Role of the Pharmacist in the Postreform Healthcare Team

In the October 2010 issue of The American Journal of Pharmacy Benefits, I discussed some of the “new”models of care delivery being created today. I havehad the honor of bei

ng part of the dialogue regarding

how these care models might be structured and am a bit

concerned as to the lack of conversation regarding inclusion

of pharmacists in these organizations.

Pharmacists bring unique value to the healthcare team. For example, when a pharmacist is part of an inpatient hospital care team, patient care in that environment can be safer and often more cost-effective. Another example is personal. I practiced medicine for 15 years in a staff model HMO in Chicago. Our office included not only physicians of different specialties with whom I could consult on a real-time basis but also a pharmacist who ran our in-office dispensing pharmacy. He helped us to understand the different medication options, with their specific side effect profiles and associated costs. I will forever be indebted to him for teaching me what a great medication Benadryl can be and how amoxicillin can be just as effective as the “new antibiotic” Augmentin at a fraction of the cost.

As part of a healthcare team, pharmacists also can support patients with a chronic condition. In cities such as Asheville, North Carolina, Polk County, Florida, and the 10 cities included in the Diabetes 10 City Challenge, pharmacists worked in conjunction with physicians to improve the clinical outcomes of persons with diabetes while also lowering costs for both these patients and the payers that were fiscally responsible for their health.

Some may ask why a pharmacist is necessary. Isn’t it the responsibility of the physician to oversee the medication care of the patient?

I believe that healthcare practiced at its best is a team effort. Physicians are trained to have a broad view of health and healthcare, which does include pharmaceuticals. They take pharmacology their first year in medical school and learn about the medications that they will utilize in patient care during their training. Physicians continue to learn about pharmacology and medication management through on-the-job experience as part of the broader ongoing education that is necessary to be a good physician. Unfortunately, that often means that we as physicians concentrate on those few medications that we use on a regular basis.

On the other hand, the art and science of medication management are the focus of both the initial training and the ongoing continuing education of pharmacists. That makes pharmacists experts in this field and a tremendous asset to the healthcare team.

When I began my career at CVS Caremark in 1999, I was 1 of 2 physicians surrounded by hundreds of pharmacists and was humbled to learn what an asset they were. I have grown to have great respect for the pharmacy profession and the many pharmacists whom I have had as colleagues and peers.

Healthcare should not be a competition. We are not competing for patients’ hearts, minds, and dollars. As we reinvent how healthcare is practiced, let’s not forget the asset that we have in our pharmacist colleagues.