Express Weight Loss Clinic : Surgical & Medical Aesthetics

The following is the ACTUAL email from the patient:
From: shira Craig
Sent: Sunday, October 27, 2019 5:15 AM
To: Lauren Holley, COO
Subject: IMPORTANT!

Hello,
I came into the clinic yesterday. The lady with the hurt foot seen me (Kimberly). First off if I pay my money for a certain service thats what I expect to get. It's one thing to say your going down to the 30mg cause you feel that would work better which I believe is Bt. I wasn't taking it daily and doing everything I was suppose to thats why I didn't loose much. Plus it was over a week since I took the fluid (water) pill. But here I am about to go to work and start my dose and she gave me 12.5 hydrochlorothiazide. We never talked about going down on that I would have never agreed to that because poor circulation runs in my family and my regular doctor always prescribe I believe it's 25mg or 30. I can drop this medicine off to the clinic. But I want my regular doses back. Even if I have to take this 30mg phentermine which I don't want because my body have already gotten used to the 37.5. I need my water pill to be back at what it was. I shouldn't have to pay my primary to call it in, if I came to your company and paid yall 45. My number is 9032163168. I need someone to call me.Emailing me works better cause I work at Azalea orthopedics and I can't have my phone at baylor scott and white emergency side. BUT I NEED THIS FIXED ASAP.

Our Response:
Dr. Nguyen states, "I don't care for her tone, but I will call her. I will fix it. Call in HCTZ 25mg and Phentermine 37.5mg under my orders."

Prescriptions subsequently electronically sent to the pharmacy of patient's choice:

hydroCHLOROthiazide 25 mg oral tablet
1 Tablet(s) 1 time a day for 30 days (0 refills)
Current 10/31/2019
e-Sent:Oct 31 2019 1:05PM CT Majors Pharmacy
Sent/Verified

phentermine 37.5 mg oral tablet
1 Tablet(s) once a day (in the morning) for 30 days (0 refills)
Current 10/31/2019
e-Sent:Oct 31 2019 1:06PM CT Majors Pharmacy
Sent/Verified

Notified patient via phone that new prescriptions have been called in, but that unwanted controlled substances must be surrendered first (Phentermine), as the DEA closely monitors all dispensing of controlled substance medications.

Patient appeared at the clinic to surrender the Phentermine. Patient wanted a refund for the Phentermine, for which she stated she was AWARE that the prescriber was lowering her dose. The patient chose to pick up the medication at the pharmacy and pay for it regardless of her knowledge that it was not what she desired. Patient stated, "Well yes, she discussed bumping me down to the 30mg but she NEVER discussed the water pill with me. But you know what, just give me back the medication and give me your manager's email."

I (clinic manager), indicated to staff to refund the patient's clinic visit entirely.

We cannot; however, legally associate with pharmacies in any way. Legal guidelines and restrictions absolutely prevent clinicians from working with pharmacies in any financial or contractual manner whatsoever. Therefore, the CLINIC cannot refund the patient for PHARMACY purchases, as this would be monitored and viewed by the State Board and DEA, possibly resulting in loss of licensure (livelihood), and legal fines to the clinic as an act of clinic/pharmacy relations.

The clinic did; however, offer to refund the patient for her clinic visit, despite the time an effort devoted to caring for the patient (creating a monetary loss for the clinic). Patient left after terse verbal communication to the staff in front of other waiting patients, because the patient wanted a refund for a medication that she chose to pay for, even though she knew she did not want it (the phentermine).

In an effort to relive the patient for the monetary burden of purchasing a lower dose of HCTZ ($5 per the pharmacist), the clinic offered to refund the CLINIC fee, which overly compensates the monetary value of the HCTZ prescription loss.

Another bit of information to keep in mind: We are a clinic, not a fast-food restaurant. Prescriptions are prescribed by clinicians based on years of medical training, knowledge, and experience. If patient's do not receive "what they want" at any other medical facility, such as a primary care physician, an emergency room, or an endocrinologist, this type of patient behavior would result in prompt dismissal of the patient from the practice, without refund, much less would monetary support be offered for services provided by an outside facility (the pharmacy).

Legally, records for controlled substances cannot be deleted for 7 years per Federal and State Guidelines.

If patient has not returned for the refund, the clinic is still able and willing to refund the patient for the clinic visit. Unfortunately refunds cannot be offered electronically, as payment records are not kept for patient privacy purposes.