September 19, 2007 
There are several models for dispensing drugs. I talked about kiosks the other day. Obviously, there is a physician dispensing also. In this case, the physician stocks and fills drugs for patients and collects cash payments. They can make good money, but it can represent a (perceived) conflict of interest and present some challenges (e.g., space, cash management, drug-drug interactions). Several companies that help this model are Allscripts, Dispensing Solutions, and Purkinje.
Another model which is very interesting, but it hasn’t taken off is generic sampling using physician kiosks like MedVantx. It is a cool technology. And, since generic manufacturers don’t provide samples, it is a good way of starting therapy on a generic drug. (The reason for pharma using samples is to get the patient started on their drug.)
Some scary data and a good discussion on this topic can be found on the Medinnovationblog.
Each pharmacy call back costs physicians’ practices $5-$7. With the average physician writing 30 prescriptions a day and handling another 30 requests for refills, the costs escalate rapidly. The estimated 20 pharmacy related phone calls per day costs $20,000-$28,000 annually. In general, physicians are oblivious to this cost center. By moving dispensing into the physician’s office, this overhead can be cost shifted to better serve patients as well as create additional income.
Enabling Healthy Decisions 
Since when is earning a living a conflict of interest? Physicians spend years and hundreds of thousands of dollars learning and honing their skills. Once they are practicing, they find they are limited by the insurance companies, PPO’s, and HMO’s who dictate what their reimbursements will be. Reimbursement rates have been frozen for years. Additionally, medical malpractice rates continue to skyrocket in this litigious society where patients view potential malpractice as a lottery ticket. Costs of running and office and paying a staff go up every year. This all adds up to declining income for physicians. Physician dispensing is one way that doctors can respectfully and professionally offer their patients additional services without seeing more patients, working more hours, or adding staff. They already write the prescriptions, and 75% of patients would prefer to get their medications right at the doctors office if available.
I suspect in-office medication dispensing will continue to grow in popularity as our health care system becomes more patient-centered, and as physicians are further pressured to provide more care with fewer reimbursement dollars.
EMR Software Guy,
http://www.electronic-medical-record.blogspot.com