The Clinical Community Pharmacist

Clinical community pharmacist (CCP) has begun to appear recently in various venues. It was in the title of a continuing education (CE) session presented at the recent National Community Pharmacists Association convention. The CE session was presented by a panel of innovative community pharmacy practitioners who have been leaders in new direct patient care services.

Why has CCP crept into the pharmacy vocabulary? There may be many reasons, but let me suggest 1: to make the point that as the health care system changes, community pharmacy can no longer be practiced in the same way. Changing the name of the pharmacist provider may help emphasize that the old way of doing things is winding down and a new way will be required. Of course, just changing what something is called does not change what is done. To change what is done requires a change of perspective. Perhaps the use of a new name like CCP will inspire interest in the activities in which CCPs are engaged, but this approach does not always work.

Remember when pharmacy wanted to change the pharmacy curriculum to give everyone a PharmD degree? Some pharmacists and pharmacy organizations became early adopters and supported the goal. Most pharmacists probably gave it little attention, while a few pharmacists and pharmacy organizations fought it or even tried to award pharmacists a credential of pharmacy doctor (PD). A few pharmacists still use it today, but the issue is no longer of interest to most of us. The profession continues to serve patients, and PharmD graduates and BSPharm graduates work side by side.

The change in curriculum did create a new “breed” of pharmacists who have a different skill set, the desire and the experience to work as team members, and a focus on drug therapy outcomes. Yes, we are producing a different graduate today, but many current pharmacists have gained many of the same skills, an understanding of the new roles of pharmacists, and the professional maturity to lead the changes in pharmacy practice. When I see CCP, I see the growing recognition that community pharmacy will not survive if it continues to focus on the drug product and not the patient who uses it; if the end goal is to get the right medicine in the container rather than to pay attention to the outcomes achieved by a product; if each refill is just another event rather than part of a continuous care process; and if pharmacists practice independently rather than interdependently. CCPs need to focus on managing the patient population in a practice as well as on meeting each patient’s needs.

We are not there yet, but maybe using CCP will help us get there sooner. Changing the way community pharmacists are paid may get us there even quicker. When reimbursement becomes based on outcomes achieved rather than processes performed, much will change.

The promoters of the CCP recognize that a changing reimbursement system is coming, so the present practice model will not be sustainable. It will not be as simple as changing what we call ourselves, but perhaps the first step is to give ourselves a new name in order to recognize that we must do something different.

Regarding change, I have often heard the adage, “If we don’t take care of our business today, we may not be around to do business tomorrow.” Of course, if we only focus on today, we may miss oppor- tunities that tomorrow may bring. Actually, we have to focus on today and tomorrow. We have to protect today’s business while innovating tomorrow’s opportunities, but too much of either can be dangerous. CCPs will learn to balance both, keeping a handle on today’s practice model while implementing changes that will be part of tomorrow’s pharmacist role. Those who do that will be the CCPs of today. Tomorrow, they will be called pharmacists, because the whole profession’s mission will have changed.

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 life- long 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.