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Gabej777's blog
Always searching for a way to become more advanced and efficient. Remembering Patients First.
Busted!!!!! WOW its always the nice ones...
6 Comments
Its always the nice ones that you should be wary of. In this case the nurse was the shady character that got caught.
The story goes that this nurse has been calling in the same narcotic for two different Pt's. I thought something was up when I noticed that the person picking up the narcotic Rx appeared to be the same person. When I talked to my pharmacist she called the Doc's office spoke to the nurse regarding our concern. The nurse said "oh no Pt. A has chronic pain therefore should be on this med as well as PT. B" after that call was made I thought to myself well maybe the nurse is involved. But already being shut down once I kept my thoughts to myself.
Now a year or two later, CURES (I believe since I know little info) called the Doc's office to ask about the RX's and now we find that the nurse has been fired, Doc is beside himself thinking he will have trouble with CURES and all involved parties. I was asked by my pharmacist to pull all the Rx's to see who wrote or called them in. Now we see that the same nurse has been calling in and approving all the refills as well as phoning in all the orders. I knew it all along. How does my pharmacist justify always taking narcotic orders from the same nurse? If you look at my other posts I'm very suspect of many of our Pt's. I told my pharmacist that we are too nice and have other Pt's scamming us in other or similar ways. From the same Doc's office we have a Pt who gets 360 Fiorinals for one month yet the Pt weighs roughly 100 pounds. Now I have seen intervention on A&E where abusers take so many pills they forget to eat. I'm sure this is the case. To top it off my pharmacist believes the Pt is a meth addict but continues to fill the Pt's scripts without questions. Hummmm?!
So what happens when the other shoe drops? How can I prepare the pharmacy for impending audits and authorities coming for our records? Will this happen?
Also I hesitate going to my director of pharmacy for these issues for fear of retribution. My pharmacist has been here for 20 + years, me only 3 my first pharmacy job yet I see through all the bull. If they are too nice something is up!!! Anyone agree?
Comments
Location: clackamas, OR
Posts: 495
Most Rphs are way too busy to monitor scam artists. Also Rphs do know that there are patients who are rightly and chronically treated for pain. We cannot suspect and/or discriminate against every chronic pain sufferer.
Location: New Albany, IN
Posts: 123
Well I am sure that you like the IPledge program http://www.fda.gov/ohrms/dockets/ac/07/briefing/2007-4311b1-13-addendum-...
I am sure that you will love the next FDA program to control drug distribution REMS
http://www.readyforrems.com/AboutREMS.aspx?gclid=CK_iic-ogZ4CFWpd5QodkE5rpw
This time they are focused all C-II. but I am sure that it will be expanded to the rest of the the scheduled drugs before it is over.
The demands on your time is about to explode exponentially.. Those that would abuse substances - other than alcohol & tobacco - have moved their abuse from the hard illegal drugs to legal Rx opiates.. and the FDA is determined to push back on this growing abuse in this area... of course, these people will just move back to the illegal drugs and it will just make it harder on docs, Pharmacists and the legit chronic pain patient... not to mention the one-two time acute Rxs pts.
I can assure you that any pharmacy that initiated a policy that they run a state controlled substance database report - it is available in 30+ states - on every new patient presenting a Rx for a controlled substance and notify the docs & pharmacies involved when a "shopper" is uncovered .. within 3-6 months...the number of these "shopper" at your counter, will drop off dramatically. Once "the word" gets out on the street that you are not to be screwed with.. because you screw back... the number of reports that you have to run will be at a minimum...because they will go somewhere else.
Like everything else in our society.. if you do not take care of something within your control.. the bureaucrats will develop a methodology to make you do it.
There is a old lobbyist saying within "the beltway"... horror stories do not make good policies ... but they do make policy!
REMS is a good example of this..
Location: clackamas, OR
Posts: 495
Much of these programs are only putting a band-aid on the problem. Should they not get to the source and/or cause of the problem? What is the cause and/or source of this epidemic?
Location: New Albany, IN
Posts: 123
There are so many entities that has "skin" in this game... that it is hard to tell who the enablers are and who are just interested in job security or some sort of "power"
Some stores without a doubt have a profit motive in filling every rx that appears to be legit..
The chains don't want to ruffle any feathers of people who may spend money in the rest of the store and/or afraid of the liability of taking some action against those who would be a shopper or abuser.
I have seen docs that make pts sign a "pain agreement" and then does nothing further to enforce it or make sure that the pt is following it.
There is a growing private industry that operate jails & prisons and it has been reported that they have been lobbying state/fed to increase the jail time for drug offenses... which would cause more/bigger jails to be built and more people for them to get paid to house.
In my area.. the bureaucrats talk out of both sides of their mouths - surprise - they have fought tooth & nail keeping new meth treatment centers from opening and the only one that does exist... they are always trying to find ways to shut them down... and yet they keep funding the war on drugs...
Most of the people that are addicted to something .. have some underlying mental health issue.. and they are simply self-medicating.. they either prefer the "rush" of doing some illegal or prefer to exist in a twilight mental state ... at the very edge of having to deal with reality.
None of us know if or how much the DEA lobbies bureaucrats behind closed doors to keep the regulations as such to keep the funding coming to keep the war on drugs on-going... it has only been going on since 1914 with the Harrison Narcotic Act...
I can assure you that the vast majority of people who are addicted to opiates .. if the opiates from the Pharmas dried up tomorrow.. they would go back abusing street drugs ... whatever is most available... in vogue .. or most affordable
Location: clackamas, OR
Posts: 495
I like these lines of yours:" Some stores without a doubt have a profit motive in filling every rx that appears to be legit..
The chains don't want to ruffle any feathers of people who may spend money in the rest of the store and/or afraid of the liability of taking some action against those who would be a shopper or abuser." Well put!
Location: New Albany, IN
Posts: 123
The two states that I am licensed in (IN& KY) have similar controlled substance database.. but the legislature in both states PROHIBITS anyone from data-mining to uncover such activity. Law enforcement can only get into the database once a person is under investigation. Healthcare professionals can get into the database and request a report once they have signed up and can ask for reports ONLY ON THEIR PATIENTS.
In this area, healthcare professionals are not required to run reports or even signup for the access to the database. I have yet to see a doc or pharmacy that has paid any consequences for filling Rxs for doctor shoppers nor has any doc been held responsible for not safe-guarding their Rx pads and having them stolen and used in the community to get controlled substances.
The vast majority of RPhs that I have talked with .. only care about if the Rx is "technically legal"... otherwise they operate under the premise of "..don't ask .. don't tell..." and are afraid of being drawn into a confrontation.
IMO, if docs & Rph's were required to run reports on ALL NEW PATIENTS wanting controlled substances... it would put a BIG DENT into the doctor shoppers. Right now there seems to be better profits and job security keeping the war on drugs at a status quo level.