Provided by: Pat Berline, Guest Contributor

In an article in the December 2, 2011, Orlando Medical News, attorney Stanley T. Padgett stated that “In Florida, a few bad apples nearly spoiled the whole bunch. The recent legislative session produced new laws to curb “pill mills.” Fortunately for Florida patients and physicians, the new laws do not prevent Florida physicians from dispensing medications to their patients because dispensing is good medicine.”

Under Florida law, Statute 465.0276, Florida physicians are authorized to dispense prescription medications to their patients in the regular course of their practice. A physician registered with FDOH to dispense may also register ARNP’s and PA’s under their supervision to dispense. Once properly registered, a physician complying with FDOH requirements, can legally dispense prescription medications to their patients for patient convenience, medication compliance and physician profit.

The actual dispensing of medications can be interpreted in many ways, but the following is generally understood in regards to physician dispensing:

• The drug dispensed must be to a patient of the physician.
• “Dispensing” means the transfer of possession of one or more doses of a medicine by a physician to the patient.
• The physician must certify, via written prescription or e-scribe, that the prescription is ready for transfer.
• The physician shall provide counseling on proper drug usage, either orally or in writing.

The key is that the actual sales transaction and delivery of the medication is not to be considered as “dispensing”. Dispensing is defined in the Florida Statutes as “selling medicinal drugs to patients in the office”. A certified staff member may “deliver” the drug to the patient and accept payment. The actual dispensing, or prescribing, of the medication is not a responsibility that can be delegated to a staff member.  It is important to understand that the practitioner is still required to give the patient a written prescription and the option to fill that prescription in the practitioner’s office or at a pharmacy of the patient’s choice. Also, a dispensing practitioner may not dispense a controlled substance listed in Schedule II or III as provided in Section 893.03. Florida Statute. You can find the statutes and laws regarding physician dispensing at http://www.leg.state.fl.us/statutes/index.cfm and www.doh.state.fl.us/mqa.

This information is to aid in your research and due diligence regarding prescribing requirements in Florida and should not preclude reading and becoming familiar with the laws and rules themselves.  It is almost impossible to prepare a document that is all inclusive about dispensing because, as you might expect, the Federal government, DEA, HIPAA, as well as other entities may also have laws, rules and policies concerning dispensing. But, while this document should not be used as a substitute for legal advice, I hope that it will give you a comfort level in moving forward as you consider implementing a dispensing program for your practice.

Physician dispensing has been around for many years.  Since new FDA regulations were enacted over 30 years ago, the practice is now growing rapidly in the United States. According to industry experts, it is estimated that approximately 10% of practicing physicians offered point-of-care dispensing at the beginning of 2010, and that the industry will grow by approximately 25% by 2015.

In a recent study, 75% of patients surveyed said they would elect to have their prescription filled in their doctor’s office instead of a pharmacy if given the choice. 84% of respondents said such a service would be more convenient, and 62% said it would help them better manage their health. Studies have shown that up to 40% of patients never get their prescriptions filled.  It has also been found that over 90% of the patients in the practices where a dispensing program is installed prefer to use the in-house dispensary, rather than going to a regular pharmacy. When patients leave the physician’s office with medication in hand, compliance rates dramatically increase. Also, travel and wait times at many pharmacies can be hours on occasion. Patients appreciate receiving medications in the physician’s office to avoid a trip to the pharmacy and waiting for their prescription to be filled.

In addition to the added convenience, physicians consult with the patient as they receive their medication. Doctors can have an open discussion with their patients about such points as taking the medications on time, completing the regimen as directed, and verbally warning them of interactions that may occur with any other medications they may be taking. Compliance with drug therapy is 60% to 70% better when medications are delivered at the point of care than when patients are handed a written prescription.

It is often asked if dispensing will cause malpractice insurance to increase.  The best answer is that it shouldn’t.  A physician’s medical license mandates that they are allowed to dispense medications and, as you know, they frequently pass out drug samples. It shouldn’t make a difference whether or not you get paid to do so as far as malpractice insurance is concerned. I am not aware of an instance where there was an increase in premiums, however, I recommend that you contact your insurance agent for verification.

Ironically, years ago, almost every physician dispensed medications to their patients in their office.  Change occurs in every industry and the reduction of insurance reimbursements and increasing costs are forcing physicians to find alternative sources of revenue to enhance their practice. Many in the industry believe that one day, almost all physicians will be dispensing from their office. It is simply a sign of the times.

Dispensing medications is a simple and easy income solution.  Patients overwhelmingly appreciate the ability to fill their prescriptions where they receive their care, thus generating instant, positive patient satisfaction.. And when you look at the profitability benefits to the practice, it becomes obvious that this is a ‘win-win’ for everyone.

Article prepared by Capital Medical Services LLC of Atlanta, GA with the cooperation of Pat Berline.  Pat Berline is a Representative with Capital Medical Service, LLC which is affiliated to Physician Dispensing Company LLC and Johnson Rx, Inc. of Cedar Bluff, AL.  Pat Berline is based in Orlando, FL.  To contact Pat Berline, please call (407) 414-3054 or via e-mail at patberline.pdc@gmail.com.