It was a dark and stormy night.
OK, it was a warm and sunny afternoon. But Halloween was approaching. Strange things happen. Plus, the patient’s name was Ichabod ...
OK, his name was Jerry. Jerry came to Boston from Chula Taco, Calif., to study at CIT, the famed Boston Chipotle Institute of Technology. He’d finished 4 months of isotretinoin and needed one more.
I asked him to call iPledge to request a transfer to me. He called back later to say thatThis seemed odd, since his pills had only run out 3 days before.
Having confirmed his name, address, telephone number, and the last four digits of his social security number, I tried enrolling him on iPledge at 5:30 p.m. (Cue: thunder and lightning), expecting to get a request for an override code. Instead the screen just asked for his iPledge number (you have to use the old one, you know). I called iPledge (my favorite pastime), identified myself by the usual means (Full name. iPledge ID number. Date of personal significance. Office telephone. Thank you. How can I help you?).
I explained my dilemma. The representative asked that I verify Jerry’s identity. I gave her his name, date of birth, and the last four of his social.
“We have his name and date of birth,” she said, “but the social security digits don’t match.” She asked for his phone number, but his Boston number didn’t match what she had. “Do you have his address?” she asked. I did not, since he’d given me his Boston address, not his California one.
I left her on hold and called Jerry on my cell. He confirmed that the social security digits he’d given me were correct. He gave me his mother’s cell phone number, but that also turned out not to be what iPledge had on file.
“What other identifying information can I give you?” I asked the iPledge rep. “How about his home address?” she said. Back to my cell: “Jerry, what’s your home address?” “It’s 2470 Chalupa Drive, Chula Taco, California 9090909-090909,” he said.
I repeated that to the iPledge representative. “Please hold a moment,” she said.
She was back. “The street address is correct,” she said, “The ZIP is correct. But the town is wrong.”
The town is wrong? If Jerry didn’t know either the last four of his social or his town, how did he get Amazon deliveries? Was this identity theft by an Accutane seeker? Maybe Jerry was really a Russian spy with dry lips posing as an acne patient! (Cue: screeches, howls, more thunder.)
“Can you tell me which town you have listed for him?” I asked iPledge.
“No,” she said, “because you haven’t identified him properly yet,” (emphasis added).
Back to the cell: “Jerry, are you sure you know what town you live in?” He insisted he did. (But then, so would a spy, wouldn’t he?)
In near despair, I returned to the iPledge rep. “I really want to get this patient his medication, “I said. “And I really want to go home. Can you help either of us?”
“Let me get my supervisor,” she said. “This may take a few minutes.” I hung up on Jerry and, in a blaze of multitasking, filled out three Prior Authorization forms for clindamycin gel.
“I found your patient,” said the rep, returning at last. “Not only that, I was able to reregister him in the iPledge program. Want to know his iPledge number?
“Now that he’s registered,” I said, “could you give me the name of the town you have him listed as living in on Chalupa Drive?”
“Sure,” she said, “We have him in Rancho Carmen Miranda. Can help you with anything else today?”
“No, thanks ...”
“Would you be willing to take a 2-minute survey ...?”
“No, but thank you very much!” I said, hanging up in triumph. (Cue: sunshine, violins.)
Back to the cell: “Jerry, you’re in! Here’s your iPledge number.”
“By the way, Jerry, iPledge has you living in the town of Rancho Carmen Miranda. Do you live there?”
“No,” said Jerry. “I don’t.”
“Well, Jerry, for 1 more month, for federal purposes, you do!”
I’m sure there’s a good explanation for all this. I just don’t want to know it. Just pass the candy corn.
Dr. Rockoff practices dermatology in Brookline, Mass., and is a longtime contributor to Dermatology News. He serves on the clinical faculty at Tufts University, Boston, and has taught senior medical students and other trainees for 30 years. His second book, “Act Like a Doctor, Think Like a Patient,” is available at amazon.com and barnesandnoble.com. Write to him at.