Physician Dispensing Pros and Cons

The most common question we get from a number of potential customers is, what are physician dispensing pros and cons?

When it comes to the argument surrounding physician dispensing, many practices and doctors alike have their own pros and cons to consider. What it often shakes down to is patient compliance and convenience on one side, versus increased cost and possibility for doctored up (no pun intended) incentives with the possibility of additional errors. With good intention, often uncertain outcomes can arise in this practice.

Patients are somewhat accustomed to seeing their physician as a healthcare provider, receiving a diagnosis if applicable and then running across the street or across town to fill a prescription (or several). In most states, it is legal for physicians and other medical practitioners to dispense drugs directly to the patient. This is known as physician dispensing.

The practice of physician dispensing has varying levels of restrictions and regulations as monitored by the State Boards of Pharmacy. While the convenience seems like a no-brainer, there are many controversial aspects to this practice to consider before any provider chooses to support this arrangement.

The Pros of Physician Dispensing

• Patient Compliance
  As many healthcare providers are aware, developing a treatment plan is only half of the equation. Patient compliance is where the plan will prove its effectiveness.Physician dispensing ensures that the patient receives medications in their hands before they leave the appointment. This is huge for patient compliance.

  It is estimated that somewhere between 20-30% of prescriptions are never filled. Offering physician dispensing in a practice can start to chip at the number. However, there are many other reasons that prescriptions are not filled or taken, for example the patient might not believe in the medication, they might not understand how to take the medication or just plain forget to take it.

• Treatment Timelines
  Having physician dispensing done in-house also ensures there is no gap in treatment. Even if a patient desires to take their prescriptions, they do not always get to the pharmacy in a timely manner.
• Convenience
  The convenience of physician dispensing is undeniable. Some patients have a hard time getting to the pharmacy – whether it be finding the time or finding the ride. Perhaps they physically have a hard time getting around. Whatever the reason, it takes that burden off of them.
• Additional Patient Privacy
  A physician dispensing company would argue that doctor’s offices follow more stringent privacy policies.This remains to be seen, but pharmacies in general also have quality privacy practices. Keeping patient information private and confidential is important.
• Accuracy
  Proponents of physician dispensing will argue that it will reduce certain errors that a pharmacy can make. For example, a pharmacist might misread or misunderstand a physician’s directions. This might be the least convincing argument as others would say that having a pharmacist take a second look would make more sense.

The Cons of Physician Dispensing

• Cost
  The cost of physician dispensing could become a financial burden on patients. In some cases, prescriptions at a physician’s office would be marked up by as much as 40-50 times the cost of the prescription. Also, some offices only accept cash and without the help of insurance, this could largely impact patients.There are however, some states with regulations to protect the patients. Some states have a cap on mark-ups and require doctor’s to inform patients of their option to fill a prescription in-house or at a pharmacy.
• Conflict of Interest
  There is an obvious conflict of interest that arises when a physician can profit from in-office dispensing. Will they have the capacity to still prescribe medications appropriately without being focused on the bottom line? It is hard to tell and for patients, it would be nearly impossible to know if health will supersede desire for incentives.
• Patient Safety
  A second set of eyes on a prescription and instructions can reduce prescription errors. Those against physician dispensing will argue for the added security measures when a pharmacist reviews a prescription. Pharmacists can aid in checking for adverse interactions between multiple medications, advising and educating patients on their medications. Risks increase when this buffer is no longer part of the equation. The fear is that the physician’s office and staff will not perform these functions properly or adequately.

Bottom Line

It is obvious that in any case, there needs to be oversight and regulation. Physician dispensing can have some great advantages for the patient and financial incentives. However, this can all be clouded by safety, cost and conflict of interest.