I said. "You guys make the mistake, and we end up footing the bill for it? YOUR error prevents US from getting paid? Does that make sense?"

She paused for a couple seconds before saying, "well, I'm not going to argue with you." Then she hung up.

If this was an isolated incident, it would be one thing. However, it's something that happens quite often. The people working in doctors' offices seem to forget that we actually have to buy the drugs before we can sell them to people. Therefore, when they tell the patient that the pharmacy will simply do an exchange to make up for their mistake, they forget that the pharmacy ends up being the loser.

The only time I pull this exchange bullshit is if the error is clearly ours. If we make the mistake, well, that's our fault, and we'll do what we have to in order to correct it. If the doctor's office makes the mistake, and the patient ends up having to pay a second copay because of it, I'll often tell the patient to go ask the office for a refund of their wasted money. The pharmacy already gives away so much. There's no way I'm wasting more money when we had nothing to do with the error.


Anonymous said...

The problem is many pharmacies will take it back. So when most pharmacist put up with this, why would doctors office think otherwise. They are the almighty doctor we are just the lowly pharmacy.

RxBoy said...

I'm glad to know that our pharmacy isn't the only one that deals with that crap. Unfortunately our managers have spines of jelly and typically take the medicine back for a refund. Then of course we have to throw it away. I agree with you that the doctor who made the mistake should reimburse the patient for the error.

As a retail technician, I've come to dislike doctors in general. They write so sloppy you can't read the damn prescriptions. They love to send us electronic prescriptions and promise the patient that we will have them ready in 15 minutes without checking with us first. They also love to tell patients how much drugs cost at our pharmacy. I love it when something is $300 and the customer whines that the doctor told them it was on our $4 list. We should tell them to go back to the doctor and demand that they reimburse them the difference.

pharmacy chick said...

Break the friggin tablets in half. Both regular metoprolol AND XL may be broken.. Yes. XL may be broken in half but not crushed or chewed. It says so in the literature. If you feel so inclined break them FOR the patient or have the dr do it for them since they were the ones who screwed up. If the patient insists on 50mg tabs then have the DR refund the patient for the price of one copay. I just dont see a problem least for YOU mike :-)
I have my own Metoprolol story I should share on PC site...

Pharmacy Mike said...


The drug wasn't actually Metoprolol. I changed the drug name to protect the innocent, lol. Of course, the one she actually got could have also been cut in half, but this patient wanted the correct medication with the correct directions on the label as not to be confused.

The best part of the whole story was that 2 minutes after I got off the phone with the snippy medical assistant, the patient himself called and ranted about how fed up he was with the doctor's office staff, and how they continually mess things up. He didn't put any blame at all on us.

Needless to say, he's now one of my new favorite customers.

Anonymous said...

My decision to take something back for a refund depends on several things.

If it is our fault, I take it back, apologize, apologize, and refund and new Rx for no charge.

Now I have people pick something up and then later realize that they picked up the wrong thing, or someone picked it up for them...sorry tough crap not my fault you did not pay attention.

There is one exception to the above rule, if the patient is a long time patient and they have spent a lot of money, and the rx is not expensive. Now we are not talking 20 rxs over 3 years, we are talking my patients that we know by name, and pick up 60 to 100+ rxs a year, they are worth keeping around!

Anonymous said...

This is why we ask patients at the drop-off window "Has your dose changed for any of your medications today?" The deer in the headlights response indicates that we fax the the Dr. to clarify - then the onus is on them, not the pharmacy.

Pharm.Tech RDC "06

pharmacy chick said...

we have had occasions such this happen. If the dr has made a mistake, I will "invite" the physician (or their office staff) to make arrangements with the patient to reimburse them for the copay the patient had to pay. I never really know if it happens, but I make it understood that it won't be me. Sometimes I even say it as such " Shall I have the patient contact your office about reimbursement for their copay? I can't take it back"

Anonymous said...

In any retail situation in which I've been involved, when 'a pharmacist took the medication back that was not unit-dosed or in untampered unit-of-use packaging', the drug went to the 'to be destroyed' pile. It did not go back on the shelf!

Anonymous said...

It's a business tactic. If you want the customer or the doctor's office to continue to reference your pharmacy then you take the medication back. That is why most pharmacies take it back. They do not want to lose future business.

If it wasn't the fault of the pharmacy, I would never take it back. I don't care if I lost future business.