||[Jun. 9th, 2006|12:22 am]
The American Caliban
|[||Tags|||||commerce, doom, drugs, failure, health, honk, it get an error, medical-industrial complex, medicine, mergers, tag||]|
This is the story about how refilling one generic prescription that I have been on for more than a year has taken the whole week so far and is not done yet. I present to you the combined effects of: tightly coupled systems; similar numbers; incompetent yet confident clerks; persistent computer errors that are not corrected; supply chain mishaps; and poorly handled mergers. Ladies and gentlemen, come with me on a fantastic voyage to: THE PHARMACY!
Monday, June 5: I call in a refill for two prescriptions. Both expired simultaneously and required that the pharmacy phone my physician for approval because the number of refills had run out. I call their automated system. I punch in the numbers very carefully because they differ only by one digit. The system tells me that my refill may be delayed because they'll have to call the physician. I had planned for this. I schedule my prescription pickup for the next day to give them time. The system instructs me to call before I come in and check on the prescriptions by number, again using the automated system.
Tuesday, June 6: I call the pharmacy in the late afternoon to check. I press the button for "get status" and put in one of the numbers. After a long moment the system says that I will have to speak to someone. A phone rings fifteen or twenty times. The Gruff Old Pharmacy Clerk Guy answers.
"I called to check on my refill and it transferred me to you," I say.
"Okay," he replies, "what's the prescription number?"
"There are two, just one digit apart. They are 2060102 and 2060103."
There is a very long pause, in which I say "Hello?" and he confirms he's still checking.
Finally he comes back on the line and says "You got two of the same one."
"No, I don't. One is metformin and the other is triamterene-hydrochlorothiazide. The numbers are really close."
"Oh, you're right! Okay, we'll get those done for you. Come on in."
Wednesday, June 7: I go to the pharmacy in the evening. The clerk pulls two prescriptions out and looks at them thoughtfully.
"Do you have insurance for both of these?"
"Yes, I do. They're generics, they usually cost about a buck."
"This one isn't covered." She holds up a triamterene prescription.
"Yes it is. You should look again."
She goes to the computer for a few minutes. She comes back and says "You have two of these. Only one is covered." Indeed there are two triamterene scrips there, and no metformin, so that one of them is $15.
"This is what I thought we fixed last night!" I'm getting a little steamed. "The gentleman I talked to then said he'd corrected it and that I had a prescription for metformin too, not two of this."
For a moment the clerk looks at me with wide frightened eyes. Then she ambles back over to the computer. After another few minutes she's back.
"Okay, sir, we got it. But we're out of metformin. We can give you a couple but not the whole prescription. It'll be ready tomorrow."
I pay for the triamterene and take that and a day's worth of metformin.
Thursday, June 8: I go to the pharmacy in the evening. The clerk is a personal acquaintance this time, a very nice efficient woman whose daughter I know. Before I even come up to the counter she's been back looking under my name in the list.
"Did you just call this one in? I don't see one for you."
"No, it's been going on for a while. It really should be here, they told me yesterday it would be."
She looks through the computer at some length. Old Gruff Clerk guy keeps trying to help but is clearly disoriented and she straightarms him away vigorously. After a very long (> 10 min) search she returns looking dejected and says she can't find anything I could be refilling. At this point I tell her the entire story with the narrative hook and the build to climax and the cliffhanger with the four-part harmony and original soundtrack by the Foggy Bottom Boys. She looks again, and finds my metformin prescription! For some reason it has been "deactivated". She then goes to find the actual pills.
Another ten minutes passes.
The clerk returns with a long face. They're still out of metformin. I express disbelief, and suggest that a curse may be involved. Apparently it's not a curse, but a supplier change. They're getting their generics from someone else now, and the change has caused an interruption.
During this, Gruff Old Guy twice tries to help by finding unrelated medications and offering to call my physician. She gives him the universal gesture indicating that he should tell it to the hand. It becomes clear who has screwed this up in the first place.
I am to return again, and this time I should call and ask to speak to a human, and get a human to hold the prescription in said human's hand and speak the truth to me about it. She and I understand each other completely now. But there's one more thing. Looking at the prescription, she says: "Do you have insurance for this?"
"Of course. It's generic. Costs a buck each time."
"It shows that there is no insurance."
"That cannot be true." She nods and goes to the computer again to slay this last dragon.
Another long period of computer searching ensues. "Have you always got this here?" Yes, yes I have. I have no other pharmacy before thee. She looks at the screen, perplexed.
"I found it. It's because we're switching from being a Sav-On to being a CVS. It looks like your insurance request was made from Sav-On's system and then not cancelled, and when we made the request from CVS it showed up as from a different pharmacy at the same time and the insurance denied it."
There's a long silence, in which I look at a ceiling tile and count its dots and breathe a bit.
"So. Then. How do I... I mean..."
"Just come in tomorrow after you talk to someone. It'll be fine."
[...to be continued!]