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Pharmacy and Practice Same Roof

Discussion in 'Med Business [ MD/MBA, DO/MBA, DDS/MBA ]' started by Joat, Oct 17, 2016.

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  1. Joat


    Apr 5, 2016
    Just curious
    Why aren't there healthcare practices that include both physicians and pharmacists under the same roof, of course on a smaller scale than a hospital. Like having the actual practice upstairs and the pharmacy downstairs. Prescriptions could be filled same day, 15 minutes after an appointment or even during the appointment, and the prescribers and pharmacists could have face to face contact. I understand that independent pharmacies are having more difficulty obtaining reimbursement but surely this could be overcome being the designated pharmacy for the practice.

    I'm positive I'm not the first one who's thought of this but it seems like a net benefit to patient care and would result in greater margins if one were to own the practice and the pharmacy. So what am I missing? There has to be some reason this doesn't exist. Is there a law prohibiting owning both a practice and a pharmacy as a conflict of interest?
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  3. lord999

    lord999 Pharmacist Faculty Moderator Emeritus 10+ Year Member

    Feb 20, 2002
    Stark II laws make it annoyingly difficult due to the anti-kickback rules (and rent policy), and most states actually have preventative clauses about competitive restraint of trade dating from before the 1950s due to some old practices.

    It's not impossible, but the practices have the burden of proof to their respective boards that close relationship doesn't mean kickback.
  4. mercerpharmacist


    Oct 15, 2016
  5. zeloc

    zeloc Senior Member Physician Faculty 10+ Year Member

    Aug 22, 2003
    I have seen a number of them, they do exist.
  6. Blizzard1mage

    Blizzard1mage 5+ Year Member

    Apr 4, 2012
    In most instances of a pharmacy being co-located in a physician office, the pharmacy tends to be neglected. It's great for the physicians' patients who can pick up their meds right there. But you typically don't get outside patients coming into the pharmacy. That being said, there are advantages too, e.g., you can do incident-to billing for many pharmacist services performed "on behalf of" the physician.
    mercerpharmacist likes this.
  7. FamilymedMD

    FamilymedMD Physician 7+ Year Member

    Nov 25, 2009
    Rockport, ME
    Most physicians don't realize that we can dispense medications in most states. Lots of Direct Primary Care (DPC) practices have picked up on this and we routinely order and dispense meds in the office. With the pricing for many meds all over the place, lots of our patients save quite a bit on meds via us. We charge a small markup over the wholesale cost to cover the minimal employee time involved. If a med is cheaper or about the same price locally (including via, etc) then we encourage them to use the pharmacy.

    In-house Dispensing for Your Practice | Physicians Practice
  8. eeyore spice

    eeyore spice 10+ Year Member

    Apr 6, 2006
    the fifth quadrant
    Well, hot damn, this is exactly what my partner has been pushing me to do, not so much an under-one-roof deal but a pharmacy with associated prescribers, maybe an urgent care clinic? I can see how kickback issues would arise, but more communication between a patient's prescriber and their pharmacist would solve SO many headaches inherent to retail pharmacy.

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