Are Physicians and Pharmacists Too Busy to Change Their Practice Models?


The implementation of the Affordable Care Act demands changes in the way that primary care practices and pharmacies operate, but they may be too busy to make the necessary adjustments.

A recent article in Medical Economics focused on expert opinions of how the Affordable Care Act (ACA) will transform primary care practice. Updating workflow was one of the predicted changes. However, the author noted, according to data released by the Medical Group Management Association in October 2013, more than half of medical practices were planning no changes to their business to coincide with the launch of the health insurance exchanges. The reason for this resistance to change, explained the author, was that the practices—especially primary care practices—were so busy that they didn’t have the time or staff available to think about what changes might be beneficial and how to implement them.

As I read this article, I was struck by how similar the situation of primary care practices is to that of community pharmacies. If the ACA leads to a dramatic increase in the number of patients filling prescriptions—and a corresponding increase in the need for reimbursable cognitive services—the existing community pharmacy practice model will not work. However, like primary care practices, most community pharmacies are so busy that they don’t have the time available to think about how this model will need to change.

Chains might have an advantage in this regard because of their central administration support staff, but they will find it difficult to change thousands of practices at the same time. Independents can move much more quickly, but change won’t happen without a plan. I think the key will be expanded use of pharmacy technicians with enhanced computer supported dispensing systems.

We have the tools in place to make this happen. Now we need laws or regulations that will allow pharmacy technicians to play a new role. This sort of change, even when agreed to by the profession, doesn’t come quickly. Without planning, it doesn’t have a chance of happening. It will be very interesting to observe the transformation of community pharmacy over the next few years. I am, of course, assuming that it will transform. Is this just wishful thinking? What do you think?

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