At Molina Medical Group clinics in Southern California, a vending machine rather than a pharmacist dispenses prescription drugs.
Molina officials say the machines make life simpler for patients, but their use has drawn objections from some pharmacists.
The kiosks are the size of a large refrigerator. They hold a stock of medications for common ailments such as colds, flus and rashes, so patients can have their prescriptions filled before leaving the clinic.
"With our patient population, there may be some barriers to getting over to the pharmacy to pick up medication," said Gloria Calderon, vice president of clinic operations for Molina.
The company serves largely low-income patients through programs such as Medi-Cal and Healthy Families. The robotic pharmacies improve access to medications for patients who may struggle to find child care or transportation.
InstyMeds Corp. of Minneapolis released the kiosks in 2002. They are now installed in about 200 locations around the country, company spokeswoman Emily Theisen said.
Long Beach-based Molina is the largest organization to have installed the dispensers. They operate in all its clinics in California and Washington, including its 10 in Southern California.
In Sacramento, many of the patients at Molina's clinic on Norwood Avenue are children, and the robotic pharmacy, which has been in place for almost two years, is especially popular among their parents, clinic administrator Veoletta Huerls said.
The machines also eliminate delays that result from transferring insurance information from clinics to pharmacies.
"My last name is different from my kids', so I'd have to bring more documents into the store or they'd have to call the doctor to verify that I am the mother," said Angelica Garcia, who brings her four children to the Norwood Avenue clinic.
Their pediatrician, Dr. Bobbi Underhill, said approving prescriptions for insurance purposes can sometimes require more than a day. Using the dispenser at the clinic, the wait is rarely longer than 10 minutes.
Doctors at Molina clinics always offer their patients the choice of having the prescription filled at a regular pharmacy. Underhill said only one of her patients had taken that option.
Some pharmacist groups have raised safety concerns about the kiosks, which are potential competitors.
Jon Roth, chief executive of the California Pharmacists Assn., said removing pharmacists from the process of prescribing drugs "could at best result in suboptimal therapy and at worst result in dangerous therapy."
Pharmacists traditionally consult with patients and physicians, suggesting cheaper, safer, or more effective treatments when they are available.
"That dialogue is all about maximizing outcomes for the patient and minimizing the risk," Roth said.
Safety concerns are unfounded, said Calderon, who noted that no problems resulting from drugs prescribed by the robotic pharmacies had been reported to Molina.
"You cannot substitute for a human being with experience," Underhill conceded. Yet, she said, the robotic pharmacy checks for drug interactions and prints an easy-to-understand disclosure for patients.
"It is a machine, but it is a very well-thought-out machine," Underhill said.
Some InstyMeds machines are used directly by patients, who type in a code and their birth date to get their prescriptions. But at Molina clinics, nurses and medical assistants operate the machines.
Underhill watched a medical assistant retrieve drugs from the Norwood Avenue clinic's kiosk, which sits in a converted exam room. "I think it's the future," she said.
The prescription was for one of her patients, a newborn who was having trouble breathing. Without the dispenser, she said, "He'd start wheezing again before they got to the pharmacy."
Ehrenfreund writes for the Sacramento Bee/McClatchy. Times staff writer Salvador Rodriguez contributed to this report.