Nursing Home: Pharmacist Counseling patients about medications

[ChristopherMD20]

Hello WCI community.

My wife is a clinical pharmacist and she is considering doing some "moonlighting" by offering her expertise with patients in nursing homes. She is considering taking this one of two routes. One, she would do medication therapy management for which she could charge a fee for her professional services. There would be an extra twist that would combine her profession as well as one of her hobbies (I'll spare you the details for multiple reasons). Two, would be that she does this as a charitable deed and does not charge the NH and helping elderly people. Either way she would be happy.

Questions:
1. How lucrative is MTM counseling for pharmacists (she's quoting me very large ranges, but I can't imagine it is a very lucrative endeavor)?
2. Are there liabilities one should consider and protect against outside of her private malpractice insurance?
3. Do you think nursing homes would benefit from having a clinical pharmacist make "counseling rounds" once a week?
4. How does one "write off" their professional time as a charitable deed?

[startupdoc]

Polypharmacy is a problem, no doubt. Many geriatricians are addressing this very issue in their outpatient visits (which would be covered by insurance).

 

1. It may be profitable if you are in a market without geriatricians or other PCPs who do not stress this as part of their practice.

2. As long as you don't overstep the boundaries of a pharmacist (i.e. encouraging patients to change their medication regimen without consulting their doctors first).

3. Yes. But it all comes down to cost and who's paying for it. Many nursing homes would welcome it... if its free.

4. Time? Don't think you can, but don't know for sure. Anyone else chime in?

[spiritrider]

4. Regardless of the type of free or discounted services provided by the taxpayer, they can not take a deduction for the value of those services or discounts.

[jasonfog]

I'm mostly a hospital-based pharmacist, but thought I'd try to help some..

I have some limited experience with MTMs and have found them minimally rewarding financially.  This was based out of a Retail pharmacy a couple years ago, so it may be different for a doing similar activities in a nursing home.

Many nursing homes need a pharmacist to review their charts and pay them as a 1099 to do this.  There are some Medicare regulations (i think) that require this.  I did this a handful of times to help out another pharmacist friend who had the actual contract agreement (I wasn't paid directly by the nursing home, so i don't have much more info)

Professional liability would plenty i'd think (and super cheap for pharmacists).

Everyone would likely benefit from chatting with someone knowledgeable about their prescription medications.

You basically cannot ever deduct your "time" for tax purposes.  Potentially mileage to and from, if it was a 501(c) maybe??

 

Hopefully the above is somewhat helpful,

Jason