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My husband's neurologist took over a week to reply to my Depakote refill request. I had to call the office to talk to a live person. She emailed the Dr. and after 2 hours, I got a notification from the pharmacy that the prescription order was received. Then another hour later, I got a message via the myhealth portal that the neurologist has spoken to and is passing the management of Depakote going forward to the primary care physician, who has had no prior experience with Depakote. Although she agreed, which may not be such a bad thing, I'm just wondering why this occurred. Neuro cited reason was for the better management of my husband's sodium level, which has been low for quite some time now even prior to taking Depakote. Shouldn't this be managed in tandem by the 2 doctors and monitored as we have been for the past year and a half? I couldn't help but wonder the real reason, especially with such a long delay in the refill request...

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Think of your primary care physician or primary care manager as a conductor of a symphony. The symphony consists of all your other doctors. It is incumbent on your primary to know the totality of your care so that he or she is better able to coordinate your healthcare. Also, the cost to insurance is less for primary care than for specialist care; so, visits or rx or test ordering with primary is more easily approved by insurance for visits, rx refills, testing.
Hope this bigger picture helps.
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Reply to Lolly56
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Yes, it actually is pretty common. A lot of neurologists will stabilize someone on a med like Depakote and then hand the long-term prescribing and monitoring back to the primary care doc. They do it because PCPs usually keep a closer eye on the labs, overall health, and day-to-day stuff like sodium levels. The neuro can still be consulted if things get complicated, but the routine refills and labs often end up with the PCP.

I get why it feels odd though, especially after you’ve had the neuro handling it for so long. If you’re uneasy, you can always ask that both doctors stay in the loop and share notes. Sometimes it’s more about office workflow than anything else — long waits for refills can just be a system issue, not a personal decision
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Reply to TenderStrength5
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SOS369 Sep 10, 2025
Thanks. I read the phone call notes and it is as you said. Neuro stated that DH has been stable on depakote, so he handed over the management due to ongoing monitoring of sodium level would be better handled by PCP.
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I don't think it's all that unusual. In Nursing Homes, etc, it's expected that all medications are managed by the Physician's Group contracted by that facility. Boodwork orders come in from a Cardiologist visit, but the NH fills out the lab slip with the ordering physician being the NH's physician (at least in the places where I work). Managed by two physicians? That do not practice together? That's a recipe for crossed wires. Too many cooks in the kitchen sort of thing. The long delay is probably why the neuro gave it over to the PCP. Would you rather the neuro keep the it and there be constant delays? Or hand it over to the PCP who is probably very capable and there be no delays? The neuro is also not someone that your husband will see as regularly as the PCP. If you run into an issue involving the meds and your husband needs a visit to get it squared away, it could be a few to several months out to get an open appointment for the neuro. I'm just guessing here, but I don't really see an issue with it. The PCP is not dumb. They can read, get advice, do what they do, and figure it out. They can also call the Neuro for guidance and get a response faster than you can.
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Reply to mommabeans
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