first patient of the day...

he came in with a plastic bag of medications and placed 3 empty prescription bottles on the desk. His plastic bag was still full. I looked at him and smiled, " What else do you have in there?" He then proceeded to bring out bottle after bottle of dietary supplements until half of the table was covered in green vials. " I stopped taking my prescription drugs a long time ago because I couldn't afford them. I don't want chemicals in my body anyways, eventually I want to be able to get off all these meds". I rechecked the list I had with what he showed me and did not see any of his diabetic medications. " I've been taking cinnamon. I read on the internet that cinnamon lowers my blood sugar".....I looked at the last A1C the patient had on file and was shocked.

apparently, the patient turned to dietary supplements to control his blood sugars after his medications became ridiculously expensive. " I'm getting depressed because I don't know what to do anymore. " His prescription drug plan did not cover any of his medications until he paid his share of cost out of his own pocket. Somewhere along the line, the patient got screwed over.

i spent 2 hrs with him, navigating through the Medicare Part D website to find a plan that would cover all his meds but stumbled upon a system issue. Even though the patient had what they call "medi medi or dual eligible" - meaning that the patient has Medicare and Medical, the Medicare system itself would not recognize the patient as dual eligible. Great, the patient can't switch plans today. No meds.

Then we applied for his low income subsidy which won't kick in for another 2 weeks. Pt still has no meds.

Then I tried checking the walmart and target $4 prescription drug list. Some meds were covered but the pt wasn't interested in his diabetes or blood pressure meds, he wanted his $140 brand name antibiotic for his ears. Pt has some meds but not the med he wants. *sighs*

What do you do when your patient runs out of resources?