Pharmacies and privacy - I'm pissed!

[kedrys]

I have reason to believe that the pharmacy where we're getting our prescriptions filled is ratting out the s.o. to one of their doctors - namely, the pain management specialist. The s.o. went to see the specialist this week and had to sign a release and agreement before being allowed to see the doctor. What we think happened is that the pharmacist tattled to the specialist about a prescription written by *our dentist* after the s.o. had their wisdom teeth taken out.

Has anyone else had this kind of experience, and what the hell is going on???



P.S. The release was three pages, something like 15 items of "we'll monitor you and drug-test you and you have to tell us when you switch pharmacies and we can deny you treatment on a whim", etc. I've never seen anything like it, and we're having our lawyer look at it, but I'm freaked out, and so's the s.o.

[OhioChick]

1. That's quite typical with pain clinics.......

I know several who visit them and they have to sign releases, undergo monthly drug testing, etc. Pain management doctors want to be the only physicians prescribing. I've heard of patients being released from their pain management docs after using ER's and such for unrelated physical ailments and med use that wasn't ordered by their PM doctor. I wouldn't be too freaked out......

[kedrys]

3. What's screwed up is that the s.o.'s been a patient for years

The release form stopped short of accusing the s.o. of dealing and/or doctor shopping...unless we find out that the specialist is asking *everyone* to all of a sudden sign the form, yeah, I'll be freaked out.

And we were going to switch pharmacies anyway, but now we're, shall we say, highly motivated.

[SeattleGirl]

4. You are taking this too personally, kedrys.

Again, if this is the first time you have encountered this, I can totally understand you being upset. It's a fairly standard form, which, as you said, seems to be accusatory, but it's a one-size-fits-all kind of form.

[kedrys]

8. Fair enough

I still think it stinks, but there's not much getting away from it. The s.o. is threatening to bolt and move to some country where they'll be left alone - I understand the feeling, if not always the impulse.

[OhioChick]

6. I've heard of this happening for years,

I believe that it's now common practice. I understand your concern and frustration, but wanted to assure you that your s.o. is likely not being singled out.

on edit: spelling

[SeattleGirl]

2. It's common practice, kedrys.

It has to do with "doctor shopping", which people do when they are trying to get more narcotic meds than they are supposed to have. Don't misunderstand -- I'm not suggesting that your SO is doing that; his situation sounds perfectly legit to me. I deal with people injured on the job, and believe me, I see that kind of stuff all the time, so the pharmacies started deliberately looking for this type of behavior. What people do is they will go to different docs to get the same meds, or they will tell the doc that they "accidentally" dropped all their pills down the toilet, or the meds were "stolen" from them. The pharmacists are just part of the ""alert" mechanism that is in place.

I understand your anger and frustration; it does seem intrusive. But believe me, there are far more people out there who try to get more meds than they are supposed to have than you realize.

[undeterred]

5. A friend of mine was on major narcotics after surgery

and when he had to switch or refill drugs it was a major pain in the ass. I remember that they wouldn't let his wife pick up the meds because she had a different last name... and he was yelling at them- should I drive to the pharmacy in excruciating pain or in an altered state?

[SeattleGirl]

7. Now that's a stupid move on the pharmacy's part.

Mr husband and I have different last names, but we can sign for each other's meds. We've both had surgery, and were in no shape to drive. So the other would go get the meds. That would definitely make me change pharmacies if they were basically saying, be in pain or be a dangerous driver on the road.

[Divernan]

15. Under the new HIPPA privacy laws, the pharmacy needs written

permission (in the form of a health care power of attorney) from the person to whom the RX is prescribed to allow anyone else to pick up the Rx, because the fact of taking a particular medicine provides privileged information about someone's health status. Ridiculous? Yes, but that's the current law.

[vickitulsa]

17. That one surprises me too.

I've been a pain patient for over five years, and I'm only too aware of the nervewracking, worrisome, and in some cases life-threatening HASSLES that every branch of the healthcare industry can put patients through just to get our pain meds.

The form referred to in the OP is standard, all right, as others have said. I've signed three or four of them over the years as I had to change pain docs (due to moves), and each one of them had me fill out the same form. The first time I encountered it, though, it was with my regular doc I'd had for a long time, and he prepared me for how it sounded. I was still shocked at the intrusiveness of it; but my brother's been a pharmacist for over 30 years and I do understand why the docs have taken to using this form, trying to keep a lid on the illegal market in prescription drugs. (Not that they can ever do that.)

None of my pain docs has ever tested me, though, or done any of the other stuff it says in the form they can do, though I haven't given them any reason to be concerned about me either.

But not letting a wife pick up a husband's pain meds? That's just crazy! I've been using Walgreen's, mostly for convenience, for the last few years, and in addition to two regular monthly pain meds I'm on seven other prescription medications as well -- five of them are for controlling my high blood pressure alone.

So I often expect my pharmacy workers to know me and be halfway familiar with my meds -- they've seen me enough! Still I'm surprised sometimes by how clueless they seem as they bustle about their jampacked busy days.

Lately I've been finding it difficult to do all my own shopping and run errands, so I've been teaming up with my neighbor, loaning her my car which she uses to do her own errands plus pick up things for me. Many of those stops are for my meds at the Walgreen's, and four or five times now they've let her pick up even my PAIN MEDS without a hassle. The first time I sent along my DL and told her to tell them they could call me at home if they had a question. No problem!

After that, I haven't even sent my ID with her for this. They can see (if they've paid attention) that she's driving my car, but I admit I've been a bit surprised that it's been this easy for her to pick up my pain meds.

I have to wonder, does anyone else here think maybe your friend's pharmacy did that because patients and pharmacies had been ripped off by crooks who claimed, picked up and paid for scripts WITHOUT authorization? That's about the only thing that makes sense to me. Looks like such a thief would have to be present at a pharmacy when a pain script was dropped off and listened for the name to be spoken aloud, then went back later to get the meds before the rightful patient.

There are NO END of scams and tricks that some people use to get narcotic prescription meds. A scant few of them actually NEED pain meds but can't get them through normal channels; but by far MOST of them are just junkies. They're the ones who make it so hard for us real PATIENTS to get our meds!

BTW, my brother has said for many years that narcotics should be legal -- that other countries handle this far better than the U.S. does. He says it's all just part of the phony "war on drugs" which causes way more problems than it could ever solve. I agree with him of course.

[Horse with no Name]

9. Typical pain management contract

They agree to treat your pain and adjust your pain medications to get you to the most comfortable, you agree to let them. And only them.
This is standard procedure.

[jwirr]

10. I do not know about your situation but I KNOW that someone

in the health care industry should start wising up. I live in a neighborhood where all too many people are selling their pain meds to users who are addicted to them.

Tomorrow I will begin taking care of my great-granddaughter because her mother is totally out of control on oxys and any other drug she can find. My grandson just left treatment and is holding his own. This is and has been a problem for many years and doctors/dentists/pharmacists are neck deep in the middle.

[Jamnt]

11. I'm a Pharmacist and I can tell you that

this was probably innocent. If you dentist prescribed a pain med and the s.o. was already on them, the RPh was obligated to call the md. He/she could be held liable if they didn't call. And btw..you can have your scripts filled anywhere. CII narcotics (Percocet, Oxycontin, morphine, etc..) don't have refills, so it wouldn't matter. If your docs are requiring you to use one pharmacy and not giving you the option to switch when you want, they may be violating some laws relating to freedom to choose where you do business. Any lawyers out there?

[Divernan]

12. "You have to tell us when you switch pharmacies" was the language

quoted in the "agreement" (i.e., contract), which is different than requiring a patient to use a particular pharmacy.

Yeah, I'm a lawyer. If you freely sign a contract, you're bound by the terms - it's that simple.

My health insurance allows me to use any pharmacy I want for one time, i.e.,a month or less prescription. However for ongoing meds like blood pressure meds, I must use a mail order pharmacy which sends out 90 days/3 months worth of Rxs at a time. I could take the longer term Rxs to any pharmacy I want, but my insurer has no obligation to cover my costs. Seems reasonable and cost saving to me.

[Horse with no Name]

13. And a patient is always free to use whichever pharmacy they want

They will just have to find a different physician.

[mcscajun]

14. As others have already stated, the pharmacy is obligated to inform

a doctor when they have these kinds of situations, regardless of what may or may not be legitimate use. This is routine for all pharmacies; notifying the doctors not only of multiple prescriptions for controlled substances, but for any discrepancies or conflicts with the patient's entire current prescription sue.

Additionally, if your prescriptions are covered by insurance, insurance companies routinely send reports to doctors' offices of patients who are getting multiple prescriptions for controlled substances from more than one doctor, and may be overmedicating.

Your S.O. is not being singled out, but to cover all the bases, talking to your lawyer can't hurt, either.

[mrreowwr_kittty]

16. Thank people like Rush for this.

It does stink but we are all under scrutiny because certain people (usually affluent white druggies like Limbaugh) shop for doctors.

[Buchananfan]

19. People would not have to "shop for doctors"

If doctors did not have more power than an individual regarding his/her health choices. What is wrong with a free market, anyway?

[SeattleGirl]

20. "Doctor shopping", at least in the way I used it above, refers

to people wo display drug-seeking behavior, as I discussed in my post #2, above.

[Buchananfan]

21. I agree, that is the conventional wisdom

I guess drug-seeking behavior simply means that a person wants to buy a hit of something. That said, there are two options: The unlicensed drug-dealer or the licensed one (pharmacy). The former sells an unpredictable and possibly deadly product at a higher cost and the latter sells a predictable product but requires a permission slip to purchase.

If this last problem was eliminated, people would not have to waste their time and money trying to get a permission slip, and could buy their pain pills at the pharmacy just as easy as a bottle of aspirin. As it was a century ago, when the percentage of people with addiction problems was lower than today.

Also, the drug-dealers would be put out of business.

[mrreowwr_kittty]

23. Not a free market issue

Doctor's need to know if their patients are obtaining pain medications from other doctors. They're doctors, not dealers. That little thing called the Hippocratic oath, you know.

[Buchananfan]

25. In my opinion, they are people selling a service

I have a difference of opinion.

They are no more entitled to know anything more than their customer wants to share with them. The person paying is the boss. As much as your car dealer service dept needs to know if you are getting work done at an independent place.

My mention of (licensed drug)dealers was directed at pharmacies, by the way. If a person wants to purchase a product, no need to persuade a middleman to permit you to have a business relationship with the pharmacy. Enough influence can buy laws that restrain trade, however.

[mrreowwr_kittty]

26. And doctors have a right to know what their patients are taking

They face liability issues as well as ethical obligations. I also happen to think that a lot of drugs that are currently prescribed should be sold over the counter. So I'm in partial agreement with you.

[Buchananfan]

18. We sure have allowed medical interests to control our lives

Put everything over the counter. People 100 years ago sure did not have this, and all the other clusterfuck problems with the medical industry. At one-tenth of the cost with less bloodsucking middlemen.

I am of the belief that policies that are meant to "protect us" are really
to keep us dependent on one hand with the other hand in our pockets.

[Commie Pinko Dirtbag]

29. People 100 years ago had 2/3rds of the life expectancy we have today.

Good ole times, yep. Wanna go back to that. NOT.

[meisje]

22. They don't want to get sued when your wife O.D's by accident

[bedazzled]

24. do they call this the limbaugh law?

i admit to being very angry when i have to give driver's license numbers and social security
numbers to have my teeth cleaned, even though i don't have dental insurance and will be paying
myself.

course, i remember when you used to be able to pick your doctor because you thought he was
a good one. you weren't forced to take any clown who was in your plan. feels like that was
100 years ago, now...

[kedrys]

27. If they don't already, they should

We don't hang out with the s.o.'s side of the family, but my mother-in-law is alleged to have said repeatedly that databases and any sort of gathering of personal information in a consistent and centralized manner, no matter for what purpose, is the ultimate mark of the beast. Colorful description, but it makes you think...

I remember those good old days as well - less than 10 years ago. We were assigned some alien creature we've never met as our new Primary Care Provider this time around, because the web site glitched and wouldn't let me pick a doctor. Come to find out, after calling to get our regular GP back, that he's no longer in the plan, even though he's listed on the HMO's website. Don't get me started.

[FlaGranny]

28. The doctor is covering his butt.

Pain management doctors can get in a whale of a lot of trouble for overprescribing. Sometimes, perfectly ethical physicians can scrutinized by state boards and the police if any patient of their's is getting too many narcotics. The pharmacy also can get in deep trouble for not reporting it. The doctor and the pharmacist must both take note of any patient that has gotten a narcotic prescription from more than one physician. Their butts are on the line. Don't be upset. They're doing what they have to do. Any ethical pharmacist would do the same.