"missing" pills

[labcoatguy]

What is your procedure when a patient accuses you of "missing" medications? If it's a sealed bottle of 30 tabs and patient needs 90, I would print 3 labels and write: 30+30+30 (1 of 3), etc.

But this patient CONSTANTLY accuses us of not giving the full amount. It's not owed medication either because we keep a clear, written record of that. When patients say that they are short like 2 or 3 pills for a generic drug, I just give it.

But what do you guys do when people like this say you owe them 30 tabs for expensive brand name medications? And on days when another pharmacist filled the Rx?

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[Carboxide]

You make a rule that ALL HIS MEDS must be double counted and verified as double counted on the label. After that, any time he says you owe him, you say no - you don't.

If you lose his business because of that, then there is nothing you're really losing...giving away brand name meds is going to cost you way more in the long run.

 

[pharm B]

You make a rule that ALL HIS MEDS must be double counted and verified as double counted on the label. After that, any time he says you owe him, you say no - you don't.

That's what I've seen done in the past. Sometimes, mistakes do happen, though.

 

[npage148]

Count it in front of him at the register and make him sign the label

 

[thisoneorthat]

I would leave a note in the patient's profile indicating that you need to double count everything (not sure at your store if you can "force" reminders/notes to appear for every script). If it's a regular customer, make sure to alert the staff to double count for that particular person.

Even if another pharmacist or tech filled it, the pharmacist working that day should still take the responsibility of the "mistake" or whatever and make things right again. If it really is a filling issue of an expensive med and RxM can't be reached, I may give the whole bottle but not until I fully researched the situation. I think my RxM would kill me if I simply "gave" away something like Livalo.

But really, consistently missing 30 pills? If you must, count the pills in front of the patient like someone else already mentioned.

 

[Pharmavixen]

I had a few patients like that over the years. And yeah; triple-count if necessary.

Where I live, seniors don't pay for prescriptions, but it was usually seniors who were accusing me of ripping them off. Too much free time on their hands, I wager.

 

[type b pharmD]

Hehe.. We add 'Double Count' as the patient's middle name sometimes when this gets severe.. I dont know if this is sanctioned or not but it helps get you psychologically prepared when they come to drop off lol.

I know back in the day many stores used to put nasty comments in the pt's profile if they were a repeat scam artist or had a complaint at each visit .. but this has generally been completely outlawed now by management. For good reason in my opinion. Dont document personal grievances in a person's official record.. Occasionally it will print out somewhere on a label.

 

[thisoneorthat]

Hehe.. We add 'Double Count' as the patient's middle name sometimes when this gets severe.. I dont know if this is sanctioned or not but it helps get you psychologically prepared when they come to drop off lol.

I know back in the day many stores used to put nasty comments in the pt's profile if they were a repeat scam artist or had a complaint at each visit .. but this has generally been completely outlawed now by management. For good reason in my opinion. Dont document personal grievances in a person's official record.. Occasionally it will print out somewhere on a label.

The place where I work, only the RPh can put certain comments in the patient's "additional" info tab, and he/she has to acknowledge on a pop-up screen that what's inputted is not defamation (or something along those lines). I've had to put in things like the password that the patient requires each time someone (family, friends, whoever) picks up their controlled drugs

I definitely would be careful about what comments you put and where, because there was an instance where an RPh had commented in the wrong place and whenever a leaflet printed, " **problem patient** " printed on each one, right under the address. Shouldn't have been stored anywhere in the patient's profile or prescription comment section, and patient was pissed. She became a true "problem patient" then lol

 

[owlegrad]

I am really not a fan of this game at all. I had a patient accuse us of shorting her tablets. Well, no way. She has a forced note in her profile about this same issue so I personally counted her medication before verifying the script. Well she called on my day off and we gave it to her. Well, ok, fine, but I think it is silly we bend to her silliness/theft. Like someone else mentioned, let them go somewhere else, you are not losing anything when you take a loss every time you fill their script.

 

[MindOverMatter]

Put a patient note stating to double count all meds, double count them and mark it as so, then check your on-hand inventory when they call to make sure it matches the system.

If everything matches up, sorry, can't do anything for you.

 

[zelman]

Keep in mind, the patient may not be at fault here. Plenty of people steal family members' meds.

 

[Digsbe]

I am really not a fan of this game at all. I had a patient accuse us of shorting her tablets. Well, no way. She has a forced note in her profile about this same issue so I personally counted her medication before verifying the script. Well she called on my day off and we gave it to her. Well, ok, fine, but I think it is silly we bend to her silliness/theft. Like someone else mentioned, let them go somewhere else, you are not losing anything when you take a loss every time you fill their script.

I agree with this, and I view them wrongfully saying you miscounted when that didn't happen to be a form of theft. They got and paid for their dispensed amount and if it's clear that there was no shortage they are trying to steal extra pills or reacting to someone else taking their medications (and in that case the patient should secure them and try and find out who was taking them). I was at a pharmacy where controls were counted by a machine that weighed how many were on a tray to calculate how many pills were there, it would then take a picture of the tray that if need be could be verified after the med was given to the patient. If the pharmacy has a device like this maybe they could count her other drugs using it and show her the picture when she complains about being shorted with picture evidence that she was not.

 

[WhiteSnows]

Call the police.

 

[rx2010]

I would put a note in their profile to have the patient count their meds in front of us before it's released, and also inform the patient to always ask the person checking you out for a counting tray and for you to count them yourself each time it's picked up.

 

[type b pharmD]

Call the police.

This seems too serious for that. I would call the fbi or even interpol

 

[positivesign]

I've seen ***triple count all meds*** before too.

 

[boriqua]

lol triple count. that's a little OD isn't it? I say if a pharmacist counted it, that should count as a double count and it should be over from there.

 

[All4MyDaughter]

For triple count patients, we count twice while we are filling, and the third count is in front of the patient at pick up. If someone repeatedly alleges they are shorted CS, this is what we do.

 

[PriorAuth]

For controlled substances,

1) My tech puts his or her initials with a marker at the bottom of the vial.
2) I circle the quantity on the vial with a red pen.

If I see the red circle on the rx label and black marker on the prescription vial, they can scream and yell all day but I don't buy their story.

 

[All4MyDaughter]

For controlled substances,

1) My tech puts his or her initials with a marker at the bottom of the vial.
2) I circle the quantity on the vial with a red pen.

If I see the red circle on the rx label and black marker on the prescription vial, they can scream and yell all day but I don't buy their story.

I find that doing the final count in front of the customer prevents screaming and yelling, because they know we know (and have documented) that they left the store with the correct quantity.

 

[type b pharmD]

I find that doing the final count in front of the customer prevents screaming and yelling, because they know we know (and have documented) that they left the store with the correct quantity.

Yup. Can't lose in that situation esp if they complain you just point to the camera hahaha

 

[All4MyDaughter]

Yup. Can't lose in that situation esp if they complain you just point to the camera hahaha

I have also worked in one pharmacy that had the camera that would take an image of the counted pills and number each one. That was also helpful, but not as effective as counting in front of the customer. Prevents them from saying, "You took out some after you took the picture, blah blah blah."

 

[labcoatguy]

Thank you all for the advice. I agree that giving away brand name drugs is going to cost a lot more since it keeps happening. I know that mistakes happen in the pharmacy or family members steal drugs but when the same patient keeps accusing us of shorting brand name med, it's rather suspicious to say the least. I have a "double count" note in the profile and next time, I'm going to count it in front of the patient. If this happens again, then goodbye scammer.