The Black Hole of Prescription Refills

My doctor’s office wouldn’t refill my prescription over the phone; instead, they told me to contact my pharmacy. When I stopped in to pick up my refill the pharmacy told me they hadn’t heard back from the doctor yet, despite it being nearly a week since I’d requested it. When I called my doctor’s office to find out why, THEY told me they had already faxed it to the pharmacy 4 days ago, but the pharmacy claims they never heard back. Who’s telling the truth?

Both of them are.  Many doctor’s offices now instruct you to “don’t call us, call your pharmacy instead” for any refills, and it’s very frustrating to get caught in the middle, with both sides claiming that it’s not THEIR fault, it’s the OTHER party that didn’t follow through. Trouble is, when you need your medicines refilled, when you run out it of them it becomes YOUR problem.

It seems that today’s doctor’s offices only want to hear from your pharmacy if you need a refill, not from you. I see three reasons why doctors offices created this policy:

1. A refill request sent to your doctor from your pharmacy has the important information about your requested refill already organized for the doctor, including which pharmacy to send the refill request to, saving your doctor a lot of time.

2. A faxed refill request doesn’t require a nurse or staff member to stop what they are doing, answer the phone, listen to you state your request, then write it down for the doctor to respond to later. It may not seem like very much time, maybe 3-4 minutes, but multiply that times the number of medicines prescribed by just one clinic and it really adds up.

3. The medication, dose and directions you are requesting a refill for may not be exactly the same as what your doctor has on file for you. You might have seen a cardiologist specialist for a heart problem and they changed your medicine, or you may be asking for a refill of medicine that is managed by another doctor, and should be directed at another physician’s office instead. As a pharmacist, I often see medications coming from 2 or 3 doctors on the list of prescriptions we fill for our customers.

What’s supposed to happen when you run out of refills of your medicines? First, you call your pharmacy to request a refill; next, your pharmacy faxes the doctor’s office with the details of what you are requesting; your doctor then reviews that request and responds to it with any changes and additional refill instructions and sends it back to your pharmacy, which refills it in time for you to pick it up or mail it to you so you don’t run out of your medicine.

It doesn’t work like this every time, though. What goes wrong when it doesn’t? Why do your pharmacy and doctor’s office get into this blame game of, “I’ve already sent it, it’s not MY problem?”

These days, the medical community communicates both by manual and electronic faxing. Manual faxing involves walking up to a fax machine, sticking a piece of paper into it, dialing the number of the fax machine you want it to go to, then listening for a confirmation tone which will tell you that your fax was transmitted successfully to the fax at the destination you requested. With a manual fax, you can tell if your fax was received, or not.

Today’s faxing is electronic, and I’ve noticed that it works differently than the old way of “put a piece of paper in, get a piece of paper out”. Using a computer instead of a fax machine, when you click the FAX button on your computer screen your faxed request goes to a central holding area first before being transmitted on to the doctor’s office. What’s good about this is that with electronic faxing you don’t have a stack of paper to deal with.

An electronic fax will show only that IT WAS SENT, not that it was received by its intended recipient. Unfortunately, electronic faxes get lost every day, sucked into some “black hole” somewhere, never arriving at their expected destination. Just because an electronic fax was SENT doesn’t mean it actually ARRIVED!

That’s why you get the “we’ve already sent it” response from both your pharmacy and your doctor’s office when you ask why your refill isn’t ready. It’s SO tempting to bypass all that hassle and just call your refill requests directly to your doctor’s office to avoid dealing with your pharmacy. Instead, why not accept the fact that there is a “black hole” out there that sucks up unsuspecting and innocent electronically faxed refill requests, and expect that sometimes refill requests will go missing on their to or back from the doctor’s office despite everyone doing everything right. I believe that this “black hole” of electronically faxed refills really exists, and recommend that you always call ahead for refills early enough to allow for the possibility that your requested refill won’t get through the first time. Call your pharmacy back a day or two later to verify that your requested refill is ready in case it needs to be re-sent to avoid the hassle and stress of the blame game and of going without your medicine. Good luck!