Why do medical card patients have to bring their hospital prescription to their GP?

Re: Why do medical card patients have to bring their hospital prescription to their G

At least it was until I was switched from quarterly clinic appointments to annual clinic appointments. When my prescription runs out (after three months) my GP has to renew it by copying a list of meds from one page to the next, signing, stamping and dating the new page. I pay him €10 for this.

Don't get me wrong - I don't begrudge him the tenner, but why can't I have a prescription that lasts me from one clinic appointment to the next? Surely he has more important medical work that needs doing rather him being a clerk for the HSE? My GP does not examine me, but has me in his waiting-room taking up space, wasting my time and his time all because of some stupid admin rule, created by the old health boards and being perpetuated by Drumm & Co.

This and the original question are two examples of lack of "joined-up-thinking" in our Health Services. First off, in Irish law, no prescription is valid longer than 6 months after it was written, even if the Dr writes 'Repeat for one year' or 'Repeat for life' or some such on it. The doctors know (or should know) this. Any of you on regular medication should be familiar with this as the pharmacy should be sending you back to your Dr after each prescription runs out. This is as it should be, as otherwise the pharmacist has no way of knowing if the doctor is keeping an eye on your condition.

However, in Mathepac's case, the consultant obviously feels that a once-yearly check-up is sufficient, since annual appointments are being made.
In that case, why is the consultant issuing 3 month prescriptions? You'd need to ask the consultant that, but it doesn't make sense to me.

2 possible solutions:
1. Always ask for 6 month's worth of repeats, not 3. Then you only have to see the consultant and the GP once each per year.
2. Ask the consultant to write two prescriptions, each for 6 months but with the 2nd one pre-dated for 6 months later. Then you don't need to see GP at all.

As another poster has said, GP should always be informed of decisions/changes made by other Drs. Nevertheless, it isn't the patient's job to do that. The hospital should, but system falls down ocasionally.

Re the original question: yes, it really is a matter of stationery and databases. Hospital Drs do not have access to GMS prescription forms, and even if they did, they would have no access to any way of checking who's entitled to get their meds for free. So they just write private (ie plain paper) prescriptions for everybody. When a GMS patient brings that to the pharmacy, they are supposed to bring their medical card with them to prove their entitlement. In actuality, we pharmacists usually are familiar enough with the patient and have filed away their number in the past, so we know if they're entitled`or not.

2 points to note:
a. The scheme that allows you to get 7 days' supply only applies if you present the prescription in the pharmacy within 24hrs. If you wait 2-3 days, I think the logic is that it's not really urgent and you should have gone to the GP!
b. It does not apply to private hospitals eg Beacon, Blackrock, Galway, Hermitage Clinics. I think the logic there is that if you can afford to go there, you can afford your medicines. There is a flaw in that logic, though: what if the patient has a Medical Card and was sent to a private clinic under the National Treatment Purchase Fund? (I can't answer that one)
 
Re: Why do medical card patients have to bring their hospital prescription to their G

Re the original question: yes, it really is a matter of stationery and databases. Hospital Drs do not have access to GMS prescription forms, and even if they did, they would have no access to any way of checking who's entitled to get their meds for free. So they just write private (ie plain paper) prescriptions for everybody. When a GMS patient brings that to the pharmacy, they are supposed to bring their medical card with them to prove their entitlement. In actuality, we pharmacists usually are familiar enough with the patient and have filed away their number in the past, so we know if they're entitled`or not.
Thanks for the update. Can you clarify if in practice, you find that GMS patients are bringing the 'private' prescription directly to the pharmacist, and not going to their GP first as per the official procedure?

Also, is there any reason why this could not or should not be the official procedure - bypass the GP, and bring the private prescription to the pharmacist. Once the pharmacist knows (and/or can verify that) this patient is GMS, the meds can be issued on the GMS account.
 
Re: Why do medical card patients have to bring their hospital prescription to their G

Thanks for the update. Can you clarify if in practice, you find that GMS patients are bringing the 'private' prescription directly to the pharmacist, and not going to their GP first as per the official procedure?

Also, is there any reason why this could not or should not be the official procedure - bypass the GP, and bring the private prescription to the pharmacist. Once the pharmacist knows (and/or can verify that) this patient is GMS, the meds can be issued on the GMS account.

Sorry, I think you may have misunderstood me. The closest thing to an 'official procedure' that exists is:
1. Take script to pharmacy, along with proof of GMS entitlement, within 24hrs of leaving the hospital, and you will be given 7 days' supply (or 'one pack' for something like a tube of ointment.)
2. Make an appointment to see GP.
3. See GP before your 7 days' supply has run out, and get an ongoing script from him/her.
4. Take that to the pharmacy to get your ongoing meds.

At the end of the day, your GP is the person with primary responsibility for your general care. Any consultant you see is only responsible for their part of you! So it is very important that your GP still gets to see you despite the fact that the hospital doctor has written your prescription.
If someone sees a consultant for a condition such as epilepsy, for example, but yet also suffers from high blood pressure, diabetes and dermatitis, then the epilepsy consultant may not have really considered those. That's why it is still important to have a GP responsible for overall care, and also why it's a good idea to have a medicines specialist (ie a pharmacist) involved in your care too.

Hope this helps.
 
Re: Why do medical card patients have to bring their hospital prescription to their G

Sorry, I think you may have misunderstood me. The closest thing to an 'official procedure' that exists is:
1. Take script to pharmacy, along with proof of GMS entitlement, within 24hrs of leaving the hospital, and you will be given 7 days' supply (or 'one pack' for something like a tube of ointment.)
2. Make an appointment to see GP.
3. See GP before your 7 days' supply has run out, and get an ongoing script from him/her.
4. Take that to the pharmacy to get your ongoing meds.

At the end of the day, your GP is the person with primary responsibility for your general care. Any consultant you see is only responsible for their part of you! So it is very important that your GP still gets to see you despite the fact that the hospital doctor has written your prescription.
If someone sees a consultant for a condition such as epilepsy, for example, but yet also suffers from high blood pressure, diabetes and dermatitis, then the epilepsy consultant may not have really considered those. That's why it is still important to have a GP responsible for overall care, and also why it's a good idea to have a medicines specialist (ie a pharmacist) involved in your care too.

Hope this helps.
Thanks for the clarification. From my inexpert and amatuer opinion, I have to disagree that there is a 'medical care' reason for getting the patient to attend the GP, for the following reasons;

1) This requirement only applies to GMS patients. There is no suggestion/recommendation/best practice of getting other patients to attend their GP after discharge. If there is a medical reason for this practice, why does it not apply to non-GMS patients?
2) I really can't accept that the consultant (earning €250k per annum) doesn't check the patient's medical history/chart before making his recommendations.

This is just a paperwork issue, and there is an opportunity here for the pharmacists to add value to the process by eliminating the need for the GP visit.
 
Re: Why do medical card patients have to bring their hospital prescription to their G

1) This requirement only applies to GMS patients. There is no suggestion/recommendation/best practice of getting other patients to attend their GP after discharge. If there is a medical reason for this practice, why does it not apply to non-GMS patients?

As I said above, it's really down to the availability if stationary. Private patients don't have to get a GMS Prescription Form, so they don't have to visit the GP! The GP will recieve a letter from the consultant re: whatever adjustments s/he has made, and the GP is still responsible overall, but the patient doesn't have to go to the GP to pick up the script.

2) I really can't accept that the consultant (earning €250k per annum) doesn't check the patient's medical history/chart before making his recommendations.

(Crass generalisation approaching!) You'd be surprised!!

Apologies to any conscientious consultants that are reading. The vast majority are very good. Some aren't. Same goes for GPs, and for pharmacists too. Most very good, some not. However, having the 3 sets of eyes looking over your care is a good thing, reduces the risk of some major drug interaction making it through.

This is just a paperwork issue, and there is an opportunity here for the pharmacists to add value to the process by eliminating the need for the GP visit.

This goes back to what I said at the beginning; lack of joined-up thinking! Why not have GMS Prescription Forms in the hospitals? Or why have a separate form for GMS patients at all?
The answer is that because any change would be down to the HSE and the DOHC. And they are 2 bodies who will never settle for one layer of beaurocracy when 5 layers will do the job!
 
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