Smooth Operator...

I feel things can go much more smoothly in a pharmacy if the pharmacist can make a substitution without having to consult the doctors.  There have been talk of this before, but nothing has really gotten going.

What I'm referring to is when a patient brings in a prescription for Nasonex and their crappy insurance either doesn't cover it or requires a prior authorization.  In normal cases, a pharmacist would have to tell the patient  that they are sorry but their insurance isn't going to pay for the medication.  Then the patient gets angry and complains that they pay $9999 a month for this insurance and that it is impossible that they don't cover it.  Then we tell them that we have to call the doctor to get it changed.  We then call the office and get a nurse/receptionist that when I say "I'm calling from Blah Blah Pharmacy", I immediately get cut off and told "For refill requests you have to fax it, we don't give it over the phone".  Then I have to explain to this person that I'm not calling for a refill, I'm calling because a med is not covered.  I give them the information and the nurse repeats back to me "Ok, Lasix isn't covered", which I then have to correct them and spell it out.  Then I get told that the doctor is busy and that I will get a call back in either 10 minutes of 1 week (I exaggerate a little).  Then I have to turn to the patient and tell them we have to wait for the doctor to call back and that they have to leave and come back later.  Then I get cursed at when in actuality, this entire problem could have been avoided if the doctor used his or her brain and just prescribe something pretty much guaranteed to be paid for.

So I'm for the pharmacist being able to use their knowledge and make a substitution to fluticasone (Flonase).  See how quick and convenient that was for the patient, pharmacist, and doctor?  There is one doctor in the area where I work that I must give kudos to for his prescription writing.  When he writes for a brand that he knows there is an equivalent that has a generic he writes on the script "if not covered, may sub to any covered generic in same class".  So for example, he will write a script for Nexium and will put "may sub with generic PPI".  So, I'm able to switch to omeprazole or lansoprazole if need be.  What an outstanding idea!

Your thoughts?  Comment below...