tl;dr: I think pharmacies shred faxes they've received when it isn't convenient for them to fill the prescriptions

We seem to be living in an age of pervasive lying, at least in politics and business. When it comes to health care, though, I believe we should be held to a higher standard.

Apparently many pharmacists don’t agree.

On an almost daily basis, we get a frantic call from a patient saying “the pharmacy said you never sent my prescription!” About one in fifty of those calls are correct: occasionally I get busy and forget to send a prescription (particularly likely if you have multiple pharmacies or some faxed and some printed prescriptions), or something goes wrong in the fax transmission and I haven’t yet had a chance to re-send the fax. Those are rare, though. The vast majority of time the pharmacies are lying.

Some people have said that calling it “lying” is kind of harsh. Maybe it was some kind of mechanical failure? A misunderstanding? A mistake? Except that it happens nearly every day, and often multiple times a day. Patients have been seriously injured by it. And consider the following:

    • We always send prescriptions by fax, never telephone, and we get an acknowledgement from the receiving fax machine when the prescription has been received and printed at the pharmacy.


    • Back in the early 2000’s I had a patient whom I saw weekly on Friday afternoons (late). His pharmacy always said they didn’t get prescriptions I would send Friday evenings. When I would re-send the prescription on Monday, they would always get it. So once I called the pharmacy and asked a technician about it. “I’ll deny I said this if you tell anyone, but we’re short staffed on weekends and if we come in on a Saturday or Sunday morning and there are too many faxes, we just put them in the shredder.”


    • I was once was dealing with a controlled substance and was uncomfortable sending a  duplicate prescription, so I asked the pharmacist to send me a note stating the she hadn’t received it. What she faxed back to me was the prescription she was claiming she hadn’t gotten. Visible, in reverse, was a note written in marker on the back of the prescription saying that she had never received it. You read that right: at the moment she was telling me that she had never received the prescription (she was on the phone to me with the patient at her counter) she was holding the “missing” prescription in her hand. She then used it as scratch paper to write the note telling me she hadn’t received it. I wonder what subconscious force of guilt caused her to put the note in the fax machine upside down.


    • I have several patients who have learned from bitter experience to just confront the pharmacy staff and tell them that they know it was sent and to check again. They say that the pharmacy then, invariably, tells them “it just came in.” (Unlike email, faxes arrive in real time. They can’t be delayed. So, again, this is… a lie.)


    • We’ve had pharmacies receive prescriptions, try to get insurance coverage, contact us to ask us to submit a request for a prior authorization, then tell the patient “We never got a prescription from your doctor.”


  • One of our patients, fed up with the lies, asked to have his prescriptions printed out instead of faxed (something we’re generally happy to do). He went to the pharmacy, handed the prescriptions directly to the pharmacist. When he went back later to pick up the filled prescriptions, guess what they said: “We never received the prescriptions.”

It seems apparent that there’s a rule in the pharmacy business that says “never say we’re not ready; always tell the patient that it’s the doctor’s fault.”

But the pharmacies’ lies injure you.

They need to start being honest with their customers. So, if your pharmacy tells you they didn’t get a prescription, let us know. It could be one of those unusual (but still too common, sorry) cases where I screwed up. If so, I’ll fix it and let you know, honestly, that it was my fault. But if they’re lying to you, consider using a different pharmacy.

There’s nothing convenient about a pharmacy that you cannot trust.