I wonder why it's so important to have a doctor's office and a pharmacy in separate buildings anyway? It's not like Saldana is out to get Oxycontin.

My Canton in Switzerland allows doctors to dispense drugs. The neighboring one does not.

It's so convenient--unless the prescription is a weird one, the doctor just hands it to me.

Of course, because drugs come pre-packaged with a standard number of pills (so drugs you take every day come in 30 day bottles, an antibiotic that you take for 10 days comes in a pack of 10), so pharmacists don't have to count anything, and that speeds up the pharmacy process as well.

I really like the Swiss system.

As I understand it, the reason pharmacists and doctors are separate professions is that pharmacists study the interactions of medicines in much more detail than doctors.

If true, patients on multiple medications may be better of getting their medication from a pharmacist who would be aware of potentially harmful interactions.

I think the reason that they don’t allow it, is because drugs are a very lucrative area for Medicaid and Medicare fraud.

If the doctor and the dispensary are combined it makes it much easier to run a pill mill and bilk the government.

I prefer to drive out to the clinic on the AFB and pick up my prescriptions once every 90 days, but if I want able to do that, they will push you to get them by mail in a heartbeat,

Not sure why people who have transportation issues wouldn’t just do that.

They are avoiding conflict of interest:

My understanding is that in the US this is an old and traditional division. The underlying idea is that because the doctor makes no profit by ordering expensive medicines, he will not be tempted to prescribe expensive drugs for personal rather than professional reasons.

It would mean more to me to be able to just skip the doctor. It would be just as easy to get to a pharmacy as it is to get to the doctor.

I advocate being able to self-screen. For example, after catching strep throat 30+ times, I know the symptoms pretty well. Why can’t I go to a lab and ask for a rapid strep test? If it’s positive, a doctor could call in a prescription or could even see me at that point if it’s necessary.

One time I had a parasitic infection. After 5 doctors and 27 visits, the doctor finally ordered tests. After the first 5 visits, I had began to suspect a parasitic infection, which I was told was “ridiculous”. I called a lab and asked them to run a test. I was told that it was illegal for the lab to run any tests without a doctor’s order. The test was $30. I ended up being hospitalized before it was finally diagnosed and paid several thousand dollars unnecessarily, not to mention to costs to my family and employer.

While monitoring the pressure in the eye is important to make sure that medication can keep the eye pressure under control without further medication or surgery, access to medication is even more important. Remove the barriers, whatever they may be, to treatment. After all, these medicines aren’t likely to be abused. (And if they are, people will find a way to get them anyone, generally at a higher cost to society.)

To add to the reasons others have listed here on why doctors cannot sell medicines . . . there was a time when doctors could sell the medicines they prescribed to their patients.

This caused many (although not all) doctors to determine which drug they prescribed by determining which medicine gave them a bigger profit.

Not the best way to determine what is the best course of treatment for the patient!

I'm all for less government meddling; but, in this case I think it is a good thing doctors cannot dispense the medicines they prescribe.

As for the pharmacists being better at judging drug interactions, from what I can tell that isn't actually true.

On the conflict of interest issue, doctors do dispense drugs down here in Texas. But they have to be consumed on the premises. I.e. if you are getting a vaccination that is purchased through the doctor and consumed (injected) at the doctor's office. Many doctors also offer injectable antibiotics. What you can't do is buy and take the drugs home. As for the conflict existing, yes it does exist. I've gone to a doc-in-a-box and had to repeated say 'cash customer'. Every single time I said those magic words the drug choice changed and the price dropped. But separating doctors and pharmacists hasn't really removed or even reduced that conflict. Drug manufacturers still send all kinds of things to doctors to encourage them to prescribe their medicines.

So I am ambivalent about the separation. It isn't a significant cost but there aren't significant benefits either.

C'mon, Amy, you know that people cannot tie their own shoelaces without government help. /sarc

Here in TX there are lots of home visit MDs and almost every pharmacy delivers. So no one has to get out at all.

"I wonder why it's so important to have a doctor's office and a pharmacy in separate buildings anyway?"

Because of insurance. It's the same reason that a lot of states don't allow doctors to own medical labs. Doing so allows doctors to do a lot of sleazy cost-shifting; e.g., they can overcharge for tests to cover other areas that insurance doesn't cover to their satisfaction. The result is often that a lot of unnecessary tests get ordered. We don't want doctors being tempted to prescribe unnecessary drugs just so that they can recoup costs in other areas.

(Having said that, the state I live in allows doctors to dispense prescriptions in certain circumstances. For instance, my urologist sells a generic Viagra, at a pretty good price, with the provision that it's strictly cash-on-the-barrelhead -- no insurance accepted. I don't see any problem with this.)

Another reason is to have two unrelated people looking at it (e.g. people in the same office may have aligned interests). As a teenager I had the pharmacist catch that I had been prescribed a poor combination of medicines. One blocked the effectiveness of the other.