Forged Prescription (Alleged)

RE: Forged Prescription (Alleged)

Anthony Dennison — Wed, 27 Jan 2021 02:08:50 GMT

We do the method Bob described, but also give out paper copies. Had a couple of clients fake them over the years, one or two are repeat offenders and we've sacked them.

Like the idea of the hologram stickers though, will look in to that

RE: Forged Prescription (Alleged)

Gillian Mostyn — Sat, 23 Jan 2021 14:59:52 GMT

[quote userid="6897" url="~/001/nonclinical/f/life-in-practice-discussions/29613/forged-prescription-alleged/228042#228042"]Just wonder how you do it Michael - does the client place their order on line first and then give you the internet pharmacy's order reference number for you to attach to the prescription that you send in to them?[/quote]

I work at a practice that does this - the client places their order with the pharmacy, provides us with the reference number then we email the prescription direct to the pharmacy.

Not aware there is much resistance - but, there again, they do have 2 choices. Take it or leave it.

RE: Forged Prescription (Alleged)

bob lehner — Fri, 22 Jan 2021 15:34:54 GMT

I think Michael's method is probably the only sure-fire way to avoid any possibility of fraud, as even VMD accredited internet pharmacies will take e mailed prescriptions from the client (apart from prescriptions for Controlled Drugs, when they do ask for the original). Stickers/signing in red ink etc only work if the pharmacy asks for the original - as would Bob's photocopy-blocking method which wouldn't preclude e mails being sent to multiple pharmacies.

Just wonder how you do it Michael - does the client place their order on line first and then give you the internet pharmacy's order reference number for you to attach to the prescription that you send in to them?

Have you had any resistance from clients to your method - I know you said you don't do very many?

RE: Forged Prescription (Alleged)

Michael Woodhouse — Thu, 21 Jan 2021 20:24:36 GMT

[quote userid="5012" url="~/001/nonclinical/f/life-in-practice-discussions/29613/forged-prescription-alleged/228011#228011"]I thought owners had a right to request one? [/quote]

My understanding is they have a right to a written prescription for any medication I'd be willing to prescribe (other than emergencies). I don't see why I can't ask who they intend to purchase from and send the prescription directly to them? Not refusing to write a prescription (although I charge time and it's relatively expensive).

RE: Forged Prescription (Alleged)

David Mills — Thu, 21 Jan 2021 19:13:24 GMT

[quote userid="8958" url="~/001/nonclinical/f/life-in-practice-discussions/29613/forged-prescription-alleged/228017#228017"]Should they be compulsory?[/quote]

No, as you have to be a BVA member to access them (and they're not free?), and you need the original - not very modern for an increasingly electronic age.

There could be a number of approaches:

1. Only using VMD prescriptions, each with an individual serial number or barcode that is scanned (similar to doctors). Feedback loop to practice to say prescription has been issued for an animal under their care.

2. Pharmacies to check each prescription with the issuing practice or vet - there's a phone number on there for a reason I assume?

3. Pharmacies only to accept direct vet to pharmacy prescriptions (insurance companies require a stamp most of the time, and vet only sections to fill in)

4. Only VMD-recognised pharmacies allowed to issue VPS, and complying with one of the

Question is how serious an issue is there? I would hope the VMD would audit pharmacies and as part of that rejected prescriptions would be picked up in terms of volume. I do think that pharmacies could do more to check the legitimacy of these things, but then I suppose that isn't their primary focus.

RE: Forged Prescription (Alleged)

Neil Wheadon — Thu, 21 Jan 2021 17:50:57 GMT

They do

Should they be compulsory?

Neil

RE: Forged Prescription (Alleged)

Sarah Keir — Thu, 21 Jan 2021 17:43:45 GMT

Doesn't the BVA provide hologram stickers to go on prescriptions to reduce fraud? Perhaps if there was wider use of these?

RE: Forged Prescription (Alleged)

Evelyn Barbour-Hill — Thu, 21 Jan 2021 17:12:26 GMT

Would it need a change in the law to make it necessary for the pharmacy to send the prescription or a notification back to the prescriber, once fulfilled?

RE: Forged Prescription (Alleged)

Clive Ansell — Thu, 21 Jan 2021 15:55:08 GMT

[quote userid="3169" url="~/001/nonclinical/f/life-in-practice-discussions/29613/forged-prescription-alleged/228009#228009"]We don't do many but always get the pharmacy details and send direct. Don't give it to owner, ever.[/quote]

I thought owners had a right to request one?

RE: Forged Prescription (Alleged)

Clive Ansell — Thu, 21 Jan 2021 15:54:39 GMT

[quote userid="8958" url="~/001/nonclinical/f/life-in-practice-discussions/29613/forged-prescription-alleged/228008#228008"]What's the correct way to avoid this?[/quote]

I don't think it is avoidable, although it may be possible to make it harder.

At the moment it is so easy for a client to copy one, modern scanners and printers are now so good.

It is not only altering or creating one, but stopping multiple use of the same one.

Maybe some form of code or password, that would be sent directly to the Pharmacy. If an electronic document, may encryption and password protection?

RE: Forged Prescription (Alleged)

Michael Woodhouse — Thu, 21 Jan 2021 15:50:15 GMT

[quote userid="8958" url="~/001/nonclinical/f/life-in-practice-discussions/29613/forged-prescription-alleged/228008#228008"]What's the correct way to avoid this?[/quote]

We don't do many but always get the pharmacy details and send direct. Don't give it to owner, ever.

RE: Forged Prescription (Alleged)

Neil Wheadon — Thu, 21 Jan 2021 15:44:44 GMT

I've seen prescriptions handled in many different ways

What's the correct way to avoid this?

Neil

RE: Forged Prescription (Alleged)

Gillian Mostyn — Thu, 21 Jan 2021 15:27:51 GMT

[quote userid="5012" url="~/001/nonclinical/f/life-in-practice-discussions/29613/forged-prescription-alleged/227990#227990"]Would you all automatically sack the client in such a situation?[/quote]

Yes because of a breakdown in trust

RE: Forged Prescription (Alleged)

David Mills — Thu, 21 Jan 2021 14:12:01 GMT

Prescriptions are quite easy to forge for veterinary medicines I suspect. Most pharmacies (at least high street physical ones) are happy to dispense against something knocked up on Word with sufficient details and a signature - as people have said, it's easy to find an RCVS registration number, the only thing that could be checked really. I know I have used a homemade prescription letter to get meds from both human pharmacies and veterinary practices (e.g. when away from home) and minimal if any checks that I could see.

RE: Forged Prescription (Alleged)

Bob Russell — Thu, 21 Jan 2021 12:46:02 GMT

Yes where there is no doubt.

RE: Forged Prescription (Alleged)

Clive Ansell — Thu, 21 Jan 2021 12:33:45 GMT

Would you all automatically sack the client in such a situation?

I can't as a locum of course, but all cases I know of the client as been got rid of.

RE: Forged Prescription (Alleged)

Gillian Mostyn — Thu, 21 Jan 2021 10:45:46 GMT

[quote userid="6550" url="~/001/nonclinical/f/life-in-practice-discussions/29613/forged-prescription-alleged/227969#227969"]A criminal offence so sacking the client would be top of my list followed by a call to VMD.[/quote]

Exactly what we did.

RE: Forged Prescription (Alleged)

Sarah Keir — Wed, 20 Jan 2021 19:32:19 GMT

[quote userid="5012" url="~/001/nonclinical/f/life-in-practice-discussions/29613/forged-prescription-alleged/227973#227973"]used an incorrect or made up RCVS number. [/quote]

when it's so easy to find online!

RE: Forged Prescription (Alleged)

Clive Ansell — Wed, 20 Jan 2021 16:41:35 GMT

[quote userid="8958" url="~/001/nonclinical/f/life-in-practice-discussions/29613/forged-prescription-alleged/227972#227972"]

Did anyone contact the client

Haven't done that yet

[/quote]

In our case the practice manager contacted them to dismiss them before sending them a recorded deliver letter.

In all 3 cases, details and dates had been altered, no doubt whatsoever. In one case they had mis-spelt the vets name and used an incorrect or made up RCVS number.

RE: Forged Prescription (Alleged)

Neil Wheadon — Wed, 20 Jan 2021 16:33:55 GMT

Did anyone contact the client

Haven't done that yet

Neil

RE: Forged Prescription (Alleged)

Clive Ansell — Wed, 20 Jan 2021 16:31:41 GMT

In my 3 month locum before Christmas, we had 3 of these from 3 different clients that were picked up by the online pharmacies - full marks to them for detecting them, but I wonder how many others go undetected.

One of the clients is a member of a profession (not ours) and a so called pillar of the community etc. If their superiors got wind of it the faeces would certainly collide with the ventilator.

All 3 clients dismissed and reported to the VMD, who say they will take it seriously, particularly in one case as it involved Phenobarbitone, a controlled drug. They also said they usually deal with it, for a first offence, by issuing a severe reprimand (Euphemism for doing the square root of FA squared)

I work in many practices, and overall I feel we could do far more to make written prescriptions less open to fraud; using different colour inks, no copies allowed, no repeats, addressed to a specific pharmacy, time limits etc.

RE: Forged Prescription (Alleged)

Bob Russell — Wed, 20 Jan 2021 16:10:50 GMT

A criminal offence so sacking the client would be top of my list followed by a call to VMD. It is over to them after that. Just make sure it is a wrong'un first.

We use paper that will not copy or fax well as it comes up with bands over it showing 'copy' or similar.

We have someone try to fax one over but missed off the bit at the bottom stating copies and faxes are not valid! Just enough doubt as to the intent that the client remains on the books.