Doctor's Office ATM

The advantages of getting your medication from the doctor's office are obvious. Either you're sick and don't fancy sitting around a drafty drugstore or crowded supermarket waiting for your prescription -- or you're herding a slew of sick or cranky kids and would just like to go home.

Enter InstyMeds and FirstFill, two systems that allow commonly prescribed drugs to be distributed right from a doctor's front desk or waiting room.

Ken Rosenblum, MD, CEO of Mendota Healthcare in Minneapolis, is the creator of InstyMeds. He says the idea of not having to leave the doctor's office without the drugs hit him when he came home late one evening. He had to go out again and roam the city looking for a pharmacy to get a medication his wife had been too busy to pick up for their 5-year-old.

"This is crazy," he recalls thinking that night. "Why do we have to get our healthcare in two places?"

Rosenblum also learned that drugstores were facing a severe pharmacist shortage and that many pharmacists would prefer to be counseling patients and collaborating with doctors on care plans rather than spending their time on the old, "count, lick, and stick."

The result was InstyMeds, a soda-machine-sized unit stocked with common medications that sits right in the doctor's waiting room.

No More Sloppy Handwriting

How does InstyMeds work? When you're ready to leave the office, your doctor describes the medication you'll take, explains how to take it, lists side effects to watch for, and asks you about any drug allergies you may have. Your doctor then writes the prescription on an electronic device like a Palm Pilot that uses the InstyMeds software. The system calculates the right dose based on your weight.

At this point, the doctor also asks, "Do you want to take this to your drugstore or would you like to pick it up outside on your way out?" According to Rosenblum, half of all patients choose to get the medicine immediately. If that's what you want, your doctor prints a voucher with a security code instead of a printed prescription, and you then insert the voucher into the InstyMeds dispenser.

The machine holds about 35 different commonly prescribed medications that are available in different strengths and quantities (but none that contain controlled substances). The voucher information comes up on the machine, and if you have a copay or are paying for the whole thing yourself, you use a credit card to take care of the fee. The prescribed drug passes through three barcode checks and rattles down just like a soda or candy bar, neatly labeled with your name and particulars about the medication.

When the machine starts to empty, it automatically reorders supplies. "Our idea is to make this as easy as possible for the office staff," Rosenblum says. "If this slows the doctor down, it will be a nonstarter." Doctors also make a commission on each prescription.