Opinion | Phoning It In — As a Favor to a Friend

Just a few days ago, very late in the evening, a friend of mine called me up with a conundrum.

He apparently had been feeling poorly for the past few days, with a bunch of symptoms he couldn’t quite put his finger on, and had even tested himself for COVID-19 a couple of times and was always negative. (By the way, he has given me his permission to discuss his case here.)

Ultimately, he ended up going to an urgent care center in his neighborhood, where he was examined and told he likely had “some sort of infection” and was given multiple medications. He told me that they’d examined him, done some blood tests and an EKG and a chest x-ray, and retested him for COVID-19 as well as influenza and HIV and other STDs, and ultimately told him that while they were sure what he didn’t have, and they weren’t sure what he did have, but they sure as heck were going to treat him.

So in the end, at discharge, he got a prescription dose NSAID, Tylenol, a decongestant, an albuterol inhaler, an inhaled corticosteroid, a Medrol Dosepak, antibiotic eyedrops, antibiotic ear drops, and an oral antibiotic.

Can You Do Me a Favor?

While his first question to me was what do I have and what were they treating (no idea…), the thing he’d really called me about was the fact that when he got to the pharmacy where the prescriptions had been sent, they told him they didn’t have the particular oral antibiotic in stock that had been prescribed for him. He tried calling back to the urgent care center, and had gotten lost in their endless phone tree. He tried emailing them through their patient portal, with no response.

He admitted to being somewhat anxious about starting the medication, but the pharmacist had told him they wouldn’t be able to get it in for at least a day or two, and they couldn’t transfer the prescription to another pharmacy for him. He asked me if I would mind calling in the prescription for him to another pharmacy, so that he could start on it right away.

We’ve all been placed in this position, when friends, acquaintances, relatives, or friends of friends call us asking for some help, and it sort of reminds me of the Randy Newman song, “You’ve Got a Friend in Me” from the movie Toy Story. Or rather, you have a friend who has a medical license who has the power to call in medications to pharmacies.

Usually most of us don’t like to do this too often, and there’s always the downstream possibility of something going wrong; the last thing we want is for a friend of ours to take a medicine we prescribed when they aren’t under our care and some adverse reaction occurs. No matter what, it’ll end up being our name on that prescription bottle. But in the name of getting someone the care they need, without sending them back to another urgent care center to start all over from scratch, or worse to end up in the emergency room, we’ve all stretched the limits, we’ve all gone there and used our licenses for good.

These are the wheels of healthcare that we can sometimes help grease. How often have you all gotten an email or a phone call from a friend of the family, a distant relative, someone you know from work, who has been told they need to see a specialist “right away” and then were told that the wait to get in was months when it seemed like they needed to be seen in days? We’ve all called in favors, made that phone call or email or chat, asking if someone could do us a solid and see someone for us. There aren’t a lot of perks in our healthcare lives, but our ability to help out in these situations feels like something that’s worth doing.

This Shouldn’t Be Necessary

People are always incredibly appreciative when we are able to get them into the specialist they wanted to see in a timely fashion, and they trust us to help get them to the best folks. But wouldn’t it be better if we had a healthcare system that just worked on its own, that allowed everyone to get their prescriptions filled, to get in to see the people they needed to see, and to get the care they needed right when they needed it?

What should have happened at that point when that pharmacy said they didn’t have a medicine, there should have been a mechanism in place for the original prescriber to be notified in some rapid fashion and then allow them to rectify the situation, instead of having it fall back on someone else. And when someone needs to see a specialist, how have we let it happen that the wait is months instead of days?

Wouldn’t we all want that for healthcare? Isn’t that what we all have when we ourselves seek care and flex our healthcare credentials, and isn’t it what our friends and family get when we pull some strings to get them seen? Over and over again, we see that when we put in a referral for a patient to see a specialist, the patient then sends us a message back through the portal that says they were told that it’s 3 or 4 or 6 or more months before they’re going to be able to be seen, isn’t there something we can do?

Let’s Change the System

I think we should restructure the system so that primary care providers have more time to take care of and manage patients for the vast majority of their issues, so that we don’t have to resort to sending people to yet another specialist for every issue that comes up with them.

No need in general for a neurologist for their headaches, a cardiologist for their high blood pressure, an endocrinologist for their diabetes, and a gastroenterologist for their reflux. The specialists should be saved for the tough cases, and give us, the primary care doctors, the time and resources and support we need to effectively and safely manage and counsel and treat our patients for almost everything that ails them. This should free up enough time with the specialists, culling from the ranks of their patients the chronic, the stable, and the less complex that don’t need that extra special specialist’s touch — then the wait should plummet from months to days.

And someone should be able to get the antibiotics they need, right when they need it.

Without having to call in a favor from a friend.