Why Won't My Doctor Give Me A Medication Refill?

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. 

Patient Getting Refill in the 14th Century

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.