In the spring of this year, I changed jobs, moved and finally obtained health insurance that doesn't exclude WLS. After speaking with several co-workers regarding recommendations for a PCP, they almost all suggested that I go to an internationally known teaching hospital. I established myself as a patient of one of the internal medicine specialists and, until today, have been very happy with the coordinated care that I have received. The clinic related to this hospital provides complete care, including labs, diagnostic testing, and specialist care in-house. All of my medical records are available for all of my doctors to review. If my gyn orders bloodwork, the reports are available for my PCP, my bariatric surgeon and my endocrinologist to review. They also have a secure online site that I can access my test results myself.

However, today I am wondering if this practice is too bureaucratic and regimented.

I have been taking the antidepressant Effexor XR for over 10 years. This drug runs through your system very quickly and causes horrible, awful withdrawal symptoms if a dose is missed. I had my prescription set up with "autofill" with my pharmacy. I don't call in monthly refills; the pharmacy automatically processes refills and notifies me when I need to pick up my medication. Thus, I was not aware that the refills had run out and new script needed to be obtained. Last week, I called the pharmacy to check on the meds and I was told that my doctor needed to authorize a refill and they had contacted their office. They stated that there was nothing I needed to do. On Monday, when I had one dose left, I called the pharmacy and was told the same thing. I panicked a bit because of the short supply of my medication. I was told that my PCP denied the request for a renewal of the script.

I determined that the pharmacy called my doctor near my former residence who denied the renewal because I was not currently a patient of his. I told the pharmacy that they needed to contact my current PCP and they informed that they had faxed her also. I also called the PCP department as well. I was told that the refill would be called in within 24 hours. Today, I followed up with the pharmacy, who has not heard from anyone regarding my script.

My PCP doc is working the hospital until Friday. She is not responding to her admin assistant's urgent message on my behalf. The pharmist flatly refused to give me a dose or two hold me over. I am dizzy, nauseated, irritable and unable to control my emotions. I am scheduled for an upper endoscopy tomorrow with my WLs surgeon ( the last test before I get a surgery date, insurance is approved. As a last resort, I called the bariatric department to see if my surgeon would call in a small script to hold me over and to enable to me undergo the endoscopy with him tomorrow. If I am shaking, hurting and vomiting, I doubt he will be able to do the endoscope. My request that the surgeon call the script was flatly refused. I was also accused of lying by the patient coordinator on the phone because she didn't see any indication that I had called my PCP more than one time yesterday morning. Apparently my PCP's secretary didn't note the calls in the system. My surgeon's patient coordinator believed their computer over me.

At this point I am emotional mess and a physical mess. I don't know what to do. Tomorrow, I don't know if I should try to have the endoscope done or if I should try get an appointment with my former PCP and drive 3 hours to see him.

I am worried about what kind of aftercare or emergency care I may receive if I have surgery with this surgeon's practice. I am sure that I am going to change pharmacies and change PCPs. I have never experienced a situation where there wasn't another internist or P.A. available to cover for another.

Am I overreacting? Does anyone have any thoughts or suggestions?

Well because new drug laws went in to effect as of July 1st anyone taking certain medications are required to see their pcp for refills in person and it doesnt matter how many years you have been taking the same medication. Doctors are covering their asses for patients who do not use their medications properly. Its sad that people like you have to suffer but its the way the laws are that make these things happen.

Yep your in Florida so that is why. That includes any controlled substances and pychotropics next time get your script before you leave the office.