I am one of the geriatric care coordinators in the law firm so it is my job to understand how the medical system works. I have come across something that really bothers me and I was wondering if anyone else was seeing the same thing. Three times recently I have been with family members at three different doctors’ offices when the same situation came up. Here is the scenario: We were taken into the exam room and the medical assistant/nurse asked the usual questions and then asked if any refills were needed. My family member said yes, and before we knew it the assistant had electronically sent the prescription to the drugstore. After researching I came to understand that “repeat prescribing” by the medical assistant/nurse is a common practice. Is this really something we want to entrust to office staff even if they have authorization from the doctor to do so? The assistant has no idea if the doctor is going to adjust the dosage or discontinue the medication all together. Once that prescription has gone electronically it is difficult to get it back, especially if it has gone to one of the large mail order pharmacies like MedCo or Prescription Solutions. The third time this started to happen I stopped the assistant from sending in the prescription and, sure enough, the doctor discontinued the medication.
Our clients, patients and family members don’t need to be paying for and receiving medications that they don’t need and they don’t need to be spending time on the phone with pharmacies explaining what happened at the doctor’s office. Another thing I have noticed is that at the end of the visit the prescription list that many offices hand out to the patients does not reflect any medication changes that have occurred during the visit. It is usually printed by the assistant while the doctor is in with the patient. What is the point of a medication list if it is not current?
Finally, as more and more doctor’s offices become completely computerized we need to try and make sure that the doctors are spending time listening to their patients face-to-face and not spending time with their noses in the computer. Also, I don’t see a problem with “repeat prescribing” but it should be done after the fact instead of prior to the visit with the doctor. I don’t think this is asking too much. Do you?
Dawn Houston RN, BSN
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