Health care is becoming more complex. This has increased specialization within most professions, and pharmacy is no exception. However, many rank-and-file pharmacists have resisted this idea. So, in fact, have some pharmacy organizations. The thinking is that licensure as a pharmacist is all that is needed to assure the public of high-quality performance. This leads to thinking that a licensed pharmacist is qualified to perform any function that a pharmacist is legally allowed to do.
When there was a shortage of pharmacists, even employers were reluctant to demand other credentials besides licensure for pharmacist recruits. But the manpower situation has changed. With many candidates applying for each position, employers can demand credentials that help assure that the pharmacist has the knowledge and skills to function in specialized areas of practice.
Pharmacy graduates are looking for ways to distinguish themselves from other graduates. With increasing frequency, they are opting to do residencies and obtain certifications beyond licensure. Health care organizations often require an individual to be “privileged” in order to perform a specific scope of patient care services within that organization. A candidate’s credentials may be used to grant that privilege. This is putting more pressure on pharmacists to get credentials beyond licensure.
Things seem to be changing. A few of you may be old enough to remember how some in the profession reacted to the proposal that pharmacy implement the doctor of pharmacy degree as the entry-level degree. Feeling that pharmacists with a bachelor of science degree were equally qualified as PharmD degree holders, or that employers might preferentially hire PharmD graduates, some national organizations and even some states proposed the adoption of the pharmacy doctor (PD) designation to show that an individual was qualified. I think that the motivation behind this effort was the belief by many that licensure is the only credential pharmacists need to be qualified. The fear that led to this effort was unfounded, so the PD designation has been slowly forgotten by most.
Now that board certification is growing, will the profession embrace it or fight it? The Council on Credentialing in Pharmacy (CCP) (www.pharmacycredentialing.org) has taken the position that “Due to the variability in complexity of care and increasing differentiation of pharmacy practice, CCP believes that pharmacists, like many other patient care providers, should be expected to participate in credentialing and privileging processes to ensure they attained and maintain competency to provide the scope of services and quality of care that are required in their respective practices.”
The Board of Pharmacy Specialties (BPS) recently announced that in 2013 the number of BPS board-certified pharmacists increased by almost 21% to 19,109. Six specialties are currently offered by BPS: ambulatory care pharmacy, nuclear pharmacy, nutrition support pharmacy, oncology pharmacy, psychiatric pharmacy, and pharmacotherapy. BPS has announced that it will add specialization in pediatric pharmacy and critical care pharmacy. Also, pharmacotherapy specialists can add qualifications in cardiology or infectious disease.
Besides BPS, pharmacy has the Commission for Certification in Geriatric Pharmacy (CCGP). CCGP says that the purpose of the certified geriatric pharmacist (CGP) credential is to identify and recognize pharmacists who have expertise and knowledge of drug therapy principles for older adults. CCGP’s literature suggests that the CGP credential is ideal for pharmacists who provide medication therapy management (MTM) services to older adults. Although not mandated yet by any payer, you could predict that some payer wanting to reimburse for MTM might make the CGP necessary for a pharmacist to be eligible to be reimbursed.
CCGP has about 2400 pharmacists with the CGP credential, representing a 20% increase in 2013. With this growth in the number of pharmacotherapy practitioners, in the future, many of you might be working with pharmacists holding these credentials. If credentialing becomes necessary for pharmacists being recognized as a provider—or for reimbursement for certain services—some of you may be seeking an additional credential, too.
Mr. Eckel is a professor emeritus at the Eshelman School of Pharmacy, University of North Carolina at Chapel Hill. He is emeritus executive director of the North Carolina Association of Pharmacists. A lifelong advocate for the profession of pharmacy, Mr. Eckel has lectured on pharmacy issues and trends in all 50 states and has traveled to 6 continents to promote, and educate audiences on, the role of the pharmacist.