Direct care and in-office dispensing

Direct care physicians are often able to provide their patients with discount options for services that are not covered in their monthly membership fees, such as laboratory services and prescription drugs. A number of direct care physicians, however, have opted to provide in-house dispensing of medications as part of their services within the practice.

Ron Lamberts, MD, an Elation Health client, writes in Physicians Practice about his experiences, at first doubting the need for in-office dispensing and then deciding that it is a benefit for both his patients and his practice. Dr. Lamberts did not think that in-office dispensing was necessary initially, since his patients were happy with the existing services he provided them and his practice was growing. He changed his mind on the urging of colleagues and began dispensing medication in his office in late 2017.

As Dr. Lamberts describes it, “I underestimated the impact it has had on my practice. It has become one of the biggest areas of patient satisfaction, as well as a very powerful marketing tool to both draw in new patients and retain my current ones.” He cautions that there are some factors to consider for the direct care physician who is weighing the option of in-office dispensing.

First, regulations differ by state as to whether medications can be dispensed from within a direct care practice. In fact, in Texas, Minnesota, and Wyoming, in-office dispensing is not allowed at all. In other states, there are specific requirements that must be met before the direct care physician can dispense medications. Dr. Lamberts practices in Georgia, which has “some of the most lenient dispensing laws for physicians and does not require extra licensure within the practice to dispense.”

Other considerations include choosing medication vendors, deciding on pricing, and integrating the prescription drug services with the practice’s existing technology. Dr. Lamberts uses Elation Health’s electronic health record (EHR) system, which assists his direct care practice with inventory and billing. “Our solution allows us to enter prescription in the EHR, go to the dispensing software and print the label, and send it to our billing system. If the prescription brings the inventory down to a set level, it notifies us that we need to order more. It’s quite simple to use and lets us manage an inventory of over 100 drugs.”