The profession of pharmacy is at a significant crossroads between its conventional drug-dispensing identity and a pioneering clinical role with health care provider status. For the past several decades, the concept of provider status has been tossed around at every pharmacy school, pharmacy association meeting, and pharmacy work site. Provider status is frequently discussed, but is it really vital to our profession’s survival? The answer is a definitive yes.
A Rapidly Evolving Landscape
Federal legislation for pharmacy provider status is not a want, but a need, for the future of pharmacy. This legislation provides a new channel for reimbursement of patient care services that will not only demonstrate the importance of our profession but also provide financial benefits. It is not going to “fix” pharmacy, but it will put our foot in the door for future considerations. As a millennial, I have grown up with the adaption in the face of a rapidly evolving system as a constant requirement.
As California Goes, So Goes the Country
Provider status allows for additional opportunities within pharmacy. New roles will be created that enable pharmacists to serve the increasing patient population and needs of the new health care system. There is a commonly known phrase that describes California, one of the world’s largest economies: “As California goes, so goes the country.” California’s new provider status law has created an advanced practice pharmacist role; these pharmacists can order and interpret drug therapy– related tests, perform patient assessments, and manage disease states. Currently, the pharmacist’s role is evolving into a clinical health care provider specializing in drug therapy interventions and treatment.
My Next 40 Years
I believe that over the next 40 years pharmacists will not only dispense medications but will also provide patient-centered, individualized pharmaceutical services. As tech-check-tech, the practice of one technician checking the accuracy of another, becomes more prevalent, the pharmacist will be available to practice more clinically. With more available time, pharmacists will have to prove their value within the setting, and provider status will allow for payment to occur. Pharmacists will perform medication therapy management (MTM) services, and hold anticoagulation clinics and diabetes clinics. Furthermore, I believe that with provider status, pharmacists will need to have specialized training to work in these particular settings. Hopefully, with this new community practice setting, pharmacists will help to decrease health care costs and improve patient safety.
Within a health-system setting, provider status will effect changes ranging from the opening of new jobs to the expansion of services offered. In hospitals, pharmacists will work alongside physicians in their clinic settings to be a valuable resource for drug information, MTM, and much more. In my previous rotation site, the pharmacist would meet with the patient prior to the physician visit to go through all medications. After the physician’s meeting with the patient, he or she would direct the pharmacist to speak with the patient again about new medications, any additional questions, and much more. It was great to see collaboration between health care providers and see how pharmacists truly provide excellent services. Through all this, though, the pharmacist could not bill for their services for the hospital. In a long-term care setting, pharmacists would be able to follow up with patients on their anticoagulation medications or discuss their 20-plus medications with the individuals. Additionally, pharmacists are providing a variety of services including leading outpatient psychiatry groups at hospitals and offering home health visits for intellectually disabled individuals.
With the snowballing demand for health care services by the increasing population and shortage of physicians, something will have to change. Pharmacists could be that defining factor for many companies and patients; however, we need to make our services and value known. We have a vast array of knowledge that needs to be used at the “top of our degree.”
Pharmacist provider status is just 1 piece of the colossal health care delivery system change puzzle. Defining our role within each particular pharmacy practice setting over the next few years will determine my practice for the next 40 years.
How will pharmacy practice evolve to meet the needs of the 21st-century health care system? That is up to us, and if we don’t take measures to define it in our terms, somebody may define it for us. The first step is the passage of federal provider status legislation.
Laura Vollmer is a 2015 PharmD candidate at Drake University. She works as a graduate research assistant at the university and serves as the president of the school’s chapter of the American Society of Health-System Pharmacists. Laura is the Pharmacy Times 2014 Future Pharmacist of the Year.