When Patients Place Blame, Physicians Hear it First

Once upon a time, physicians wrote prescriptions and the patients took them to the pharmacy to get it filled. Doctors wrote orders for tests, and the patient took the request to the lab or radiology to get it done.

Now, with things being done by phone, fax, or Internet, all in the name of being more efficient, physicians are often put in an awkward position in the old blame game.

Case in point, a patient called on a Friday night (of course) and left an angry message that he just went to his pharmacy and the pharmacist told him that they had called my office a week before and that we didn’t fill his scrip. And, he continued, because of my office he is now out of insulin and he also demanded that I call “immediately." Now, this occurred post-superstorm. I had no access to his records, so I could neither confirm nor deny his allegations. Well, I had several questions: 1.) how is he sure they called my office?; 2.) how is he sure I didn’t fill it and the pharmacy botched it; 3.) why did he wait til he was out of insulin to call; and 4.) why was he being a jerk about it? I did not ask him questions three and four, but I did ask him the first two. He didn’t answer, but he did say, “then I guess we’re through.” He then called and left another message letting me know that he would be informing his physician relatives about how I run my practice and that he would be “taking this further.”

Well, once the power came on two days later, I looked up his chart. I had received one refill request for him on the day in question, and it was not for insulin. And I had dutifully filled out the form and faxed it back. Three days later, so about five days after his call, I get a fax from his pharmacy asking for said insulin. I let them know that because they had accused me of not refilling his insulin, that I had been dismissed as his physician.

Things like this, although not as extreme, happen all the time. “The pharmacist said you didn’t call in my refill.” “You didn’t send the request to the lab.” “Your staff didn’t fax my records to my doctor.” Never, “they didn’t receive…” or “they can’t find…” Well, the beauty of the EHR is that everything is time stamped and everything is documented. Every fax sent out, every call, every electronic scrip. It’s all in there. So I can tell you precisely when I received a fax, when I sent it back, and who it was sent to.

I hate that we are so easily blamed and that the anger falls on us; that it is all our responsibility. And that it occurs to no one, that maybe some else misplaced the scrip, or that something got lost in the mail or somewhere between one computer to another. How did doctors’ offices become the scapegoat?

And don’t get me started on how we get blamed for how much their medications or tests cost!