Although the practice of physician dispensing is making a quick and largely appreciated reemergence, critics argue that dispensing doctors could be influenced by negative factors that could lead to abuse of office.
While this is not entirely wrong and unheard of, it is important to note that there are regulations in place to checkmate these excesses.
Depending on the state or national laws, doctors around the world may be allowed to dispense everything from injections to drugs, or they may only be permitted to dispense injections and free samples, in the case of emergencies or in very remote rural areas where the services of a pharmacist are unavailable.
The importance of good prescribing habits cannot be overemphasized as they are essential to ensuring the shortest duration of patient’s illness, effective and safe treatment, less distress and injury to the patient, and lower health care costs. Bad habits, on the other hand, make dispensing physicians vulnerable to influences that could lead to irrational prescribing.
Before we outline the factors that could influence a dispensing physician’s prescription and subsequent dispensation, picture these two scenarios.
Scene 1: Patient A visits non-dispensing physician
- Physician defines the patient’s problem
- Physician specifies the therapeutic objectives
- Physician verifies if a drug is necessary
- Physician chooses a specific drug while considering its effectiveness and safety
- Physician provides the information necessary, by writing a prescription
- Pharmacist collects prescription from the patient and provides the right dosage and regimen.
Scene 2: Patient B visits dispensing physician
For a patient visiting a dispensing physician, the prescribing process entails that the physician defines the patient’s problem, specifies the available therapeutic objectives, verifies whether or not a drug should be used, selects the specific drug while considering its effectiveness and safety, choose the right dosage and regimen, write the prescription, then start treatment. A dispensing physician can also monitor a patient’s recuperation process.
In the first scenario, the chances that a doctor would overprescribe drugs for a patient are very slim if any because there is no monetary gain. But in the second scenario with a dispensing physician, there is the risk of overprescribing and high charges for selfish reasons. And with more doctors dispensing medications it is important to know what factors influence prescribing by dispensing doctors.
So what factors really influence prescriptions by dispensing physicians?
There are so many factors that influence the dispensing doctor’s prescribing process. These factors include:
- Years of Practice and Education
- Pharmacological knowledge
- Marketing activities in the drug industry
- Patients’ demands
- Advice from colleagues
- Diagnostic and therapeutic skills
- Standard treatment guidelines
- Prescribers’ personalities
- Consultation time
- Information and knowledge on drug costs
- Quality assurance
- Regulatory and control measures
For the purpose of this article, we’ll briefly explain the first three factors listed above…
Years of Practice and Education: The number of years a physician has spent in practice and how educated they are about a particular patient’s ailment plays a very important role in the kind of drugs, dosage, and regimen that the dispensing physician would prescribe and dispense to the patient.
A doctor with relatively more years in practice would most likely prescribe a proven method as against a textbook method.
Pharmacological knowledge: A dispensing doctor’s pharmacological knowledge is essentially their knowledge of the properties and reactions of the possible drugs that could provide therapeutic solutions to a patient’s ailment.
This knowledge varies from one doctor to another. Hence, Doctor A could prescribe and dispense a certain drug with confidence in its therapeutic value, while Doctor B would prescribe and dispense yet another drug as well.
Marketing activities in the drug industry: Physician dispensing is not only a practice, it is also a business where the physician has to consider not running his or her business at a loss. And as costs and availability fluctuate in the drug manufacturing industry, this could influence a dispensing physician’s prescription.