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This afternoon, I grabbed Bowdu’s scrip for Soloxine and set off on a doggy drug run. Unfortunately, this whole affair has taken so long that he’s down to four days worth of meds — which means he needs a refill to keep his thyroid supplemented until his next blood draw, which I have not yet scheduled because we’re inbetween vets. Had things gone smoothly when I first placed my order, we would have received the drugs by mail in plenty of time. Had I anticipated the obstacles I have so far encountered, this would’ve been taken care of weeks ago.

But there’s some rule that things in the American health care system are never supposed to proceed as smoothly as we’d like, right?

So after verifying on the phone that I could get what I wanted from the low-cost clinic and supply store across town, I drove over to pick up the pills. Turns out that they misunderstood our phone conversation. Both Bowdu and Bowpi have been seen there once for other issues, when it was a matter of getting more Temaril-P for Bowdu’s allergies and to get a general checkup and dental evaluation on Bowpi. It was a $15 visitation fee for both of them. Medications were sold at less than 70% of what the VCA charged me. And when we renewed the prescription with another online pharmacy, the low-cost clinic did fax the order their way with no complaint.

I thought I made it clear that the thyroid issue was a recent diagnosis, verified by another vet. They would not, however, fill a prescription for a problem that they did not diagnose. I had Bowdu’s entire stack of paperwork with me, including labwork from two places, the entire book of records from the VCA, and the original, unfilled prescription in hand. They could not give me the medications.

“But you guys can’t diagnose hypothyroidism anyway,” I pointed out. “It requires a blood draw and testing with specific equipment that most vets don’t have on site. Why do you even have thyroid medication on hand if you can’t dispense it?”

The only response I got was a shrug and “I don’t know.” As it turns out, the thyroid medication they stocked wasn’t even the brand I wanted anyway. So I asked for some assistance in finding another pharmacy, and they directed me to the vet down the road.

I made my second stop at a big, fancy hospital with the largest waiting area I’ve ever seen at a vet. Strangely enough, it was completely empty on a Saturday afternoon (which I imagine should be a pretty busy time for many active practices). I explained my situation, presented my paperwork, but again, they wouldn’t fill my prescription unless I was already an established client. They, too, had no recommendations as to where to go. I explained that I had originally tried to get the order filled with an internet pharmacy, and the woman behind the counter revealed just the hint of a scowl before saying, “Yeah, we don’t deal with those. Most vets around here require the patient to have been seen within the last year before they give you any drugs.” This is what they call a veterinarian-client-patient relationship. But despite how generally it’s defined by the AVMA, there’s still an unwritten sense of propriety that determines how the relationship is executed.

My final resort was the pet emergency service and referral center in town, though I was almost certain they would not have the drug on hand. The ladies there were so nice and so calm about everything, despite the palpable waves of stress coursing back and forth across the cramped little waiting room. No, they didn’t have any Soloxine on hand to offer me, but I should check with VCA — which was still open for the evening.

As in, my ex-VCA.

With the wryest grin on my face, I told her, “I don’t want them to fill my prescription.”

Apparently my facial expression was sufficient for her to understand there was more to the story than needed to be explained. She recommended checking with another VCA, which was in the direction of the low-cost clinic which had been my first stop, about an hour and a half ago.

At that point, I gave up for the day. I was near tears, I was hungry, and I had other things that had to be done by yesterday. With bitter irony, I wondered, What thrill is there in supposedly “outsmarting” the system when the system is so DUMB?! Why does the AVMA make it a point to state that doctors should allow their prescriptions to be filled elsewhere, as a matter of ethics, but at the same time, the doctors that control these pharmacies WON’T fill prescriptions they did not issue? Given these circumstances, why wouldn’t a client prefer an internet pharmacy?

[EDIT 19 September 2010: I find this post and discussion from Dogster, originally dated 22 June 2008, to be interesting.]

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