Pain Doc Says I got Script, but I Didn't

[Eva 14]

I want to wish everyone best wishes for 2014. Sorry I haven't been on the forum for a while. Life has been hectic. Thanks in advance to anyone who can offer me any advice as to how to proceed with this situation. It's never happened before, and I've been seeing my pain doc for 5 years.

Here's my problem: On Jan. 6th, I had my appointment with my pain doc.

Here's how he writes his scripts: We have our appointment, then I'm sent to the waiting room to wait while he writes out my scripts. I wait for a while, because I'm on a lot of different meds. Finally, the receptionist hands me my scripts and tells me to look them over to make sure everything is there. My pain doc remembers to write out my crucial C-II pain meds, but recently he's been forgetting to write scripts for non-controlled substances like phenergen (for nausea) and my high blood pressure med.

By the time the receptionist hands me my scripts, my doctor is already with another patient, deep in consultation. She's very reluctant to disturb him at that point.

This Jan. 6th, I did have a simple question about the amount on one of my pain meds. She waited a little while, then decided to interrupt the doc to ask my quick question. (Often, she doesn't want to interrupt him at all, leaving me waiting for an hour or more). I got my answer, and decided that I'd asked enough of both the receptionist AND my pain doc. I know that non-controlled meds can be faxed into the pharmacy, so the paper script wasn't crucial. Plus, I'd been in the office for over 2 hours that day and I really needed to get home.

While in the office looking over my scripts, I knew immediately that my doctor had forgotten to write my scripts for phenergen and for my high blood pressure med. (In recent months, he has forgotten to write scripts for both of those meds). I actually had several refills left over from past scripts, so I just used those in recent months. Now, my refills are exhausted, which I didn't realize until today. (I had dropped my scripts off at the pharmacy yesterday).

My pharmacist called me up today and told me that they had faxed a refill request to my pain doc for my blood pressure med. (It turned out the pharmacy had one last old refill on my phenergen, so they did not have to request that one, I believe. I'm still unclear about that one). My doctor replied by faxing this message: "Tell patient that she already has paper scripts for these meds, written on Jan. 6th". My doc denied my refill request for non-habit forming drugs, which really surprised me. I've never had him deny a refill request before.

I've been going to the same pharmacy for 5 years. The pharmacist seemed sympathetic and seemed to believe me, but obviously she can't fill a script that my pain doc denied.

I'm pretty upset that my pain doc has forgotten to write scripts for these two important meds for at least our past two visits. I'm even more upset that he seems to think I received a paper script on Jan. 6th, when I absolutely did NOT. I don't even understand why he would argue this point, since the meds aren't controlled.

I really don't want to have to call the receptionist and inform her that the doctor is WRONG, and that I never got a paper script. Even though it's for non-habit forming meds, it still might make me look like a liar or something. Obviously, there's no way to prove that I did NOT get a paper script. (I was able to use an old refill to get my phenergen this month. I really don't need the blood pressure med, so I let that one go. However, I will need the phenergen next month, and now I'm out of refills).

I don't know what's going on with my doctor. I think he may be expanding his practice too quickly and important things are falling through the cracks. He's only in the office 3 days a week, so that makes things even more difficult. I don't know if he's actually FORGETTING which meds he wrote to me? I would think all pain docs are required to keep meticulous records of EVERY script they've written, so I'm VERY hesitant to call up and insinuate that my doctor is WRONG and I never got a paper script on Jan. 6th. Maybe that could get me put on some sort of "bad list"?

I'm inclined to wait until our next appointment (8 weeks away) and tell my pain doc this news face-to-face. I HATE the idea of this being filtered through the receptionist and things getting twisted. I'm totally honest with my pain doc, and I don't want to do anything to jeopardize our relationship of trust.

I'm not sure what I'll do next month when I need the phenergen. I'm unclear whether or not my PM denied the phenergen AND the blood pressure med, or just the blood pressure med. Either way, he claims that he gave me paper scripts for these meds on Jan. 6th., but he did NOT. Maybe he's not bothering to look up his records of scripts that he wrote? Or his own records are incorrect? I suppose it's anyone's guess.

Should I wait until my next visit with my pain doc to discuss this face-to-face? Next month I might have the pharmacy request a refill on my phenergen, and just see what happens. Worst case scenario, I THINK I could make it through next month without that med. It would be difficult, though.

When I talk with my PM at our next appt, I'll ask him if I need to inform the receptionist of EVERY missing script while still in the office. As I've said, my PM ALWAYS writes the important C-II pain meds, so at least I'm not without those. I hate the idea of bothering both the receptionist and the doctor even more, when these meds can be faxed easily. I know my PM doesn't like the extra work of having to fax anything, but he also doesn't like to be disturbed and have appointments interrupted. The receptionist is SO hesitant to interrupt one of my PM's appointments, and I therefore hate to ask her to do so. (I also hate all of the extra waiting time in the office when this happens). At most, I guess I'd better ask her to make a WRITTEN note that I did not receive "X" script.

Has this situation ever happened to anyone on this board? If so, how did you handle it? Something tells me that extreme caution is required here, since I don't want to get accused of being a liar. I also don't want to accuse my PM of forgetting which scripts he wrote! What a dilemma. Should I wait until our next appt., and just somehow make it through without my anti-nausea med? (I think I may have accumulated enough extra meds to make it through. I'm still unsure whether or not I should have the pharmacy fax a refill request for my anti-nausea med next month or not). If I call my PM's receptionist and tell her all this, I'm afraid I'll get labeled as a liar or something even worse.

Thank you so much for any advice!

Eva

[tic chick]

hi eva !

call the receptionist (as soon as the office opens) and ask her to ask the nurse to check your chart to see if your doctor had discontinued your blood pressure and your anti-nausea drugs because they weren't among the scripts you had dropped off at your pharmacy. if the nurse responds that the doctor wrote you scripts for them because it says so on the chart, tell her your pharmacy said you didn't hand in any scripts for those 2 drugs. tell her the pharmacy had found an old script for your phenergan that had one refill left on it and ask the nurse if it's okay to not take your bp meds for a month.

i am sure no nurse would make that decision and she would ask the doctor. if the doctor still says he wrote you the scripts and the nurse tells you this, ask her if the doctor would call you before he starts to see his patients, during his lunch break, or at the end of his day.

if you talk to the doctor, tell him you weren't feeling well by the end of your visit with him and when you went to the pharmacy, you didn't have the scripts for the bp meds and the phenergan. tell him the pharmacy had called him about the bp meds and he said you received a script for them and that the pharmacy was able to refill your phenergan from an old script, but after that you have no more phenergan. tell him you've been going to the same pharmacy for 5 years and they can verify that they have no new bp script for you and they have no new script for the phenergan. ask the doctor if it's okay to not take the bp meds for a month. this avoids any back and forth discussion that he wrote you the scripts and you saying that he didn't and puts the decision whether to call in the 2 scripts on him.

hopefully he realizes he might have not written you a script for them and sees you need bp meds and phenergan and not your pain pills and he calls them in to the pharmacy.

it's up to you whether you want to bring up the fact that you hadn't received written scripts the last 2 times you visited him. you know your doctor best and know how he would react to that. trust goes two ways. you have to be able to tell your doctor what you need to and you have to feel that he trusts you with the information you're giving him.

in the future, i think you should look through your scripts in front of the receptionist, or whoever gives them to you and if there's a script missing, mention it right then. the nurse should be able to write the body of the script and just ask the doctor to sign it.

i hope this helps. i understand the importance of having a doctor that you trust and that trusts you when you need medication for chronic pain. you want to keep that relationship on that trusting level.

jeannie

[Eva 14]

Jeannie, thanks so much for your excellent advice! I think one of the reasons why things are falling through the cracks at my pain doc's office is the fact that there has NOT been a nurse there for a while now. It was great when the nurse was there to help double-check things, etc.

I'm not quite sure why the nurse is on an extended leave of absence. I know it has something to do with a serious health problem that she's been dealing with. I do feel sorry for whatever she's going through. My pain doc is very loyal to the nurse and does not want to hire a replacement. I have no idea when she will be back.

So now the receptionist is really overwhelmed; having to answer phones, greet patients, take payments, make appointments, AND hand over the scripts. I also feel sorry for the receptionist, since she is dealing with far more work than she used to.

I just thought I'd mention the current lack of a nurse at my pain doc's office. I wish I were able to call and talk with the nurse, or that she were able to help write out any scripts that my doctor may miss.

I do plan on letting the receptionist know of any missing scripts at the time of my appointment, even though I may not be able to wait around an extra hour to get a script that can be faxed into the pharmacy.

Now that I'm stuck with relaying the info about the missing scripts to the over-worked receptionist, I'm hesitant to call. Both the receptionist and my pain doc are nice, but it's an awkward conversation to have to tell them that the doctor is incorrect and I did not get my scripts. (Since the scripts are NOT for pain meds, one would think they'd understand, but I've read too many bad stories on the forums of adverse consequences happening to pain patients who were totally innocent). I wouldn't want to get written up as a patient who "loses" scripts, because I've never lost a script before in my life.

I think if I wait until my next appointment, look my pain doc in the eye, and tell him that I unfortunately did not receive my scripts for phenergen and my high blood pressure med, then I think he'd believe me. After all, I can't even imagine why a patient would lie about not getting these kinds of meds.

By the way, thanks for that beautiful bouquet of flowers!

Eva

[Mark N]

Eva, I am sorry to hear about the issues with your doctor. I avoid them by having the dr write my scripts while I am in the examination room with him that way we get worked out any problems with my scripts. I don't know if your doctor will do that but you don't have to wait around and he can write in your chart as he fills them out.

[Eva 14]

Mark, thanks for your reply. When I first started seeing my pain doc, I recall him handing me my scripts at the end of my appointment. Glad your pain doc works this way, because it makes life a lot easier.

For the past several years, though, my pain doc always sends me out to the waiting room to wait for my scripts. He does this with all his patients. I'm beginning to think that I can't possibly be the only patient who has not been getting his or her full amount of scripts. But then again, one never knows.

I'm still leaning toward waiting till my next appt. and talking about this to my doc face-to-face. Once a patient has left the building, it's probably not too wise to call up and claim that the doctor "forgot" to give them a certain script. Weird that my doc is remembering to write the C-II's, but not the scripts for the non-controlled meds.

Thanks for your reply.

Eva

[Mark N]

Eva, I was wondering how your situation has turned out with the dr not giving you your prescription? I hope you were able to get the scripts you need.

[Eva 14]

Mark, thanks for your question.

When I went to see my doctor, I told him what had happened. My doc is really nice, so there was no problem at all.

My pain doc's office has a 'new rule' where they are required to photocopy every single one of the scripts that they write. I talked with the receptionist about it. She agreed that my script probably got stuck in the photocopy machine. She told me to always look over my scripts before I leave. And if I ever have a 'missing script' in the future, I should just call the receptionist and let her know about it.

I know I'm very fortunate to have found a kind and compassionate pain doc with a great receptionist.