First of all I want to thank everyone for the all the well wishes and salutations on my blog-day. I felt I was at the centre of the sun.
After such jubilation, the question arose: “Now what?” What could I possibly write to follow such hype?
I thought I would start the next decade of blogging by sharing a little lesson in humility I recently received.
At work I am on the look-out for rapscallions who are ‘doctor shopping’ for prescriptions. Last autumn soon after I saw Dicky Purdy* his pharmacy called to inform me dastardly Dicky was getting duplicate amphetamine prescriptions from myself and another doctor. I looked in the controlled substance prescription monitoring program (CSPMP) to discover his profile proved to have parallel prescriptions from Urs Truly and a Dr. Demento**.
Dicky Purdy came in to his appointment today and I had the CSPMP print out ready. My approach is not to immediately pounce or accuse, but to get the suspect to talk first and hang themselves. Mr. Purdy reported he was OK, the Rx remains efficacious. He had no other prescriptions but the one he got from me, and it was due to be refilled (the CPSMP shows he got a three-month supply Rx in December). I then brought up in matter of fact and neutral tone I was confused for the CSPMP reports says he is getting a similar scripts from Dr. Demento. How do I make sense of this? Pause and wait. Normally the patient turns beet red and starts to protest or run out the door. Mr. Purdy looked bewildered; he didn’t know what I was talking about.
After a long and at ease process I learn Mr. Purdy lives with his father, Mr. Purdy senior. They have the same first and last name and address. The printout was printing his and his father’s prescriptions as the record of one person. The pharmacy hadn’t seen there were two date of births on the report; neither had I. His last Rx from me was right on time.
He was not upset; he explained this mix up error has happened before. Dicky Purdy senior and junior will go to the pharmacy to process this matter.
Afterwards I realized I felt not a relief but a disappointment. A disappointment! I stopped to ponder this revelation. I was actually feeling disappointed I had not caught him in a ‘I gotcha you rascally rabbit!” scenario. By talking about it rather than creating an accusation I had saved the alliance and I did not have egg on my face for having been wrong.
It reminded me to presume innocence until proven guilty and not be so quick to judge or profile. Also, I learned not to assume the monitoring program is a guaranteed truth (or pharmacy reports for that matter).
Patients can be right after all – who knew?
It was a humbling experience but a good lesson I won’t soon forget.
*Not his real name of course.
**Again not his real name but I suppose you figured this out.