Doctors dispensing medicine: Potential for medication errors?

Having to go from the doctor to the pharmacy to pick up a prescription seems like an extra, unnecessary step to many patients. Now, that extra step is no longer necessary for some.

Doctors are increasingly dispensing medications in their offices. This is a financially-beneficial arrangement for doctors since they can make money from selling the drugs, especially during a time when pharmacy reimbursements are declining. Yet, is a financial benefit to doctors a health risk to patients? Does it increase the risk of medical malpractice?

According to a 2007 report by the Institute of Medicine, most medication errors are prescribing errors; a doctor doesn’t fully evaluate a patient’s past medical history and prescribes a medicine that reacts negatively with another medication that the patient is taking, or he or she miscommunicates a drug order, for example.

Pharmacists are trained to review the prescription to ensure that it is appropriate for the patient. They catch nearly half of the prescribing errors that occur, protecting patients from serious harm.

When a doctor prescribes and dispenses the medicine, that safeguard is removed.

Other potential problems include:

  • Office staff, not physicians, may dispense the drugs
  • The medications may not be labeled properly if the doctor does not follow the same standards as pharmacies
  • The doctor or office staff member may not know how to give proper patient counseling

Unlike other states, New Jersey requires doctors to obtain a special permit to dispense medication from their offices, which could remove at least some of the concerns listed above. Yet, the licensing does not remove the potential profits that a doctor might make from prescribing and dispensing medication. This brings to mind kickbacks that a doctor might make from dispensing one medication over another, perhaps more beneficial, medication for a plaintiff.

Patient safety must always come first. Most doctors are very capable professionals who take steps to prevent medical errors. Yet, we must also ensure that the culture surrounding medical changes remains focused on patient safety.

Source: Philly.com, “When doctors – not pharmacists – dispense meds,” Michael Cohen, Mar. 13, 2012.