Drug Topics - July 2011 - (Page 60)
Drilon Saliu, PharmD, and Jennifer D. Goldman-Levine, PharmD
It’s now or never
I If we want to protect our futures, we need to a acknowledge that the pharmacy profession needs signiﬁcant transformation, now more than ever. s
The Rodney Dangerﬁelds of healthcare
Pharmacists have prescribing authority in most states. Yet this privilege is not recognized or employed to the extent that the law allows, despite a training in pharmacology and pharmacotherapy that is greater than that of other midlevel providers such as nurse practitioners and physician assistants. As experts in pharmacotherapy, pharmacists should be valued members of care teams. Instead, the same companies that are demanding quantity and speed are pushing pharmacists to become immunizers as well. Is this truly about pharmacists being midlevel providers? Why would we expend so much effort, time, and money to seek this role when we should be practicing collaboratively as experts in pharmacotherapy? Hundreds of published papers support this more informed understanding of the practice of pharmacy, yet we still are not recognized nationally as providers.
Rigorous training In our profession the entry-level degree is now Doctor of Pharmacy. In spite of this, we have missed many opportunities to propel our profession forward. In the United States today, 4 years of graduate study of pharmacy lead to the Doctor of Pharmacy degree. This period of study equals in length the Doctor of Medicine degree. The pharmacy curriculum encompasses perhaps one of the most demanding trainings to be found in all the professions, spanning 3 years of intense classroom study coupled with introductory clinical experiences and concluding with a year of advanced practice rotations. Today’s pharmacy graduate receives more training in the disciplines of pharmacology and pharmacotherapy than does any other licensed healthcare professional in the United States. These 2 disciplines have been a naturally collaborative and complementary unit since the division of pharmacy and medicine in the 1400s, when the physician began focusing on diagnosis and the pharmacist on pharmacotherapy. So what’s wrong? So what is wrong in this country? Why are we producing clinical pharmacotherapy experts with advanced training when there are not enough positions waiting for them? Today, after 4 years of advanced study, those graduates choosing careers with large chain operations face demands for speed and quantity rather than accuracy and quality. Patients are thought of as “customers” and are rewarded with incentives if the pharmacist doesn’t ﬁll their prescriptions within a certain number of minutes. For pharmacists who do not ﬁll prescriptions fast enough there are negative ﬁnancial consequences. Why is it unacceptable for the patient to wait for a prescription to be ﬁlled accurately? Ninety-eight thousand people die every year from medication errors; why is it unreasonable for the patient to wait while the pharmacist screens for possible problems and conﬂicts in drug regimens?
No more lost time As we move forward with healthcare reform, let us not lose any more time. Let us come together, focus, plan, and demand that we be recognized as healthcare providers making a critical contribution that this country can ill afford to do without. The statistics are frightening. Morbidity, mortality, and costburden are astronomical in terms of preventable medication errors. Pharmacists are better prepared than any other licensed healthcare professionals to contribute in ways that will surely change these statistics. Let us redeﬁne our practice as community and independent pharmacists to include the roles of community health practitioner, patient advocate, and resource for interdisciplinary healthcare teams. We also need to continue to expand our roles in ambulatory care centers and inpatient settings. We can’t depend on professional pharmacy organizations to fix this for us. If we continue to accept the status quo, then so will the public and other healthcare professionals. It’s time to put into action what we were trained to do and protect the future of pharmacy.
Drilon Saliou is a senior medical science liaison – diabetes with
Boehringer-Ingelheim Pharmaceuticals. Jennifer D. Goldman-Levine is a professor of pharmacy practice at Massachusetts College of Pharmacy and Health Sciences.
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