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Information for the “Pharmacist”

It is 7:30 PM on a Saturday night. A young man/woman (age approximately early 30s) comes walking up with a cane to your pharmacy counter, in apparent distress. The patient starts talking to you about his/her bad knee, giving you a long, detailed history about his/her injuries. S/He then presents you with a prescription for Oxycodone 5mg, 2 tab PO Q6h, #150. The prescription is typed up on a plain white piece of paper that looks like it has been folded numerous times, and the physician’s name and practice office is unfamiliar to you. The prescription was written 25 days ago. The patient continues to tell you that s/he recently lost his/her job so s/he no longer has prescription drug coverage, but s/he is willing to pay cash for his/her medication. S/He is new to your pharmacy.

  • How do you approach this patient? What information do you need?

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Information for the “Patient”

  • Read the case prompt, then begin the encounter by handing over the prescription (on page 2) and blurting out “I need this filled right away.”

  • Wince as you start the encounter.

  • Act overly friendly.

  • Provide detailed history about injuries: “A year ago I got into a motorcycle accident and had to get my knee surgically repaired.”

  • Your partner may start by beginning to ask background questions and confirming patient identity. During this attempted information gathering, be curt, rude, interrupt the student potentially, ask “Why do you need to know all of this? I just need this medication RIGHT NOW.”

  • Be hesitant when asked for ID.

  • If asked about why the prescription was not filled earlier, say: “I lost it and just found it.”

  • If asked whether this medication has been used before, say: “Yes. It’s the only thing that helps my pain.”

  • If your partner mentions calling the prescriber, say: “I have the doctor’s cell phone number, his office probably isn’t open today but I can give you that if that helps!” Try to distract your partner by talking about your injury, experiences with other prescribers/pharmacies, etc.

  • If/when your partner refuses to fill the prescription, become belligerent (eg, “You think I’m an addict,” “I’m going to write a letter to your boss,” etc.).

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