BLOOD PRESSURE RISING

WARNING: RANT AHEAD

A few weeks ago I tried to get a refill on a prescription for my low dose blood pressure medicine, but my request to my mail order pharmacy had been ignored when I was on vacation.  I returned home early this month and tried again, and finally heard from my (newish) doctor that he would refill it but I had to come in for a recheck on BP and labs.  OK, fine.  Made the appointment and went in.

First the nurse confessed there was a screw up along the line and my meds should have had a whole year of renewals instead of none.  Uh-huh.  Agree.  Then as she reviewed my med list she rattled off a bunch of supplements I had been taking but at my last visit the doc told me to stop some of them.  Guess they had not made that note in the electronic records (which were supposed to make things oh so much easier!)  When I told her he took me off them, she sort of rolled her eyes and said she still takes the supplements she wants to; she tries never to go to the doctor; her supplements are her business, etc etc.  Hmmm...team approach to health care?  When I laughed and said I would follow her advice, she did try to backtrack, but the damage was done.  Nurse undermining doc -- noted.

Then the doc came in and immediately after saying hi, without taking a breath, started telling me about his recent trip to NYC.  He went on and on about this and that person, event, meal, site, death in family, family birthday, Uber experience, income inequality in NYC, tips for being safe on the street, price of restaurants, gentrification of Brooklyn and his dislike of Queens ....  Interspersed was some minimal attention paid to why I was there, but really I learned MUCH more about his life than he about mine.

He reviewed the lab results and I think he was ready to leave me on the lower BP med dosage, in spite of my numbers being intermittently a little high and also seemed to want to ignore my rising cholesterol numbers since going off the previously prescribed statin from which I had some minor side effects.  He also said those labs shouldn't really have been done yet, since he'd need to repeat them in a few months, but he was out of town and, well, someone approved them.

I was actually glad we had the labs because with the new results I insisted he take the numbers seriously.   I have a family history of cardiac disease and vascular dementia/stroke and I want to be well-controlled, not borderline.  He said OK, but not to worry about dementia because most people don't get it and all you have to do is challenge your brain with new learning which is why he is learning French and then he showed me he has the French version of Harry Potter on his Kindle.  Sigh.

What I think should have been a 15 minute visit strung out to 40, but there was the value added travelogue and brain exercise tip, so no complaints.  And I got a good laugh out of the whole experience.  (Also, after two visits with this guy I'm looking yet again for a new doctor.)

Since that appointment last Friday I've waited for an email from the pharmacy to let me know my meds were on the way....thinking he'd called them into my mail order place.  No word yet, so today I went online to check.  No orders pending.  Then I thought maybe he called them into the local pharmacy so I called them.  Sure enough they had his order.  I asked why I hadn't received a call from them.

The tech on the phone said, "We didn't fill the orders because we didn't know if you wanted us to."  What?!?  Of course I wanted them to fill my prescription.  She said they often just wait to hear from the patient.  I was so confused, I let it go, telling her to fill them asap!

But the more I thought about it, the madder I got.  What the hell?  I called back for an explanation of the delay and the protocol for filling prescriptions.  A new tech told me they often get orders from docs that people do not intend to fill at that pharmacy if the patient isn't already in their system.  They don't have the staff or stock of medicines to fill orders that will never be picked up.  So they just hold the order until the patient calls in...eventually...as I did.

I let her know I've been using that pharmacy for 30 years on and off and I definitely should be in the system.  Turns out they were recently sold to another outfit and my information was there, but "old".

I fell into the category of "don't do anything until the desperate and/or irate patient figures out we aren't filling their prescription."  "We will go ahead only when the patient calls from their deathbed  due to untreated this or that because BY GOD WE, THE PHARMACY,  WILL NOT TAKE 2 MINUTES TO CALL AND GET THE PATIENT'S OK TO FILL A PRESCRIPTION CALLED IN BY THEIR PHYSICIAN!"

I do not have dementia (no foreign language study notwithstanding) and I speak English; I have a college education and fair degree of confidence in dealing with authority figures.  And I know how to navigate an infuriating health care system (with persistence).  What of those who have any number of difficulties that preclude figuring all this out?!?  I sort of ranted to the pharmacy tech that I hear loudly and clearly that it is obviously the patient's responsibility to coordinate their health care needs among all the various entities involved.  She basically agreed, but assured me I'm now current in their system.

I simply cannot fathom trying to negotiate all of this as a person who is critically ill, disabled, alone, hearing or vision impaired, mentally ill, maybe with a touch of dementia, whatever....  You have to be the picture of health to get appropriate health care!   And I'm not dealing with some back country mom and pop GP office.  This is the largest multi-specialty clinic in the region, with the ridiculous marketing slogan, "We're Here for Your Health".  Are you?  Are you really?

At least, that's the view from here...©