With physician dispensing, instead of writing patients a prescription for a medication and sending them to the pharmacy, providers supply medicine directly from the doctor’s office.
Physician dispensing not only makes obtaining medications more convenient for patients but can also enhance their overall satisfaction with care and improve their outcomes. Learn more about the dispensing process and its benefits.
What is Physician Dispensing?
Physician dispensing, also called in-office dispensing or doctor dispensing, isn’t a new concept. Some accounts suggest it began as far back as the 1200s, but it was in the 1980s that physician dispensing as it’s understood today was introduced. It was during this period, the United States Federal Drug Administration (FDA) began allowing medical practitioners to repackage medications.
Before then, patients mostly relied on pharmacy dispensing. This is when physicians send patients to pharmacies to retrieve prescribed medications. Pharmacists were also responsible for educating their patients on these drugs, but the lack of communication between pharmacists and doctors meant that physicians couldn’t always be sure their patients were wholly informed about the medications they took.
This situation gave way to modern medical dispensing. With physician drug dispensing, doctors can prescribe and dispense drugs at the point of care, ensuring their patients receive the right medications at the correct dosages.
How does doctor dispensing work? Dispensing providers will obtain medications according to their preferred formulary and sizing from physician-dispensing companies offering prepackaged medications. Typically, doctors utilize web-based software to dispense medicine, manage their inventories, and keep records. When patients visit the physician’s office for care, doctors can conveniently dispense drugs by entering the patient’s information and choosing the medications they need.
Benefits of Physician Dispensing
Doctors dispensing medications in-office find that the service provides multiple advantages for their practice and patients. Overall, it can boost the quality of care and support cost-effectiveness: two factors integral to delivering better services in today’s healthcare market. The following details the key benefits of in-office dispensing of medications:
- Makes obtaining prescription medication easier
- Gives patients more access to a wider selection of medications
- Enhances medication management for patients with chronic conditions
- Grants access to customized medication options
- Saves patients time and money
For Dispensing Doctors
- Reduces errors or delays with prescription drugs, such as incorrect labeling or improper dosages
- Can enable physicians to obtain additional revenue streams
- Helps providers save time and money, boosting productivity and efficiency
- Enhances compliance with regulatory guidelines on medication dispensing
- Empowers better continuity of care and follow-up monitoring
- Streamlines the process of delivering prescriptions to patients during urgent care situations
Regulations and Legal Considerations
If physicians wish to offer in-office dispensing, they must be cognizant of federal and state regulations for the practice. In most cases, as long as providers follow federal and state guidelines, local governments will allow them to dispense medication. It’s essential to understand and adhere to these laws to avoid legal trouble and potentially lose a dispensing program.
On the federal level, FDA is the primary organization dictating regulations for physician dispensing. It’s responsible for verifying that all medications on the market are dispensed safely.
Another federal agency involved in regulating physician dispensing is the U.S. Drug Enforcement Administration (DEA). The DEA works alongside FDA to enforce one of the most important federal regulations, the Controlled Substances Act (CSA). This law lays out how to classify, store, inventory, and dispense prescription medications. CSA categorizes drugs into five schedules ranging from I to V that indicate their potential to cause addiction in patients. Schedules include:
- Schedule I: Have the highest potential for abuse or addiction and are prohibited from medical use in the U.S.
- Schedule II: Have a high potential for abuse that may cause significant physical or psychological addiction/dependence
- Schedule III: Have the potential for abuse, but less so than the previous schedules
- Schedule IV: Have a lower potential for abuse than the first three schedules
- Schedule V: Has the lowest potential for abuse of the five categories and consists mostly of mixes with limited amounts of certain narcotics
In addition to establishing these schedules, CSA provides registration and record-keeping guidelines for pharmacies and dispensing providers who register with DEA. Each participant must undergo a thorough inventory of all the controlled substances in their possession.
Each state has separate requirements for medication dispensing. Some states require physicians to complete an additional registration beyond DEA registration before they can dispense controlled substances in that state.
Depending on the state, regulations may be more or less stringent than federal guidelines. For example, Texas and Massachusetts are among the handful of states with the most restrictions on physician dispensing, while California has minimally restrictive regulations. Providers can contact their state’s Board of Pharmacy for information on the unique guidelines in their state.
Inventory Management and Product Selection
The benefits of clinic dispensing are many, but physicians risk losing those advantages unless they invest in proper inventory management.
The first step is making sure you have a thorough understanding of your inventory. This makes it easier to confirm a medication is in stock and locate it when a patient needs it. Doctors may also consider placing the drugs least often needed at the back of shelves and moving the drugs they most often prescribe to the front to boost efficiency. Knowing your inventory can also prevent expired medicine from lingering on shelves.
Choosing the right medications is another critical component of inventory management. Order more quantities of popular medications and over-the-counter drugs to ensure no patient is turned away when needing a standard item. Remember that some medications are more requested during different seasons, such as cough medicine during the fall and winter.
Once physicians begin in-office dispensing, they’ll develop relationships with pharmaceutical distributors like Proficient RX, which will provide the medications to the physicians’ offices without the need of sourcing from different companies. These specialists can provide insight on managing inventories, so doctors can collaborate with them to ensure the medicines are received securely and efficiently.
Ensuring Patient Safety and Quality Care
While there are many proponents of physician dispensing, it’s not without opposition. The primary concern among opponents is that without the checks and balances provided by pharmacies, prescriptions can become more susceptible to errors.
Dispensing doctors can dispel these concerns by implementing best practices to preserve the safety of their patients. Strategies for maintaining better patient safety with in-office dispensing include:
- Following established labeling requirements for medications
- Educating patients on dispensed medications, including dosage, frequency, guidelines for administration, possible side effects, and other special precautions
- Tracking and reporting on adverse drug reactions
- Developing an understanding of drug reimbursement, including ensuring patients have sufficient coverage for medications from their insurance policies or Medicare programs
Setting Up a Physician Dispensing Program
Before pursuing physician dispensing at your hospital or practice, it’s vital to assess the feasibility of having such a program. Some questions to ask when making this decision include:
- Which drugs will the physician dispense? What is more beneficial to dispense directly, and which medications should continue being fulfilled at pharmacies?
- Which dispensing system will be most productive for the physician?
- Does the physician have the resources to train staff in handling this new responsibility?
- Do any staff members have experience with dispensing to guide doctors, physician assistants, and other personnel?
- Does the physician have the correct licensing from federal and state agencies to dispense medications?
- How will dispensing drugs affect insurance premiums?
Working With Proficient Rx as Your Physician Dispensing Partner
Medical dispensing has grown significantly over the years, with the introduction of electronic prescribing being one of the most recent developments enhancing the process. Now, dispensing doctors can utilize web-based software to streamline these tasks and provide further convenience to patients. As medical technology continues to expand, hospitals and practices can expect more innovations to enhance physician dispensing and contribute to the end goal of better patient outcomes.
Integrating dispensing into an already extensive list of responsibilities can feel overwhelming for doctors. To avoid missing out on its benefits, physicians can partner with a pharmaceutical repackaging company that simplifies dispensing. Proficient Rx offers point-of-care prepackaged medication and dispensing programs to meet the needs of every licensed provider. With our web-based dispensing software, physicians can manage and dispense medications and review updated information about pricing and more from any device with an internet connection.