{"id":4763,"date":"2013-11-13T15:13:36","date_gmt":"2013-11-13T20:13:36","guid":{"rendered":"http:\/\/blogs.nejm.org\/?p=4763"},"modified":"2015-06-04T14:32:48","modified_gmt":"2015-06-04T18:32:48","slug":"how-doctors-nurses-and-other-medical-providers-spend-their-free-time","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/how-doctors-nurses-and-other-medical-providers-spend-their-free-time\/2013\/11\/13\/","title":{"rendered":"How Doctors, Nurses, and Other Medical Providers Spend Their Free Time"},"content":{"rendered":"

More absurd paperwork follies, this time from our friends at a mail-order pharmacy:<\/p>\n

\"dx<\/a><\/p>\n

Here, confronted with the challenge of refilling a patient’s HIV medications — which for the record he has been receiving unchanged for over 3 years — the pharmacy decides for the first time to reject the request and send the prescription back to us (by fax of course), including a cover sheet that reads, “Required Information Missing — Pls complete ASAP<\/span><\/strong>.”<\/p>\n

(No doubt they saved plenty of time by omitting 3 letters in the word “please.”)<\/p>\n

Is there a problem with the dose? The instructions? Is there a concerning drug-drug interaction? Did we forget a key component of the regimen?<\/p>\n

No, no, no, and no. The problem is that each medication now requires its own “Diagnosis Code,” those inscrutable numbers that already bedevil our billing sheets. Otherwise the pharmacy won’t get paid.<\/p>\n

Of course you could ask what else could darunavir, ritonavir, raltegravir, and lamivudine be used for besides<\/em> HIV, or \u201c042\u201d in ICD-9-ese. Or ask why suddenly now<\/em> they require the code, since they never did in the past — it’s not as if the indications for these drugs have somehow changed.<\/p>\n

And does someone really<\/em> check to see that the diagnosis code matches the medication? Just to make sure, next time I need to refill HIV meds at this particular pharmacy, I plan to put 380.4 down — that’s “ceruminosis,” or ear wax, in case you’re wondering.<\/p>\n

I’ll let you know what happens.<\/p>\n","protected":false},"excerpt":{"rendered":"

More absurd paperwork follies, this time from our friends at a mail-order pharmacy: Here, confronted with the challenge of refilling a patient’s HIV medications — which for the record he has been receiving unchanged for over 3 years — the pharmacy decides for the first time to reject the request and send the prescription back […]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,4,8],"tags":[],"class_list":["post-4763","post","type-post","status-publish","format-standard","hentry","category-health-care","category-hiv","category-patient-care"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/4763","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=4763"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/4763\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=4763"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=4763"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=4763"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}