When I entered the exam room of a young adult patient last week, he sat back in his chair, crossed his arms and gave me a stern look.
“You seem upset,” I said. “How can I help?”
“Well, I don’t understand why I had to make this appointment just to get my asthma medications renewed,” he replied, clearly annoyed. “This is the same medication I’ve been on for years, and it works perfectly fine.”
Perhaps you have had a similar experience with your own doctor. If everything is going well and there are no concerns, why would the doctor require an annual visit before issuing a long-term medication refill? How does this help you?
First, it is best to ask about this requirement at the onset of your relationship with the practice. Thus, when you request your initial medication refill, there will be no surprises. If the office policy on prescription refills is not clear to you, be sure to ask for an explanation, as the protocol may vary, depending on the type of medication and specific monitoring recommendations.
Most often, though, your doctor may want to reassess and determine whether that is still the best medication to treat your condition. Medication guidelines change and evolve, and a periodic visit is the best way to be sure your treatment is current and safe.
Further, patients often see more than one doctor, and a medication prescribed by a specialist may influence your primary-care treatment choices. For instance, a muscle relaxant, which can be sedating, may affect medications used for sleep or anxiety. All clinicians should routinely check for drug interactions before prescribing, but your primary-care office is your medical “home,” where monitoring all aspects of your health and treatments is a standard goal.
Some medications require a kidney or liver function blood test to ensure safe prescribing because these organs are important in how your body processes medications; others may need a test to check the level of medication in your bloodstream. You may also be due for some routine preventive health screening or vaccinations, which can be updated at your visit.
When I asked my patient about his asthma inhaler, he said he was using it more often than advised — four or five times a day — in order to feel well. This required frequent refills and some inconvenience throughout the workday. There are risks to excessive use of beta-agonist “rescue” inhalers, which rapidly open lung airways, and it turned out that he was much better off with a twice daily, long-acting maintenance inhaler. The visit ended up being very productive, and he was grateful.
When you request prescription refills and your doctor’s office says that you are due for a visit, approach it with an open mind rather than viewing it as an inconvenience. In the words of Thomas Edison, “Opportunity is missed by most people because it is dressed in overalls and looks like work.”
Jeffrey Millstein is a primary-care physician and medical director for patient experience-regional practices at Penn Medicine.