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Are You Caught in the Middle Between Your Doctor and Your Pharmacy?

I have been waiting patiently for my prescription of hydroxychloroquine to be filled for days now to no avail. I am stuck in the power struggle between the pharmacy and my doctor’s office. Have you ever been here before? I have. In between my parents as a kid. And it has a term: triangulation. It’s when one parent says to the child, “Tell your mother/father that…”

Triangulation is wrong to do to children, and it’s wrong to do to patients.

This morning, when I started making the calls to find out if my script was going to get filled or not cause I was down to four pills in my bottle, it was, “Please inform the pharmacy that they have to send the refill request to us via fax. We don’t have the capability of their e-messaging services.”

And from the other corner of the triangle I was ordered, “Please let the doctor’s office know we require them to switch over to the new e-messaging service.”

This is triangulation. It is when there are two people or entities in a relationship of some kind and a third gets pulled in to act as a stress release valve or as an intermediary, or even as a third pull in a power dynamic.

It is very similar to when children are put in the position of the go-between when parents are at odds or simply aren’t mature enough to work on their communication skills. This is especially common with children of divorce. I am not going to go into all the research on how damaging triangulation can be to children. It can be damaging to patients too. For example, I have yet to get my medication.

It can happen in other relationships as well. Friendships, families, professional environments, etc. Today, it happened to me. Or, at least, it was attempted on me. I put up a boundary which I should have done years ago. I refused to be the messenger. I told the pharmacy technician to call the doctor’s office himself. “Don’t tell me,” I said. “Talk to them. Figure it out.”

I am the patient. I am the one in need of care. This needs to be handled by the two with the relationship issue: the doctor and the pharmacy.

I have no control over the workings of the doctor’s office. The burden of getting them technologically up to date should not rest on my shoulders. I’m having enough of a time trying to get my body into the shower and get breakfast.

Nor do I have control over the pharmacy. It is not my duty to hand the phone to the pharmacist or technician to get them to communicate with the doctor, especially in a world where technology seems to make a major shift about every five minutes these days. I can barely keep up with the updates to my cell phone.

Who has the most power in this dynamic? A lot of people want to say the patient because of where they spend their money. Oh no. Not true. I have to follow the rules of the insurance company of where I want to get my medications filled if I want to protect what little funds are available to me. The insurance companies have a lot of say in a conversation they remarkably find ways to stay out of. They are not going to take my call on this matter.

Do I have to use this doctor? Yes. Because after nearly a lifetime of getting the run around from doctors when I would complain about odd symptoms, he was the one who finally stopped to listen and got me a proper diagnosis and care. But this doctor is one man in his own practice. He doesn’t have the financial backing to push back. He doesn’t have the financial ability to keep changing the technology the pharmacy chains want doctors like him to use. Constantly updating takes time and money and resources he and I would rather he spent on patients like me.

My other two main doctors are in larger, organized clinics. They get much the same lack of attention from the pharmacy chain as this lone doctor in his own practice in my experience. Maybe this is only happening in my neighborhood? I doubt it.

Who really has the most power in this dynamic? The pharmaceutical industry: the pharmaceutical manufacturing corporations, the pharmaceutical chains, all of them. They are the ones imposing new rules requiring new technologies from the doctors. They have the tools to help doctors save lives. That’s a lot of power.

What it really comes down to is mommy and daddy at war in the financial bedroom, and one of them holds most of the blankets. Would you both please do us a favor and get out of the bedroom, sit at the dining room table, and talk this out calmly like adults should? Pharmaceutical companies could do a much better job of helping doctors and clinics and even hospitals update their technology on a regular basis. They could offer incentives or IT technicians. Do something instead of hiding in the bedroom complaining they aren’t getting things done their way while the little ones are in the living room waiting for their needed bottles of nourishment.

I would like my Plaquenil, please. Thank you.

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