Several years ago, my days go much longer with over an hour a day going through huge stacks of refill requests with most of them inappropriate on some level, and all from pharmacies, not patients.

I always write prescriptions to cover to the next office visit, so unless I instruct a patient over the phone to increase a dosage, these should be infrequent. When they first started, I would approve them, but that created a problem in that as long as I approved them, many patients would never make a follow-up visit (until a crises developed). I also noticed that many of these requests were for meds that there should be active prescriptions for, or were for old dosages or discontinued meds. Often when I called the pharmacy in frustration, they checked and had my last active Rx on file, and I was left wondering why I got a fax without them checking. Now I know.

BTW, I never fax private information as faxes are notorious for being misdirected.

I all makes for very bad medicine. I came up with a solution that worked, albeit with a little alienation (but not of anyone that I have missed). Now I know the cause and why my solution worked.

I charge 25$ for refills. Now I rarely have refill requests. The 25$ charge, which I virtually never actually collect, focuses the mind wonderfully, and made the accompanying form on obtaining refills relevant reading for my patients. It also removed most of the finanacial incentive to just call in for a refill while skipping the recommended follow-up visit.

Yet just another of many examples of how badly applied automation creates inefficiency and wastes labor instead of saving it.

BTW, we have an EMR, which means that order misentry is now the most common cause of med errors. That drop down menu with dozens of meds spelled nearly alike in 8 point type on the laptop screen . . .