An increasingly integral part of the healthcare system.
By Cindy Stowe
Every day, pharmacists make a difference in people’s lives. Modern healthcare is complex and getting more complicated all the time. Often, patients lack the information they need to make good decisions and may struggle to afford the medications prescribed. Pharmacists are medication experts who work with the healthcare team to help patients achieve individualized healthcare goals.
Although pharmacists are among the most accessible healthcare providers, they are unfortunately also some of the most underutilized. A simple explanation for the under-utilization is related to the reimbursement model for most pharmacy services. Pharmacist reimbursement is linked to a product (dispensing fees for medications) rather than the care they provide to patients.
Despite the history of the profession as a product-driven, mercantile business, recent advances in pharmacy practice have led to an interesting evolution of the profession towards a more robust and diverse model for the delivery of direct patient care services.
Pharmacists as Leaders
I believe that today, more than any other time in my career, the profession needs pharmacists who are leaders – not only committed to improving the health and wellness of their patients but willing to advocate for their profession. There are many reasons to consider a career as a pharmacist.
As a pharmacist who has spent my entire career in academia, I have participated in numerous pharmacy school candidate interviews and a consistent finding is that most applicants state that they want to be a pharmacist because they have a desire to help people and they value the diversity of career paths within the pharmacy profession.
These are both true, and I am excited about what the future holds for the profession and for those who are pursuing a career as a pharmacist. Despite many advances to the practice of pharmacy many people still perceive the community pharmacist as one who ‘just’ dispenses medications.
However, the figurative gap between community-based pharmacies and ambulatory clinics is beginning to narrow with the provision of direct patient care services by pharmacists in what have historically been referred to as retail pharmacies.
Contemporary pharmacy education strives to prepare entry-level practitioners who can advance the health and wellness of their community through the provision of direct patient care regardless of the setting in which pharmacists practice. Pharmacists, once licensed, may enter directly into practice or pursue further education through a residency. Residency education prepares pharmacists to take on practice in more specialized settings or with specific patient populations.
Direct Patient Care
Pharmacists provide a wide array of health screening services such as blood pressure, blood glucose and bone density. Direct patient care services are provided in pharmacies by pharmacists in collaboration with other healthcare practitioners such as physicians, nurse practitioners and physician assistants to maximize the health and wellness of patients. These services are focused at helping manage chronic diseases such as diabetes, hypertension, lipid disorders, asthma and COPD to name a few.
In addition to helping manage chronic diseases, pharmacists have become critical in disease prevention and other public health activities through the administration of immunizations and advancing access to naloxone for the treatment of opioid overdoses. It is hoped that pharmacists in Kentucky will soon be able to provide an even wider array of services (e.g., tobacco cessation therapy, tuberculosis skin testing) by protocol (standing-order) from a physician for any patient that may come to the pharmacy meeting the criteria outlined in the protocol.
Legislative initiatives to advance the role of pharmacists and expand access to quality healthcare are being actively pursued. An example of this in Kentucky is SB 101, an act allowing pharmacists to administer immunizations under protocol to patients down to nine years of age. This bill was approved by both houses of the legislature and signed by Governor Matt Bevin, ensuring that pharmacists can deliver healthcare to more patients.
On the federal level, provider status is being sought to improve patient access to healthcare through pharmacist delivered patient care services (115th Congress: Pharmacy and Medically Under-served Areas Enhancement Act, HR 592 and S 109). This will allow pharmacists in designated medically under-served areas to get reimbursed for the provision of direct patient care services.
The pharmacy profession is on the cusp of a significant transition from a product-driven profession to a service-driven profession. It is an exciting time to be a pharmacist or pursuing a career in pharmacy!
-Cindy Stowe is dean of the Sullivan University College of Pharmacy in Louisville, Ky.
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