A patient I've treated for many, many years. Suffers from mild Atrial Fibrillation. Makes him feel tired. Takes digoxin and coumadin. Has mild COPD, makes him tired, hasn't smoked in years. Former lobster man. Getting progressive senile dementia. Wife may not be "tracking" so well, either. They called in today asking for a refill on generic coumadin 5 mg tablets. They secretary okayed the refill, called the pharmacy and orderd Aricept 5 mg tablets. Aricept appears at the top his printed med list. The error was not discovered until the patient and his wife got home. They called the pharmacy and were told that medicines could not be returned. Unponed bottle, reliable patients. The secretary called and explained it was her mistake. The pharmacy agreed and said they would not reimburse the patient 150 dollars for the wrong script.
I spoke to the pharmacy manager. She was insistent that it was not "fair" that 150 dollars should come from their "bottom line". I asked if she thought the answer was for my secretary to pay the patients 150 dollars from her salary and should I fire the secretary? She simply said it was not her fault and gave me the 800 number for "corparate headquarters".
Questions: Do we fire the secretary? Do we reimburse the patient? How to we improve patient call-in refill requests?
