Be glad to.
First, regulations for physician dispensing in my state are fairly lax. I have to use labels that meet the criteria from the Board of Pharmacy, keep an accurate inventory, and have a mechanism in place so that if there is a recall I can notify the appropriate patients. Fortunately, my EMR does all of that. Its actually not that much more work than generating a prescription. When drugs come in, I put them in inventory (takes about 30 seconds per bottle). When it comes time to dispense, its just like a regular prescription except it prints out a label instead of a script. My automatic pill counter does the rest, so it adds maybe 45 seconds per prescription compared to just sending the script to a pharmacy.
Second, my practice is part of a growing movement called Direct Primary Care. Its cash-only and subscription based: meaning my patients pay a monthly fee ($50 at my practice) for unlimited office visits and my cell phone/e-mail address for after hours/weekends/don't want to come into the office. I offer medication dispensing as a service to them, partly for the convenience but mostly for the huge savings. To give you a few examples: a z-pack currently runs $1.65, 90 capsules of gabapentin 300mg is $3.78, a month of 10mg Norvasc is 70 cents, 65mEq iron tablets are half a cent each (as is baby aspirin), flonase is $4.60 each, a 90 day supply of Crestor 10mg is $15, a month of meloxicam 7.5 is 72 cents. You get the idea.
I do mark up the drugs 10% to cover the costs of bottles and labels. My cheapest bottle is 13 cents, so if the script costs less than $1.30 I actually lose money doing it. But that's offset by more expensive drugs, so basically doing this is revenue neutral.
My goal is 600 total patients under this set up (I'm at 400 right now). 600 patients times $50/month equals $30,000 per month. My rent is 5k/month, my one MA wages runs with taxes runs about 3k/month. Malpractice is $300/month. Internet/website hosting/my EMR/e-consult service runs about 1k/month. Loans are about 3k/month. Let's add another 1k/month for random expenses. That comes to 14k/month if we round up. The remaining 16k/month is mine. Multiple by 12 months for a yearly salary of 192k/year, which is slightly above average for a family doctor just doing outpatient. Going forward, if I bring on another doctor almost all of that overhead is unchanged - just have to add malpractice, so we'll both end up making way above average for family doctors.
