Adding A Nutriceutical Pharmacy To A Medical Practice: Part 2

Part 1 of this article briefly discussed the concept of adding a nutriceutical pharmacy to a medical practice.

Besides helping the health of your patients, it is not unusual for a physician with a moderate size practice to be able to increase yearly profits by $100,000-$200,000 by adding an efficiently run nutriceutical pharmacy.

Here are questions I typically receive from physicians about nutriceutical pharmacies along with my answers:

Q-“I was taught that taking vitamins and minerals just give you expensive urine. Can’t we get all the nutrients we need from food?”

A-Every nerve, muscle, bone, organ, gland, cell and all bodily fluids in the human body are entirely formed from nutrients. Every metabolic pathway (i.e. citric acid cycle, urea cycle, Phase I and 2 liver detoxification, etc.) is formed from nutrients and dependent upon nutrient co-factors to keep functioning. All tissues need a continual supply of high quality nutrients to function because many nutrients are used up and are not recycled. Mitochondria require a constant supply of thiamin, riboflavin, niacin, pantothenic acid, pyridoxal-5-phosphate, alpha lipoic acid, and coenzyme Q10 in order to convert a one molecule of acetyl CoA into 38 units of ATP.

The Standard American Diet (SAD!) is junk food laden and horribly deficient in the nutrients that help our bodies function optimally. In fact these junk foods actually increase the need for specific nutritional supplements like chromium, vanadium and certain B vitamins.  Because of poor farming practices many fruits and vegetables contain only half the nutrients they contained in the 1950s.

Q-“I’m considering this but are their really any good studies about the efficacy of nutritional therapies?”

A-Yes. There is now a very large body of well-designed studies showing the efficacy of specific nutrients for specific health problems. In fact, these studies are much less biased than the ‘junk science’ that many pharmaceutical pay for to sell their products.

Q-“Isn’t selling nutrients out of my own office a ‘conflict of interest’?”

A-That is your individual choice but consider this: Pharmaceutical companies pay for their own studies and will often suppress findings that show ineffectiveness and even dangers of their drugs. That is a major conflict of interest!

So is providing your patients with professional grade, much needed Vitamin D3 and you making a profit instead of the health food store a conflict of interest for you? Especially when you can provide them with a more absorbable form with certificates of analysis proving the product actually contains the dosage claimed and is free from toxicity?

Q-“ I’m not sure my state board will allow me to dispense and sell nutrients out of my own office.”

A-Often their is no specific published ruling about this so many physicians just choose to do what’s best for their patients. If your board specifically prohibits you from selling nutrients from your office, form a coalition of like-minded physicians and keep bringing your board research to establish you are providing your patients scientifically researched nutritional therapy.

About: Dr. Dean Raffelock is a nationally known expert in integrative health care and consults for physicians nation-wide at Raffelock and Associates. You may contact him at dr.dean.raffelock@gmail.com

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Physician Income: Adding A Nutriceutical Pharmacy

By Dr. Dean Raffelock D.C., Dipl. Ac., CCN, DIBAK

Many fine physicians I know have been struggling with working longer hours for significantly decreasing revenues.

The dilemma they face is that they want to be able to spend enough time with their patients to provide quality health care but feel pressured and handcuffed by insurance company dictates. This problem has gotten so troubling for some that they question whether all the hard work and investment in medical school has been worth their present frustrations. These frustrations increase stress levels, potentially harming the physician’s own health. Some even question staying in practice.

There are a number of possible solutions to this dilemma. Some with busy practices with motivated patients establish concierge practices. Yearly fees for joining offer patients more quality time with their doctor. Insurance companies are still billed for services rendered but the entry fee often covers basic overhead and sometimes more. This allows patients to receive better health care and guarantees the physician a baseline income that can allow them to practice in a more thorough, less hurried manner while retaining more profit.

Here’s another solution that is becoming increasingly more popular. I have coached many doctors to establish their own ‘in office’ nutriceutical pharmacy. Many physicians have significantly increased their incomes by taking evidence-based seminars on nutritional interventions for common diseases and providing their patients with ‘doctor only’ professional grade nutritional products. This is a win/win for doctors and their patients. Most patients would much prefer to take nutritional products over pharmaceuticals whenever possible and prudent.

Here’s how establishing a nutritional pharmacy can work. Let’s use the example of prescribing Niaspan (niacin) to help lower LDL and raise HDL cholesterol and even more importantly lower Lp(a). If one prescribes Niaspan, the pharmaceutical company and the dispensing pharmacy make all the profit. On the other hand, if you dispense professional grade niacin out of your office, you make $15 on a $30 dollar bottle than provides 120 tablets of 500 milligrams each. In many cases the co-pay for Niaspan is more than 30 dollars.

If the patient’s liver enzymes elevate on the niacin, a standardized extract of milk thistle herb containing 80% silymarin very effectively restores liver enzymes to normal range in most cases. The win/win is that your patient gets to keep taking a highly effective cardiovascular intervention and receive all the hepato-protective effects of the herbal extract and you have just added a continuing monthly profit of $35 for the one patient.

If you choose to provide this same cardiovascular risk patient with high quality fish oil (Lovaza is massively overpriced and every bottle I’ve tested is rancid), ubiquinol (a superior form of CoQ10), and D-ribose to enhance heart muscle endurance; you now have an ongoing monthly profit of over $100 with this one patient. Plus the patient will thank you for how much better they feel.

About: Dr. Dean Raffelock is a nationally known expert in integrative health care and consults for physicians nation-wide at Raffelock and Associates. You may contact him at 303.541.9019. 

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