JP at large: How wrong could I be?

February 5, 2007

It seems to me that doctors are pretty much taking off the better-than-you crowns and the are-you-looking-at-me cloaks these days. They seem to be much more egalitarian than ever before. They often appear to be more democratic than they were just 10 years ago. I can even call them by their first names without getting attitude. When I question them on restricted refills on something like Freestyle strips, they are likely to back off and change to p.r.n. Doctors are getting human on us.

I know! Watch out that you don't fall down laughing. I was brought back down to reality recently. This guy on the telephone starts asking about prescribed medicines for his brother who was just released from a hospital about 40 miles away. The patient needed to get home to Ohio, and the brother wanted to get going on the long road trip. I should have wondered why he was calling me when there are plenty of drugstores closer than 40 miles. Was I the last resort?

"He also needs Diastat [diazepam rectal gel, Valeant]."

"That is hopeless," I said, "I doubt if you will find any drugstore with that in stock."

"Why?" Did I smell a haughty attitude? The odor is unpleasant.

"Pharmacies don't keep it in stock because it is rarely prescribed and it is very expensive." I walked to the order computer. I was anticipating the next question.

"What is expensive?" Oh, there was the attitude, loud and clear.

"How about a wholesale price of $320 for a 20-mg twin pack? That's just two doses. There is not a pharmacist alive, with any sense at all, who will keep Diastat in stock."

"Isn't that a pharmacy's duty?" he demanded, "To be adequately stocked?"

That was enough for me. "Man, who do you think you are talking to? I have been doing this for a long time, and I'm not going to let anyone question me like that."

A silence, then this: "I am Dr. Michael Stewart, from Michigan. My brother needs these drugs, and I want to leave for Ohio by noon tomorrow. My brother has Humana insurance, and I want to pay only his co-pay."

"What you want and what you get may be two different things, Michael."

A long silence. "That's Dr. Stewart."

"That is going to get you even less." I was swiftly punching numbers into the calculator.

Like a smart rat, his tone changed. I might have been his last resort. "Can you guarantee that you will have these drugs by 10:00 tomorrow morning?"

"I won't guarantee anything."

"But you said..."