HIGHLY IMPORTANT- Allowing physicians to dispense!!!

[pharmstud]

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From TSHP:
In State of Texas!

Call to Action! As reported, SB 546, the bill which would change state law and allow physicians to begin dispensing drugs from their offices and charging for it, has passed the Senate, and is now on "fast track" in the House of Representatives.

A meeting on the bill is scheduled for the House Public Health Committee this Wednesday – May 18 – beginning at 8:00 AM in Capitol Extension room E2.012.
Please contact your State Representative immediately and state your strong opposition to this unnecessary and unsafe legislation. You can find your representative's name online.

To find your representative's e-mail address, click the link on this search page. A copy of the letter that all Texas pharmacy organizations sent to members of the Senate is on the TSHP website and you can use it to supplement your own reasons to oppose the bill.

The most critical people to contact IMMEDIATELY are members of the House Public Health Committee:

Chair: Rep. Lois W. Kolkhorst
Vice Chair: Rep. Elliott Naishtat
Members: Rep. Carol Alvarado
Rep. Garnet Coleman
Rep. Sarah Davis
Rep. Veronica Gonzales
Rep. Susan King
Rep. Jodie Laubenberg
Rep. Charles Schwertner (MD)
Rep. Vicki Truitt
Rep. John Zerwas (MD)


Don't put this off! It is too important to our profession and our patients.

 

[confettiflyer]

it would have been nice to have the name of the state somewhere up top and not buried within the post.

 

[UES Girl]

it would have been nice to have the name of the state somewhere up top and not buried within the post.

This is in Texas ? I am not suprised.

 

[owlegrad]

This is in Texas ? I am not suprised.

Oh Snap!

 

[PharmaTope]

my dermatologist sells the prescriptions right out of their practice. how is this any different?

 

[pharmstud]

it would have been nice to have the name of the state somewhere up top and not buried within the post.

Texas

 

[lauradiddle]

Bill Text: http://www.mygov365.com/legislation/view/id/4d54f2a749e51b337d621b00/tab/versions/

 

[johnep34]

In the UK, Doctors can dispense for their pts if the pt lives more than a certain distance from a pharmacy. Out dated in this age of the car and many surgeries (Drs offices) are very near to pharmacies.

With the tendency for groups of Drs to be in the same building, a pharmacy on the ground floor becomes a highly profitable proposition and, with the removal of the law preventing Drs from owning pharmacies, many Drs are opening pharmacies. If these are open for 100 hours a week, no restrictions on opening.

There was a ruling many years ago that a Dispensing Dr did not need to employ a pharmacist or directly supervise his staff.

So fight with all your might.
johnep

 

[MountainPharmD]

I do not see the big deal here. If I am reading it correctly it applies to Doctors who practice in remote localities without a Pharmacy close by. The bill also says a Doctor cannot dispense controlled substances. That takes some of the highest profit margin drugs out of the equation. I cannnot see a Doctor stocking a bunch of medications you can get for $4 at Wal-Mart.

Kansas Pharmacy Law allows Physicians to dispense medications out of the office. It has been there forever and I know of no significant impact it has made.

It would be far more threatening if they were allowing Doctors to own Pharmacies. Then I would get excited because that would be a game changer.

 

[Doctor M]

I do not see the big deal here. Do you really see alot of Doctors doing this? The bill says a Doctor cannot dispense controlled substances. That takes some of the highest profit margin drugs out of the equation. I cannnot see a Doctor stocking a bunch of medications you can get for $4 at Wal-Mart.

Kansas Pharmacy Law allows Physicians to dispense medications out of the office. It has been there forever and I know of no significant impact it has made.

It would be far more threatening if they were allowing Doctors to own Pharmacies. Then I would get excited because that would be a game changer.

I agree. Since controls are not involved, the high profit drugs still go to the pharmacy. Perhaps the docs would try to stock up on brand name drugs that the drugs reps are pushing, and that would be fine with me. Let them dispense all the low profit high cost drugs. I will dispense the high profit, low cost generics 🙂

 

[pharmstud]

I agree. Since controls are not involved, the high profit drugs still go to the pharmacy. Perhaps the docs would try to stock up on brand name drugs that the drugs reps are pushing, and that would be fine with me. Let them dispense all the low profit high cost drugs. I will dispense the high profit, low cost generics 🙂

That's true. But that is considered a first step, then they would want to dispense controls and so on!
It creates conflict of interests and basically takes away our job!

 

[rxlea]

If this was happening in AZ, I would just try to enter into a collaborative practice agreement with a doc or a group practice and open a pharmacy downstairs. They would see patients and I would manage their meds for chronic illnesses. That would take their headache away of OK-ing refills, calling in scripts/refills, getting calls from pharmacy to change meds because of insurance issues, etc. They wouldn't have to pay me either because I would own the pharmacy. I would probably try to do some consulting on the side as well and being networked with some docs could send business my way. By having an independent, I might also be able to drive people into those docs, too. Who doesn't want their health care + meds all in one place?

Maybe I am just an idealist and as a rising 2nd year, I probably don't know that much. What I do know is that the pharmacists in Tucson who prescribe/are in collaborative practice agreements and/or own their pharmacies are making BANK. It's the networking!!!!!

 

[MountainPharmD]

That's true. But that is considered a first step, then they would want to dispense controls and so on!
It creates conflict of interests and basically takes away our job!

Are there really any Doctors who want to dispense medications as well as practice medicine? I don't think there are to many.

If you read the bill it specifically addresses Doctors practicing in remote localities without a Pharmacy. Unless I missed something this does not cover that many Doctors.

Most Docs are stressed enough trying to see a patient every 15 minutes in order to make any money. I doubt many would want or welcome the added hassle and responsibility of dispensing medications.

 

[MountainPharmD]

If this was happening in AZ, I would just try to enter into a collaborative practice agreement with a doc or a group practice and open a pharmacy downstairs. They would see patients and I would manage their meds for chronic illnesses. That would take their headache away of OK-ing refills, calling in scripts/refills, getting calls from pharmacy to change meds because of insurance issues, etc. They wouldn't have to pay me either because I would own the pharmacy. I would probably try to do some consulting on the side as well and being networked with some docs could send business my way. By having an independent, I might also be able to drive people into those docs, too. Who doesn't want their health care + meds all in one place?

Maybe I am just an idealist and as a rising 2nd year, I probably don't know that much. What I do know is that the pharmacists in Tucson who prescribe/are in collaborative practice agreements and/or own their pharmacies are making BANK. It's the networking!!!!!

This mirrors the collaberative system the Veterans Affairs employees. You see the nurse, then the Doctor, then the Pharmacist, then pick up your meds and head home. Honestly it is probably the only thing that will save the profession. I do not think we will ever 100% get away from dispensing. However combining dispensing with a collaborative practice aggrement would not be so bad.

 

[DYSF777]

If this was happening in AZ, I would just try to enter into a collaborative practice agreement with a doc or a group practice and open a pharmacy downstairs. They would see patients and I would manage their meds for chronic illnesses. That would take their headache away of OK-ing refills, calling in scripts/refills, getting calls from pharmacy to change meds because of insurance issues, etc. They wouldn't have to pay me either because I would own the pharmacy. I would probably try to do some consulting on the side as well and being networked with some docs could send business my way. By having an independent, I might also be able to drive people into those docs, too. Who doesn't want their health care + meds all in one place?

Maybe I am just an idealist and as a rising 2nd year, I probably don't know that much. What I do know is that the pharmacists in Tucson who prescribe/are in collaborative practice agreements and/or own their pharmacies are making BANK. It's the networking!!!!!

The bill is to allow physicians to dispense medication for profit. The whole point is that they wouldn't need a pharmacist to run their own mini pharmacy.

 

[MountainPharmD]

The bill is to allow physicians to dispense medication for profit. The whole point is that they wouldn't need a pharmacist to run their own mini pharmacy.

Someone else skim the bill and see if you read the same thing I did. This does not allow every single Doctor a free pass to dispense medications. It only allows Doctors in certain under served communities to dispense medications and be excemt from being licensed as a Pharmacy.

 

[karizma098]

they are already doing this in illinois/indiana, it doesn't mean your doctor is going to be dispensing HIV meds or compounding medication, it's for basic meds.

There is no need for a patient to go to the pharmacy or shop around at multiple pharmacies to pick up something as simple as a zpak, antibiotic, cough medication, or other basic medication. it decreases compliance and increases cost to the patient. most family practice clinics in illinois are already starting to dispense and sell the medication to the patient, and they charge less than the pharmacy does, docs arent making money on this, it's simply to improve compliance for simple pathologies.

 

[DYSF777]

Are there really any Doctors who want to dispense medications as well as practice medicine? I don't think there are to many.

If you read the bill it specifically addresses Doctors practicing in remote localities without a Pharmacy. Unless I missed something this does not cover that many Doctors.

Most Docs are stressed enough trying to see a patient every 15 minutes in order to make any money. I doubt many would want or welcome the added hassle and responsibility of dispensing medications.

I think there are plenty of family physicians that would like to dispense medication. They could probably cut the patients they see in a day in half and still make a profit from the prescriptions that they sell.

 

[karizma098]

I think there are plenty of family physicians that would like to dispense medication. They could probably cut the patients they see in a day in half and still make a profit from the prescriptions that they sell.

wrong. doctors that sell drugs rarely make much profit on it, if any at all. if they want to make money they can start giving botox shots and freezing warts.

 

[DYSF777]

It only allows Doctors in certain under served communities to dispense medications and be excemt from being licensed as a Pharmacy.

You would be incorrect. Currently, physicians are allowed to dispense medications but only in rural counties and not for profit.

 

[DYSF777]

wrong. doctors that sell drugs rarely make much profit on it, if any at all. if they want to make money they can start giving botox shots and freezing warts.

opinion.

 

[karizma098]

opinion.

No. Fact. I just finished 3 months in a family practice office in Illinois. Freezing Warts + Botox pays hundreds of dollars for 15 minutes of work. Botox is typically cash as well so no insurance BS to deal with.

A physical exam or diabetes check consult will pay 30-50 bucks for 15 -20 minutes, and requires follow up and lab work.

The profit margin on antibiotic medication after adding in overhead and an extra staff member to monitor and dispense medication is <5 %.

 

[MountainPharmD]

No. Fact. I just finished 3 months in a family practice office in Illinois. Freezing Warts + Botox pays hundreds of dollars for 15 minutes of work. Botox is typically cash as well so no insurance BS to deal with.

A physical exam or diabetes check consult will pay 30-50 bucks for 15 -20 minutes, and requires follow up and lab work.

The profit margin on antibiotic medication after adding in overhead and an extra staff member to monitor and dispense medication is <5 %.

Fact. Thanks.

 

[MountainPharmD]

You would be incorrect. Currently, physicians are allowed to dispense medications but only in rural counties and not for profit.

Copy and paste the lanuage in the bill that changes that. I saw the part where they could charge a resonable amount and I also the part that limited it to Doctors in under served areas with out a pharmacy near by.

 

[Old Timer]

There are companies that supply the drugs and the software. They stock the machines & everything. Amoxicillin 500 in bottles of 30, etc. They are not going to carry a million dollar inventory like a pharmacy. The machine has about 30-50 drugs.

MD Scripts

Doctor Dispense

Google is your friend

 

[Its Z]

Nothing new. We were talking about this same chit 20 years ago......small margin for pharmacy also means small margin for all......docs ain't going to get rich practicing pharmacy..... demise of pharmacy isn't going to be physician dispensing.

Trust me on this one.

 

[Jabberwocky12]

Google is your friend

Here, maybe this is better for you Old Timer. I thought of this immediately.

Google is your friend

 

[DYSF777]

Copy and paste the lanuage in the bill that changes that. I saw the part where they could charge a resonable amount and I also the part that limited it to Doctors in under served areas with out a pharmacy near by.

I think you might be right. I just finished reading the engrossed version of the bill which has the subsection that you mentioned. I was reading the senate committee report and it didn't include this stipulation.

Either way, I'm torn on what I think about this bill. I understand that it could help improve patient compliance but also think that there could be a conflict of interest when you add the opportunity to earn a profit.

 

[GreyFox2002]

No. Fact. I just finished 3 months in a family practice office in Illinois. Freezing Warts + Botox pays hundreds of dollars for 15 minutes of work. Botox is typically cash as well so no insurance BS to deal with.

A physical exam or diabetes check consult will pay 30-50 bucks for 15 -20 minutes, and requires follow up and lab work.

The profit margin on antibiotic medication after adding in overhead and an extra staff member to monitor and dispense medication is <5 %.

You need to be a little more careful before describing your single family practice experience as "fact." A simple google search for "physician dispensing" will reveal a plethora of physician dispensing programs that are advertised to promote substantially for-profit dispensing for physicians. Some of these programs even advocate charging a higher price at the office then at the pharmacy for generics, stating that the added convenience for the patient is worth the extra money for them. Some of these programs even offer third party billing.

Not saying your completely wrong, but to say this does not provide decent profit for physicians is misleading.

 

[Got Em]

This bill is now DEAD in the house. The rep that brought it up will no longer support it, so there is no more voting this year on this bill.

 

[Got Em]

Nothing new. We were talking about this same chit 20 years ago......small margin for pharmacy also means small margin for all......docs ain't going to get rich practicing pharmacy..... demise of pharmacy isn't going to be physician dispensing.

Trust me on this one.

Agree 100%. 40+ states already allow physicians to dispense and it hasn't really affected our bottom line.