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Forced voicemail and diagnosis codes are endangering patient access to medications

Arthur Lazarus, MD, MBA
Meds
July 8, 2025
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I won’t be using CVS pharmacies anymore. Sure, I may still need to send prescriptions their way as a physician—but as a consumer, I’m done.

Why?

CVS has recently implemented a new phone system that forces callers to leave a voicemail instead of waiting on hold. The idea is to streamline operations, letting pharmacy staff return calls when they have time. It’s supposed to manage call volume, reduce wait times, and shield staff from verbal abuse during peak hours. On paper, it sounds efficient. In practice, it’s alienating and frustrating.

Voicemail system: When you call to speak to a pharmacist or tech, you’re routed to voicemail. No human option. No option to wait.

Call backs: Staff return your message when they can—maybe within an hour, as promised, maybe not.

Justification: CVS claims this improves workflow and customer experience.

Reality: It’s yet another example of patient convenience being sacrificed for corporate efficiency.

For many, especially older adults or those with urgent medication needs, this impersonal system can be a barrier to care. I didn’t consent to become part of an asynchronous call center experiment every time I need to ask about my medication.

But that’s not all. CVS has also quietly implemented another policy: All prescriptions for controlled substances—including refills—must now include a diagnosis code. If the code is missing, the prescription is delayed or denied. This includes essential medications like opioids for pain, stimulants for ADHD, and benzodiazepines for anxiety or seizure disorders.

Allegedly, this is to prevent fraud and promote safety. In reality, it’s more about protecting CVS from regulatory scrutiny than protecting patients from harm.

If a diagnosis code is missing, patients are told to contact their doctors. CVS staff might message your doctor for you—but then again, they may not. And so, medications are withheld. Patients run out. And the consequences can be dangerous.

Benzodiazepine withdrawal, for instance, isn’t just uncomfortable—it can be life-threatening, with risks of delirium, seizures, psychosis, and cardiovascular instability.

When I raised this concern with a pharmacist, asking hypothetically whether he’d at least dispense an emergency supply of benzodiazepines, he replied:

“Not without a diagnosis code.”

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“Patients can have life-threatening withdrawal,” I said.

“Not my problem,” he shrugged. “They’ll have to go to the emergency room.”

That’s not just indifference. It’s institutional cruelty hiding behind the mask of policy.

Let’s be clear: Our health care system is in crisis. ERs are overcrowded, mental health care is under-resourced, and primary care physicians are already drowning in paperwork. And yet here we are—forcing patients to chase down diagnosis codes to access medications they’ve taken for years. And for what? To protect corporations from liability?

Yes, the opioid epidemic is real. But this crackdown disproportionately harms patients with legitimate medical needs—people with cancer pain, chronic illnesses, anxiety, ADHD, or PTSD. Instead of nuance, we get blunt policy instruments that punish the vulnerable.

I remember when CVS entered the pharmacy business in 1967, adding prescription services to its health and beauty offerings. It stood for Consumer Value Store, and its mission was to “help people on their path to better health.”

What happened?

Today, CVS feels more like a Corporate Veto System than a health care partner. A place where operational expediency and liability protection trump compassion and access.

As a physician and as a consumer, I find these policies unacceptable. And while I may still have to interact with CVS professionally, I’ll be filling my own prescriptions elsewhere.

To the independent, community pharmacies still out there: I see you. And I hope others do too.

We need a system that puts patients first—not policies.

Arthur Lazarus is a former Doximity Fellow, a member of the editorial board of the American Association for Physician Leadership, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia, PA. He is the author of several books on narrative medicine, including Narrative Medicine: New and Selected Essays, and Narrative Rx: A Quick Guide to Narrative Medicine for Students, Residents, and Attendings, available as a free download.

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