Douglas Benner, M.D.
Chief Medical Officer, EK Health Services, Inc.
An interesting article in the May 2014 JOEM highlights a still significant issue in workers’ compensation: dispensing of medication out of physician offices. The results confirmed similar findings in a study in CA by CWCI in 2013. This Illinois study1 reviewed 6,824 comp claims with Accident Fund of Illinois for the years 2007 to 2012. When physicians dispensed medications out of their office; the number of prescriptions per claim, frequency of lost time days as well as the medical and indemnity costs were higher than cases where the medications were dispensed by pharmacies. The negative impact was even greater when opioids were dispensed out of office.
Some of the findings when medications were physician dispensed:
- 39% higher medical costs (78% higher when opiates dispensed)
- 27% higher indemnity costs (57% higher when opiates dispensed)
- 34% higher frequency of lost time days (85% higher for opiates)
The study controlled for age, sex, attorney involvement and injury complexity, so it raises significant questions about the care received in these cases where a financial incentive or profit conflict of interest exists with the physician dispensing medications in their offices.
The EK Health MPN Physician Handbook says: The physician shall not dispense medications from his/her office; except during first visit for first fill not exceeding a 72-hour supply.
1“Effect of Physician-Dispensed Medication on Workers’ Compensation Claim Outcomes in the State of Illinois”, Jeffrey A. White, MS, Xuguang Tao, MD, PhD, Ryan D. Artuso, PhD, Craig Bilinski, MS, James Rademacher, BA, and Edward J. Bernacki, MD, MPH, JOEM r Volume 56, Number 5, May 2014.