When doctors - not pharmacists - dispense meds

Started by Parklife
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Parklife

Parklife

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10+ Year Member
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I was speaking to my pre-health adviser today, and he brought up an interesting issue. With nurses and physicians assistants playing a bigger role in healthcare are physicians finding others ways to be more beneficial to their patients?

http://www.philly.com/philly/health/142460165.html

I thought it was an interesting read especially when considering our recent debates with job prospect.
 
Looking from the patient's view I would be more concerned. From my exp most patients don't understand the role of a pharmacists. Some patients confuse the pharmacists for us techs.

If this is to be allowed, the physician should give the option to the paitents and explain what is going on. This would cut liability for the physician, give patients an option and keep them more educated. Most people interact with their physician more than their pharmacist. I guess it's a trust thing. "Don't worry Timmy, if Dr. Smith says ok then it must be ok! I have been going to Dr. Smith for years! Dr. Smith is so nice!" - elderly lady letting her grandson take medication he isn't suppose to.

See what I mean?
 
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I completely disagree that patients see their medical provider more than their pharmacist. For example, I work in an out-pt HIV clinic and see my patients for the most part monthly, while if they are doing well they won't see the MD for 3-6 months.

Anyhow, I guess this depends on the medical providers. The providers at my clinic rely on the "dispensing" PharmDs to double check all orders for dosing, interactions, etc, as well as provide detailed counseling to the patients. We receive calls from the providers with specific questions multiple times per day, while also I find issues to discuss with the providers before dispensing a prescription at least twice per day. The providers at my clinic would NEVER be comfortable without a PharmD around.
 
HIV- That's a specialty and a small niche compared to the retail world. In many cases I can see this happening.

For example, instead of a dermatologists sending patients off to their local CVS or Walgreens for doxycycline or solodyn or some topical cream they could dispense it themselves. Especially since most pharmacies have to order in these anyway(ours does anyway).

I sure hope this doesn't catch on. It'll mean more trouble for pharmacists! 😀
 
Parklife said:
HIV- That's a specialty and a small niche compared to the retail world. In many cases I can see this happening.

For example, instead of a dermatologists sending patients off to their local CVS or Walgreens for doxycycline or solodyn or some topical cream they could dispense it themselves. Especially since most pharmacies have to order in these anyway(ours does anyway).

I sure hope this doesn't catch on. It'll mean more trouble for pharmacists! 😀
Click to expand...


Yea, Let those doctors try to process those manufacturer coupons all that solodyn, aczone, and tazorac.
 
Most physicians do not want to dispense medications. It doesn't make them money, and they have to obey all the pharmacy laws. Most find it is not worth the hassle.
 
OUTexan said:
Yea, Let those doctors try to process those manufacturer coupons all that solodyn, aczone, and tazorac.
Click to expand...

We're talking about a derma. I think they will be fine lol almost every problem = tretenoin cream +hydrogen peroxide wash+washed pillow cases+water
 
Parklife said:
We're talking about a derma. I think they will be fine lol almost every problem = tretenoin cream +hydrogen peroxide wash+washed pillow cases+water
Click to expand...

I can definitely see physician dispensing for niche fields, but like others posted about, there is no profit in low volume dispensing. The profit in retail pharmacies are made by volume, especially on generic meds. It's just not worth the physicians time to have $200 tubes of acne cream on the shelves to make a $3/dollar profit while keeping in line will all the legal ramifications of dispensing.
 
I thought physicians could not dispense because of a conflict of interest. That certainly hasn't changed. And really it would be more beneficial cost-wise for most patients to still go to a pharmacy because they can buy in bulk to lower the retail cost unlike a small doctor's office.
 
Most veterinarians do their own dispensing. None of my pets have needed anything expensive, and the cost was about that of going to a retail pharmacy, without the extra trip. You just know that wouldn't be true for people, however.
 
pinipig523 said:
Excuse me?

From my understanding, we are allowed to dispense drugs only if it is rural and there are no pharmacies available.
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Physican dispensing is a matter of state law. People keep posting as if there was one ABSOLUTE rule on it, but there is not. Personally, I don't find it to be much of a threat to pharmacy.
 
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A real life example for a point made up-thread: My stepdad has many health issues. He has a different doc for heart, lungs, diabetes, kidney, liver, general doc, etc. At last count, he was seeing 12 doctors. My stepdad carries a sheet with his current medications on it, but the only real safety check he gets is at the pharmacy. One of his doctors insists on giving samples "just to see if it works" - without even charting that he dispensed the med! Alternately, he will change dosing verbally & write different instructions on the prescription "so the pharmacy will give him enough." This doctor is aware of my stepdad's occasional cognitive issues & other health issues. Due to this doctor's practices, my stepdad had to be admitted to the hospital last year for issues resulting from confusion with verbal changes & one of the sample drugs. (This happened to be when we found out the doctor wasn't charting the samples.) He uses the same pharmacy for all his medications. Had the pharmacy been involved, they would have found duplication of therapy and been able to clarify how the doctor intended the drugs to be taken. My stepdad no longer sees this doctor. Call it student naivete, but I feel that the pharmacy is an important safety check, shown especially well in this situation.
 
Parklife said:
HIV- That's a specialty and a small niche compared to the retail world. In many cases I can see this happening.

For example, instead of a dermatologists sending patients off to their local CVS or Walgreens for doxycycline or solodyn or some topical cream they could dispense it themselves. Especially since most pharmacies have to order in these anyway(ours does anyway).

I sure hope this doesn't catch on. It'll mean more trouble for pharmacists! 😀
Click to expand...

You make me angry. How do you go about giving doctors more responsibility aside from seeing their patients? Do you want to go to your doctor just to see him/her for 5 minutes and feel like not getting anything out of it because he/she has to dispense your med? Also, who is going to check him? Is he going to go through inventory and order medication daily?
 
20 years ago we were talking about how physician dispensing would put pharmacy out of business..... well...
 
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