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Micromanaging Nonsense: What It Takes To Swallow A Pill

June 17th, 2009 by AlanDappenMD in Primary Care Wednesdays

There was an old lady who swallowed a pill
I know why she swallowed a pill.
To keep her alive.

There was old lady who mailed in her Rx
with wiggles and scribbles written on it.
She mailed the Rx to fill the pills.
I know why she swallowed the pill.
To keep her alive.

I know an old lady who ran out of pills, had no pill to swallow
How absurd she was left to wallow.
She’d mailed the Rx with wiggles and scribbles written on it.
She mailed the Rx to fill the pills
I know why she swallowed the pills,
To keep her alive.

I know an old lady who swallowed her pride
Wouldn’t have cried, she had too much pride.
She called Express Scripts to explain she had nothing to swallow.
She’d mailed the Rx with wiggles and scribbles written on it.
She mailed the Rx to fill the pills.
I know why she swallowed the pills .
To keep her alive.

There was an old lady who swallowed a whopper
“Your Rx was rescinded by your doctor.”
Imagine that, he canceled the order
With wiggles and scribbles written on it!”
She’d mailed the Rx to fill the pills.
I know why she swallowed the pills.
To keep her alive.

I know an old lady who swallowed frustration calling her doctor
She must be off her rocker to call her doctor.
She asked him to swallow his pride she knew he had nothing to hide.
To call Express Scripts about the Rx with wiggles and scribbles written on it.
She’d mailed the Rx to fill the pills.
He fully understood why she needed to swallow the pills.
To keep her alive.

I know the doctor who spent half a day
I dunno why there was such a delay
But a recorded voice during the stall
Said “Faxing an order might get you home before nightfall.”
He wrote another Rx with wiggles and scribbles written on it.
He again faxed the Rx to fill the pills
Saying she had to swallow the pills.
To keep her alive.

I know the old doctor who got back a fax
Saying, “Sorry Charlie. We’re sending this back.”
This medicine doesn’t need “Authorization. “
Just resubmit the Rx with wiggles and scribbles written on it.
What a nightmare to be trapped in midair
And so the doc did, with exclamation points!!!! written on it.

But the old lady  never did get those pills,
Finally had to buy them herself.
To keep her alive.

Afterwards, from the above true story:
Generic cost to buy a 90 day supply of the medicine: $ 30
Insurance CEO payment:  $30
Local pharmacy payment:  $30
Cost of hospitalization without meds: $40,000
Cost to doctor for another “check-up” with his mental health “Provider”: $200
Number of hours of lost human productivity for this case alone: 10
Estimated average annual cost of lost productivity per/ primary care physician  managing nonsense: $64,859
Physicians who smile and put up with it:  98%
The gaggle administrators, interfering in the doctor patient relationship: Priceless!

Until next week, I remain yours in primary care,

Alan Dappen MD

Tags: Dr. Alan Dappen, Primary Care Wednesdays