Unlicensed personnel calling in prescriptions?! - page 3

My sister is a nurse in Indiana and the story she related to me makes me mad. Is this legal? I know I have seen posts about secretaries and others triaging phone calls but I haven't heard anyone... Read More

  1. by   TennNurse
    [QUOTE]Originally posted by jemb

    If a physician/ facility would require of whatever employee calls in the RX to spell out the name of the drug along with the directions, many problems could be avoided.

    1) The physician would have to write or print legibly.

    2) The person calling the RX would not risk misreading or mispronouncing a name. (i.e. Zantac would not become Xanax.)

    3) Risk of mistakes due to variations in dialects/ accents would be minimized. (May be a regional issue, but definitely can create problems in my neck of the woods!)

    I think this is a great idea. However, in order for it to really cut down on errors, the pharmacy must also take action of some sort. It's just too easy to get around them.

    When I was still in New Mexico, I knew of several employees in the doctors' office who had a nice little scheme going. They would wait till after office hours, and call a script into WalGreen's or another 24-hour pharmacy. They would select the option to leave the rx information on the pharmacy's voice mail, and give whatever name, drug, DOB, etc, they pleased. They had DEA numbers, drug handbooks, and insurance coverage information ready for handy reference. The reason this works is that pharmacies, like most other businesses, are trying to improve customer service with greater convenience and less time waiting. Calling the office to confirm the script would have to wait till the next day, and if the customer in front of the counter is complaining of pain, fever, or a nasty cough, the pharmacy generally won't ask them to wait. If they did, they'd have found that these employees were not who they said they were, and the MD had never prescribed what they said she did. (I did report this to my supervisor- absolutely nothing happened. I left there after less than a year.)

    These employees, incidentally, were MAs, but that doesn't scare me quite as much as what anyone who knows how to work the pharmacy system can do.

    Also, I've called in prescriptions to pharmacists and pharmacy techs who had such strong accents that I had no idea what they were saying. What struck me as the big worry was whether or not they could understand what I was saying. There was at least one instance I knew of when I called in Estrostep for a pt, spelled the name of the drug and gave the DOB of the pt, and the pharmacy still gave her Estratest.

    There's no question that giving too much authority to unlicensed personnel in the doctor's office (or anyone anywhere else) can create dangerous situations, but we also need to worry about the lenient policies of the pharmacy. They need to let pts know that all phoned-in requests (or at least those for new prescriptions) need to be confirmed with the MD prior to being filled, and that this is necessary for patient safety.

    Just my 0.02.
  2. by   Brownms46
    Good post! Nice to read some balance for a change. Unlicensed pesonnel are not the real problem in this, but anyone who decides they want to circumvent the system to their own personal gain. And the way the system is now, anyone can and do abuse it.

    Not to mention the fact, that the way things are now, there are too many mistakes made on all sides, and that is something we all need to work toward changing.
    Last edit by Brownms46 on Oct 19, '03
  3. by   Itisazenlife
    Right on!!!!
  4. by   icie rn
    This is so funny to me because I spent 3 hours on the phone on Friday trying to get the pharmacy, the nurse, and the doctors to get hubby's Rx right before we leave for a month to visit daughter up north. Here in WV, I know less than licensed personal call in the RX's, so I know there are lots of mistakes. I shudder to think of what would have happened to hubby if I did know the correct meds, doses, and how he is to take them. I know there must be several patients who are mistreated because of these mistakes. The problem is how to fix it? Some doctors here just do not do as adequate a job as needed when writing RX's and keeping records. Hard to believe, well just make a visit and see for yourself.
  5. by   jade823
    i worked for a doctor's office for a year and a half in new york state...i was hired to be a secretary basically but ended up doing many other things that i now realize that i shouldn't have been doing. the doctor i worked for had told me that as long as he okay'd what i was doing then it was fine. i gave flu shots, B12 shots, did the Coumadin testing, removed stitches, gave allergy shots, called in prescriptions to pharmacies, performed EKG's, and also he would sign scripts but have me fill them out with the drug information and such. the prescriptions that i filled out were sometimes for narcotics, which i wasn't comfortable with. i explained this to the doctor on more than one occasion, but once again he assured me that it was perfectly fine. he also began to tell patients that i was a medical assistant, which i was not, and he never corrected the patients when they called me the nurse. of course, i corrected them because i am in no way a nurse or a medical assistant.

    to make a long story short, i was eventually let go due to filling out a script for a patient, that he told me to and had signed the script, which was questioned by the pharmacy. the doctor then fired me and stated that he was going to involve the police because it was forgery. in no way did i forge his signature or the script, i was just following what he told me to do.

    i do think that there should be some law that states that only a doctor can write the actual prescriptions and the only people who are allowed to call in prescriptions are doctor's or registered nurses, whose license information should be taken down at the time of the call. no unlicensed personnel should be able to do any of the things i was told that i could do under his supervision. i had planned on attending school for nursing but now that option is completely out of the question. i now know that what i was charged with doing was not exactly legal and was in no way "perfectly fine". i know this post is old but i just wanted to leave a comment with my opinion and personal experience.
  6. by   wizeone7
    I think the doctor didn't have a leg to stand on because HE signed it even if you wrote it. It is the signature that is in question. He just scapegoated you. I used to do the same things as you before I was a nurse and now I cringe at what I was allowed to do!!
  7. by   nurse jen 1979
    Quote from bassbird
    My sister is a nurse in Indiana and the story she related to me makes me mad. Is this legal?

    I know I have seen posts about secretaries and others triaging phone calls but I haven't heard anyone say they also call in prescriptions.

    My sister had an encounter this week regarding a presciption for her daughter. She received a phone call informing her that the physician's office was calling in a script for antibiotics for her daughter (after a urine culture). She asked what her daughter was being treated for and what the antibiotic was and was told "a UTI and the antibiotic is microbid". (The med was obviously Macrobid). She said she wanted to know what the organism is they were treating and at first the person said she didn't know, then came back with nitrosomething. My sister said she had never heard of such an organism and asked to speak to a nurse. She didn't get one. This is the person who called in the prescription! My niece said she didn't know what the big deal was. She works afterschool in a doctors office and calls in presciptions all the time! Is this legal in Indiana?

    Also, my niece had surgery recently and my sister found out the person doing the prescreening on the phone was not a nurse either! This is not right!

    I'm still a nursing student but I'm constantly informing people I know about the healthcare situation. Most of them are totally unaware that they are being treated by people with very little education or training. It isn't just nurses. They are also training people to take x-rays at clinics. They know the procedure but have no formal radiology training. What next?

    Okay, I'm done ranting. I would like to hear if anyone else has heard of unlicensed personnel calling in prescriptions though.

    I am nurse and never would have done anything like that before i was licensed...however, i know people do all the time...secretaries, medical assistants , etc.... a good friend of mine has a sister -in law that is a MA and she and her friends do it at work.... it's amazing how all these people think it ok to play nurse....for any one on here who is a an MA or knows one inform them they/you are not nurses!!!!! you acn not call yourself one or play one ....the training you get is not close enough to do this ....... PS and thanks to you who wrote this hopefully people will become more aware ...congrats on school and glad to see you are concerned with this issue... i wish the world was different in so many ways....noone cares anymore, has morals or seems to realize they the way they affect other people... i love what i do and am damn good at it....partly because i care so much... the rest is common sense , integrity and intelligence which you need to be a good nurse...sounds like you do have integrity....thanks again!
  8. by   RNTOBE_1970
    The medical assistant that my previous PCP had on staff was an idiot...I have hypothyroidism, and this doc was doing a metabolic syndrome workup on me. When the moron called me to give me my results, she congratulated me for not being anemic because my hemoglobin A1C was normal. Wow, really??? Good to know. And I worked briefly for my kids pediatrician, and there was a girl there that wasn't even a MA-she was an EMT-B. She was quick to room patients but had no clue with meds-a baby had horrible diaper rash and the MD wanted questran mixed with aquaphor. She only called in the questran. The parents called the next day clueless as to what to do with the questran. Shame on the EMT, but shame on the pharmacy for not catching that goof up too.
  9. by   N1colina
    Hate to admit, but this happens at my office all the time, as well. MA's are given prescriptions to write out for patients and the doctor signs them. They screw up ALL the time, and sometimes the doc's catch it, sometimes they don't. They'll just sign it and we (the nurses) get the call from the pharmacy later about the mistake....it's a huge issue. They also call in prescriptions, and even used to give shots before I started, I was told.
  10. by   N1colina
    Quote from Dazedgiggle
    The first time I ever called in a prescription to a pharmacy, I told them my name and that I was a nurse. They asked for the name of the meds, then that was it! I asked them if they needed my license number or any type of proof that I was who I said I was....they said no, they were lucky to even be GETTING a nurse to call them in! It was usually secretaries, med assistants and the like. I was horrified! How easy would it be to just call in scripts for myself if I wanted? I had access to DEA numbers galore! This is in NH by the way. I'm not sure of the law, but this is what I'm told goes on. I call in as few scripts as I can now, just to help out a patient once in a while and I actually get permission from the doc or the PA-C before I do it. I really think if they're going to do anything like that over the phone they need a little more I.D. info so people can be held accountable.
    They don't need any more than your first name from you, the MD your calling it under, and the office phone number. The pharmacy has all the MD's info, (NPI, DEA, License number) that's what's important. Remember, it's THEIR license your working under, when doing this, NOT your own.
  11. by   jazmine09
    I agree with nurseJen however, when employed by a doctor as an medical receptionist or medical assistant, the doctor takes advantage of what responsibilities he can assign.. And as an employee many perform the task b/c its their job, they have bills to pay ...etc... whateva the case may be.... Instead of insulting the medical employee....its the employer who is taking advantage AND GETS AWAY WITH IT meanwhile they are doing what they are told. ultimately the employer is the one who is responsible if anything should go wrong,,however they have their attorney swindling every which way so the employer/doctor can getaway with it. Alot of doctors/ employers employ uncertified MAs and have them administer mx, write rx perform radiology and diagnostic test however to perform these exams you have to be a (LICENSED PROFESSIONAL) . I believe but do not quote me on this,,, Being that it was brought to the employers attention about the rx writing .. the employer may have you perform other exams and administerating mx and billing for it....that may be considered insurance fraud? Because technically the employer didnt administered it an unlicensed professional did. And NurseJen lay off of MAs....is the doctors that uses, lies, abuses them so they dont a licensed RN...get on the doctors back!!!! Every doctor does it so if the MA quits they will just find another doctor employer to take advantage of them also....The Law needs to change and the Drs cannot get away with this!!!
  12. by   nurse jen 1979
    I did not insult anyone...it's very true...it is not ok to play nurse...you are not as a MA given the education to to this job, you can not pretend to know what you don't.The docs only take advantage if you let them too, you have to say I am not qualified to do this, you are not practicing on a license you do not have one, that is the point...and no you are not working on theirs...you are a MA...MA's do not receive a license .. I do agree that dr.s take advantage, but only if you let them. The law says you have to be licensed to do these things, so we do not need new laws, as they exist , you have to follow the law. I hope people here understand by me saying MA's do not have the education , I don't mean to insult, I mean you don't have the knowledge base to do my job...period...you did not go to nursing school, that's all
  13. by   wizeone7
    I think it is a shame that non nurses are allowed to do this. I did it before I was a nurse and thought I knew what I was doing. The problem is that I didn't even know what I didn't know! I have had to speak to my MD twice this year about "weird" messages/results I received from the MA.