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When medication is used correctly, it has the opportunity to save lives. Medication can help people recover from painful surgeries, overcome the common cold and treat a vast assortment of medical ailments.
When medication is not used correctly — if the wrong drug is prescribed, if the wrong dosage is administered, or if there are dangerous interactions between drugs patients are taking — the results can be serious or even fatal.
Currently, there are a few checks and balances in place. Doctors write prescriptions and pharmacists dispense them. If the doctor overlooked a possible complication when he or she was prescribing the prescription, it may be caught by the pharmacist. Pharmacists often have more advanced software designed to catch interactions between newly prescribed medications and drugs patients are already taking. Moreover, a study by the Institute of Medicine revealed that “medication errors originate most often during the medication prescribing process.”
Now, some physicians in Pennsylvania have started dispensing the drugs they prescribe on their own. There are several concerns with this new process — most notably, the danger it poses to patients.
In many states, physicians are not allowed to dispense drugs. In states where it is allowed, it is highly regulated and restricted. Doctors are typically only allowed to dispense samples or medications for conditions that need to be administered immediately. In other states, physicians must be registered with the state’s Board of Pharmacy in order to dispense medications at all.
In Pennsylvania, however, physicians are not required to have any special permits or licenses to dispense drugs from their offices. There are some exceptions, but the general rule states, “Physicians may dispense drugs within their office practices provided such dispensing primarily benefits the patients.”
It’s certainly a slippery slope. Who determines if patients are the primary beneficiaries? Is there a potential conflict of interest when the physician prescribing the medication is also dispensing it — and might even profit by choosing one drug over another?
For most patients, being able to pick up prescriptions at the doctor’s office is a convenience, and some studies suggest that patients demonstrate better adherence to medication plans when they receive drugs directly from their doctors. However, until there are greater safeguards in place to reduce the number of medication errors at the place where they are most likely to originate — the prescriber — perhaps physicians should not be allowed to dispense medications from their offices.
The practice may be a convenience to patients, but putting them at risk for serious and deadly medication errors is anything but convenient.
Source: Philadelphia Inquirer, “When doctors – not pharmacists – dispense meds,” Michael Cohen, March 13, 2012