When Pharmacies Fail: A Doctor and Patient's Perspective on a Broken System

As a licensed physician and someone who relies on insulin every single day to stay alive, I never imagined that the greatest threat to my health wouldn’t be my diagnosis—but the system that’s supposed to help me manage it.

For the second time in just a few months, I have found myself fighting tooth and nail to access the medications that keep me alive. These are not optional. Insulin is required at every meal. My continuous glucose monitor (CGM) is required to ensure I don’t slip into a deadly low while I sleep. And yet, delays, miscommunications, and outright neglect continue to stand in the way of timely access to care.

This month, after a perfectly routine visit with my doctor, prescriptions for insulin and my CGM were sent—accurately and on time—to my local pharmacy. Over two weeks later, those medications have not been filled. I received auto-messages for routine prescriptions like pen needles and albuterol, but no word about the life-saving items. I called the pharmacy at 2 p.m. I got a text saying they received my message and would call me back within an hour. They never did. It’s now the next day. Still nothing.

This isn’t about a one-off error. I’ve escalated this before. After a previous review I posted online, I was contacted by a regional manager who seemed genuinely eager to help. And still, here I am again—staring at automated messages and a silent phone line, with no insulin, no CGM, and no information.

I’ve worked with countless patients who’ve faced similar struggles. As a physician, I’m expected to advocate, to intervene, and to solve problems. But what happens when even I, someone with training, credentials, and insider knowledge, can’t get a callback from a pharmacy? What happens to the patient who doesn’t know what questions to ask? Who doesn’t understand their coverage? Who assumes, wrongly, that the system is working?

Let me be crystal clear: this is a systems failure. It is not a matter of one pharmacist or one bad day. It is a predictable, repeatable harm, born of understaffing, poor communication systems, and the consequences of corporatized care. And the cost of that failure isn’t just frustration. It’s human life.

To illustrate how widespread these challenges have become, I recently had a patient on Medicaid who required a Dexcom G7 continuous glucose monitor. This device wasn’t a preference—it was a requirement, because it was the only CGM compatible with their insulin pump. Despite a timely and accurate prescription, the pharmacy failed to provide the CGM. Days passed. The patient returned to my office, discouraged and confused, thinking the issue was with their coverage. But there was no communication, no guidance, and no solution offered.

When I called the pharmacy myself, I was told that although the patient is covered by Medicaid, the prescription was being routed through Medicare Part B, which the pharmacy could not process. Why? Because they had lost their credentialing—allegedly due to corporate restructuring following a merger and financial fallout.

This made a routine prescription essentially impossible to fill—until I personally called the patient’s insurance, verified benefits, and sent the prescription to a pharmacy across the street. It was filled without issue. But it took all that effort from a physician—something most doctors simply don’t have the capacity to do.

Another case that continues to trouble me involves a young patient who came in with swelling of the face. While the swelling had resolved enough not to warrant emergency intervention, it was imperative that they have access to an epinephrine auto-injector in case the reaction progressed. I prescribed a generic EpiPen, thinking this would be the most likely option to be covered and readily available.

The patient was turned away. According to them, the pharmacy simply said it wasn’t covered—no price offered, no alternatives discussed. Weeks later, during follow-up, I learned they still didn’t have the medication. When I called the pharmacy, I was told they hadn’t carried that particular generic brand for over two years. Their system continued to try to order it daily, failing repeatedly, until the issue escalated internally—at which point it appears the pharmacist simply let the matter drop.

I had marked the prescription for substitutions allowed. Any brand of epinephrine would have been acceptable. Instead of reaching out for clarification, they did nothing. I had to make a forceful phone call and demand they get this done—immediately. It took nearly three weeks for that patient to receive a life-saving medication that should have been available that same day.

This is not what any of us go into medicine to experience. I don’t want to yell at pharmacists. I don’t want to threaten action. But how else do we make sure patients are safe? How else do we hold systems accountable when there’s no acknowledgment of responsibility, no sense of urgency, and no apology?

These are not isolated incidents. I’ve seen countless variations: a patient confused by a change in pill color, thinking it’s the wrong drug. A pharmacy making substitutions without explaining them to elderly patients. A physician office being blamed via templated letters from insurers that obscure the truth.

We are failing the most vulnerable at every step.

Pharmacies exist to fill prescriptions accurately, quickly, and safely. If a problem arises, doctors must be contacted in a timely and respectful manner. That is the basic standard of care. And yet, it is no longer the norm.

I want to be clear: my goal here isn’t just to criticize. I’m not writing this out of bitterness—I’m writing it because I still believe collaboration is possible. In fact, I need collaboration.

I’ve seen what’s possible when a pharmacist is engaged, curious, and committed to patient safety. I remember calling a pharmacist early in my training about a complex case involving dozens of supplements and medications. They didn’t brush me off—they dove in. They helped me think through every risk and helped me protect that patient. That is what we should all be striving for.

And so I ask: where are the pharmacists who are just as upset? Where are the protests? The walkouts? Are they happening and I’m not seeing them? Or have we all been so overwhelmed by the system that we no longer believe change is possible?

I believe it still is. I believe pharmacists, physicians, PAs, NPs, counselors, and every healthcare professional have something essential to offer—and that when we actually work together, we can save lives. But that collaboration is being stripped from us by bureaucracy, by corporate dysfunction, and by silence. We need it back.

I will not stop speaking out. Not just for myself, but for every patient who doesn’t have the strength, the language, or the position to fight back. Access to medication is a human right—not a privilege to be negotiated with algorithms and voicemails.

Until this is fixed, I will keep documenting, keep advocating, and keep pushing for a system that puts patients—not profits—first.

If you’ve experienced something similar and want to take action, I’ll be sharing ways to report pharmacy misconduct and advocate for yourself in a follow-up post.

—Dr. Jason FauntLeRoy, ND