Redesigning the Health Care Delivery System

OCTOBER 17, 2010
Fred M. Eckel, RPh, MS; Pharmacy Times Editor-in-Chief
Writing in the Archives of Internal Medicine (Volume 170, No. 15, October 11, 2010),  pharmacy professor R. Joseph Guglielmo, PharmD, responded to the suggestion made by Kevin Grumbach, MD, that in a redesigned health care delivery system, “all healthcare workers should function at the top of their level of training and skill with genuine teamwork.”

In an ideal team care setting, doctoral trained pharmacists “would not count pills” but would “counsel patients about complex polypharmacy regimens and spearhead interventions to eliminate medication errors, with pharmacy technicians and automated devices handling medication dispensing in retail pharmacies.”

In his response, Dr. Guglielmo examined this model as it has evolved in the hospital setting. He explained that one reason more of that role was not being performed in community pharmacies was that the current reimbursement system pays for drug dispensing—and not for medication therapy management.

Several questions came to my mind when I read this. Do doctoral trained pharmacists really want to undertake this role? Is it a role society wants them to play?  How long after graduation and functioning in a dispensing role does the pharmacist lose the skills, knowledge, or confidence to perform that role?  Does a pharmacist have to have a PharmD degree to be able to do this?

What do you think?


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