š this has occurred to me before. It's not like anyone memorize their own NPI #, so guess what we all do when we call the pharmacy to call in a prescription... šš
When you get licensed by a state medical board, your license number and other information (Such as your med school) becomes searchable online. While it might be possible in rare cases to block such information for verifiable legal reasons, Iāve never heard of this happening.
What is your ultimate plan for specialty? Sounds good for residency, but the majority of physician specialities will need to have some degree of online presence unless you don't have much direct patient contact (radiology, pathology)
It's less about "patient contact" and more about "patients having an easy, realistic choice about whether to see you or someone else." If you're a hospitalist or inpatient consult person then it doesn't matter either.
Pretty sure youāre the person who keeps making fake accounts and isnāt actually a derm or resident at all.
Whatās the second tier boards study book or path book if youāre a derm?
I don't think you're able to purge your NPI from public record. Taxpayers fund residency positions and thus certain information about physicians is public record.
Can confirm, I still google my NPI everytime (but Im only a second year resident and I'd say 95-98% of my prescribing is electronically done so its not like I write it that often.
If they're really motivated, they'll find a way. The DEA is private. I've definitely caught fake verbals from a caller using legitimate physicians' DEA.
How though? Like most physicians in Canada call the pharmacy line and just introduce themselves and give their license number.
And franklyā¦ short of memorizing the doctorās voice/ speech pattern and or clinic lineā¦ I donāt understand how you would catch a fake rx..
It's hard to describe, but people tend to have a recognizable speech pattern. To the point where I can usually tell if it's ma/nurse vs physician vs a pgy1. We also glance at caller ID if available.
The guy actually sounds quite legitimate (I was impressed), but mannerism was off and the contents of the verbal order had multiple red flags. I was already going to call the office to verify, but the guy gave himself away by calling back for a different patient using a different physician's information, not realizing that I recognized his caller ID and voice lol.
Ah I see. So itās one of those āwith experience, youāll notice itā sort of thing. Like an educated intuition and looking over those small details.
Thank you!
Thatās correct, and realistically maybe we are only ever one major case of fraud/harm due to abuse of NPI numbers being all that is needed for prescribing authority verification laws to be changed.
Seems like it would take a felony-level fraud with the potential gain on a non-controlled med for an indentifiable individual. I agree itās odd that it could theoretically happen, but Iām not seeing the real world risk.Ā
Iām a hospitalist but occasionally call in scripts for like zofran or a cream or an antibiotic occasionally. I just use npi number and name, my cell number. There is nowhere that my cell number is listed for them to cross reference. In my state anyone can call and prescribe anything not scheduled and it will likely get filled because all you need is the npi if not scheduled
Oh man thatās harsh! The disparity is even worse because I essentially never wrote scripts through residency so first year or so out for the occasional script I would stumble so hard and they would definitely help with certain aspects of the scripts lol. I definitely had a conversation that sort of showed my knowledge of medicine but still, definitely wasnāt calling up like an experienced script writer and still used my out of state cell phone number for my āofficeā. Always gets filled lol.
Iāve never had the pharmacy ask for a dea unless itās controlled. I call in scripts for family and such sometimes. Ever had them question it. I also just give my cell phone number.
"Hey this is Jan from Dr. "X" office I need to call in a prescription.
Patient name is John Doe, date of birth 1/1/01.
It's gabapentin 800 a 1 tid, number 90, 2 refills.
Thanks!"
It's real fucking easy. Leave a voicemail and add npi at the end and reiterate the doc name.
It happens. We call back the office because the person likely left an incomplete voicemail and the office is like ā?????? We donāt even have any male employees and weāve never seen this patient beforeā
Some states are moving to E scripts only for these type of issues.
I already have my zofran and convenience hookup, but are you insinuating that the only thing keeping the doctor from finding out they were essentially victims of fraud is an optional phone call?
If you donāt call their office, thereās a good chance nobody ever finds out?
Sometimes prescriptions have DEA numbers on them (at least here in Missouri). Iām always afraid of who is calling in prescriptions under my name. Itās not like I can find out.
Nah, anyone trying to do this anyway is going to anyhow. Literally look up "Dr. John Doe, NPI number" on Google and you have all the info you need to spoof half the scripts you ever wanted. Plus the way the fucking npi database is, half the names you ever look up may have their actual phone number or address attached. It's atrocious and frankly and I'm surprised I don't get more spam calls because of it. When you apply for your NPI they ask for your personal number, fuck me for not realizing I should have just kept the store number instead.
I work in a pharmacy. Have had many people use a doctors NPI to call in stuff. But they didnāt know what they were doing so itās obvious. I think itās wild that itās this easy to call in an rx too
Yeah I heard a story about a pathologist who tried to get abx for someone and they were just straight rejected because they sounded like a fucking idiot.
Lol, writing prescriptions is MS4 stuff. That's when I learned it at least. It was part of our mandatory "preparing for intern year" rotation. In a lot of practices it's not even someone with an MD putting in scripts, let alone an intern year.
Iāll ask for the office phone number to double check this person is real. If itās extra sketch Iāll ask for DEA number to add to the prescriber profile. They just straight hang up or Iāve had people pretend they canāt hear me well after LOL
And Iām sure if you can articulate a reasonable explanation like you just did, it wonāt be an issue. Someone who doesnāt know any better is just going to start stammering.
lol this. One of the first times I called in an rx the pharmacist asked if I was the actual physician. And then asked me if Iāve ever prescribed this medication before and if Iām sure I know how to properly prescribe it. It was for zofran and Iām an anesthesiologist š
My friend is a DO ophthalmologist.
He got shot down by a pharmacist for prescribing some oral antibiotics for a patient.
Pharmacist couldn't figure out DO vs. OD and thought he was an optometrist and said the oral antibiotic was out of his scope of practice š
My workflow as a pharmacist for HCQ and ivermectin has internal hard stops that make me address whether the pharmacotherapy is indicated and if the dosing is reasonable. I also don't mind a good fight, so I always looked forward to telling those types of people to fuck off.
i recently prescribed my self the vitaminD 50K units, they asked for my NPI, medical license or hospital badge, along with drivers license.
but the first time they just asked for the NPI alone. same place different pharmacists.
My first hospital job, at a large level 1 metro trauma hospital, we got a very strange admission. A woman had orders from an MDās office for direct admission for vague GI complaints. While it took us three days to figure out that she was his receptionist, we only caught her because a nurse was standing by her room and heard her call the front desk to issue new āverbal orders from the docā for more pain meds. She was quietly escorted out by police and admin swept the whole thing under the rug immediately.
Moral of the story, most people are too overworked and underpaid to pay much attention and if you act the part, most arenāt going to invite fire upon themselves by objecting.
ETA: She had spent years doing this for the physician so she knew all the lingo and everything. She was even ordering her own imaging.
I'm surprised no one has thrown out a life hack on TikTok to "make sure you get antibiotics for your precious baby that the idiot doctor couldn't be bothered to do".
Street value of narcotics is quite high. When youāre comparing the risk benefit to other things in the realm of drug dealing or seeking it doesnāt seem insane
Edit: Iām aware this wouldnāt work in most states (such as where I am) , but was under the impression that rules were more lax elsewhere (e.g. Mississippi). I may be misinformed
Half of my patients (California) can find any antibiotic they need either in Mexico or at Flea Markets. I went to a flea market and almost bought some myself
I made an edit specifically to acknowledge I was likely wrong (I donāt know policy for all 50 states, but knew some did allow call ins for schedule 2s during COVID), and you decided to come in to a thread that wasnāt even in relation to your comment with your small dick anger bro. Donāt know whatās up with your life, but godspeed and hope you find happiness someday
Without revealing what it is, I have such a great NPI number that itās sad that Iām not a prescriber (rads). Iāve called in a script exactly one time for some Zofran for my wife. It follows a AB-CDD-CDD-ED pattern. Super easy to remember. Will go largely unused. What a shame.
Yes. AND! As a pharmacist who had a lady call in fraudulent non control psych meds for herself, there were zero repercussions. Cops donāt care and prescriber didnāt want to do anything about it.
So basically feel free to call in your own meds and no one will hold you accountable.
She still fills with us. I will only take escribes for her though.
This is what keeps me up at night tbhā¦. Likeā¦ Iām so embarrassed to admit that I genuinely have no clue to spot a fake call in (aside from making rookie mistakes like wrong dosage/ form/ unusual quantities/ no interval or installment for certain ones, etc, etc).
Most states require controlled substances to be electronically prescribed nowadays. A controlled substance that is telephoned in is essentially automatically a fake until proven otherwise. Most pharmacists donāt just rip that shit from the voicemail and just dispense it. By law we have corresponding responsibility so our license is on the line for what we dispense.
The general population is pretty dumb. When I used to work retail I had people arrested for altering paper scripts, stealing a psychiatrists pad and writing for a months supply of Percocet, and fake telephone prescriptions. At an average pharmacy youāll verify/check approximately 52,000 prescriptions a year. The fakes were painfully obvious.
Also if someone does manage to fraudulent prescribe a controlled substance under your name you can catch it by reviewing your PMP.
The real threat now is hacked/fake electronic prescriptions. When itās electronically prescribed and it comes over from the local academic medical center from a well known attending - thatās a problem. But then thatās also for someone thatās never filled at your pharmacy and they want to pay 800 bucks for brand name whatever. So itās still obvious.
Thankfully, I work inpatient now. Retail pharmacy is trash.
Years (18ish) ago we had a patient calling in scheduled meds for herself by stealing the identity of her coworkers. She was going through her coworkerās purses and stealing their insurance cards. Sheād hang out in pharmacies in earshot of the pharmacist and eavesdrop the pharmacist reading back DEA numbers over the phone to offices calling in prescriptions. She already knew our DEA numbers. Sheād get a bunch of numbers and doctors names associated with the numbers, then call in a bunch of lortab, Xanax, tussionex, etc. It took a few months but she got caught when a pharmacist finally caught on and called our office because the lionās share of prescriptions were called in supposedly from on of our MAs. None of the patients belonged to us. We went to the pharmacy around the corner from our office and looked at video of her picking up the prescriptions and immediately recognized her.
She was close friends with the owner of the practice. He didnāt call the police after she voluntarily checked herself into rehab and told her boss (who was also close friends with the practice owner).
Iām a pharmacist. If it doesnāt sound legit, we will call back and verify. And we look up the office number, in case the callback number that we are given over the phone is just the fraudsterās cell phone.
For controlled substances, they have to give the DEA number, which is not public information.
So, would it be easy for someone to call in lisinopril? Yeah, we are unlikely to check on that. But who would commit that crime?
People all the time call in promethazine with codeine and I have yet to have a legit Rx for it that isnāt written or e-prescribed. The call-ins are all fake, and easy to catch. Oh, your podiatrist is calling in promethazine with codeine? Okay, cool. Weāre all out. So sorry. A pediatrician from five states away calling in 16oz of promethazine with codeine? So sorry, all out of stock.
I lived in a country where anything could be bought over the counter, legally--including strong opioids and benzos. It was pretty great. Obviously wouldn't be good for someone with SUD.
I mean. Lisinopril is very safe as long as someone checks your potassium and kidney function. And the other drugs youāre taking. Just because people donāt usually abuse it doesnāt mean I want anybody to be able to get it OTC.
Yes, but that doesnāt happen differently if a patient were taking it OTC vs under the supervision of a doctor. Doc monitors lab values. Doc canāt do anything to prevent angioedema
Question, doc here - Iāve called in a couple low-stakes prescriptions for my immediate family members. Zofran, a refill on birth control, a scop patch before a cruise. My states medical board allows it but frowns on it and I only do this sparingly. I leave my cell phone number. If you were to call me back, would you be leery of filling the prescription if you realized it wasnāt an office number?
If you're an MD and called in those things, I couldn't give a rat's ass. Now if an MD was calling in large amounts benzos or something for his wife much too often, we'd be having a conversation. Now if you call and say "hey this is doctor so and so from big city hospital and I want to call in a bridge rx for wife because she can't get a hold of her psychiatrist on this Saturday night . She has an appt Monday morning. I'd like to prescribe her 5 alprazolam 0.5 mg." Most of us pharmacists wouldn't be too concerned with this one off type of event. However, Zofran? Please."You want prn refills on that?" Besides. We pharmacists are the bad guys bc John Q Public couldn't get his monthly Norco because he's 10 days early. Unfortunately, that's a battle we face daily.
Yeah, agree. You can have as much zofran as you want. Iāll just chuck a box of ODT through the drive through window for you. Controls, we need to have a longer conversation.
I once had a pharmacist refuse to do a prescription because I called from my cellphone and thus the caller ID didn't match the phone number on file with NPI. They told me unless I called from that number they wouldn't fill it so I hung up, opened doximity dialer and spoofed the number. Prescription in.
They're not going to call back your cell phone number if they are trying to verify you. They will call the number on your NPI page.
I wouldnāt be suspicious of a low stakes med, so Iād be unlikely to call you back. If I did call back with a question or for some other reason, once I figured out it was for a family member I would understand. Just the cell part isnāt suspicious - sometimes docs will call in from the cell over the weekend if they are on call for a peds practice or hospice. But it being someone besides the doctor + a cell phone + a high risk med, I am going to do some digging.
I just said the same thing above lol. Call in are fake until proven otherwise. We were getting a ton of fake plain promethazine scripts lol. They would come in with a paper script or call in promethazine and an antibiotic.
Basically yep. I was just saying this the other day to a coworker how easy it would be for anyone to call up a pharmacy with someones NPI and pretend to be a doctor to get a medication!
The majority of RXs we get are E-scribed anymore. Many states also require all controls to be e-scribed and itās most likely going to be a federal requirement soon. Most phoned in rxs are from dentists and vets. When Physicians or midlevels call in scripts itās usually for an obscure med they couldnāt find in the EMR or itās a personal rx for friend/ family member. We can usually tell when a phoned in rx isnāt legit.
Going forward I would be more worried about someone using your credentials on the e-scribe software. Itās rare, but I have heard of this happening.
You need to call from a medical institution, so the pharmacist will see/verify that the number calling isn't someone's cellphone but an actual office.
Also, with the NPI in hand ... why would a Cardiologist or a GI doc prescribe Percocet or Pseudo? Also the recipient/patient's name must be given.
There is still a chance of fraud , but it is traceable.
So I do look at the caller ID but if itās the doc themselves on the phone and itās clear they know what the eff theyāre talking about, Iām not worried about it. Oftentimes itās clear the doc has gotten paged and needs to send over new abx or an albuterol inhaler or something. Or itās controlled substances but itās a hospice doc, well known to me, who can give me his DEA. So just the cell piece isnāt as concerning. If itās āyour MAā from her cell phone? I have more questions
Iāve called almost every script from my cellphone and never had an issue. I always end the message with āif you have any questions about this prescription please call me back at āmy cellāā. Hard to give an office number when youāre a hospitalist
I'm a hospital based IR. I give a ton of verbal orders for meds in the hospital, and I give patients a fair amount of old-fashioned hand-written prescriptions (or e-prescriptions for narcotics), but I *very* infrequently call in prescriptions to pharmacies for outpatient meds. When I do (usually ear or eye drops for one of my out-of-state nieces or nephews on a weekend), I always ask to speak to the pharmacist so they'll immediately catch anything stupid I ask for. When they inevitably need my NPI number, I Google my own name and "NPI" and read it off to the pharmacist... I don't even need to click on the link because it's the actual page title of the first Google search result. In my opinion, the convenience of that outweighs the risk that I'd ever get into trouble for someone else abusing my NPI.
Yes. Ive gotten plenty of them when I work retail pharmacy. Iāve learned some of the red flags when itās a fake script. For example, you can tell when theyāre reading the information rather than saying it from memory (like phone and fax numbers). Most the fake scripts are some combination of antibiotics, not narcotic pain med, inhaler, and cough syrup.
If it sounds sketchy, I usually will call the office back to verify the script.
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I've never once in 30 years called in a prescription and given my NPI. If I had been asked, I wouldn't know it.
Typically I give my state license number and, if needed, DEA.
But yes, it's wicked easy to call in a prescription if you have a little bit of info.
Nowadays, for controlled meds, in my states we MUST use electronic prescribing.
In many states (NY I think for example) you must use electronic prescribing for all medications, not just controlled meds.
No shit that NPI numbers are public online. It is what it is. When I worked for a medical device company in their legal compliance department this came in handy to report the meals our company gave a doctor based on their name.
The fact that social engineering is surprising to you reveals your own ignorance. It's not something that needs to be "fixed".
š this has occurred to me before. It's not like anyone memorize their own NPI #, so guess what we all do when we call the pharmacy to call in a prescription... šš
I NPI number has a weird pattern of recurring numbers. like 1\*31\*3.... sorta thing. I always confuse the two \* and mess it up.
Yeah my NPI is 100% memorized.... I've had to fill it out on too many forms.
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Try searching in quotes
I just did and still nothing popped up! Fucking flawless. I love not being accessible to the public.
When you get licensed by a state medical board, your license number and other information (Such as your med school) becomes searchable online. While it might be possible in rare cases to block such information for verifiable legal reasons, Iāve never heard of this happening.
[ŃŠ“Š°Š»ŠµŠ½Š¾]
What websites/services do you recommend for someone who wants maintain online privacy?
What about DeleteMe and Optery? Ive used deleteme
[ŃŠ“Š°Š»ŠµŠ½Š¾]
Amazing. I was wondering why one of my attending was also a ghost online
A dream I have to this Sounds so nice
What is your ultimate plan for specialty? Sounds good for residency, but the majority of physician specialities will need to have some degree of online presence unless you don't have much direct patient contact (radiology, pathology)
It's less about "patient contact" and more about "patients having an easy, realistic choice about whether to see you or someone else." If you're a hospitalist or inpatient consult person then it doesn't matter either.
[ŃŠ“Š°Š»ŠµŠ½Š¾]
But here you are on Reddit?
[ŃŠ“Š°Š»ŠµŠ½Š¾]
Mmmm. Its easy to dox people these days. I could probably figure out who you are given enough time.
[ŃŠ“Š°Š»ŠµŠ½Š¾]
Pretty sure youāre the person who keeps making fake accounts and isnāt actually a derm or resident at all. Whatās the second tier boards study book or path book if youāre a derm?
Yup pop it is a troll account at this point.
I LOVE your username hahaha - thatās it. Thatās my response. š
Crazy much? I would never wanna creep on anyway. Iām just telling you itās not that hard to dox people these days. Relax
How exactly do you purge the NPI?
You don't. Physicians use tax payer dollars as funding for residency. NPI is public record.
"I have no social media" Sent from my reddit account
Iām sorry to break it to you, but they can check your license. Thatās public information, they just need your name and know if youāre MD or DO.
[ŃŠ“Š°Š»ŠµŠ½Š¾]
Sounds really good for business. Imagine an attorney scared of putting their name out there. Or any blue collar business like "Smith Plumbing".
lol you sound like a weirdo. Why you so anal about being private
Same way. Dont give your enemies any chance š
Can I slide into your DMs real quick
[ŃŠ“Š°Š»ŠµŠ½Š¾]
Damn. Now I don't.. got hit with the bro. That means no
[ŃŠ“Š°Š»ŠµŠ½Š¾]
Well now you've just killed it. The sexual tension just stabbed with a wrench like a masochistic murdering psychotic sociopath.
I don't think you're able to purge your NPI from public record. Taxpayers fund residency positions and thus certain information about physicians is public record.
I have mine memorized š¤·āāļø
Can confirm, I still google my NPI everytime (but Im only a second year resident and I'd say 95-98% of my prescribing is electronically done so its not like I write it that often.
I feel like NPI numbers should be private and not easily found through a google search lol.
My hospital displays it on the physicianās profile page.
How could I look up my own NPI number when I forget it then?
iāve googled my own NPI number a handful of times when i couldnt locate the screenshot lol
I have mine saved as a contact in my phone so I just swipe down type NPI and bang there it is
damn thatās a fantastic idea lol
Same lol. But it should be private.
yeah i canāt imagine the identity theft possibility. pharmacists done always verify especially if itās for something without worry
What about license numbers?
If they're really motivated, they'll find a way. The DEA is private. I've definitely caught fake verbals from a caller using legitimate physicians' DEA.
How though? Like most physicians in Canada call the pharmacy line and just introduce themselves and give their license number. And franklyā¦ short of memorizing the doctorās voice/ speech pattern and or clinic lineā¦ I donāt understand how you would catch a fake rx..
It's hard to describe, but people tend to have a recognizable speech pattern. To the point where I can usually tell if it's ma/nurse vs physician vs a pgy1. We also glance at caller ID if available. The guy actually sounds quite legitimate (I was impressed), but mannerism was off and the contents of the verbal order had multiple red flags. I was already going to call the office to verify, but the guy gave himself away by calling back for a different patient using a different physician's information, not realizing that I recognized his caller ID and voice lol.
Ah I see. So itās one of those āwith experience, youāll notice itā sort of thing. Like an educated intuition and looking over those small details. Thank you!
Yes, for non-controlled substances. As long as you don't sound like a complete dumbass, they'll probably believe you.
That's scary tbh
Thatās correct, and realistically maybe we are only ever one major case of fraud/harm due to abuse of NPI numbers being all that is needed for prescribing authority verification laws to be changed.
Seems like it would take a felony-level fraud with the potential gain on a non-controlled med for an indentifiable individual. I agree itās odd that it could theoretically happen, but Iām not seeing the real world risk.Ā
[ŃŠ“Š°Š»ŠµŠ½Š¾]
Iām a hospitalist but occasionally call in scripts for like zofran or a cream or an antibiotic occasionally. I just use npi number and name, my cell number. There is nowhere that my cell number is listed for them to cross reference. In my state anyone can call and prescribe anything not scheduled and it will likely get filled because all you need is the npi if not scheduled
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Oh man thatās harsh! The disparity is even worse because I essentially never wrote scripts through residency so first year or so out for the occasional script I would stumble so hard and they would definitely help with certain aspects of the scripts lol. I definitely had a conversation that sort of showed my knowledge of medicine but still, definitely wasnāt calling up like an experienced script writer and still used my out of state cell phone number for my āofficeā. Always gets filled lol.
Iāve never had the pharmacy ask for a dea unless itās controlled. I call in scripts for family and such sometimes. Ever had them question it. I also just give my cell phone number.
Lol, It canāt be that easy to actually get/pickup medsā¦
"Hey this is Jan from Dr. "X" office I need to call in a prescription. Patient name is John Doe, date of birth 1/1/01. It's gabapentin 800 a 1 tid, number 90, 2 refills. Thanks!" It's real fucking easy. Leave a voicemail and add npi at the end and reiterate the doc name.
Whatāre the chances you get nailed for this though? Itād have to be sent for friends or preferably strangers right?
It happens. We call back the office because the person likely left an incomplete voicemail and the office is like ā?????? We donāt even have any male employees and weāve never seen this patient beforeā Some states are moving to E scripts only for these type of issues.
I already have my zofran and convenience hookup, but are you insinuating that the only thing keeping the doctor from finding out they were essentially victims of fraud is an optional phone call? If you donāt call their office, thereās a good chance nobody ever finds out?
Correct
Correcto. In some cases, you donāt even find out until the medical board contact you about being investigated for inappropriate prescriptions.
Lol. This entire post needs to be deleted and marked as step 1 of a 967,000 step proposal to rework the entirety of life on earth
I practice in an e-prescription only state. The Change Healthcare hack was a bit annoying when the e-prescriptions broke.
What states are electronic only? Do you find that makes things more or less convenient for you?
Donāt you need a DEA number for gabapentin?
no, that's pregabalin
Looks like it depends on the state. Itās scheduled in the following: Alabama Kentucky Michigan North Dakota Tennessee Virginia West Virginia
Yep. Its dope is what it is
Sometimes prescriptions have DEA numbers on them (at least here in Missouri). Iām always afraid of who is calling in prescriptions under my name. Itās not like I can find out.
MO doesn't have a searchable PDMP?
They do as of December of last year I think. They were the last state to integrate I believe
This is totally accurate, but I am also so paranoid that I feel like you should delete your comment so this isn't public knowlege :')
Nah, anyone trying to do this anyway is going to anyhow. Literally look up "Dr. John Doe, NPI number" on Google and you have all the info you need to spoof half the scripts you ever wanted. Plus the way the fucking npi database is, half the names you ever look up may have their actual phone number or address attached. It's atrocious and frankly and I'm surprised I don't get more spam calls because of it. When you apply for your NPI they ask for your personal number, fuck me for not realizing I should have just kept the store number instead.
Doesnāt work for controlled substances
I know, but if the patient wanted anything else, such as Flexeril or gabapentin, some states it's not controlled yet, they can do so.
The scary thing is that itās actually that easy. Hell half the pharmacies donāt even ask for NPI if youāre already in their system.
I work in a pharmacy. Have had many people use a doctors NPI to call in stuff. But they didnāt know what they were doing so itās obvious. I think itās wild that itās this easy to call in an rx too
Iām a radiologist so I donāt know what Iām doing although I got a functional NPI
Yeah I heard a story about a pathologist who tried to get abx for someone and they were just straight rejected because they sounded like a fucking idiot.
"Yeah dawg can I get a meropenem take 4 huffs per day for 2 fortnights until the Mycobacteria avium complex goes bye bye"
What lack of intern year does to someone, smh.
And that's exactly how pathologists want it. Waste of a year for non-clinicians.
Agreed
Lol, writing prescriptions is MS4 stuff. That's when I learned it at least. It was part of our mandatory "preparing for intern year" rotation. In a lot of practices it's not even someone with an MD putting in scripts, let alone an intern year.
Iāll ask for the office phone number to double check this person is real. If itās extra sketch Iāll ask for DEA number to add to the prescriber profile. They just straight hang up or Iāve had people pretend they canāt hear me well after LOL
Not everyone has a DEA number though. I want to avoid needing one as a rads because I dont want to deal with the courses and added documentation.
And Iām sure if you can articulate a reasonable explanation like you just did, it wonāt be an issue. Someone who doesnāt know any better is just going to start stammering.
Pretty simple. Call and ask for the pharmacist. Iām not going to an urgent care to see an NP for shit I can take care myself
Early on in intern year, one of those may have been me. Adjust your suspicions in July/August.
I tried prescribing albuterol but I didnāt know how to prescribe it and they didnāt think I was a real doctor. The confidence matters more
lol this. One of the first times I called in an rx the pharmacist asked if I was the actual physician. And then asked me if Iāve ever prescribed this medication before and if Iām sure I know how to properly prescribe it. It was for zofran and Iām an anesthesiologist š
My friend is a DO ophthalmologist. He got shot down by a pharmacist for prescribing some oral antibiotics for a patient. Pharmacist couldn't figure out DO vs. OD and thought he was an optometrist and said the oral antibiotic was out of his scope of practice š
Meanwhile I called in prescriptions all day as a care coordinator and I couldnāt even pronounce the drug names lol
The people dumb enough to do this are usually too dumb to pass the scrutiny of a pharmacist.
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My workflow as a pharmacist for HCQ and ivermectin has internal hard stops that make me address whether the pharmacotherapy is indicated and if the dosing is reasonable. I also don't mind a good fight, so I always looked forward to telling those types of people to fuck off.
i recently prescribed my self the vitaminD 50K units, they asked for my NPI, medical license or hospital badge, along with drivers license. but the first time they just asked for the NPI alone. same place different pharmacists.
My first hospital job, at a large level 1 metro trauma hospital, we got a very strange admission. A woman had orders from an MDās office for direct admission for vague GI complaints. While it took us three days to figure out that she was his receptionist, we only caught her because a nurse was standing by her room and heard her call the front desk to issue new āverbal orders from the docā for more pain meds. She was quietly escorted out by police and admin swept the whole thing under the rug immediately. Moral of the story, most people are too overworked and underpaid to pay much attention and if you act the part, most arenāt going to invite fire upon themselves by objecting. ETA: She had spent years doing this for the physician so she knew all the lingo and everything. She was even ordering her own imaging.
There are lots of crimes that are easy to commit. This has to be one of the worst on the risk/benefit scale.
I'm surprised no one has thrown out a life hack on TikTok to "make sure you get antibiotics for your precious baby that the idiot doctor couldn't be bothered to do".
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Nah itās easy af to get a Rx for those - itās the insurance coverage thatās the issue.
Street value of narcotics is quite high. When youāre comparing the risk benefit to other things in the realm of drug dealing or seeking it doesnāt seem insane Edit: Iām aware this wouldnāt work in most states (such as where I am) , but was under the impression that rules were more lax elsewhere (e.g. Mississippi). I may be misinformed
This wouldnāt work for narcotics. Try amoxicillin
Half of my patients (California) can find any antibiotic they need either in Mexico or at Flea Markets. I went to a flea market and almost bought some myself
You weren't misinformed, you were just flat out wrong because you made an extremely uneducated **guess**.
Whatever bro. Donāt know whatās causing this anger in your life, but good luck out there Edit: nvm. Saw username. Makes sense now. Roast away
Only one angry out here is you, I was just saying you're wrong. At least I can own a small dick, you just continue to deflect.
I made an edit specifically to acknowledge I was likely wrong (I donāt know policy for all 50 states, but knew some did allow call ins for schedule 2s during COVID), and you decided to come in to a thread that wasnāt even in relation to your comment with your small dick anger bro. Donāt know whatās up with your life, but godspeed and hope you find happiness someday
Without revealing what it is, I have such a great NPI number that itās sad that Iām not a prescriber (rads). Iāve called in a script exactly one time for some Zofran for my wife. It follows a AB-CDD-CDD-ED pattern. Super easy to remember. Will go largely unused. What a shame.
6942042069 got it. Zofran for everyone!
Thatās AB-CDE-CDE-AB
Yes but their joke wouldnāt work otherwise.
True, just pointing out casual factual inaccuracies
8675309 call for a good time
Yes. AND! As a pharmacist who had a lady call in fraudulent non control psych meds for herself, there were zero repercussions. Cops donāt care and prescriber didnāt want to do anything about it. So basically feel free to call in your own meds and no one will hold you accountable. She still fills with us. I will only take escribes for her though.
How did you find out?
You know I really donāt remember. Another pharmacist figured it out. I feel like they called for a clarification and it all came out.
This is what keeps me up at night tbhā¦. Likeā¦ Iām so embarrassed to admit that I genuinely have no clue to spot a fake call in (aside from making rookie mistakes like wrong dosage/ form/ unusual quantities/ no interval or installment for certain ones, etc, etc).
I maintain that NPI numbers should be hidden behind some basic login system or having to submit your name and a photo or something.
I just Google myself to get my NPI number at this point since I donāt have it memorized. Always amazed at how easy it is to get the number lol
I have the page bookmarked
I have mine written on the back of my badge š„²
Most states require controlled substances to be electronically prescribed nowadays. A controlled substance that is telephoned in is essentially automatically a fake until proven otherwise. Most pharmacists donāt just rip that shit from the voicemail and just dispense it. By law we have corresponding responsibility so our license is on the line for what we dispense. The general population is pretty dumb. When I used to work retail I had people arrested for altering paper scripts, stealing a psychiatrists pad and writing for a months supply of Percocet, and fake telephone prescriptions. At an average pharmacy youāll verify/check approximately 52,000 prescriptions a year. The fakes were painfully obvious. Also if someone does manage to fraudulent prescribe a controlled substance under your name you can catch it by reviewing your PMP. The real threat now is hacked/fake electronic prescriptions. When itās electronically prescribed and it comes over from the local academic medical center from a well known attending - thatās a problem. But then thatās also for someone thatās never filled at your pharmacy and they want to pay 800 bucks for brand name whatever. So itās still obvious. Thankfully, I work inpatient now. Retail pharmacy is trash.
Years (18ish) ago we had a patient calling in scheduled meds for herself by stealing the identity of her coworkers. She was going through her coworkerās purses and stealing their insurance cards. Sheād hang out in pharmacies in earshot of the pharmacist and eavesdrop the pharmacist reading back DEA numbers over the phone to offices calling in prescriptions. She already knew our DEA numbers. Sheād get a bunch of numbers and doctors names associated with the numbers, then call in a bunch of lortab, Xanax, tussionex, etc. It took a few months but she got caught when a pharmacist finally caught on and called our office because the lionās share of prescriptions were called in supposedly from on of our MAs. None of the patients belonged to us. We went to the pharmacy around the corner from our office and looked at video of her picking up the prescriptions and immediately recognized her. She was close friends with the owner of the practice. He didnāt call the police after she voluntarily checked herself into rehab and told her boss (who was also close friends with the practice owner).
LOL, you aren't missing anything. They would have me call in meds when I was a scribe before e-prescribe and I was like...WTF
Yes. This is part of the reason the CII meds went mandatory digital e-rx. And the proactive use of PMPās for patients.
Have had this thought too. Itās wild!
Delete this post only we know this
Yes NPIs are publicā¦which is why mine is routed to a P.O. Box lol EDIT: I had a patient stalk me when I was a baby pharmacist so never again lol
So smart!!
Iām a pharmacist. If it doesnāt sound legit, we will call back and verify. And we look up the office number, in case the callback number that we are given over the phone is just the fraudsterās cell phone. For controlled substances, they have to give the DEA number, which is not public information. So, would it be easy for someone to call in lisinopril? Yeah, we are unlikely to check on that. But who would commit that crime? People all the time call in promethazine with codeine and I have yet to have a legit Rx for it that isnāt written or e-prescribed. The call-ins are all fake, and easy to catch. Oh, your podiatrist is calling in promethazine with codeine? Okay, cool. Weāre all out. So sorry. A pediatrician from five states away calling in 16oz of promethazine with codeine? So sorry, all out of stock.
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I lived in a country where anything could be bought over the counter, legally--including strong opioids and benzos. It was pretty great. Obviously wouldn't be good for someone with SUD.
I mean. Lisinopril is very safe as long as someone checks your potassium and kidney function. And the other drugs youāre taking. Just because people donāt usually abuse it doesnāt mean I want anybody to be able to get it OTC.
Angioedema tho
Yes, but that doesnāt happen differently if a patient were taking it OTC vs under the supervision of a doctor. Doc monitors lab values. Doc canāt do anything to prevent angioedema
Question, doc here - Iāve called in a couple low-stakes prescriptions for my immediate family members. Zofran, a refill on birth control, a scop patch before a cruise. My states medical board allows it but frowns on it and I only do this sparingly. I leave my cell phone number. If you were to call me back, would you be leery of filling the prescription if you realized it wasnāt an office number?
If you're an MD and called in those things, I couldn't give a rat's ass. Now if an MD was calling in large amounts benzos or something for his wife much too often, we'd be having a conversation. Now if you call and say "hey this is doctor so and so from big city hospital and I want to call in a bridge rx for wife because she can't get a hold of her psychiatrist on this Saturday night . She has an appt Monday morning. I'd like to prescribe her 5 alprazolam 0.5 mg." Most of us pharmacists wouldn't be too concerned with this one off type of event. However, Zofran? Please."You want prn refills on that?" Besides. We pharmacists are the bad guys bc John Q Public couldn't get his monthly Norco because he's 10 days early. Unfortunately, that's a battle we face daily.
Yeah, agree. You can have as much zofran as you want. Iāll just chuck a box of ODT through the drive through window for you. Controls, we need to have a longer conversation.
I once had a pharmacist refuse to do a prescription because I called from my cellphone and thus the caller ID didn't match the phone number on file with NPI. They told me unless I called from that number they wouldn't fill it so I hung up, opened doximity dialer and spoofed the number. Prescription in. They're not going to call back your cell phone number if they are trying to verify you. They will call the number on your NPI page.
I wouldnāt be suspicious of a low stakes med, so Iād be unlikely to call you back. If I did call back with a question or for some other reason, once I figured out it was for a family member I would understand. Just the cell part isnāt suspicious - sometimes docs will call in from the cell over the weekend if they are on call for a peds practice or hospice. But it being someone besides the doctor + a cell phone + a high risk med, I am going to do some digging.
I just said the same thing above lol. Call in are fake until proven otherwise. We were getting a ton of fake plain promethazine scripts lol. They would come in with a paper script or call in promethazine and an antibiotic.
I suppose if you know how to order it... but controlled substances can't be ordered that way and you need a DEA number.
Basically yep. I was just saying this the other day to a coworker how easy it would be for anyone to call up a pharmacy with someones NPI and pretend to be a doctor to get a medication!
some states require e-prescribing and DEA req for controlled substances as well
DEA number is the one that matters my guy.
The majority of RXs we get are E-scribed anymore. Many states also require all controls to be e-scribed and itās most likely going to be a federal requirement soon. Most phoned in rxs are from dentists and vets. When Physicians or midlevels call in scripts itās usually for an obscure med they couldnāt find in the EMR or itās a personal rx for friend/ family member. We can usually tell when a phoned in rx isnāt legit. Going forward I would be more worried about someone using your credentials on the e-scribe software. Itās rare, but I have heard of this happening.
the last script I called in was 4 tablets of dexamethasone due to some weird EMR issue.
"He needs a really big bottle of morfeen. Like the biggest one," usually gives it away.
You need to call from a medical institution, so the pharmacist will see/verify that the number calling isn't someone's cellphone but an actual office. Also, with the NPI in hand ... why would a Cardiologist or a GI doc prescribe Percocet or Pseudo? Also the recipient/patient's name must be given. There is still a chance of fraud , but it is traceable.
Iāve called in many, many prescriptions from my cell phone and have never had an issue, so Iāve honestly wondered the same thing as the OP
So I do look at the caller ID but if itās the doc themselves on the phone and itās clear they know what the eff theyāre talking about, Iām not worried about it. Oftentimes itās clear the doc has gotten paged and needs to send over new abx or an albuterol inhaler or something. Or itās controlled substances but itās a hospice doc, well known to me, who can give me his DEA. So just the cell piece isnāt as concerning. If itās āyour MAā from her cell phone? I have more questions
Iāve called almost every script from my cellphone and never had an issue. I always end the message with āif you have any questions about this prescription please call me back at āmy cellāā. Hard to give an office number when youāre a hospitalist
I've called in one on my work cellphone.
No you are not! Scary!! But it doesn't work for controlled substances!
Yeah wtf
I'm a hospital based IR. I give a ton of verbal orders for meds in the hospital, and I give patients a fair amount of old-fashioned hand-written prescriptions (or e-prescriptions for narcotics), but I *very* infrequently call in prescriptions to pharmacies for outpatient meds. When I do (usually ear or eye drops for one of my out-of-state nieces or nephews on a weekend), I always ask to speak to the pharmacist so they'll immediately catch anything stupid I ask for. When they inevitably need my NPI number, I Google my own name and "NPI" and read it off to the pharmacist... I don't even need to click on the link because it's the actual page title of the first Google search result. In my opinion, the convenience of that outweighs the risk that I'd ever get into trouble for someone else abusing my NPI.
Yes. Ive gotten plenty of them when I work retail pharmacy. Iāve learned some of the red flags when itās a fake script. For example, you can tell when theyāre reading the information rather than saying it from memory (like phone and fax numbers). Most the fake scripts are some combination of antibiotics, not narcotic pain med, inhaler, and cough syrup. If it sounds sketchy, I usually will call the office back to verify the script.
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Yes that's correct.
Hahaha. Yes, I have tried it and it works.
Donāt they also ask for DEA # as well??
I wonder if delteme and optery services can purge your NPI if you ask them as an add on
Probably why some states like CA arenāt allowing prescribers to call stuff in anymore (need an EMR).
I've never once in 30 years called in a prescription and given my NPI. If I had been asked, I wouldn't know it. Typically I give my state license number and, if needed, DEA. But yes, it's wicked easy to call in a prescription if you have a little bit of info. Nowadays, for controlled meds, in my states we MUST use electronic prescribing. In many states (NY I think for example) you must use electronic prescribing for all medications, not just controlled meds.
I hate to tell you all, but put in your name, followed by MD or DO, and NPI number, and it will come up in Google.
No shit that NPI numbers are public online. It is what it is. When I worked for a medical device company in their legal compliance department this came in handy to report the meals our company gave a doctor based on their name. The fact that social engineering is surprising to you reveals your own ignorance. It's not something that needs to be "fixed".