One of the perennial patient gripes I confront is why on
some occasions I refuse to refill a patient’s medication that I have previously
prescribed. Usually, but not always,
when I offer my explanation for this roadblock, the patient understands why I advise a face-to-face meeting.
Here is a sampling of patient feedback I’ve received over
the years.
Why do I need to come in?
I’ve been on the same prescription for years?
Why should I have to pay a copay when all I need is a
refill?
I live 45 minutes away.
The doctor doesn’t have an appointment for 2 months and I
only have 4 pills left!
I don’t drive anymore and I can’t get a ride.
This doesn’t happen with any of my other doctors.
Here’s how I see it. Of
course, I understand the sentiments expressed above from the patients’ perspective. Certainly, when a patient I know whom I have
been in regular contact with asks for a refill, I send it right through. If, however, I feel that too much time has
lapsed since I’ve had personal contact, then I will request an office visit so
that I may determine that the refill still makes sense or if there are other
digestive issues to address. In general,
I’ll ask refill seekers who haven’t seen me in a year to make the trek to my
office, but I admit that my 1 year interval is arbitrary and that other capable
physicians may have a different standard.
Here's a sampling of what might transpire at the yearly
refill appointment.
Let’s try a lower dosage of your medicine which might be
just as effective.
I’m not sure you need the medicine anymore. Let’s hold on the refill and see how you do.
The medicine you want refilled hasn’t been working as well
as it used to? Perhaps, something else
is going on. I think we should look into
it.
Since you were here last year, a new medicine is available
that might give better results than your current medicine.
Since your visit last year, your brother developed colon
cancer. I’m glad that he is doing well.
This new family history means that your next colonoscopy is due now, not in 5
years as we originally planned.
The yearly refill visit isn’t to hassle or inconvenience
you. And often, this will be a quick
visit where I send the refills through.
But not always. Many times, these
seemingly routine yearly visits can really be time well spent.
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