June 24, 2011
Calls for refills are out of control! As the economy worsens, more patients are ducking trying to avoid follow up visits by calling for refills on their medications. They tie up the office phone lines, consume large amounts of secretarial and nursing time, and put themselves in harm’s way. They plead for “just one more refill”; they promise to come in; they make excuses; anything not to have to spend time and money in my office.
I love making my patients happy! I work hard to save them money. I work even harder to keep them safe and out of harm’s way. In “Your Doctor the Master Chef” (http://livewellthy.org/2011/02/17/your-doctor-the-master-chef.aspx), I explain how a chef prepares a delectable sauce by seasoning his dish, letting it simmer, and then tasting the dish, repeating the cycle until it is perfect. Medications are like seasonings and good health is the recipe. Your doctor, the chef, has to see you on a regular basis, both to adjust your medication and monitor your health to assure the recipe is right for you.
When I prescribe a medication that treats a chronic problem, I give the patient enough medication to last until his next visit. I expect that my patient will see me prior to his/her medication running out so I will have time to collect and analyze any laboratory values needed to monitor the medication, evaluate the effectiveness of the medication , and refill the medication prior to the patient running out. Each and every medication has expected benefits and potential risks.
Evaluating a medication’s benefit is critical. If the medication is for elevated blood pressure and it is not controlling your blood pressure, something has to be done. My nurse cannot take your blood pressure over the phone. We have to see you in the office to evaluate your pressure.
Monitoring your medication for possible side effects (http://livewellthy.org/2011/03/29/possible-vs-probable.aspx) includes both a physical exam and lab testing. While the I-Phone can do many things, it can’t draw blood or help in examining you. Refilling your medication over the phone may seem like the nice thing to do but it is often the wrong thing to do.
The best way to save money is to be healthy. The expense of a follow-up visit is much less than the expense of letting a disease go under-treated or missing an adverse reaction at an early stage. Help me help you! Come in for your appointed follow up. Put two weeks worth of your medication in a properly labeled medicine bottle; and, when you reach for that bottle, plan on coming to the office. If your doctor requires fasting labs, then make sure you are fasting (water only) 10-12 hours when you come in. Please make sure you drink plenty of water prior to coming in. If you use a mail order pharmacy, plan on coming in 3 weeks prior to your refill. Buying medications in small quantities locally can be very expensive.
Remember, the life you save may be your own. Don’t cut corners when it comes to your health. Most of all, be happy and healthy!