Journal of Dermatology for Physician Assistants

The official journal of the Society of Dermatology Physician Assistants

Listening To Patients: Getting the Right Drug

By Alan Rockoff, MD

You will just have to take my word for the fact that things happened exactly this way. Only the names have been changed to protect the incompetent.

“Yes, Rosebud?”

“Denny Dugan called, Doctor. He is having trouble getting the medicine you prescribed.”

It was the middle of a busy day. Rosebud put me through to Denny.

“Hello, Mr. Dugan. I hear your pharmacy doesn’t have Xolotl-PC? Can’t they order it?”

“It’s my mail-order pharmacy, Doctor, MeddleCo. They say they do have it but need to speak with you before they can dispense it.”

“Why not try your local pharmacy?”

“I use the mail-order, Doctor. I’m very cost-conscious.”

“Rosebud, could you please call MeddleCo? Here is the patient’s name, date of birth, and ID number. You have my license, DEA, and UPIN. Please buzz me when you get to the right person.”

“Hi, Doctor, it’s Rosebud. I went through four people before I got to this one. I gave every one of them all the patient’s numbers and your numbers. The second person told me that this is a covered medicine, no prior authorization needed, but they need to talk to you directly about it, so they kept on transferring me. Anyhow, the pharmacist is on Line 6.”

“Hello, this is Dr. Rockoff. What did you need to talk to me about?”

“Good morning, Doctor. You wrote for Xolotl-PC for Mr. Dugan, manufactured by Peeples and Cootie.”

“That is correct. Do you have it?”

“Did you want the Xolotl-PC solution?” “I think that is how it comes.”

“There is also a gel.”

“I didn’t know that.”

“But the gel has been discontinued.”

“I see. So you wanted to speak with me to ask whether I want the solution, or the gel that’s been discontinued?”


“I think I’ll go with the solution.”

“Yes, Doctor, just wanted to check if that is the one you want.”

“Is there anything else?

“Yes. You wrote that Xolotl-PC is manufactured by Peeples & Cootie.”

“I just put that down in case the drug was unfamiliar and needed to be ordered.”

“So you want that manufacturer?”

“If it’s available as generic, then I don’t care whom it’s manufactured by. Does anybody else make it?”


“Then what do you want to know?”

“We’re just checking to see if you want the product manufactured by Peeples & Cootie.”

“But nobody else makes it.”

“Yes. But we just wanted to be sure that is the one you wanted.”

“So you told the patient that you have to speak to me because you need to find out whether I want the solution or the gel that has been discontinued, and if I want the drug that is manufactured by its only manufacturer?”

“Yes, Doctor. We just like to check to be sure that the medication we dispense is the one you want.”

“Well, now I guess you’re sure.” “Yes, Doctor.”

“OK. I guess I’ll go back to seeing patients now. Have a nice day.”

“You too, Doctor.”

“Mr. Dugan, I spoke with MeddleCo, and it’s all set.”

“Thanks a million, Doc. I really appreciate it! You know how important it is these days to be cost conscious.”

“Oh, yes, Mr. Dugan, I know just how important it is. Take care now.”

Alan Rockoff, MD, practices dermatology in Boston, Massachusetts. He graduated with his medical degree in 1972 from the Albert Einstein College of Medicine in Bronx, New York and then completed a pediatric internship and residency at Bronx Municipal Hospital Center in Bronx, New York. Continuing his education, Dr. Rockoff completed a dermatology residency program at the combined program at Boston University and Tufts University in Boston, Massachusetts. Dr. Rockoff is a Clinical Assistant Professor of Dermatology at Tufts University School of Medicine. He has taught senior medical students and other trainees for more than 35 years.

Dr. Rockoff has been named one of Boston’s Top Doctors by Boston Magazine for five years. Dr. Rockoff is board certified by the American Board of Pediatrics and the American Board of Dermatology. Dr. Rockoff is a Fellow of the American Academy of Dermatology and a member ofthe Massachusetts Medical Society and the Massachusetts Academy of Dermatology.
Dr. Rockoff’s publications have appeared in numerous journals. He writes a monthly column for his dermatologic colleagues in Dermatology News as well as a blog for the magazine Psychology Today. His first book, “Under My Skin: A Dermatologist Looks at His Profession and His Patients” is available on Amazon and is his second book, “Act Like a Doctor, Think Like a Patient: Teaching Patient-focused Medicine” is available on Amazon and at Barnes and Noble.

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