Aside from being appalled at how unbelievably cheap narcotics are, and, gee, that couldn't possibly be a huge part...
Aside from being appalled at how unbelievably cheap narcotics are, and, gee, that couldn't possibly be a huge part of why people kept getting prescribed the least expensive thing (it doesn't matter with or without insurance, they are unbelievably cheap), we now get to be appalled at the fact that even in hospice care, to protect you from getting addicted and keep a tighter control over narcotics prescribing, you are expected to wait until you are on your last or next to last dose before you can get a refill.
It's not that I don't think people at every step of this process need help managing the prescribing, acquiring, and use of the meds. I do. But when you make it supremely difficult for the patients to get documented needed things, and I cannot even imagine what someone without other support would do, and multi-hoop jumping for the prescribers and dispensers, you may not be balancing out your system in an effective way.
Specifically, there's some lock-out time period that is not keyed to when a prescription is written, received, or filled, but when it is picked up by someone. However, this doesn't work if the prescriptions are always only sent in on a Monday, and the pharmacy may or may not get them (nice system, e-prescribing) until Tuesday, and they may not be able to fill them until Wednesday or Thursday, because stuff takes time, and even if they fill it Wednesday, the automated system that calls and tells you to pick up your Rx may call you Wednesday or Thursday, and you may not be able to pick them up even if you wanted to until some time between Wednesday and Friday, even if you don't wait for a call and just go bug the pharmacy. Do you have time to constantly just stop by the pharmacy? How many hours can you wait for them to fill the Rx, or how many times can you come back?
We assume that when we speak with hospice there is some bureaucratic paperwork thing that can be done about this. We assume it because the pharmacist said that there is some bureaucratic paperwork thing that can be done about this.
Fun times.
It's not that I don't think people at every step of this process need help managing the prescribing, acquiring, and use of the meds. I do. But when you make it supremely difficult for the patients to get documented needed things, and I cannot even imagine what someone without other support would do, and multi-hoop jumping for the prescribers and dispensers, you may not be balancing out your system in an effective way.
Specifically, there's some lock-out time period that is not keyed to when a prescription is written, received, or filled, but when it is picked up by someone. However, this doesn't work if the prescriptions are always only sent in on a Monday, and the pharmacy may or may not get them (nice system, e-prescribing) until Tuesday, and they may not be able to fill them until Wednesday or Thursday, because stuff takes time, and even if they fill it Wednesday, the automated system that calls and tells you to pick up your Rx may call you Wednesday or Thursday, and you may not be able to pick them up even if you wanted to until some time between Wednesday and Friday, even if you don't wait for a call and just go bug the pharmacy. Do you have time to constantly just stop by the pharmacy? How many hours can you wait for them to fill the Rx, or how many times can you come back?
We assume that when we speak with hospice there is some bureaucratic paperwork thing that can be done about this. We assume it because the pharmacist said that there is some bureaucratic paperwork thing that can be done about this.
Fun times.
You could obsessively refresh the relevant part of your account on the pharmacy website, but that certainly doesn’t help the rest. Also, people on hospice care should get ALL THE NARCOTICS THEY WANT, ffs. As long as it’s monitored enough by hospice staff to satisfy to within a reasonable doubt that the medication consumed is actually going into the patient and not, like, the patient’s deadbeat nephew, load ‘em up.
ReplyDeleteThere's an official visit once a week and they are required to count and document pills every time.
ReplyDeleteF-L Silver man. When my grandfather was on hospice, he was on oral suspension drops because he’d already lost the ability to take pills, so we dodged that. The hospice folks just looked at the med log we wrote dispensing in, shook the bottle to determine if she was willing to believe it was within tolerance for what the log said, and that was that. We had a pretty free hand with the dosing, though, which was surprising and gratifying.
ReplyDeleteIt's particularly galling since my dad is on one med, at a very low dose. I cannot imagine what it would be like for people on multiple meds. That would be a nightmare.
ReplyDeleteAnd apparently hospice has to deal with this all the time. How ... reassuring?
ReplyDelete