These are my thoughts and opinions on Nurses, PAs, NPs, MDs phoning in prescriptions to community pharmacies. These procedures will differ depending on your certification, whether you are the prescriber, location of your practice, etc.
Updated:
I am new to prescribing as an NP and I can't tell you how helpful all of the local pharmacists have been when I have had to call in scripts. I work in an ED and we have to call in antibiotic prescriptions for positive culture results if someone didn't get a script upon discharge from the ED. Not to mention they are wicked helpful when it comes to answering all sorts of random, crazy questions from us newbies.
!Chris
Overall, a lot of good advice for the newbie prescriber. However, after working in pharmacy for 12 years myself, there are a couple of things I would recommend:
1.) Know your state regulations. You do not always need to speak to a pharmacist when calling in a prescription. In many states, certified technicians are allowed to take over the phone prescriptions autonomously, and this takes the pressure off of the pharmacist when s/he is busy with pharmacist-specific tasks.
2.) I personally would not advise using the Latin sig over the phone. BID can sound a lot like TID, etc.; please say "twice daily" or "three times daily."
3.) Unless it is urgent, pharmacy staff usually prefer that you use the voicemail system or e-scribe so that they can get to the prescription when it is convenient for them, in case they are in the middle of a rush, a complicated insurance issue or consultation, etc. This is especially important if you are calling in 20 different prescriptions for 10 different patients all at once. This being said, please do not wait until closing time to call in prescriptions, in case there is something that needs to be clarified.
4.) Unless you are in an independent practice state, you must also leave the name of your supervising/collaborative physician, and possibly his/her DEA number.
Roles and Responsibilities
It is your job to relay the prescription information from the prescriber to the pharmacist in a safe and effective manner. All three players have their roles and responsibilities in this process.
The prescriber must prescribe the appropriate medication with the appropriate dosage and accurately convey that information to the person who will be phoning in the prescription.
The caller must take the prescription information and convey it to the pharmacist. Prescribers, like all of us, make mistakes. If you see something that looks out of place, speak up before calling the pharmacy.
The pharmacist must accurately transcribe the information received from the caller and ensure that it is safe to dispense to the patient. It is the pharmacist's responsibility to ask questions, either while on the phone, or after the phone call has ended.
Before calling the pharmacy, gather all the information needed to convey the prescription.
The minimum information the pharmacist will need:
Additional information to have on hand which may be needed.
Calling in the Prescription
A pharmacy technician will probably answer the phone, but you will need to speak to the pharmacist. State your name and where you are calling from and inform the person answering the phone that you have a new prescription.
Example: "This is Sue from Dr. Walter White's office with a new prescription. May I please speak to the pharmacist?"
If you just say, "pharmacist", the tech will not know if you are a patient, someone calling in a prescription, drug rep, or someone trying to sell the pharmacist a new mat for the pharmacy. At that point, the tech will put you on hold and may tell the pharmacist there is a new prescription on line 1 and "someone who wants to speak to the pharmacist" on line 2. Even if you called before line 1, you will be second in line.
When the pharmacist picks up your line, he/she should identify himself/herself by name and state that he/she is the pharmacist. You should note the pharmacist's name for your records. You must be sure you are talking to the pharmacist. Don't assume anything.
Once you have the pharmacist on the phone:
At this point, the pharmacist will most likely repeat everything to you. If not, you should say something like, "Could you please read that back to me?"
99% of the time, this is the end of the conversation. The pharmacist may ask for some additional information, so give him/her whatever he/she needs. If the pharmacist states that the drug, dosage, or strength doesn't seem right and asks you to double check with the prescriber, please say OK and either put the pharmacist on hold or state that you will call back. Do not argue with the pharmacist. Don't say things like, "That is what it says, just fill it." Or "The doctor doesn't like to be questioned." The pharmacist is only doing his job.
During this whole process, everyone involved should think of themselves as part of a team working for the benefit of the patient. If something doesn't look right to someone, it is their duty to speak up. No one is "above" anyone else and has the right to treat anyone else in a condescending or rude manner.
One last note: It is not worth your license or job to phone in a prescription which is not authorized by the prescriber.
-Brad Wojcik, PharmD
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