Why so long to fill a prescription? (part 3)

In previous articles, we looked at reasons for the long wait for prescription-filling at community retail pharmacies.

Challenges with doctors were among the reasons cited. See: http://jamaica-gleaner.com/gleaner/20110511/health/health1.html. Here are the other factors which contribute to delays.

Money matters

Many clients cannot afford all items prescribed. Pharmacy personnel calculate and recalculate costs, based on priority of individual items in treating conditions and, of course, the patient's pocket. Pharmacists spend much time convincing some clients that prescription items they say they want are not necessarily the most important ones.

Some clients increase waiting time by refusing to state how much they wish to spend, saying, "Give me half" or "Give me quarter." Unfortunately, portions cannot be dispensed when dealing with a tube of ointment, a sealed bottle of liquid or oral antibiotics which are only dispensed in full. Halving the quantity of medication does not translate to halving the price. There is a professional fee which is a fixed charge. So, time-consuming trial and error with pricing continues.

Resolving health-insurance issues

Computer glitches aside, processing health-insurance claims and receiving authorisation from the companies is time-consuming, especially if there are several prescription items and multiple health-insurance plans being used. Delays ensue when there's not sufficient money available on private insurance to subsidise required drugs, or when the client is not registered to receive claimed items on insurance.

Client factors

Unseen Customers. Some customers fax their prescriptions to the pharmacy before they arrive. They are ahead of you in the prescription line.

Some clients have limitations. The elderly often cannot remember well, hear well or articulate quickly. They require more attention than other clients, and should not be rushed. Ironically, these special clients have prescriptions with the most items (I've seen 18-item prescriptions) and multiple insurance cards. Many times, because of decreased earning power with retirement, they also have little cash, which makes pricing challenging.

Clients trivialise prescription process. While presenting prescriptions or receiving medications, some clients prefer to use their cellphone.

Unreasonable expectations of time. Some clients approach the pharmacy when they are in a hurry. They expect that, like fast-food outlets, they may tender the prescriptions and be out of the pharmacy in a few minutes.

Present insurance card when the deal is done. Many clients present health-insurance cards after pharmacy personnel have calculated prescription costs, assuming cash payment, and the client has paid. Refunds and submission of insurance claims become necessary, consuming time.

Pharmacist factors

The pharmacy is the first port of call for many persons at the first sign of illness or for those who have health queries. While overseeing prescription-filling, the pharmacist must do the following:

• Take telephone calls from outside customers as well as speak with inside customers.
• Fill customised first-aid kit orders for companies.
• Attend to compounding products from raw materials (ointments, creams and other mixtures).
• Contact medical doctors re prescriptions.
• Perform blood-sugar, blood-pressure and pregnancy tests.
• Manage the dispensary staff and inventory.

Dahlia McDaniel is a pharmacist and final-year doctoral candidate in public health at the University of London; email: yourhealth@gleanerjm.com.