Refills

Whenever possible, I prefer to refill medications when the patient is in the office.

Telephone medicine is bad medicine. It's always in the best interest of the patient's health to do things in person. Even such an apparently simple thing as the refill of a routine medication requires a great deal of thought. Here are some examples of the complexity of prescription refills:

• Cholesterol Medication Cholesterol medicines such as Lipitor can put a strain on the liver. For this reason, blood tests need to be performed periodically to make sure that the liver enzymes are not rising. If the doctor were to simply refill the medication thoughtlessly without ordering blood tests (when needed), the patient's liver could be damaged and the patient could die.
• Blood Pressure Medication Hypertension (high blood pressure), if not controlled, causes kidney damage, heart disease and stroke, among other things. Thus, simply refilling a patient's blood pressure medication without checking his blood pressure to make sure that the medication is still at the right dose is irresponsible. A wise patient will obtain blood pressures prior to calling for refills, and let the doctor know with each refill request what his blood pressure has been. Also, there are blood tests which need to be ordered periodically for all patients with hypertension. These tests check for kidney damage, abnormal potassium levels, and dehydration, among other things.
• Sedatives and Pain Medications Sedatives (such as Xanax) and narcotic pain medications (such as Percocet) are addictive. I only refill such medications in person. It is important to review on a regular basis the need for prescribing such potentially dangerous medications. Such a review can only be effectively performed in person.

If you need a refill, and you do not have an appointment before your supply of medication will run out, then by all means ask for a refill over the phone. I would never withhold a needed medication from a patient because the patient doesn't have an appointment. However, you may be asked to come see me soon. In some cases, I may decide that the medication you need does not need to be refilled right away, and ask you to come in for the refill. Or I may decide that the refill must be done in person even though you have no appointment, and fit you into the schedule in order to do it in person.

There are several ways to request a refill:

• Call the pharmacy. Most pharmacies nowadays have an automated refill line which allows you to request a refill by simply entering your prescription number over a touch-tone phone. If there are no refills left on the prescription, the pharmacy will fax a request to the physician's office.
• Access the pharmacy's web site. Some pharmacies have web sites where you can request refills of your prescriptions.
• Call the doctor's office. This is the least desirable approach, since you end up having to be on hold if the doctor's staff are busy attending to other callers.
• Access our web site to request a refill. Click Here
• Send the doctor a letter. To use this approach, you have to plan ahead. Simply send the doctor a letter listing the medications you need refilled.

My office has a 2-business-day turn-around time for prescription refills. Most prescriptions can be refilled more quickly than this, but sometimes there are delays. For example, I may not even see the refill request until after I have finished seeing my patients for the day. I may need to do some research of the patient's lab results before deciding on the refill. Thus, you don't want to wait until the last minute to request a refill.