I was reading the comments over at The Angry Pharmacist's blog (not safe for work or the faint of heart) and there was one from a med student/resident/I don't really understand all the levels of training for MDs but I'm sure I will by the end of rotations asking how docs could make pharmacists' lives easier. I figured I'd write that blog post since The Angry Pharmacist is a busy dude and I like procrastinating (big scary test x2 this week, one mostly a surprise, oh joy).
What I really want all doctors to know about working well with community pharmacists:
1. Your computer system only sends prescriptions to ours. It doesn't send a message saying, "Oops! That was a mistake and I cancelled it here in the patient's chart." You could call us, or you could make a note on a second e-prescription saying "this is correct, do not fill the other one." Doing nothing but cancelling the order in the patient's chart just makes everyone frustrated that we have to call to clarify something.
2. Your computer system really ONLY sends prescriptions to ours. We have no information on what you're treating or what dose change you may or may not have made (on purpose or by accident). There are a couple easy solutions to this: add a diagnosis to your sigs (that's the part of the prescription that says "Take one tablet every day") by adding the words "for [hypertension or blood pressure or cholesterol or being crazy or mood]" to the end. We like that. Patients love it. Good idea. Additional solution: make notes on the rx (that's shorthand for prescription, fyi) that say: "note dose increase to ___" or something.
3. Ask us. We know stuff about medications and can help with just about any medication-related question. We also have all the best resources for looking stuff up about medications, so let us do our jobs. We see patients at all hours of the day so we have heard every stupid question ever (I promise). Your question is not stupid, and you look infinitely smarter asking us before just deciding to write an rx without knowing what you're doing and having us call you to figure out what on Earth you were thinking.
4. Don't think we're calling you stupid if you make a mistake and we call to inquire about it. Mistakes happen to people and doctors are still people, last I checked. We just want to know what you actually meant so nobody gets hurt.
5. If you're doing something strange for some reason (unusual dosing for example or adjusting the dose for an organ transplant the patient just had and somehow didn't tell us about), and you aren't sure it will translate properly or your e-prescribing software is grouchy/making you angry or whatever, CALL US. We are your colleagues. We want to work together. If you explain it on the phone to us, we'll get it right or ask you questions until we get it right.
6. We offer this thing called "medication therapy management" for patients who are having a bad time keeping their medications and/or health together. Refer people to us and then call us or fax us to tell us you recommended it to them. It's a great deal for everyone: we know lots about medications and can figure out what's going on and suggest changes to you, your patient gets someone to talk to about all the things they forget/are too scared to ask about when they see you, and the insurance company probably (most of the time) saves money in the long run.
7. We think working in teams with you is awesome and would love more clinical data access, and we could share with you if your patients are actually getting their prescriptions filled, and if it's on time or not each month. Is your clinic hiring a pharmacist? We would love that job and could save you time by doing the grunt work "what medication should we give this patient?" part of visits and patients money by finding them a medication that's a good fit for them from the start.
8. ASK US. We mean that. We try when calling to suggest something instead if the patient is allergic or the insurance won't pay. If you ask, we can tell you.
9. Pharmacists are largely PharmDs (or really wicked experienced and smart RPhs [registered pharmacists]). We know our stuff. Don't scoff at our recommendations. We keep up on guidelines and literature too and we want to do what's in the patient's best interest.
10. Did I mention asking us questions and actually talking to us? And that e-prescribing is 100% one way from your computer to ours? Remember just those two things and you are set to be our new favorite MD (and we totally have favorites in the pharmacy, in case you didn't know).