Independent community pharmacies and their unique services are growing the profession.
As I write this, I am facing another career transition, leaving my role as a state pharmacy association executive (at NCAP). I have had many different pharmacy positions and enjoyed them all, but being a state pharmacy association executive has been one of the most challenging and also among the most enjoyable and fulfilling. The breadth of activities is one of the main reasons. Almost everything going on in pharmacy affects members of the state pharmacy association. The state executive position offered me the most opportunities to influence pharmacy’s future. I will miss this role.
I began my career as a hospital pharmacist, training in and then working in an academic medical center. For a period of time, I thought only hospital pharmacists cared about the profession and were willing to invest time in advancing pharmacy practice. I held this view because I spent all my time interacting with hospital pharmacy organizations. As I broadened my pharmacy involvement, I began to realize that there are excellent, caring pharmacists in all practice settings.
When I started at NCAP I asked many people for advice. One recommendation was, take care of the local community pharmacists’ needs and your association will be successful. I do believe that pharmacist entrepreneurs, because they have so much invested in the profession, are likely to give back to the profession. A profession is made stronger by entrepreneurs who bring change. Plus, having the option to become self-employed, I think, has helped to keep the salaries of employee pharmacists higher.
With the ever-changing health care arena, independent community pharmacies are continuously presented with new challenges for delivering value and quality while controlling costs to earn a profit. They have a history of finding innovative ways to contribute to the marketplace. By offering specialized services and creating niche markets, independent community pharmacies have remained competitive and grown as small businesses. This trend, plus communicating with other health care providers, managing medications and disease states, and offering creative front-end sales, has kept independent community pharmacies earning a profit in these tough economic times.
An independent community pharmacy places at its core a dedication to its community, which allows it to provide needed niche services. This year’s NCPA Digest reports the following areas of patient care to which independent community pharmacies are contributing: medication delivery, durable medical goods, patient charge accounts, compounding, scheduling patient appointments, patient education programs, health screenings, ostomy, pain management, and home infusion. Offering patient care services provides a competitive advantage for independent pharmacies.
Community pharmacies are often the link between doctors and patients. In the NCPA Digest, pharmacists reported interacting with another health care professional regarding a patient’s drug therapy 7.1 times per day. Eighty-one percent of independent community pharmacists were reported to offer recommendations for therapeutic changes in patients’ drug regimens, and 73% of those recommendations were reported to be accepted by health care providers. Almost 93% of independent community pharmacists recommended brand to generic drug changes, and 80% of those recommendations were reported to be accepted by health care providers. Independent community pharmacists are intervening and communicating with health care providers on behalf of patients to enhance patient care.
As the baby boomers age, the number of seniors requiring special care is growing. Independent community pharmacies are providing pharmacy services to assisted living, hospice, and long-term care facilities. These senior patients are on several medications to manage many disease states. A growing niche for independent community pharmacists is offering medication review and management of medications and disease states to senior patients. Medication therapy management (MTM) services ensure that a patient’s medication regimen is appropriate for concomitant disease states—and that it is safe and affordable. Sixty-seven percent of independent community pharmacies were providing MTM services and 60% were receiving MTM reimbursement from Medicare Part D.
Through disease management, pharmacists are ensuring that the patient’s medications are achieving treatment goals. The NCPA Digest reports that the independent community pharmacies are contributing to the following disease management services: immunizations, diabetes training, blood pressure monitoring, smoking cessation, lipid monitoring, asthma management, weight and osteoporosis management, HIV/AIDS services, anticoagulation monitoring, and cancer awareness education.
The value of the pharmacist’s role in the health care system continues to be demonstrated every day. The high rate of acceptance of independent community pharmacist recommendations by providers continues to show the value of the pharmacist-patient-provider interaction. The ability of pharmacists to be reimbursed for medication and disease management shows that these activities are valued by the health care system. Because we continue to have strong pharmacy entrepreneurs, we have a strong profession. PT
Mr. Eckel is a professor at the Eshelman School of Pharmacy, University of North Carolina at Chapel Hill. He serves as executive director of the North Carolina Association of Pharmacists.
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