Dear Colleagues: The doctor is out? Not exactly, but how refreshing it was to read The New York Times lead editorial titled, “When the Doctor is Not Needed.” The article is one in a series of opinion pieces aimed at reducing the cost of medical care while improving quality. Its key point was that the worsening shortage of primary care physicians can be addressed most effectively by the more appropriate and evidence-based use of other professionals, including pharmacists.
I usually hold my breath when I begin reading pieces on a reformed health system. I know that in too many cases the “obvious” is overlooked and the roles pharmacists can play in improving quality and saving dollars go unmentioned. Not the case here. Citing the report submitted to the U.S. Surgeon General by top pharmacy leaders in the Public Health Service, the editorial suggests that more pharmacists should be empowered through state and federal regulations to manage medications, including initiating, adjusting and stopping therapy.
The editorial addressed other professionals, including nurse practitioners, community health workers, retail clinic professionals and in-home care coordinators. Thinking we’ll fix what doesn’t work in healthcare by adding more of the same players playing the same roles is simply wrong.
The AACP Council of Deans task force chaired by Dean M. Lynn Crismon, Ph.D., last year provided a laser focus on what this new health system will require of our graduates. We know they are bright clinicians armed with the most remarkable knowledge of medications. Virtually all leave school credentialed to make important contributions to public health priorities, especially increasing immunization rates in our communities.
Essential competencies for their continued success include the ability to provide education and coaching to an increasingly diverse patient population, work in teams, lead and continuously adapt to change, provide physical assessments, and use electronic patient health records and registries. All of these concepts were loudly reinforced at the September summit convened by ACPE.
The path forward is illuminated. Opportunities for pharmacy practitioners, educators and students to accelerate the needed changes in medication optimization, access to care and care coordination have never been closer to meaningful materialization. As President Bootman challenged us, “Let’s get to all the right tables of influence.” We certainly have much to bring with us.
Lucinda L. Maine, Ph.D., R.Ph. CEO and Publisher