Dispensing doctors

Prescribers who earn money from the sale of medicines (e.g. dispensing doctors), prescribe more medicines, and more expensive medicines, than prescribers who do not therefore the health system should be organized so that prescribers do not dispense or sell medicines. 

Prescription-only medicines (POMs) (see Section 1.3.3) are usually obtained on the authorisation of a valid prescription form (either an NHS or a private prescription form) written by a recognised prescriber registered in the UK and presented at a registered pharmacy (although exceptions to this do exist, for example, dispensing doctors (see Section 2.3.1), in-patient hospital supply (see Section 4.2.1) and emergency supply at the request of a patient (see Sections 7.2 and 7.3)). 

In these situations, dispensing doctors will prescribe and dispense the medication for the patient. In order for the doctor to be reimbursed for the cost of the medicine and to be remunerated for the service, dispensing doctors will submit any prescription forms they have dispensed to the NHS Business Services Authority Prescription Pricing Division (or equivalent) at the end of the month in the same way that pharmacists do (see Section 3.3.8). 

As well as dispensing doctors, appliance contractors also provide items against NHS prescription forms within the community. In this case, the items supplied are appliances (stoma equipment, etc.) and not drugs. 

The Drug Tariff is probably not the easiest book to use and navigate your way around however, it is vital that pharmacists and pharmacy technicians involved in the dispensing process are familiar with its layout. As discussed in Section 2.3, there are different classes of individuals who supply items against NHS prescriptions (pharmacists, dispensing doctors and appliance contractors) and so the Drug Tariff contains information for all three types of supplier (i.e. it is not solely a reference source for pharmacists and pharmacy technicians). 

B) the regional warehouse providing a service, usually twice per day, to every retail, community and hospital pharmacy and to dispensing doctors of any drug commercially available. 

When a patient is provided with a prescription by a General Practitioner or a Conununity Practitioner Nurse Prescriber, he/she may take the prescription to either a pharmacy contractor, an appliance contractor (commonly known as a dispensing appliance contractor), or a dispensing doctor. The contractor will dispense the items listed on the prescription and receive fees for services (remuneration) and the drug tariff price for the item which has been dispensed (reimbursement). 

English data, however, does not provide information on the number of units in each package, as doctors usually prescribe the number of units necessary to complete the treatment, and pharmacists dispense the units in accordance with the prescribed dosage. Finally, it is essential to have access to information on the number of packages prescribed for each presentation in each country. 

One in eight Japanese hospitals accepted a prospective tariff per type of disease. . . the amount of drugs supplied to inpatients decreased by 83 per cent. Japanese doctors prescribed and dispensed the drugs. .. the Ministry of Health and Welfare wants to put a stop to this practice. 

Krizan, P. Analyse des dynamischen Verhaltens dispenser Mehrphasensysteme bei ausgeprsgter Grofiraumstrbmung [doctoral thesis] TU Munchen, 1987. 

Subutex and Suboxone are unique not so much for their chemical makeup or mode of operation, but for the regulatory hurdles they overcame. Unlike other pharmacotherapies for heroin addiction (e.g, methadone, naltrexone, ORLAAM °), which can only be dispensed by specialized Opioid Treatment Clinics, specially-trained doctors are permitted to prescribe Subutex and Suboxone drugs in a standard office setting under the Drug Addiction Treatment Act (DATA) of 2000."... 

In some mainly rural areas the doctor may also dispense the medicines prescribed, but more usually the patient takes the prescription to a community pharmacist, also under contract with the NHS, who dispenses the medicines and claims reimbursement at predetermined rates. Unless they are exempt, patients pay a prescription charge at the time of dispensing. 

Then the content of the syringe was dispensed in a strip on a glass slide and a doctor blade was used to spread the solution in the orthogonal direction. The phase behavior of the blend can be determined directly by visual inspection of the sample (Fig. 2, right). Similarly, it was also possible to create gradients in both polymer blend composition and film thickness by accelerating the movement of the doctor blade when spreading the blend solution [8]. 

Drugs are not ordinary consumers products. In most instances, consumers are not in a position to make decisions about when to use drugs, which drugs to use, how to use them and to weigh potential benefits against risks as no medicine is completely safe. Professional advise from either prescribers or dispensers are needed in making these decisions. However, even healthcare professionals (medical doctors, pharmacists) nowadays are not in capacity to... 

Licensing of health professionals - doctors, nurses, paramedics - to ensure that all practitioners have the necessary competence with regard to diagnosis, prescribing and dispensing... 

Rosenberg, Charles E. What It Was Like to Be Sick in 1884. American Heritage 35 (October/November 1984) 22-27. No distinction existed in 1884 between prescription drugs and OTC drugs, and pharmacists dispensed most drugs without prescriptions from doctors. The picture of medical care more than a century ago contrasts starkly with use of prescription drugs today. 

Whether requiring a written order in a hospital chart (or other inpatient health care institution) or a prescription written on a special form, hospital and community pharmacies exercise special caution when dispensing codeine and other controlled substances. In some cases, a doctor may choose to telephone the patient s pharma-... 

---