Contrary to popular belief, there is a ton of ethical crap that goes along with being a Pharmacist.
Family comes in who are on welfare. They bring you Rx’s for 2 bottles of amoxicillin (one for each kid) and for some OTC tylenol liquid. You run their Medicaid through and they were terminated. You obviously know that they cannot be terminated because its the first of the month, and everyone gets all screwed up towards the first. Plus it helps that this family has been on Medicaid for the past (all) generations, so the chances of them being actually terminated is nil. The Amoxicillin runs about $9/each. You know that they don’t have the cash on them. Do you charge them; Do you fill and not charge them; or do you give them their Rx back with a huge “See ya!” wave.
The correct answer (as almost all if not all Pharmacists will agree, except Mail Order douches) is you give them the Amoxicillin, and tell them to get a hold of their social worker to get their insurance settled. You tell them you’ll try to process the Rx’s in a few days. Witholding antibiotics from a sick kid when it costs $9 each is pretty hard-ass (even for me). Now if it were a screaming crackhead who wanted Zyvox, to hell with her. Kids should be taught that your Pharmacist is your friend, not the man who gives mommy those white pills that make her sleep all the time.
A few days go by, and you try to process those Rx’s. Of course they won’t go through. A week goes by, nothing. 10 days go by, nothing. You call the parents to ask, and they tell you they did not call their worker, and really have no intention of coming into your pharmacy to pay the $18 they owe because they have no money. Good deed? Punishment? Thanks for playing! Be happy it was only $18 and not more.
I got bitched out for being too PC, so i’ll lay it out plain and simple. When advancing medication to a Medicaid patient, you must be fully prepared that you will eat the cost of said medication. Think about it, these are the patients that have their asses wiped by the government because they are unable/unwilling to work. What makes you think they will take the initiative to actually CALL someone when they already got the rewards in-hand. Sure, they will get shafted next time they try to get stuff filled at your store, but they’ll just go somewhere else and do the same thing. Its not until someone stands up and says “NO” to them that they will get off of their ass and make the call to get reinstated.
So this is where the ethical question comes in. At what point do you withhold medication to FORCE the patient to make that call (because you sure as shit don’t have time to call HIS worker for HIM) so you not only will save other pharmacies what you went through, but also save his OWN ass when pharmacies refuse to refill drugs that will save his life. Tough issues, and having a “come to Jesus” meeting with him will just get result in him/her agreeing with you and not following through.