Zoom+Care Wants Physician Assistants to Dispense Controlled Medications

SB 423 would remove geographic barriers for physician assistants on the dispensation of some scheduled drugs, such as Sudafed. The pharmacist lobby wants to assure that PAs are logging their dispensing records on the Prescription Drug Monitoring Program.

Zoom+Care is pushing a bill to let physician assistants dispense Schedule III and Schedule IV controlled substances to patients who visit their clinics.

“It would create uniform dispensing standards statewide,” said Zoom+Care lobbyist Len Bergstein, noting that physician assistants in rural areas can already dispense these drugs as can physicians and nurse practitioners across Oregon. Senate Bill 423 would give Zoom+Care’s urban physician assistants the same flexibility.

Dr. Albert DiPiero, the co-founder of Zoom+Care, told The Lund Report that his clinics plan to dispense just two controlled drugs -- Tramadol, for moderate to severe pain; and Pseudoephedrine, for sinus congestion. In most states, Pseudoephedrine, or Sudafed, is an over-the-counter drug, but Oregon requires a prescription because of its misuse as an ingredient in methamphetamine.

“We’re dispensing small quantities to get through a treatment,” said Larry Cartier, the pharmacy director at Zoom+Care. “Our goal is not to turn our clinics into pharmacies.”

Cartier said a clinic can dispense about 10 to 12 prescriptions a day currently, saving patients an extra trip to the pharmacy. The practice is not done for the majority of patients, and Zoom+Care does not currently dispense controlled substances.

Bill Cross, the chief lobbyist for the Oregon State Pharmacy Association, objected to the expansion. The pharmacists had previously worked to limit dispensation by non-pharmacists to rural areas with access problems.

“I don’t think these drugs are problematic at all,” said Sen. Elizabeth Steiner Hayward, D-Portland. “There’s a huge jump between (schedule) III and II,” adding she would not support allowing physician assistants to dispense Schedule II drugs, which include the most widely abused opiates and benzodiazepines.

Cross did win support from Steiner Hayward for an amendment that will explicitly require physician assistants to report to the Prescription Drug Monitoring Program when they dispense medications, as pharmacists do now.

Cartier said that Zoom+Care would have done this automatically through its computer system. However, other clinics may not be as transparent.

Zoom+Care has another bill -- Senate Bill 817 -- which is scheduled for a hearing next week. This one would delineate two types of emergency rooms -- one for traumatic incidences and one for simpler acute care such as treated at their Zoom Super clinic in the Lloyd District of Portland.

That bill will be a bigger fight as it has drawn the opposition of the Oregon Association of Hospitals & Health Systems, which have objected to Zoom’s use of the term “emergency care” to describe their acute-care offerings.. “They’ll say it’s a service issue when it’s a business model issue,” said Bergstein. “They don’t want the competition.”

Chris can be reached at chris@thelundreport.org.

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