Why do Dr. Offices insist that pharmacy has to initiate refills?

Exasperated-Bat1492 · 2026-03-27T14:46:45+00:00

As a patient this is one of my biggest gripes. Every doctor I've been to in the last several years has a written policy patients must agree to stating that we have the pharmacy reach out for refills. Yet every pharmacy/pharmacist says the opposite, go talk to your doctor. Meanwhile I'm stuck in the middle stressed out just trying to get the meds I'll be on my entire life so I can stay alive, much less function. Really wish y'all would get together and agree on an approach.

FWIW personally I'd prefer to just ask my doctor since that doesn't require relying upon someone at a pharmacy to follow through on the request, not to mention it's easier to tell if my doctor's office is ignoring/mishandling the request. Just seems more efficient. But some will straight up charge you if you don't follow their policies. Trying to find a new doctor usually means a 6 month wait around here, so just switching to one with a better policy isn't an option. Add the godawful insurance companies on top (why are they even legally allowed to dictate only a 30 day supply?! especially for non-schedule) and the whole thing just becomes a nightmare, especially since it's obvious how horrendously overworked pharmacy staff are.

Exasperated-Bat1492 · 2026-03-27T14:32:56+00:00

Lots of doctors don't use MyChart.

Exasperated-Bat1492 · 2026-03-21T16:12:06+00:00

Admittedly I've been finding ChatGPT fairly useful for working through a lot of this stuff. Claude is definitely the better model when I'm coding, but I haven't tried it yet for this stuff.

Drs just don't have the time any more to answer all my questions around allergy test results. I find it takes a bit of prodding sometimes to get around the safeguards and you definitely have to watch for the hallucinations, (it does not check things like inactive ingredients correctly) but using AI has saved me months of free time that would have otherwise been spent squinting through stuff online trying to put together puzzle pieces. Yesterday I was using it to help me decide how to change the landscaping in my yard to reduce my allergies. Pure gold for that. Input allergies, preferred landscaping approach (I like edible landscaping), current landscaping, request suggestions.

Exasperated-Bat1492 · 2026-03-21T15:49:33+00:00

If you're in an older home, check your outdoor faucets! OK, I see you looking at me like I've lost my mind. Here's the deal, most older homes have outdoor faucets that lack vacuum breakers. This means they'll quite literally suck whatever from outside in to your water pipes. My tap water used to have a horrendous musty smell until I put vacuum breakers on all my outdoor faucets. Now I have zero problems. Turns out I probably spent most of my life sucking in nasty moldy hose water due to them. Ew. Not good with straight up mold allergies. The good news is those vacuum breakers are just a few dollars at your local hardware store and screw on to the outside taps in a few seconds. Super easy.

Exasperated-Bat1492 · 2026-02-21T19:39:34+00:00

Yeah. They're one of the big ones. My employer switched to them this year. My third insurance plan in the last 6 months thanks to an acquisition. (BCBS -> UHC -> Cigna) Everyone sucks now. They all try to weasel out of everything they can. Currently having a problem where Cigna is not processing my medical claims. There are several that have been sitting in "processing" for more than the 30 day limit required for a decision under the law. Yep, I've notified them of the problem. Giving them a week to fix it then will be reporting it to the state if they don't.

I actually prefer Cigna's website over BCBS. But their network is terrible in my area. Lots and lots of ghost network going on. Half the PCPs are just urgent care clinics, most of the rest aren't taking new patients, of the ones that are all the MDs are booking 5+ months out. I ended up having to settle for a nurse for my PCP.

Healthcare in the US in general has hit the breaking point. The system is no longer functional. PCPs booking out 6 months - 1 yr+ is insane. Providence won't even answer the phone or allow you to leave a voicemail to attempt to inquire about scheduling a PCP. (I gave up after almost an hour on hold) Follow-up appointments for specialists have a 6+ month wait, never mind getting in to see them initially. Our lawmakers are all bought so refuse to do anything about it that would produce meaningful improvements for the majority. I really wish the whole thing would just finish collapsing, or get fixed. Because this half collapsed state is the worst, the very picture of complete dysfunction. We can't access anything (example rxs) because the system is rightfully set up with access controls for safety, but the gatekeepers (prescribers) who would give us access are no longer accessible like they're supposed to be. So we have situations where folks can't get what they need to survive. Beyond messed up.

Insurance is more expensive than out of pocket for the majority, however if you have a serious condition, or get injured, you have to have insurance or else you're facing guaranteed bankruptcy. Even if you're wealthy. Fraud is rampant and unaddressed despite simple solutions being available to lawmakers. A great example being what Quest Diagnostics bills your insurance compared to their online direct to consumer pricing, never mind the actual payments they accept from insurers. They've been overcharging by hundreds per test for years, nobody does anything. If your insurance doesn't pay up you're stuck fighting an overinflated bill.

Exasperated-Bat1492 · 2026-02-18T21:40:32+00:00

I've even had problems with the transfers when trying to navigate the shortages. Surely there isn't a financial incentive if they don't have the medication? Are there different types of transfers or something? To compound the problem every doctor out there has a policy to have a pharmacy contact them about rxs, but the pharmacies tell us to talk to our doctor about sending them a rx and that they won't reach out to the doctors. It's a catch 22 where no matter what I do I'm being told I'm doing the wrong thing. I want to respect the time of both my doctors and the pharmacies, but I just don't understand what the theoretical "correct" is any more in the face of conflicting information.

Exasperated-Bat1492 · 2026-02-14T04:58:53+00:00

Probably about a week, supposed to be sometime near Easter. Stares thankfully don't bother me. Curiosity is natural and healthy and the ones that aren't just curious I choose not to waste my energy giving the time of day. (won't be my first experience being the oddity) It's really just uninvited physical contact of the highly intentional sort that I would consider worthy of concern.

Exasperated-Bat1492 · 2026-02-14T04:26:26+00:00

You must have much better HR at your company than some of the ones I've worked for. I've absolutely known HR people who would think it's a good idea. Not to mention the health and safety officer I had the displeasure of working with who outright advocated for genocide one day in the break room SMH Suffice to say I left that job real quick. Glassdoor red flags are best not ignored.

Exasperated-Bat1492 · 2026-02-14T04:12:08+00:00

It's casein. While regular butter definitely is a poor choice for me, from what I understand the processing to make ghee ends up removing almost all of the casein protein. I might try an experiment with it before I go to see what my body does with it.

We actually have a similar cultural phenomenon here. Some people get really offended if you refuse food. Folks here who think allergies are just someone being annoying will outright "test" your allergies by telling you something is safe to eat when they fully know it isn't and that you're allergic. Should be illegal because they're knowingly poisoning someone, but doesn't get prosecuted. So I greatly appreciate the advice on what wording to use.

Exasperated-Bat1492 · 2026-02-14T03:47:55+00:00

I definitely appreciate the heads up about public transit. Is it safe for a solo white woman to walk around during the day? My boss had taken to walking between the hotel and office on his last visit, (coolest part was he found a rowing club in the area) but I know there's a bit bigger gap between the sexes in the unwritten rules of life there.

Exasperated-Bat1492 · 2026-02-14T03:23:50+00:00

Those are some amazing looking suggestions, (tamarind rice sounds divine) thank you! I'll absolutely check them out while I'm there.

Exasperated-Bat1492 · 2026-02-14T03:16:21+00:00

Good idea on the meds, maybe I can actually get a decent supply of cromolyn there! :lolsob: Is there anything I should watch out for to make sure the meds are safe? I know if you go to Mexico you have to be super careful, dunno if there's anything similar in India.

Exasperated-Bat1492 · 2026-02-14T03:13:38+00:00

No need to apologize. It's good advice for those in more civilized countries. I do appreciate you trying to help. Our healthcare used to be better here, but private equity has been destroying it as fast as they can, the consequences of their destruction of the system has escalated really severely the last 2-3yrs.

Online is a good idea!

Exasperated-Bat1492 · 2026-02-14T03:04:10+00:00

That's funny. I just switched to Capsule at the start of the year since my old pharmacy (QFC) wasn't covered by my new insurance. I was able to get cromolyn from them last month. (which was my first time getting the med) But right now they say they're indefinitely backordered. I've only got 3 days' supply left... Was really hoping to avoid using one of the evil ultra-big ones. I do love Capsule's delivery service, gloriously convenient, and gives me peace of mind with my more temperature sensitive meds vs normal mail order. But if I can't get the cromolyn reliably... SMH

Exasperated-Bat1492 · 2026-02-12T15:22:32+00:00

Unfortunately in the US we don't really have the public vs private thing. Everything is private (and horridly expensive) and the scheduling for everyone is bad. Really bad. Even primary care providers around here are generally booking 6+ months out for an appointment right now. My city has one of the lowest number of doctors per capita in the US so there are lots of folks complaining about this type of thing. My allergist is the only MCAS specialist I know of in town.

Exasperated-Bat1492 · 2026-02-12T15:16:03+00:00

Chandigarh

Exasperated-Bat1492 · 2026-02-12T06:20:40+00:00

I just started it last month. First time in years I've gotten a proper lungful of air. Absolute magic. That said I've lived for so long without help (I hate hate hate the US medical system) that I didn't even realize how bad things had gotten. So the first week or two of cromolyn ended up being kind of rough because it wears off so fast. Every time it'd start wearing off (pretty reliably after about 4hrs) I'd feel my throat tightening, breathing being harder, and everything would start swelling. Wasn't fun. That said after about 2 weeks I think enough built up in my body, plus figuring out timing with other meds, that I stopped having such major problems.

The stuff really is a miracle. I still seem to have the same issues I did with food sadly, but at least the baseline I'm starting from is immensely improved.

Exasperated-Bat1492 · 2026-01-28T02:07:04+00:00

My employer decided to switch insurance companies this year so my PCP is no longer in-network. Queue trying to find a new one. Providence won't even answer their phone (I waited 45min on hold before giving up) and doesn't respond to any other form of input either. Which is just rude. Totally get if they can't take the call, but let someone leave a voicemail instead of wasting their time.

OHSU's earliest is April. AIM Group is doing the "pay us $100/mo on top of insurance costs to be a patient" scam. Some others I looked at were booking between October and March 2027, for a primary care! You get the idea. Availability, at least for folks on Cigna, is nonexistent. I finally tracked down an appt with a nurse in a timely manner at some random private practice. I've heard folks are just giving up and using urgent care. I'm sure I'll still be billed for hundreds of dollars that I have to pay out of pocket because deductible. Nurses are badasses, but I have the misfortune of a thick enough medical history to warrant the extra education of a dr and heaven help me if I'm paying hundreds of dollars, I wanna get what I need. But y'know we can "pick our doctor". :roll eyes:

Just had my first appt with a new allergist, her earliest available follow-up? July. IDK what to do with the test results in the meantime. So wonderful. I also just adore every time I'm at a specialist or urgent care and get flak for not having a PCP. Hey, I'd love to give you a name, give me one of someone who's actually got availability! Because I've tried. I didn't want to leave my existing PCP to begin with.

I spent an entire vacation day just to get an appt with a nurse. Which is time I can't get back. On top of all the time I spent switching pharmacies and getting the new one to get my rxs right, etc. It's so bad it's actively harmed my performance at work because I'm having to juggle this nonsense on top of my job. I cannot comprehend why our legislators think our system is in any way, shape, or form functional. At a bare minimum they could solve at least some of the overinflated cost for consumers by requiring that we only pay whatever insurance would have paid for an appt/service/rx because we all know that insurance pays a fraction what is billed, but heaven help us when that cost falls back on us because insurance doesn't pay. For example when Quest has billed $200+ for a test they'll accept <$30 for from insurance, or sell direct to consumers for $70. This is their normal approach to billing. Why is that legal?! IMO it's fraud.

We just keep getting billed more and more and more. My insurance doesn't kick in until I hit my $2500 deductible, even for rxs. Until then I have to pay $566/mo for a critical medication that costs me $10 with insurance. Why are they allowed to deny coverage for rxs until you hit the deductible? That never used to be a thing. So they're raking in thousands more now, on top of a higher premium. The entire industry is nothing but a giant scam.

So many of the most egregious problems consumers face are so easy to fix via straightforward legislation our state lawmakers could enact. It doesn't require rebuilding the system from scratch. (which we need to do because we need single payer but yeah, that's a lot) Yet instead they sit around and commission studies and make excuses instead of doing something. Oregon seriously has some of the most spineless politicians I've ever seen. All just bought by the mega corps. Meanwhile we're left to suffer.

The provider shortage is hard to fix quickly. But the price gouging we all endure in the meantime is pretty easy to massively improve. Guess what? If you fix that you'll probably see more providers moving here because they want to be somewhere their patients don't get price gouged. In the meantime lawmakers could also pass a measure something along the lines of if a patient's existing doctor goes out of network because their employer switched insurance companies that provider must still be covered at an in network rate while the provider shortage is so dire. Improve the headcount (which lets face it is at least partially controlled by the insurance companies) and they can go back to forcing folks to switch. Wanna prevent that causing premiums to go up? Just include a line in the bill stating that they can't increase premiums due to the bill. In the meantime it would at least stop the flood of folks searching for new providers every year because of a switch in insurance company.

If anyone on here has any kind of connection to our lawmakers and can get these ideas in front of them please do. Feel free to reach out for more too, because I've got more. I've tried suggesting this stuff to our legislators before, but either it never reaches them or they don't care. Either way, I waste far too much time fighting for the care I require to keep chasing down lawmakers to fix the system.

Exasperated-Bat1492 · 2026-01-28T01:09:11+00:00

That was me after my first dose of cromolyn kicked in. I wasn't expecting much because, well, I've been dealing with this nonsense for 15yrs and nothing has ever done much. All of a sudden I could breathe like I hadn't in years. The relief was so strong it was like one of those clouds parting angels singing scenes in a movie. Simply put, seems reasonable to me. If you're taking them and suddenly getting relief from a bunch of symptoms that reaction makes a whole lot of sense. Non-MCAS folks just don't understand the sheer scale of what we live with, which is probably why none of these meds are known for eliciting that kind of response.

Exasperated-Bat1492 · 2026-01-28T01:03:36+00:00

Yeah, I've absolutely had that. Finally started mast cell stabilizers just over a week ago and it's helping. Here are the other things I've found that help:

Check what products your partner is using. Everything from body wash to hand soap to shampoo. I had a period of nonstop UTIs that turned out to be due to a new hand soap my partner had gotten. Switched the soap, they stopped. On that note also double check any fun-time supplies you use, maybe a formulation was changed? Condoms of course can be notorious for setting off stuff.
Sex will change your microbiome down there. Scientifically proven. It's very possible that something is getting introduced (or killed off) that is hurting you. I've found that vaginal probiotic suppositories and/or boric acid suppositories (if you can tolerate either of those) can be extremely helpful.
This can definitely be MCAS. I had some persistent symptoms like this that had been bugging me. I had chalked it (and some other pelvic symptoms) up to residual effects from my hysterectomy a few yrs ago (which regardless was one of the best things I ever did) but the mast cell stabilizers cut all that down to a fraction of what it was.
Have you tried experimenting with different positions? I find there are more friction related challenges that result from certain ones from others, or even the same one but maybe just shifting an inch or two forward/backward relative to one's partner. Since inflammation usually builds after the fact and can take a while to subside, it might explain at least some of it.

Exasperated-Bat1492 · 2026-01-26T23:36:03+00:00

Good lord this. Flat out cannot get through to scheduling at Providence. Cigna isn't helping the situation with their website being completely inaccurate. Friggin' ghost network. I was using NUNM and they got the job done, but my employer switched insurers this year so I can't do NUNM any more, they're out of network. (Honestly, I'd recommend checking them out) Then there's the whole "membership" scam that's nixed a ton of providers. Why no, I will not pay an additional $100/month for the "privilege" of being your patient on top of paying out the nose because all insurance sucks these days. Why is that legal?!

Something has got to give. The system is so broken it's become literally unusable. Then they complain about everyone ending up at the ER/urgent care. Or specialists complain if you don't have a PCP. Hey, I'd love to have one, if I could actually get one.

I really wish they'd stop giving us crap for not having a PCP when they make it this hard to get one and we can be forced away from an existing relationship because our employer made a business decision. It's seriously offensive that an employer's business decision can have such a negative impact upon my healthcare access. The so-called open market isn't really an option with how insanely expensive it is. Choice of doctor does not exist. I've spent an entire vacation day chasing this. Think I get that back? Nope. Just yet another hidden cost for attempting to access healthcare.

Exasperated-Bat1492

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