Rx & The Law

May I Help You?

by Donald McGuire, R.Ph., J.D.
Professional Claims Attorney
Pharmacists Mutual Insurance Company

Jack Green walked up to the pharmacy counter at Midtown Apothecary one afternoon.  He asked if Dr. Riley had called in a prescription for him yet.  The clerk looked through the will-call bin.  The clerk did not see one for Jack, but did see a prescription for Jack’s 19-year-old daughter, Julie, who was still living at home.  She asked Jack if he wanted to take Julie’s prescription with him.  Unbeknownst to Jack, Julie had been taking birth control pills for the last year.  Jack looked at the prescription and blew up. Julie Green called the pharmacist later in the day to complain about the situation.

Debbie Monday made her monthly trip to City Pharmacy to pick up her maintenance medications.  She also told the clerk that she was there to pick up her medications.  The clerk said they were ready and asked if she wanted to take Mr. Monday’s prescription also.  Debbie was shocked to see the name of a medication for erectile dysfunction on the bag’s receipt. Mr. Monday was very irate when he called the pharmacist that afternoon.   

While the appropriateness of Jack’s and Debbie’s reaction to the incident can be debated, Julie Green and Mr. Monday had reason to be upset that a family member was informed of their medications.  How did this happen?  It happened because the pharmacy staffs were trying to be helpful and save the patient a trip to the pharmacy.  This is not unusual.  Pharmacies try to help people everyday.  The problem in both cases was that the pharmacy volunteered information about another family member’s prescription.  Pharmacists are aware that pharmacy records are confidential and do not intend to breach confidentiality.  However, many pharmacists are surprised to learn that this confidentiality extends to family members, including spouses. 

Does this mean that family members or other persons can never pick up someone else’s prescription?  No, it doesn’t.  A pharmacist can provide a prescription to a patient’s agent, that is, a person acting on behalf of the patient.  In both of the above cases, the family member was not the patient’s agent.  Jack and Debbie came into the pharmacy to obtain their own medications.  The concern would be different if Jack came into the pharmacy asking for Julie’s medication.  The pharmacist could reasonably assume in this situation that Julie had sent Jack to the pharmacy and is acting on her behalf.  While the difference in these situations might seem insignificant, it really is the difference between happy patients and a claim for breach of confidentiality.

The solution to the problem is simple.  The staff of the pharmacy should take steps to insure that the person at the counter receives only the prescriptions that they have requested.  The staff should be instructed that prescriptions for other family members should not be volunteered for pick-up.  Proper delivery of prescriptions will also help prevent situations where patients with the same or similar names receive another patient’s prescription.  These situations also involve breach of confidentiality.   To help insure proper delivery, the clerk should not only ask the name of the patient, but also verify a phone number, address or some other identifying information.  Still, the most difficult step for most pharmacies is resisting the urge to do what pharmacy does best, “May I help you?”

This article discusses general principles of law and risk management. It is not intended as legal advice. Pharmacists should consult their own attorneys and insurance companies for specific advice. Pharmacists should be familiar with the policies and procedures of their employers and insurance companies, and act accordingly.