Walgreens: "Can't fill that prescription."
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I'd note the original Tweeter has the phrase 'Govt destroyed Medicine' and 'Our Rights come from God, not government', in their sig. line, so it's just remotely possible they have a bit of an axe to grind.
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Kind of reminds me of that John Mellencamp story where he was talking about his grandmother, not Biden.
@Mik said in Walgreens: "Can't fill that prescription.":
Kind of reminds me of that John Mellencamp story where he was talking about his grandmother, not Biden.
I wonder whether his grandmother was a Cougar too?
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A former colleague’s spouse is a pharmacist. She specializes in dispensing to diabetics and has done so for over 30 years. It is not uncommon for one of her diabetic clients to show up with a prescription from a G.P. that she cannot fill without putting the diabetic client at risk or even grave risk. When such occurs she tries to contact the prescribing physician to explain why she cannot fill the prescription as written but can suggest alternative medication or treatments. She says that 99% GP’s appreciate her interventions and admit they just do not have the expertise in drug interactions and pharmacology in general to know how diabetics react to certain medications or combinations of meds.
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Could it be possible this particular doctor has a bit of a reputation which the pharmacist is well aware of?
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All of these comments might be true, however, according to the doc the prescription was denied not because it was wrong, or dangerous, but because the pharmacist determined that the doc was "out of her lane" prescribing this medication for shingles.
She's an opthamologist, and, as her tweet states, she knows something about treating shingles with the possible ophthalmic complications.
Later in the thread, another doc says the same pharmacist refused to fill an off-label prescription for colchicine (a gout medication).
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All of these comments might be true, however, according to the doc the prescription was denied not because it was wrong, or dangerous, but because the pharmacist determined that the doc was "out of her lane" prescribing this medication for shingles.
She's an opthamologist, and, as her tweet states, she knows something about treating shingles with the possible ophthalmic complications.
Later in the thread, another doc says the same pharmacist refused to fill an off-label prescription for colchicine (a gout medication).
@George-K said in Walgreens: "Can't fill that prescription.":
All of these comments might be true, however, according to the doc the prescription was denied not because it was wrong, or dangerous, but because the pharmacist determined that the doc was "out of her lane" prescribing this medication for shingles.
She's an opthamologist, and, as her tweet states, she knows something about treating shingles with the possible ophthalmic complications.
Later in the thread, another doc says the same pharmacist refused to fill an off-label prescription for colchicine (a gout medication).
So it could easily be that the pharmacist is acting up, in fact it's probably the most likely explanation. It's just a little suspicious that somebody who appears to be a rather activist doctor runs into this.
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I too don’t think it is up to a pharmacist to vet any MD’s qualifications or competencies. If the pharmacist has a concern then he or she should contact their own professional college for guidance on the matter or request that it contact the physician’s professional college for clarification.
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Colchicine fell under a FDA drug thing where the Feds were cracking down on off-label uses.
Again, government has no business dictating medicine
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Colchicine fell under a FDA drug thing where the Feds were cracking down on off-label uses.
Again, government has no business dictating medicine
@Jolly said in Walgreens: "Can't fill that prescription.":
Again, government has no business dictating medicine
Hmm, not so sure about this. I think that the US FDA moves veeeeery slowly on things, and this sometimes puts them behind the rest of the world.
But....... I think this is the reason that the US medical drug system is (generally) the safest in the world. The odds of getting a hemmoroid cream that is 4% lead is pretty slim.
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I think the MD is right .. the Pharmacist should be reported. And reprimanded by the Pharmacy College, and put on notice with Walgreens. Pharmacists, the ones I know, are real smart, professional. They hold their clients’ trust and respect. Sometimes they do troubleshoot MD’s prescriptions, and med errors are prevented. Great. Thank you. But this one here? No.
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On the other hand, should not the ophthalmologist not referred the patient to or consulted with an MD if shingles were suspected? I would be surprised that the referral/consultation could not have been fast tracked to have been completed that very day.
A dentist could suspect shingles in a patient too, but that does not mean the tooth doctor should diagnose it and begin treatment.
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On the other hand, should not the ophthalmologist not referred the patient to or consulted with an MD if shingles were suspected? I would be surprised that the referral/consultation could not have been fast tracked to have been completed that very day.
A dentist could suspect shingles in a patient too, but that does not mean the tooth doctor should diagnose it and begin treatment.
@Renauda said in Walgreens: "Can't fill that prescription.":
A dentist could suspect shingles in a patient too,
DDS ≠ MD or DO.
My license says "physician and surgeon." If I tried to take out an appendix, I would be foolish, and would deserve whatever consequences come from such an attempt. Nevertheless, I am allowed to.
Whether I could ever get hospital privileges to do so is another question, but I am not expressly prohibited from doing so.
That said, is treating herpes zoster in the scope of practice of an ophthalmologist?
Yes. Yes it is.
An estimated 10–20% of shingles cases affect the eye. This type of shingles is known as herpes zoster ophthalmicus (HZO).
People with HZO may experience:
- tingling in the forehead
- severe pain in the nerves of the eyes
- fever
- eye inflammation
- Ophthalmologists can conduct exams and tests to determine the presence of HZO. Most people with HZO will receive systemic antiviral medications.
Regardless of the type of shingles specialist they choose, it is crucial for anyone experiencing symptoms of shingles to seek immediate care. Prompt treatment can help reduce the risk of developing painful conditions such as PHN.
The American Academy of Ophthalmology agrees:
https://www.aao.org/eyenet/article/herpes-zoster-ophthalmicus-pearls
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@Renauda said in Walgreens: "Can't fill that prescription.":
A dentist could suspect shingles in a patient too,
DDS ≠ MD or DO.
My license says "physician and surgeon." If I tried to take out an appendix, I would be foolish, and would deserve whatever consequences come from such an attempt. Nevertheless, I am allowed to.
Whether I could ever get hospital privileges to do so is another question, but I am not expressly prohibited from doing so.
That said, is treating herpes zoster in the scope of practice of an ophthalmologist?
Yes. Yes it is.
An estimated 10–20% of shingles cases affect the eye. This type of shingles is known as herpes zoster ophthalmicus (HZO).
People with HZO may experience:
- tingling in the forehead
- severe pain in the nerves of the eyes
- fever
- eye inflammation
- Ophthalmologists can conduct exams and tests to determine the presence of HZO. Most people with HZO will receive systemic antiviral medications.
Regardless of the type of shingles specialist they choose, it is crucial for anyone experiencing symptoms of shingles to seek immediate care. Prompt treatment can help reduce the risk of developing painful conditions such as PHN.
The American Academy of Ophthalmology agrees:
https://www.aao.org/eyenet/article/herpes-zoster-ophthalmicus-pearls
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Also, an addendum.
Any doc can purport to be qualified to treat any condition. If the results end up being unfortunate, let him bear the consequences either in court, licensing body, or public opinion.
I knew a heart surgeon who was absolutely terrible. Would operate on any patient who could fog a mirror, and when things went south, it was always someone else's fault - the anesthesiologist, the perfusionist, the nurse who took too long to pass an instrument. I hated doing cases with this surgeon. The surgeon eventually left the university and ended up working at the local veterans hospital/county hospital. Results were horrible.
Ended up leaving there (Asked to leave? I don't know) and going to another university in another state where results were also dismal.
This surgeon was denied tenure, and decided that leaving was the best option. Ended up working in an emergency room in the northern suburbs of Chicago. I don't know how long that stint lasted, but it was relatively short from what I heard.
This surgeon is now a year older than I and is still working.
Running a pain clinic in the suburbs of Chicago, specializing in "myofascial regeneration." Looking this doc up on Google, it says "Family medicine specialist."
Sometimes, the chaff gets separated from the wheat after all.
"Now look here, you Baltic gas passer... " - Mik, 6/14/08
The saying, "Lite is just one damn thing after another," is a gross understatement. The damn things overlap.
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Ocular shingles, or imminent risk thereof is an ophthalmologist’s area of expertise. Thank goodness the patient had access to this type of MD. The risk of vision loss or blindness is real.
Related, my elderly auntie woke up one morning unable to see out of one eye. She called her eye doctor (not an ophthalmologist). She went in. He looked, called an ophthalmologist, did some initial prednisone drops & got her in to see the ophthalmologist asap that day (an incredible feat given this is Alberta). Sudden vision loss is a medical emergency. What was wrong with her? She had the beginnings of a viral infection (not Shingles) targeting her optic nerve. She was told if she’d waited longer, she could’ve lost her vision permanently. Thank goodness my auntie didn’t go see her GP or go to Emerg. (this is Alberta). The ophthalmologist tweaked the prednisone dosage, told her what to expect over the course of the next few weeks, booked follow-up with himself and her GP. Moral of the story .. Optometrists know eyes. Eye MDs know bodies & eyes. Both know when to act quickly when needed.
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Also, an addendum.
Any doc can purport to be qualified to treat any condition. If the results end up being unfortunate, let him bear the consequences either in court, licensing body, or public opinion.
I knew a heart surgeon who was absolutely terrible. Would operate on any patient who could fog a mirror, and when things went south, it was always someone else's fault - the anesthesiologist, the perfusionist, the nurse who took too long to pass an instrument. I hated doing cases with this surgeon. The surgeon eventually left the university and ended up working at the local veterans hospital/county hospital. Results were horrible.
Ended up leaving there (Asked to leave? I don't know) and going to another university in another state where results were also dismal.
This surgeon was denied tenure, and decided that leaving was the best option. Ended up working in an emergency room in the northern suburbs of Chicago. I don't know how long that stint lasted, but it was relatively short from what I heard.
This surgeon is now a year older than I and is still working.
Running a pain clinic in the suburbs of Chicago, specializing in "myofascial regeneration." Looking this doc up on Google, it says "Family medicine specialist."
Sometimes, the chaff gets separated from the wheat after all.
Any doc can purport to be qualified to treat any condition. If the results end up being unfortunate, let him bear the consequences either in court, licensing body, or public opinion..
Yes, I have seen just that with my late father. When he and his wife moved to BC in their retirement, they connected with an MD who had numerous geriatrics as regular patients. In any case my father’s wife really liked him. My father not so much, in fact he didn’t think he was all that great and would only refer him to specialists as a last resort.
To make a long story short, it all came to a head in 2003 when the MD refused to order a colonoscopy for my father after a few months of ongoing big issues down south. He concluded it was amoebic dysentery and treated it without result other than a worsening of the problem. I raised hell with him over the phone a said I would drive my father to Bellingham Washington and pay for the colonoscopy out of pocket. The doctor relented and agreed to order the procedure. Yes, there was cancer and a specialist was then engaged. Luckily it was slow growing and located convenient for surgery. Surgery was successful. After speaking with the surgeon I had yet another go around with the MD over the phone. The surgeon however was not impressed with what he discovered and went after the MD. Turns out that that the MD was not a specialist in geriatric medicine, but rather an OB/Gyn with a less than stellar record with his peers. He soon closed his practice and moved elsewhere. A bit like the surgeon you described.
