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Jeb's Drugs is no place for second opinions

By HOWARD TROXLER
Published July 24, 2005

I took my prescription to Jeb's Drugstore. The sign on the door said:

JEB'S DRUGS

"I Know Best"

The store was packed. People stood in two lines, one marked "Medicaid" and one marked "Everybody Else." Behind the counter, Jeb was busy filling bottles with little pills.

"Here's is the prescription my doctor gave me," said the next customer in the Medicaid line.

Jeb, wearing a white jacket, looked at the prescription and sneered. "You're not going to get this," he said. "That costs way too much. Here, take these other pills that work just as well."

The woman seemed distressed. "But I've already tried those, and they didn't work," she complained. "My doctor says I need these other ones."

Jeb scowled. "Well, has your doctor filled out Jeb Form 27.394(b)12, Request for Permission to Disobey Jeb?"

She said that he had not, because under the state's new rules, filling out extra forms was a bureaucratic pain in the neck, and the state is taking too long to approve such requests. Jeb handed her the bag of pills and pointed sternly toward the door.

The next customer was a mother with a 5-year-old boy who seemed to be having trouble breathing.

"We are here for our asthma medicine," she told Jeb. "Thank goodness you admitted your mistake, and put back on your new approved drug list the only asthma medicine that works for untold numbers of Florida children."

"We do not make mistakes here at Jeb's Drugs," he replied. "It was the company's fault for not including it on the bid list."

The mother replied that it was odd that Jeb's Drugs didn't put the kids' asthma medicine back on the list until there was unfavorable publicity in the newspaper.

You would think, she went on, that the state's bureaucrats would have listened in the first place to doctors who actually treat little kids with asthma. Jeb handed her the bag without looking at her.

"Next," he said.

A woman I know from St. Petersburg stepped forward. Despite the fact that I am making up this entire fake scene in Jeb's Drugs, the woman I am describing is in fact a real person, the mother of two children, who suffers from a bipolar condition, and I am using her real-life case now as an example, okay?

"Can I have this one medicine that has proved to be effective against several of my problems at once?" she asked Jeb.

"Absolutely not, not without special approval," he replied. "You will have to get separate prescriptions to deal with your separate problems individually."

"But that's a terrible idea," she tried to explain. "Getting a bunch of separate prescriptions will not be as effective, and besides, it will cost the taxpayers a lot more money than the prescription I've had."

The governor was unmoved. "Tell your doctor to fill out Form 27.394(b)12."

After the next patient in line was instructed to give his kid an older anti-seizure drug with more side effects, a fellow in a doctor's outfit wearing a stethoscope stepped forward. His name tag said "M. Welby, M.D."

"Listen, finding the right medicine for a patient, especially in the psychiatric field, is not like just popping an aspirin," he said.

"It can take months or years to discover just the right mix of medications for some patients. What works for one case might not work in the next - but then if you make one subtle change, it works great.

"This is not a matter of a committee vote in Tallahassee. Didn't you run for office on the claim that Tallahassee doesn't always know best? Now, here you are making every doctor in the state do more paperwork if they actually want to do what's best for their patients."

Jeb shook his head. "It is bleeding hearts like you who are driving up the cost of medicine," he said. "Don't you know we are trying to contain costs here? The only way to do it is by not letting you doctors hand out pills like candy."

Meanwhile, over on the non-Medicaid side, I was next in line. For the first time, I was thankful for my understanding, helpful and generous PPO.

[Last modified July 24, 2005, 00:21:06]