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?
Shirah Vollmer MD 