Observation and note about  “REFILL” and other matter :

In doing refills we have observed that 75% of refill requests
come on behalf of about 150 patients out of thousands of patients. From some of
them, we get refill requests 3 or more times every week. We have learned that
most of the problem is from the big pharmacies where local pharmacists are neither
aware, nore responsible for sending refill requests,  half of them inappropriately as it is
generated by some computers sitting in one place far away. One time we had a situation
where refill request came for 10 mg ,  20
mg and 40 mg  of same medication. Rather
than updating prescriptions, the invisible computer pharmacist kept sending
refills on all medications which were ever prescribed.  Patient came in hypotension, we recognized the
problem and find many facts in subsequent many days. We are responsible for
your safety first. Other things come next 
and less no matter who is upset about not getting what they wanted.  

If these 150 or so patients bring the list of all
medications  and if their medical
condition is stable and controlled, we automatically give medications for 3
months at a time. Each  refill request  involves following steps:

1. Make sure the patient is our patient.  You will be surprised to know how many
requests we get for medications, diabetes supplies,  items and compound medications, just
expecting that doctor will sign and send them and we either never seen the
patient or is not our patient for long time.

2. Make sure patient has a condition for which the
medication is appropriate for that condition and we have prescribed it before.

3. Check if the condition like diabetes or hypertension were
in acceptable range during past visits of patient.

4. Patient has been seen within past 3 month approximately.

Then we make decision, make a note and send or do not
approve medication.

Usually we end up doing it, between 10 PM to 1 AM when we
should be resting. Before this we are busy in taking care of patients, reconciliations,
scanning, documentation, paper work, referrals, review of tests  etc. We spend significant amount of time over
each week end on refill requests. None of this this time compensated by you or  your insurance company. They say it is bundled
up in the fee of visit.  You would not do
this kind of uncompensated work for anybody for years, months, weeks, days or
hours for anybody, we know it by experience. Most people are very quick to
criticize but do not want to understand or help the situation.

But we get energy in doing it as our underlying inspiration
is value of being able to serve. We serve the poorest of poor and also listen
to snobbish visitors who do not realize that even the richest hospital owned
clinic refuse to take or severely limit the access to care to these patients
only and only due to type of insurance they have or do not even have.  We want to be your servant but even servant
can not do all that you may expect from them. So please help in some way.
Report the problem as above. Bring list of medications on your all visits. Bring
log of your blood sugar and Blood Pressure readings as requested.  Do not push us to get prescription of
antibiotics or controlled medications without being seen.