Healthcare should be designed around the patient. That principle is especially important in workers’ compensation, where every day of delayed treatment can affect recovery, prolong disability, and postpone an employee’s return to work. If our goal is to improve outcomes, reduce unnecessary barriers, and strengthen the medical home, physician dispensing should be viewed as one important tool to accomplish those objectives.
Too often, healthcare policy focuses on the mechanics of how a medication is delivered instead of whether the patient actually receives it. A prescription left on the exam room printer provides little benefit if the patient never makes it to the pharmacy. Research published in JAMA estimates that between 30% and 50% of medications prescribed for chronic conditions are not taken as directed. Medication nonadherence contributes to approximately 125,000 deaths annually, accounts for roughly 10% of hospitalizations, and costs the U.S. healthcare system an estimated $100 billion each year. These findings demonstrate that improving medication access is not simply a matter of convenience. It is a patient safety issue. (jamanetwork.com)
For an injured worker, the challenges can be even greater. Pain, limited mobility, transportation difficulties, pharmacy hours, prior authorization requirements, and workers’ compensation administrative delays can all stand between the physician’s treatment plan and the patient’s ability to begin therapy. The New England Journal of Medicine has noted that writing a prescription alone does not ensure access to medication when patients face barriers outside the physician’s office. (nejm.org)
Physician dispensing addresses one of those barriers by allowing patients to leave the office with the medication their physician has determined they need. It keeps treatment within the medical home, where the physician evaluates the injury, develops the care plan, educates the patient about the medication, and monitors the patient’s response throughout recovery. JAMA has emphasized that effective communication about a medication’s purpose, expected benefits, duration of therapy, and possible side effects is essential to improving medication use. Providing that education at the point of care, while simultaneously initiating treatment, creates a more coordinated patient experience. (jamanetwork.com)
In workers’ compensation, timely treatment is directly tied to successful return-to-work outcomes. Every unnecessary delay in starting an anti-inflammatory medication, antibiotic, or other clinically appropriate therapy represents another opportunity for recovery to be slowed. When physician dispensing allows treatment to begin immediately, it supports the broader objectives shared by employers, insurers, physicians, and injured workers alike: faster recovery, fewer complications, and a safe return to productive employment.
Like any healthcare service, physician dispensing should be accompanied by appropriate safeguards. Patients must retain the freedom to choose where they obtain their medications. Pricing should be transparent and reasonable. Clinical decisions should always remain independent of financial considerations. Those are important protections, but they are not arguments against physician dispensing itself. They are arguments for responsible physician dispensing.
The conversation should ultimately remain focused on patients. When appropriate safeguards are in place, physician dispensing can improve access to medications, strengthen continuity of care within the medical home, reduce unnecessary barriers to treatment, and help injured workers begin recovering sooner. Healthcare works best when it is organized around the needs of the patient, not the convenience of the system. For many patients, particularly those recovering from workplace injuries, timely access to medication is one small change that can make a meaningful difference.
By Gene Ransom
Chair, Physicians Research Institute (PRI)
