Medical Author: Omudhome Ogbru, Pharm.D.
Medical Editor: Jay Marks, M.D.
Although most people have visited a pharmacy, very few people are aware of all of the services that pharmacists can provide. What goes on behind the pharmacy's glass partition? Why does it take so long to get a prescription filled? This article discusses the role of the community pharmacist in providing healthcare and provides advice on getting the most out of each visit to the pharmacy.
The community pharmacist is primarily responsible for accurately filling prescriptions and ensuring that patients have enough information to effectively and safely use medications. Before a patient leaves the pharmacy with a medication, the pharmacist must be certain that the patient has the right medication, correct dose, and directions for use.
The pharmacist also provides information about how the drug works and its potential side effects and ensures that there are no contraindications to the medication (medical reasons for a patient to avoid the medication) and no potentially harmful interactions with other drugs the patient may take, foods the patient may eat, or diseases that the patient may have. The pharmacist does this by transcribing the doctor's prescription accurately, interviewing and counseling the patient, and using his or her knowledge of the condition that is being treated and the effects of the prescribed drug.
Since the pharmacist is usually the last healthcare professional to have contact with patients before they receive their medications, they are the final step in a system of checks and balances designed to ensure that medications are used safely and effectively. If the pharmacist believes that there is a problem with the prescription, he or she calls the prescribing doctor in order to review the prescription. For example, the wrong drug or dose may have been prescribed or the pharmacist may determine that there is a safer or more effective medication than the one that has been prescribed.
Apart from ensuring that patients leave the pharmacy with the right medication, pharmacists also provide drug information to healthcare professionals and the public. They assist physicians in appropriate drug selection, advise patients on appropriate over-the-counter remedies, and counsel the public on preventative therapies. Some community pharmacists offer monitoring services for cholesterol, blood pressure, and blood glucose. They also may run smoking cessation and weight-loss programs.
This description of what pharmacists do seems straightforward. So why does it take so long to fill a prescription? There are a number of reasons.
- One major reason is that pharmacies are very busy and understaffed. It takes time and staff to complete all the steps needed to fill a prescription, counsel patients, and contact physicians if there is a question about the prescription.
- Insurance companies also share a portion of the blame. If the insurance company initially denies reimbursement, it may take from a few hours to over 24 hours to receive authorization from the insurance company or a new prescription from the doctor. A good portion of a pharmacist's time is spent resolving insurance issues, clarifying the prescription with the physician or obtaining refill authorization.
- Finally, pharmacy is one of the most regulated professions, and the system of checks and balances that are in place to protect the public are time-consuming and can result in inefficiency. Everything from the height of the pharmacy's counter top to what goes on a prescription label is regulated.
Now that I have shed some light on what pharmacists do, here are some tips on how to save time and get the most out of your pharmacy visit.
- Before leaving the doctor's office make sure that the prescription contains the name, dose, quantity (including number of refills), and directions for use of the drug. It also is a good idea to know why the drug was prescribed. In addition, the doctor or the doctor's representative must sign the prescription. Also find out from the prescriber whether the drug is covered by your insurance plan. If it is not covered and you do not want to pay cash or spend a long time at the pharmacy while the pharmacist calls your doctor, ask your doctor to prescribe a similar drug that is covered by your insurance plan. Most doctors keep a list of which drugs your insurance company covers.
- Before you arrive at the pharmacy, make sure that your insurance information is accurate and up to date. Providing a date of birth or social security number that is different from the insurance company's records could lead to denial of coverage and unnecessary delay in obtaining your medication.
- Ask the prescriber to fax or call in your prescription with instructions on when you will be picking up the medication. It is also a good idea to call ahead to check whether the prescription is ready. This will save a lot of time for you waiting while the prescription is filled.
- Avoid peak hours at the pharmacy. The peak hours vary for each pharmacy, but for most, lunchtime and the end of the business day are usually the busiest.
- Tell the pharmacist about all prescribed and over-the-counter medications or supplements that you are taking. Plan to spend a few minutes with the pharmacist
discussing your medications. This is one of the most valuable services that pharmacists provide, but few individuals take advantage of this free service.
- If possible, fill your prescriptions at the same pharmacy so that they have your complete medication profile and will be able to detect drug interactions and duplicate therapy.
- If you are refilling your medication, make sure you have refills left. Your medication label usually states how many refills are authorized. If there are no refills left contact your doctor's office for refill authorization prior to arriving at the pharmacy. Call in your refill request several hours prior to arriving at the pharmacy so that your medication is ready by the time you arrive.
- For medications that you take continuously, consider using mail order or automatic refill services offered by most pharmacies. Automatic refill services even request refill authorizations from your doctor after your refills expire. If available, request a 90 day supply instead of 30 days.
- Develop a relationship with your pharmacist.
- If you have to wait for your medications, spend the time reading about preventive therapies and your medications. Check your blood pressure, weight, glucose, and cholesterol or obtain other information that may improve the management of your condition.
With careful planning, a visit to the pharmacy can be painless and, in fact, rewarding. However, if for some unforeseen reason there is a delay in obtaining your prescription, take it in stride and keep it in perspective. After all, there are other services that we gladly wait for that are not as important as our health. Pharmacies should not be viewed as fast food restaurants. They are a very important part of the healthcare system. Sometimes, the delivery of good healthcare takes time.