Why wait so long to fill a prescription? (part 2)

Last time (part 1 appeared on April 27) we looked at the prescription-filling process in a retail community pharmacy, through rose-coloured lenses, since we saw the 'ideal' prescription.

See http://jamaica-gleaner.com/gleaner/20110427/health/health1.html

Those prescription scenarios described rarely occur in any retail community pharmacy. If you're the first client for the day or you visit a quiet pharmacy or visit a pharmacy at a quiet time of day, you're likely to have a relatively short wait.

Pharmacy is a highly regulated profession and the system of checks and balances to protect the public can lead to inefficiencies.

Admittedly, there is always room for improvement. Pharmacists and their staff can always work faster and more efficiently. They regularly redesign dynamics of the prescription production line for greater output, productivity, efficiency and customer satisfaction. That aside, here's what obtains in the real world of retail community pharmacy which contributes to the long wait.

Prescription omissions

On most prescriptions the patient's address, telephone number and age are omitted by the doctor. By law, pharmacists must have these details before filling a prescription. It's time-consuming to ascertain these, especially if the client is a bearer and not the actual patient.

Illegible prescriptions

Many prescriptions are unreadable, even by pharmacists. It's challenging when the patient's name cannot be recognised. Patient-name recognition is minor compared to drug name and dosage recognition. Pharmacy personnel concur with each other then to confirm what they see, they may ask the client about his or her medical complaint. The response is usually helpful but in many instances the response is, "I told the doctor already" or, "I know why I want the drug" or, "Do I have to go over that again?"

Remember, all this may be happening while you are waiting to present your prescription or receive medication.

Doctor's identity

The doctor's name is a legal requirement for prescriptions. Many doctors place illegible signatures on prescriptions. To contact the doctor about any of the abovementioned discrepancies, the pharmacist must know who the doctor is. At least half of my clients do not know the name of the doctor they saw. Responses like, "It's a Chinese man" do not help.

Contacting the doctor

Pharmacists are the authority on drugs. To prevent clients from revisiting the doctor for prescription clarification or correction, pharmacists contact the doctor to review prescriptions. The incorrect dose may have been prescribed or the pharmacist may determine that there's a safer or more effective medication. The doctor may be seeing another patient, performing surgery, out of office or on vacation. Pharmacists sometimes leave a message and wait for the medic to return the call.

Medication scarce

If the prescribed medication is scarce, the pharmacist may call the prescriber to recommend an alternative. But many pharmacists, like myself, actually call other pharmacies to find the item for the client.

(Next time, we'll look at challenges with clients, health insurance and pharmacists themselves.)

Dr Dahlia McDaniel is a pharmacist with a doctorate in public health. She is the chief executive officer of two pharmacies and a medical practice in Kingston; email:yourhealth@gleanerjm.com.