In recent days at the Il Quadrifoglio shopping center in Lammari, Capannori Lucca, a complex was inaugurated 
including the municipal pharmacy, with the new headquarters of over 150 square meters, and the medical offices "Area Sanitaria Europa" which houses family doctors and specialists and a small gym dedicated to physiotherapy and rehabilitation.
Pharmacist33 he reports that the news has aroused perplexity and concern among pharmacists and that an invitation to investigate further has come from many, to understand if the experience complies with all existing constraints and stakes. There are those who wonder to what extent the limit of a correct collaboration aimed at the patient that there can be between doctors and pharmacists and between doctors and pharmacies is clear.
Some experts state that there is no specific legislation prohibiting proximity: "While it is not possible to have the doctor's activity inside the pharmacy, bringing the two activities together is not illegal" says an accountant according to whom the border of legitimacy "depends on the deontologically correct behavior of professionals" with clear reference to comparing and hoarding prescriptions.
The art. 45 of rdn 1706 of 1938 provides that medical-surgical outpatient clinics must always have a different entrance from that of the pharmacies, to which they are annexed, and must not have any internal communication with them.
The prohibition of combining the pharmaceutical profession with the exercise of other health professions or arts does not prevent the planning of prevention days against the main pathologies with a strong social impact in pharmacies, with the presence of a doctor in the pharmacy. This is a point that emerges from Judgment (n. 3357 of 7/7/2017) of the Council of State (Section III), "a sentence" comments Paola Ferrari, lawyer of the law firm of the same name, "which effectively clears the presence of the doctor in the pharmacy and indicates the methods and limits with which it must be implemented". The story concerns a pharmacy which "contested the outcome of the tender called by the Municipality of Borgo Virgilio (Mn) to the Lombardy Regional Administrative Court to entrust the management concession of the municipal pharmacy using the most economically advantageous offer method".
Can we talk about customer grabbing? Can we also speak of induction to prescription and therefore induction to an increase in public spending? Is there an organic plant for contracted doctors?
The proximity of medical offices to one pharmacy rather than another does not involve any regulatory or deontological offenses.
Current legislation only provides that there is no internal communication between the pharmacy and the doctor's office and that the revenues are different. The art. 45 of the Regulation for the Pharmaceutical Service (RD September 30, 1938, n. 1706) in fact provides that: "The medical-surgical clinics annexed to pharmacies must always have a different entrance from that of the pharmacies, to which they are annexed, and must not have any internal communication with them".
For contracted doctors there is an organic plan which however does not provide for a precise territorial location but the obligatory presence of a certain number of doctors in relation to the number of residents. The provision of 23 March 2005 (Rep. 2272) of the Permanent Conference for relations between the State, the Regions and the autonomous provinces of Trento and Bolzano (State Regions Agreement - SOGU n. 134, 12 June 2006) in the matter of conventional medicine, in art. 64 envisages the presence of one doctor for every 5,000 inhabitants as a minimum ratio, leaving the Regions with the possibility of indicating a different doctor/population ratio. For example, the Emilia-Romagna region has established that the optimal ratio cannot be less than 1/1,000 and the fraction that determines the deficient area must be greater than 500 (Primary assistance - Bur N. 2, 5.1.2007 - Part II). It is necessary to verify how and if the Campania Region has legislated on the matter.
The State-Regions agreement mentioned above, in art. 35, paragraph 6, provides for a ban on the activity of conventional medicine outside the territorial area in which it is located, while paragraph 14 provides that this activity can also be carried out in several medical offices.
It can therefore be said that there is an organic plant also for affiliated doctors but that it is completely different from that of pharmacies. Furthermore, the fact that the doctor can practice in different practices, within his/her area of pertinence, means that, for example, for two days a week he can practice in a practice near a specific pharmacy, and for the remaining three days, in another practice located near another pharmacy. See art. 36 the requirements for opening medical practices, remembering that nothing prevents the pharmacist from making appropriate studies available to doctors, provided they have the separation characteristics present in the pharmaceutical legislation listed above (art. 45 of the Regulation for the Pharmaceutical Service - RD September 30, 1938, n. 1706) and reaffirmed, with regard to the affiliated activity of doctors, in the 4th paragraph of art. 36 of the State-Regions Agreement (entry independent from other healthcare activities).
From the Code of Conduct of the Pharmacist
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