Yes, Pharmacists Are Healthcare Providers
Key takeaways:
The role of a pharmacist goes far beyond dispensing. Today’s pharmacists play an integral role in our healthcare system — both in the inpatient and outpatient settings.
In addition to earning a doctor of pharmacy, many pharmacists complete postgraduate fellowship or residency programs to give them specialized knowledge in fields such as pediatrics, oncology, and cardiology.
Examples of services pharmacists provide include drug utilization review, immunizations, and medication therapy management.
In the era of modern pharmacy, pharmacists are considered the foremost drug experts and one of the most accessible and trusted healthcare providers in the community. In fact, over 90% of Americans live within 5 miles of a community pharmacy.
A 2020 study found patients visit pharmacies nearly twice as often as they visit their primary care provider. However, pharmacists are still often viewed only in the context of dispensing medication and giving vaccines. In truth, pharmacists are involved in all aspects of the healthcare system.
What education is required to become a pharmacist?
Since 2000, everyone pursuing a career in pharmacy must complete a doctoral program culminating in a doctor of pharmacy degree (PharmD). After graduation, students must also take exams covering general practice knowledge and law before earning their state pharmacist license. Finally, to keep their skills and knowledge up to date, pharmacists are required to complete continuing education before each license renewal.
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Some graduates may pursue fellowships or residency programs for more specialized clinical experience and training. Additionally, pharmacists can become board certified in a number of specialties including, but not limited to, cardiology, geriatrics, oncology, and pediatrics. Pharmacists practice in a wide variety of settings, including community pharmacy, numerous roles within hospital pharmacy, long-term care, and specialty pharmacy. You can also find pharmacists behind the scenes, working in nontraditional settings like the drug industry.
The roles and responsibilities of pharmacists
Here, we’ll look at a few examples of the ways pharmacists provide care beyond their traditional dispensing roles.
Drug utilization reviews
Drug utilization review (DUR) is a comprehensive review of drug therapy conducted by the pharmacist before, during, and after dispensing to make sure that all medications are appropriate for you.
Potential problems addressed during DUR include but are not limited to:
Drug-disease interactions
Drug-drug interactions
Contraindications or precautions due to a patient allergy
Appropriateness of therapy, including duration of therapy and dose
Duplicate therapy
Checking for adherence as well as potential abuse or misuse of the medication
Pharmacists also collaborate with prescribers and other members of the healthcare team on potential interventions to improve drug therapy.
Immunizations
Since the early 1990s, pharmacists have played an integral role in public health by advocating for, and providing, immunizations. Currently, all 50 states (as well as D.C. and Puerto Rico) allow pharmacists to administer vaccines, typically through a prescription and/or protocol with a prescriber.
In fact, according to a 2021 National Community Pharmacists Association survey, 84% of independent pharmacies offered flu shots and 80% offered non-flu vaccines. Also, during the 2020-2021 flu season, pharmacists provided almost 48 million flu shots in community pharmacies, and, as of July 7, 2022, more than 258 million COVID shots have been given in community pharmacies.
Medication therapy management
Medication therapy management (MTM) is defined by the American Pharmacists Association as a “distinct service or group of services that optimize therapeutic outcomes for individual patients.” It consists of a medication therapy review, creating a personal medication record, developing a medication-related action plan, intervention or referral, and documentation and follow up.
MTM has been shown to improve medication adherence, lower blood pressure, lower cholesterol and certain diabetes indicators, increase patient knowledge, improve patient quality of life, and improve the safe and effective use of medications.
The Centers for Medicare & Medicaid Services (CMS) requires MTM services for Medicare Part D programs, as well as some third-party payers (like state-managed Medicaid programs) that will reimburse pharmacists for providing these services.
Collaborative practice agreements
Collaborative practice agreements (CPAs) are formal practice relationships between a prescriber and pharmacist where certain patient care functions — such as prescribing, adjusting medications, and ordering lab tests — are delegated to the pharmacist.
CPAs can help streamline care, reducing the number of phone calls to authorize refills or change prescriptions. Pharmacists with CPAs often work in ambulatory care clinics, prescribing and managing health conditions such as diabetes, pain, and conditions requiring blood thinners.
Most states offer some degree of delegation. Clinical pharmacists in Veterans Affairs facilities, for example, may operate under CPAs to start, change, and continue medications, order related lab tests, and perform physical measurements.
In addition to CPAs, many states allow pharmacists to independently prescribe some medications.
Expanding the role of pharmacists in patient care
As the U.S. faces a potential physician shortage, one possible solution could be looking to pharmacists to help fill the gap by expanding their ability to prescribe and manage medication regimens.
Pharmacists have the potential to help streamline care of nonemergency minor conditions and help with the management of common chronic diseases. In fact, studies have shown that community pharmacist-led interventions can improve outcomes for a wide range of chronic diseases, including diabetes, hyperlipidemia, and HIV/AIDS.
While many states do recognize pharmacists as healthcare providers, pharmacists are not yet recognized as providers at the federal level. This prevents them from being reimbursed for providing many direct-care patient services. However, there is a bill — Pharmacy and Medically Underserved Areas Enhancement Act — that has been introduced into both the House of Representatives and Senate and would recognize pharmacists as providers at the federal level.
Pharmacist expertise can be leveraged in a number of ways to improve patient care. From prevention to comprehensive medication and disease management, pharmacists’ roles will only continue to expand as the need for accessible care increases. Although this is not an exhaustive list, these are just a handful of ways pharmacists actively participate as healthcare providers in patient care to ensure that your drug therapy is safe, effective, and appropriate for you.
The bottom line
Pharmacists play an integral role in our healthcare system and provide care beyond dispensing medication. In fact, pharmacists are doctoral-level healthcare professionals who are recognized as providers in many states, and federal legislation has been introduced to recognize pharmacists as providers nationwide. Pharmacists, as providers, are capable of helping address the looming physician shortage by assisting with the management of chronic conditions and medication regimens.
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