The black hole of refill requests

Q:  My doctor’s office won’t refill my prescriptions over the phone. They always want me to contact my pharmacy instead. But when I went to pick up my refill yesterday, the pharmacy said it wasn’t ready because they hadn’t heard back from my doctor yet. But I requested it almost a week ago!  When I called my doctor’s office to complain, they said they’d already faxed the refill three days ago. My pharmacy insists they’ve never heard back from my doctor. Who’s telling the truth? 
These days, it’s “don’t call us, call your pharmacy” for any medication refills. You get caught in the middle when your pharmacy and doctor’s office claim it’s the OTHER party who’s not responding. Trouble is, when you run out of medicine, it’s now YOUR problem. 
Doctor’s offices want refill requests faxed directly from your pharmacy instead of from you for several reasons. First, a refill request from your pharmacy not only has the most current information about your medicine but also WHICH pharmacy to send it to. Ever use more than one pharmacy? Many people do, and sending a refill to the wrong pharmacy is a sure way to keep your refill from being done on time. 
Second, faxing a refill request to the doctor doesn't interrupt the nurse or doctor's work. When you call, they have to stop what they’re doing to answer the phone, listen to you state your request, write it down or type it, then send it on to the doctor for review.  It may not seem like very much time, maybe 2-3 minutes per call, but multiply that times the number of medicines many people take, and it adds up fast. 
Finally, suppose you saw a cardiologist for a heart problem or were seen in the ER or an urgent care center recently. The refill you’re requesting today may not be the same medicine, dose, or directions as what your doctor currently has on file for you. As a pharmacist, I often see medications coming from 3 or more doctors on the list of prescriptions we fill for our customers. 
In a perfect world, your pharmacy faxes the doctor's office with your requested medicine along with the date last filled and quantity you received. Your doctor reviews it, then responds with any changes or additional refill instructions. The nurse faxes this back to your pharmacy, who fills it, puts it aside for pickup, or mails it out to you. How does your pharmacy and doctor’s office get into the blame game of, “We’ve already faxed it” or, “The doctor’s office hasn’t responded yet.” What goes wrong?
Today’s medical charts are electronic files inside a computer instead of stacks of colored folders. Electronic faxing is more convenient because it can be done directly from your electronic chart by just clicking a button. Years ago, refill requests were faxed back by walking up to a fax machine, sticking a piece of paper into it, then entering the number of the fax machine you're sending it to. When you hit the SEND button, you'd get almost instant confirmation that your fax was transmitted successfully. 
Today's electronic faxes go to a central holding area and then wait in line to be transmitted to their final destination. Electronic faxes show that you’ve successfully SENT the fax. Unfortunately, they cannot confirm that it ARRIVED successfully at its final destination. Sadly, electronic faxes go missing every day, sucked into some mysterious black hole in the universe, showing up days later or never arriving at all. 
That’s why there’s finger-pointing between the pharmacy and your doctor’s officer, each claiming, “We’ve already faxed it!” when you ask why your refill isn’t ready. Here’s how to avoid that:
Three Tips to Getting Your Medication Refilled in a Timely Manner:
1. Ask for a 90-day supply.
You’ll need fewer refills, which means fewer chances to run out.   
2. Call ahead of time.
Contact your pharmacy for a refill several days before you run out of medicine, so they have time to fax your doctor. If you deal with a mail-order pharmacy, allow at LEAST 1 week of lead time to enable additional mail delivery time.
3. Don’t assume your refill is ready. 
Call 1-2 days after requesting your refill to confirm your refill. If not, check to make sure they are faxing the correct doctor and ask them to re-fax. If a second fax is not responded to, call your doctor’s office and explain your situation.  
Dr. Louise Achey, Doctor of Pharmacy, is a 40-year veteran of pharmacology and author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How YOU Can Take Them Safely. Check out her NEW website for daily tips on how to take your medicine safely. 2020 Louise Achey

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