Things I learn from my doctors!

[Ivorymist]

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Well this was actually a DDS, but I got a script for Percocet in a retail store from this dentist. There was no strength so I tried calling him.

DDS - Hello?
Me - Hi Dr. XYZ I'm calling from ABC pharmacy. I got a script for this patient for Percocet and it doesn't have a strength on it...
DDS - Oh? Hmm...what strength does it come in?
Me - Well there are several different strengths sir.
DDS - What's the most common?
Me - 5...
DDS - Sure that sounds good.

 

[ERMudPhud]

This is what drives me crazy about percocet. It used to be so easy to write for and now there are a bunch of different formulations and if I don't get it right I get a call from walgreens. I got so tired of it I started writing everyone for tylox-to the point where the pharmacist now calls me Dr. Tylox. Unfortunately one of the big local HMO's, in league I'm sure with the evil percocet people, has thwarted my protest by making percocet formulary. Now I get calls from walgreens telling me that tylox isn't on the patients formulary

By the way love this and the related thread, expect some more traffic I'm going to link them to the EM thread.

 

[Apollyon]

I'm guilty of the Percocet thing - last year, in NYC in a city hospital, all there was was 5/325 - which I didn't know. I tried to write for 7.5/500's, and that got smacked down, but Percocet wasn't the big mover that it is in North Carolina (I think it's true when I tell people that, per capita, more Percocet is written for in NC than anywhere else in the US); now, I just put "Percocet", and, apparently, it gets filled.

I just learned something last week about elixirs - I was racking my brain, trying to figure out this or that (TMP/SMX solution, Amoxicillin elixir, even Tylenol elixir), and the attending just said, "write for the med and how many milligrams, and the pharmacist will dispense it according to what they have". So, now, I just write "Amoxicillin elixir 600mg" and am done with it.

 

[spacecowgirl]

If you're the on-call doctor for the weekend. Don't get pissed when I call you. I think that's what "on-call" means - that you will get called on.


If I call you, said on-call doctor, to clarify a script written by another doctor, don't tell me "that's not my problem" while I hear the sound of a beautifully made tee shot in the background. Correction: it IS your problem, see first point.

Lastly, if you prescribe a topical cream that no pharmacist anywhere has EVER heard of, can't be found in any reference book, and isn't carried by any of our wholesalers, don't be pissed when we call for clarification.

 

[jdpharmd?]

I used to work at a pharmacy near a crazy derm's office. He loved compounding, and prescribing for off-the-wall compounds. Customers would frequently come in with an Rx from his office and small "solo" cups (like ranch dressing cups or whatever) full of weird mystery ingredients that he knew we didn't have and couldn't order. I wish I could remember exactly what they were. It was always fun to watch us all hide as the patient came in with a new rx, 2 or 3 vials of mystery chemicals, and a full sized sheet of paper with the directions/ingredients. I vaguely remeber dissolving one of his supplied ingredients in HOT alcohol and having it burst into flames (in the microwave of course). 😀

 

[bananaface]

True story.....

A patient brings in a prescription that reads as follows:

"Promethazine Suppositiories 25 mg.... Take 1 by mouth as needed for nausea/vomiting."

So I call up the ER for clarification and the nurse on duty says, "Wow. It sounds like that doc doesn't know his head from his ass."

I LOVE nurses with a sense of humor. I LOVE them!

Anna

 

[spacecowgirl]

True story.....

A patient brings in a prescription that reads as follows:

"Promethazine Suppositiories 25 mg.... Take 1 by mouth as needed for nausea/vomiting."

So I call up the ER for clarification and the nurse on duty says, "Wow. It sounds like that doc doesn't know his head from his ass."

I LOVE nurses with a sense of humor. I LOVE them!

Anna

LMAO!!!!! Although I could say a few things about nurses too ("I'm supposed to start LR at 3 pm on a patient, what's 'LR'"?

 

[jdpharmd?]

LMAO!!!!! Although I could say a few things about nurses too ("I'm supposed to start LR at 3 pm on a patient, what's 'LR'"?

I think nurses lie awake at night trying to think of more abbreviations. To be fair, I think that writing all that junk in the patient's chart does take a lot of time. So, I wd prob abbv the hll ot of it 2. 😉

 

[spacecowgirl]

Noooo, the nurse had absolutely NO IDEA what LR stood for and had to call the pharmacy. Scary!

 

[flighterdoc]

Noooo, the nurse had absolutely NO IDEA what LR stood for and had to call the pharmacy. Scary!

Was she perhaps not a native english speaker? Not educated in the US?

 

[Pilot]

Methergine is not interchangeable with Brethine. (this was actually a NP that wrote this, but the supervising Dr didn't want to discuss the prescription with me, telling me he had full faith in his NP, until I told him I would fill the prescription under his name). The patient - an 8 mos pregnant lady with contractions. Saved a life that day 🙂

 

[spacecowgirl]

Was she perhaps not a native english speaker? Not educated in the US?

If you're licensed as an RN in the United States, you'd better know what LR, D5W, and NS are - period!

 

[flighterdoc]

If you're licensed as an RN in the United States, you'd better know what LR, D5W, and NS are - period!

I agree. I'm trying not to start a race war here, but it seems that some nurses aren't particularly well trained - especially (but not exclusively) those who are not trained in the US.

 

[loo]

Please have an office policy that states, "Patients must have the pharmacist call the office for prescriptions--new or refill". Then, make sure you DON'T have enough staff to field all these calls. Then, make sure your staff puts me on hold for 10 minutes, long-distance, so they can "check the chart" or "check with the doctor...but he/she's in with a patient right now."

Result? I will have absolutely NO GUILT when I page you during lunch, off-hours, or any other time that is inconvenient to you.

OK, I'm done venting. 😀

 

[bananaface]

I like this one too:

Have half your staff and only half your staff have a policy stating that patients must obtain all Rxs at regular office visits. But, remeber not to tell your patients anything about this plan. And, be sure to avoid telling the pharmcy which doctors have this policy. Simply let them figure it out when you fail to respond to numerous faxes. Now THERE is some quality medical care.

Anna

 

[loo]

Please do not tell me that you are SO BUSY that you cannot date your written prescriptions--especially controlled substances. 🙄

Thank you and have a great day! 🙂

 

[loo]

Front staff and nurses reflect the "personality" of the practice. If you act like a jerk, they will act like jerks. And visa-versa. Of course, there are exceptions!

 

[loo]

We absolutely love it when you write "thank you" with a smiley faceon your written rx's. It makes my day brighter 😀 (I'm NOT being sarcastic). I will call you and compliment your momma for raising such a curteous child!

 

[MNnaloxone]

When I have to call your office because I can't read even half of your written prescription, and the nurse finds the chart and says "um...I'll have to call you back", there is most definitely a problem. All that school, and you forgot how to write?