Dispensing Medications from the Office

ABSTRACT

Dr. Rob Lamberts, a board-certified med-peds provider, owns and operates a direct-pay practice in Augusta, Georgia. He writes about in-house dispensing from the perspective of a converted skeptic. He writes convincingly that, unless you practice in Texas, Minnesota, or Wyoming, it will be worth your time and effort to check out (or revisit) whether your medical practice should pursue in-office medicine dispensing.

Analyzing the opportunity encompasses at least four steps:

1. Learning your state’s laws regarding dispensing drugs. Each state has specific laws that range from lenient to very restrictive (or prohibited).

2. Learning best practices for managing inventory. You can use a single-source that handles prepackaging/labeling and inventory management. However, this will make it much harder (or impossible) to shop for best pricing.

3. Learning the best places to purchase medications. Lamberts chose a vendor that interfaces seamlessly with his billing software and streamlines the process for his practice to maintain more than 100 different medications.

4. Determining which medications to stock and how much to charge. Two major philosophies attract practices dispensing meds: charge a fair price that increases practice revenue/profit; charge the lowest possible price to cover all related costs to provide convenience for patients and a powerful marketing tool for the practice.

Dr. Lamberts concludes that his practice’s medications service has proven to be a “home run” with his patients. He has recouped the cost of setting up the system, and patient satisfaction clearly received a boost when the practice added this service.

EXPERT COMMENTARY

In the past 30 years, in-house dispensing has traveled the full range of advisability—from the hottest money-making idea to “don’t touch it with a ten-foot pole.” Opponents have advanced various arguments against pursuing this service line. Some argue that it creates the potential for conflict-of-interest issues and possible over-prescribing. Others seem to suspect that practices pursuing in-house dispensing demonstrates a greedy, money-first attitude.

We suppose you could enhance your bottom line somewhat with in-house dispensing, but this author (like many happy physicians filling prescriptions in the office) has pursued the “high ground” of providing convenience and an improved “patient experience” for his clientele. By keeping pricing at a minimum to cover the cost of the service, he finds that his patients love it. He believes that prescription-compliance is thereby improved, too.

Of course, dispensing prescription medicines from the office isn’t for every medical practice— just as DME, orthotics, or dietary supplements/ vitamins won’t work for everyone. But you should certainly consider it. Do your “due diligence,” and see if you can improve quality, patient satisfaction, and perhaps your bottom line.