Shirah Vollmer MD

The Musings of Dr. Vollmer

Should Doctors Dispense Medications?

Posted by Dr. Vollmer on April 12, 2013

CVS' automatic prescription refill problem

http://www.latimes.com/business/la-fi-lazarus-20130412,0,1884241.column

 

https://shirahvollmermd.wordpress.com/2012/10/24/doctor-patient-and-pharmacies-an-oedipal-triangle/

 

Should doctors dispense their own medications? Why do we need pharmacies? Many optometrists also sell glasses, so why should a doctor not give out the medication that he/she prescribes? This question has baffled me for years. As a psychiatrist, I fantasize about the possibility of giving medication on the spot, avoiding the second step of what many of my patients call the “shame” of having to go to a pharmacy, with the often-felt look of dismay on the dispenser’s face, as my patient picks up his third psychotropic medication because the first two did not work. As the LA Times series, mentioned above, illustrates, pharmacies, as the middle-men, are subject to miscommunication and possibly fraudulent behavior. If doctors dispensed medication, the patient paid the physician, then the physician gave the patient a receipt, allowing the patient to get reimbursement. This reimbursement would be done at the same time the patient is reimbursed for the office visit. Simplicity and efficiency would prevail. Fewer mistakes, as it would be unlikely for me as a physician to dispense the wrong medication to my patient. Costs are less because I would bear the overhead expense of storing and tracking the medication. The intimacy of my relationship with my patients would benefit, as adding a third player into our relationship often feels intrusive and unnecessary. Rarely, pharmacists answer important questions for my patients, but for those situations, I would hope that there are pharmacists, on call, for a fee, that are available to explore medication inquiries, including drug interactions. There-health care in the next century-maybe if the folks in Washington consulted me-real progress could be made. Whose ear do I need?

2 Responses to “Should Doctors Dispense Medications?”

  1. Shelly said

    I love the idea. Where I live, people line up shoulder to shoulder in the pharmacies so there is no privacy at all when picking up prescriptions. Everyone in line sees and hears exactly what the pharmacist says to the patient and what questions we ask and their answers are. On the other hand, stocking the meds and issuing them can be a full-time job as well, so this may impact your patient flow. Yes, real progress could be made, but I suspect the Pharmacy Lobby would be strong in preventing any such progress as it would put them out of business.

    • Thank you, Shelly. Yes, my fantasized world does not take into accounts the politics of it all. My eye doctor also sells glasses..so I have one stop shopping. Many podiatrists sell orthotics. Without fantasy, there can be no hope for change. Thanks again.

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