Physicians have enough to do diagnosing and treating illnesses. Authorizing refills of medications, especially controlled substances, adds yet another unnecessary burden to other non-medical tasks like prior authorizations and completion of a seemingly endless variety of forms.
Physicians feel they must balance concerns about such non-medical problems as substance abuse and diversion against the very real risk that the patient will run out of (or lose) a critical medication, juggling refills around office closures on weekends and holidays, and even weather and natural disasters. When patients realize they might not get their refill before they run out, they adopt strategies to assure uninterrupted supply, such as accumulating a reserve. Physicians get annoyed when patients request refills early or claim to have lost their meds. When they prescribe controlled substances, many physicians even order drug tests to convince themselves that the patient has actually been taking the drug, and has not been taking other drugs.
All of this tends to generate feelings of resentment between patient and physician and perpetuates the illusion that physicians can and should control patient behavior.
Unlike physician offices, pharmacies often stay open on weekends and even holidays. Some stay open 24 hours a day. Pharmacists, already trained to count pills, could more easily keep track of refill status. Pharmacies could easily provide drug testing.
Physicians could remain in charge of determining which medication a patient should take, and could issue a stop order to the pharmacy as indicated.
We have a shortage of physicians. By shifting refill duty to pharmacists we could make better use of this precious resource.