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Monday, March 31, 2008

Your name is...

Customer: It's right there on the prescription: John Doe.
Pharmacist: Sorry, couldn't read it.
Customer: You can't read the prescription?
Pharmacist: It's pretty bad handwriting. I can make out the drug, though. How are you supposed to take this? What's it for?
Customer: You don't know what the drug is for? How long you been at this?
Pharmacist (now getting testy): 25 years. Drugs are used for a lot of different reasons. This one for instance. Prednisone. Used for inflammation, asthma, lupus, MS, and about a dozen others. It's also taken in different ways, and if I could read the handwriting I might be able to tell you how you are supposed to take it. Did the doctor--Oh, nurse--tell you how it's taken?
Customer: Yeah. Three the first three days, then two then one. Something like that. These doc's and their bad handwriting. They make you take a class in bad handwriting, right? [laughs]
Pharmacist: No. And I don't think it's funny anymore. Some say that about 100,000 die each year because of bad handwriting. Did you know that?
Customer: Huh.
Pharmacist: Listen, when you leave the office, look at the script before you leave. If you can't read it, ask for it to be re-written. It's your health care, right?
[An analysis by the Institute of Medicine’s Committee on Quality of healthcare [sic] America, a unit of the U.S. National Academy of Sciences, concluded that medical errors, including prescription errors caused by poor handwriting, might be partly or wholly responsible for as many as 98,000 deaths per year (L.T. Kohn et al., To Err Is Human: Building a Safer Health System, 1999).
Personal Note: The above is a fictional conversation, but I've had similar conversations with patients many times. It is no laughing matter. If you have a doctor who wont take an extra ten seconds to make the Rx legible, then either get a different doctor, or just ask him/her why they insist on putting you at risk? Some practitioners are simply obstinate and I would conclude uncaring. Case in point: A practitioner (PA I think) in Rutland Vermont who specializes in treating kids cannot write a legible Rx. The office even went so far as to make pre-printed forms. But even when using these the PA still has to put number of doses, or refills, or dosings, and these end up as unreadable. Amazing. I've let her know many times that this is dangerous for the kids, but is there any change? Nope. When I've called sometimes I get a little chuckle from the nurse who answers. I doubt there would be much chuckling when some kid dies and their practice is sued.

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