Nationally, most medical practices do not dispense prescription medications directly to their patients. Depending on your data source, the percentage of dispensing practices sits somewhere between 12% and 18% across the country. Therefore, when a patient is offered the option to receive their medication at the point of care, it is the exception rather than the rule. This series of posts will address physician dispensing from patients’ perspectives and explore their thoughts and reactions to what is still a fairly unique service.
As a patient, we have a certain set of expectations as it relates to our medical encounter. Where we seek care, how we pay for it and what we expect during treatment reflect the external realities of our health plan, our community, our age and our conditioning. Yes, we’ve been conditioned to expect a certain experience during a visit to our physician. Therefore, when we encounter anything different, it raises questions. If our physician offers a new service, we assess it based on our “health encounter conditioning” and make several value judgments:
- Is this service legal?
- Is this service ethical?
- Does this service fit with my health plan?
- Does this service benefit me as a patient?
- Is this service worth it?
In-office dispensing, a service in which the practitioner with full prescribing rights, legally dispenses an FDA approved prescription directly to the patient is one of these ancillary services that more and more practitioners are offering within their practices. If the patient has not encountered this service before, it is natural to ask the question: why is my doctor dispensing? Then, is it right for me?
Direct physician dispensing is legal is almost every state in the country and regulated in every other state. Doctors have been dispensing medications and remedies to their patients since mankind created the practice of medicine. It is no coincidence that it is called the practice of medicine. Medical practices can legally and ethically provides prescription medications to their patients and physicians are in an excellent position to counsel their patients on the appropriate use of prescribed medications. A significant infrastructure also exists to accommodate in-office dispensing: physicians can seek reimbursement for dispensed medications from various insurance payers including workers compensation and private health plans if they so desire. It may or may not make economic or operational sense to do so but the medical practice has the option of plugging into the traditional reimbursement structure. In summary: in most cases it is legal and ethical for a physician to dispense to his/her patient and some will may choose to accept insurance (although this doesn’t necessarily benefit you as the patient – I’ll discuss that in a different post).
Why is your doctor dispensing? Because it is good for him/her and good for you as the patient. The practice can recognize some additional revenue – revenue that you typically give to the pharmacy. Don’t worry, your doctor is not getting rich on your prescriptions – the margins just aren’t there. However, it does help offset some of their fixed costs and the poor reimbursements they often get for other services they provide to you as the patient. So why do it? Because it helps the patient. If almost half of patients are not filling their prescriptions or taking them correctly, the physician has the opportunity to influence better outcomes by making sure you get your meds and take them correctly. It also makes your life as a patient better by eliminating one more stop – you leave the office with your medications and don’t have to stop at or wait in a pharmacy for your prescription to be filled.
Why does your doctor dispense? To make your life better, healthier and easier. Your physician goes through the extra work to provide medications so he/she can more positively influence your health outcomes. Think about it: if your doctor is offering the medication to you in the office, it must be pretty important, right?
