Veterinary prescriptions: The point of no return

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Ginny House lived alone with her 12-year-old Lab named Billy. A daily nonsteroidal anti-inflammatory drug (NSAID) allowed Billy to run and play instead of groaning when he tried to rise after napping on the tiled kitchen floor. Billy had been a patient at the Harvest Veterinary Clinic for all of his 12 years. Ms. House liked the staff and medical care but also enjoyed the efforts they extended to meet her every request.

As an elderly single woman, she often needed help getting Billy to the clinic. The veterinary staff went above and beyond to help her with her 92-lb pet. When the weather got bad, the clinic saw that Billy's medications got to her doorstep. When distasteful medicine was dispensed, they took the medication back and replaced it with something Billy wouldn't reject. Service like this had made the Harvest Veterinary Clinic very successful.

As is true with many 90-lb 12-year-old Labs, Billy's age caught up with him. Several incapacitating senile afflictions led to the decision to euthanize Billy. Needless to say Ms. House was devastated. After a period of grief and a need for canine company, she got a new dog, but this time it was a little Yorkie. When she brought him in for his first puppy exam she brought Billy's leftover NSAID tabs and his unopened flea and tick preventive to return for credit.

Ms. House was informed that she could no longer return previously dispensed medication. She responded by saying that this had never been an issue in the past. Her veterinarian agreed that was their previous policy, but current standards followed by human drug stores had altered the way many veterinarians ran their in-house pharmacies. He went on to say that most pet owners did not want medications that had been returned and were previously in the possession of another pet owner.

This upset Ms. House. She asked if the doctor was implying that she had contaminated Billy's medicine. She then remarked that the flea and tick preventive she was returning was still in its sealed package. “This is very expensive medicine,” she told the veterinarian. “If I had known about your new policy, I would have purchased a much smaller quantity.”

The veterinarian understood her situation, and in the spirit of the clinic's excellent customer service directive acceded to Ms. House's wishes. It was understood, however, that future medication purchases would not have a return option. Ms. House appreciated the accommodation. She did go on to say that the prohibition of the return of sealed medication was inappropriate and a client hardship. The doctor saw her point but stated that 21st-century drug-dispensing precautions allowed the profession and its patients to be better safe than sorry.

Do you agree with these new medication return policies, or should they be handled on a case-by-case basis?

Rosenberg's response

I can only think of three or four medication-return issues among the literally thousands of prescriptions I have filled. If your goal is to assist your clients as much as possible, accept returns of prepackaged unopened medications. But make it clear that unsealed medications prepared from a master pharmacy supply are not returnable.

In addition to informing the client about this policy, monitor the amount of medication being dispensed carefully so as not to send home more than is needed. For heaven's sake, don't charge a restocking fee for returns. These fees along with hazardous waste disposal charges lead to client resentment. If you must recoup these costs, incorporate them into general overhead considerations.

The veterinarian in this dilemma was right to make an accommodation for a valued client. Fine practices are not built on inflexible rules and strictly a desire to help the bottom line. A well-thought-out general policy concerning medication returns is a good idea, but well-considered exceptions to meet pet owner needs are always wise.