Last night I got a script for bum balm. Bum balm is a preparation used for diaper rash. Bum balm is not a legend drug, i.e., it is not produced by any drug company and must be mixed up by the pharmacist at the pharmacy. This is no problem. I love compounding medication. It does not involve talking to insurance companies, doctors, or patients. It involves me rolling up my sleeves and putting my education to good use. Sometimes, it even involves me using a mortar and pestle (!). During long nights with nothing else to do, it provides a welcome distraction and makes me feel useful.
The problem arises any time I get a script like the above mentioned. As bum balm is not a patented drug owned and produced according to one recipe, it can be made many different ways. In my short career as a pill pusher, I've seen at least 4 different recipes for it. The prescription merely read, 'Bum Balm, 1 tube, apply to affected area TID'. The doctor may as well have written, 'give them sum kewl a$$ cream LOL'. The distressed dad that gave me the script needed it NOW, TONIGHT but I wasn't able to give it to him.
My question is, do some pharmacists fill this type of script on a regular basis, taking it for granted that they know what formulation the doctor wants? I can only assume that some do, because I get this type of bullshit often enough to believe that some of these docs aren't getting called on it the majority of the time. Do some pharmacists just not give a shit and make it for whichever formulation they use most often? My problem with this is that I'm not willing to assume any liability on the doctor's behalf. I'm not compounding a special medication unless I have explicit directions on what ingredients to use.
So, I faxed the script back to the doc this morning with a real smart-ass note attached. In so many words it read, 'hey asshole, how about doing your job instead of being a slothful quack.' Seeing as it's the weekend, I'm sure they will respond promptly. The patient is failed once again. I don't know if that gives me grim satisfaction or just bores my tits off.
1 comment:
I have had problems with a couple docs who write for "magic mouthwash" w/o ingredients. Almost always has benadryl and lidocaine, but sometimes maalox, sometimes mylanta, sometimes carafate, orapred, decadron, have even seen tetracycline capsules once. How can I know? Normally we call, but there's a local ER doc that always writes it without ingredients and he's a dick so for him I just mix 'em up a little Dave special, spike with a little milk of magnesia and some ipecac, makes for a fun night all around.
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