Why Does it Take so Long to Fill a Prescription?
This is likely the most frequently asked question about retail pharmacy. Although it is a legitimate question from a patients perspective, it is very frustrating for many pharmacists to hear. It is also a very difficult question to answer as there are infinite numbers of possible disruptions to the process of filling a prescription. Before I attempt to answer this legitimate question lets look at a couple of other services that require waiting several minutes or more.
1- Any professional service: Doctors, Lawyers, Accountants, etc. all have considerable wait times. Their services are all information based and require a significant knowledge base to complete their jobs. As a general rule we are willing to wait for these professional services due to the perceived value in the professionals knowledge and service provided.
2- A Deli Counter: I personally have waited 20 minutes or longer just to get a few slices of deli meat or cheese. This is not uncommon since there may be a few people ahead in line who also have specific orders which need to be individually completed. Occasionally it is just a single person with a large complicated order. The deli has finite resources (staff and slicers) available to complete customer’s orders and the counter gets backed up.
3- The local Auto Lube: Many places advertise 20 minute oil changes but the wait can be longer. If it is your first visit, they collect a full page of information which needs to be entered into their computer before the car can be serviced.
Each of these examples describes a situation in which the actual service being provided takes only a short time to accomplish but the wait time can be much longer depending on circumstance outside anyone’s control. It doesn’t take much to create a backlog and extended wait times.
Now lets take a look at the steps involved in filling a new prescription from a new customer. A new customer requires a few more steps than an existing customer and refills also require less work. But as you read the steps involved, keep in mind this describes an ideal situation of one prescription with no interruptions filled by a well trained competent team.
The pharmacy I currently work in breaks the process down into a series of steps. These steps may vary somewhat depending on the system in place. These steps are designed to improve efficiency and reduce errors. The effort to reduce errors will often decrease the efficiency but is absolutely necessary to ensure patient safety.
1- Presciption Reception: A new patient presenting a precription to the pharmacy needs to fill out an information sheet. The information required is at minimum: Name, Address, Phone Number, Date of Birth, Allergies, Gender, and Insurance Information. Hopefully the person filling in the information on the form will print clearly. Delays will happen if this information cannot be read and entered into the computer. Also, it is quite common for a new person, when asked “Have you been here before?” to answer “Yes.” The phamacy staff searches in vain for this person only to have to start from scratch when the patient come back to pick it up.
2- Data Entry: This part involves entering all above information in addition to the drug name, strength, quantity, instructions, refills and doctor information. This step can be difficult if the doctors handwriting is poor (there are many jokes about doctors handwriting but it is not a laughing matter, peoples lives are on the line here). The prescription is then processed and the claim sent to the insurance company. Often claim processing requires several attempts as the information on the insurance card is frequently not easily interpreted.
3- Dispensing: Usually the simplest and most straightforward part of the process. It involves locating the stock bottle, counting the tablets, stickering the vial and assebling the bag.
4-Verification: This step can only be done by a pharmacist. It involves verifying every piece of information listed above is accurate and the correct medication has been given to the patient. The final prescription is screend for accuracy, correct dosage, drug interactions, appropriateness of the medication for the patient, drug allergies and the correct product is being dispensed. This process can be very involved when a patient has multiple medications and/or medical conditions.
5- Release to Patient: This is where the medication is given to the patient and it is paid for, signed for and the patient is asked if they have any questions. Sometimes a patient has a question or presents the pharmacy with a drug reimbursement card the doctor gave them. The pharmacist answers any of the patient’s questions here. The drug card causes more delay as this needed to be done at the data entry stage.
The entire process can be done in an amazingly short time if everything goes smoothly. But each step can be quite time consuming if things aren’t perfect. Either way, please be patient with your pharmacist, your life and health depend on accurate prescriptions being dispensed.
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