My most-hated paperwork

Paperwork is never welcome, but it’s a part of this job. There are always forms – MRI approvals, patient disability, drug preauthorizations – a never-ending stream of paper in our allegedly paperless society. I can live with this.

What drives me nuts is unnecessary paperwork, often created for me by a well-meaning patient. My most hated are the multipage Food and Drug Administration forms that show up from time to time.

Let’s take Mrs. Smith, who has multiple sclerosis (MS). She’s on an injectable interferon. After 2 years, she has her first MS relapse since starting it. This is to be expected. Anyone who does this for a living knows that the medications only reduce, but don’t stop, relapses.

Besides calling me, she (for reasons I never understand) decides to notify the manufacturer. Now, Pharma Inc. is stuck with this knowledge and treats it as an adverse drug reaction. I don’t know why, but it does. So now it’s required by the FDA to send me a long form to report the problem. I fill it out and send it in and then get a second one back to clarify an answer from the first form. And so on.

Ignoring the forms won’t get you anywhere. They keep mailing them and calling until you return them. For MS drugs, this has happened twice to me in the last few months, with similar stories.

A patient gets a common (and well-documented) side effect, like chest pain after taking a triptan, and decides to report it to the manufacturer, which treats it like something previously unknown and sends me the dreaded paperwork looking for more information. Dispatching the paperwork quickly by writing, "It’s a triptan. This is what they do!" is not an acceptable answer. Trust me, I tried it.

Years ago, I saw a patient who took an overdose of a drug that is well known to cause seizures. Of course, he had a seizure. A friend of mine worked for the drug’s manufacturer at the time (although in another division), and I mentioned the story to him in a passing conversation about my weekend on call.

This was a big mistake, as he was then obliged to report it to his company, which of course sent me a 14-page form looking for more details than I had any idea of. So, with my lesson learned, now I don’t mention any of his current company’s products to him. It’s safer that way.

I have nothing against gathering new drug data or the paperwork that is involved. But to gather information that’s already well established? That’s a waste of everyone’s time.

Paperwork is never welcome, but it’s a part of this job. There are always forms – MRI approvals, patient disability, drug preauthorizations – a never-ending stream of paper in our allegedly paperless society. I can live with this.

What drives me nuts is unnecessary paperwork, often created for me by a well-meaning patient. My most hated are the multipage Food and Drug Administration forms that show up from time to time.

Let’s take Mrs. Smith, who has multiple sclerosis (MS). She’s on an injectable interferon. After 2 years, she has her first MS relapse since starting it. This is to be expected. Anyone who does this for a living knows that the medications only reduce, but don’t stop, relapses.

Besides calling me, she (for reasons I never understand) decides to notify the manufacturer. Now, Pharma Inc. is stuck with this knowledge and treats it as an adverse drug reaction. I don’t know why, but it does. So now it’s required by the FDA to send me a long form to report the problem. I fill it out and send it in and then get a second one back to clarify an answer from the first form. And so on.

Ignoring the forms won’t get you anywhere. They keep mailing them and calling until you return them. For MS drugs, this has happened twice to me in the last few months, with similar stories.

A patient gets a common (and well-documented) side effect, like chest pain after taking a triptan, and decides to report it to the manufacturer, which treats it like something previously unknown and sends me the dreaded paperwork looking for more information. Dispatching the paperwork quickly by writing, "It’s a triptan. This is what they do!" is not an acceptable answer. Trust me, I tried it.

Years ago, I saw a patient who took an overdose of a drug that is well known to cause seizures. Of course, he had a seizure. A friend of mine worked for the drug’s manufacturer at the time (although in another division), and I mentioned the story to him in a passing conversation about my weekend on call.

This was a big mistake, as he was then obliged to report it to his company, which of course sent me a 14-page form looking for more details than I had any idea of. So, with my lesson learned, now I don’t mention any of his current company’s products to him. It’s safer that way.

I have nothing against gathering new drug data or the paperwork that is involved. But to gather information that’s already well established? That’s a waste of everyone’s time.

Paperwork is never welcome, but it’s a part of this job. There are always forms – MRI approvals, patient disability, drug preauthorizations – a never-ending stream of paper in our allegedly paperless society. I can live with this.

What drives me nuts is unnecessary paperwork, often created for me by a well-meaning patient. My most hated are the multipage Food and Drug Administration forms that show up from time to time.

Let’s take Mrs. Smith, who has multiple sclerosis (MS). She’s on an injectable interferon. After 2 years, she has her first MS relapse since starting it. This is to be expected. Anyone who does this for a living knows that the medications only reduce, but don’t stop, relapses.

Besides calling me, she (for reasons I never understand) decides to notify the manufacturer. Now, Pharma Inc. is stuck with this knowledge and treats it as an adverse drug reaction. I don’t know why, but it does. So now it’s required by the FDA to send me a long form to report the problem. I fill it out and send it in and then get a second one back to clarify an answer from the first form. And so on.

Ignoring the forms won’t get you anywhere. They keep mailing them and calling until you return them. For MS drugs, this has happened twice to me in the last few months, with similar stories.

A patient gets a common (and well-documented) side effect, like chest pain after taking a triptan, and decides to report it to the manufacturer, which treats it like something previously unknown and sends me the dreaded paperwork looking for more information. Dispatching the paperwork quickly by writing, "It’s a triptan. This is what they do!" is not an acceptable answer. Trust me, I tried it.

Years ago, I saw a patient who took an overdose of a drug that is well known to cause seizures. Of course, he had a seizure. A friend of mine worked for the drug’s manufacturer at the time (although in another division), and I mentioned the story to him in a passing conversation about my weekend on call.

This was a big mistake, as he was then obliged to report it to his company, which of course sent me a 14-page form looking for more details than I had any idea of. So, with my lesson learned, now I don’t mention any of his current company’s products to him. It’s safer that way.

I have nothing against gathering new drug data or the paperwork that is involved. But to gather information that’s already well established? That’s a waste of everyone’s time.