Expanding Pharmacy's Role

Sometimes changes occur so incrementally that they are hardly noticed until we eventually realize that drastic change has occurred. Ten years ago, no one thought of the community pharmacy as the place to go for most immunizations. I remember the fights in state legislatures regarding implementation of laws to give pharmacists the ability to administer immunizations. I remember complaints by some pharmacists who spoke against such a role for pharmacists. I also heard pharmacists’ concerns that administering vaccinations could affect their ability to safely fill prescriptions.

Today, these issues are distant memories because the community pharmacy is well established as the place where the public can get its flu shots quickly and easily. Pharmacists are a recognized health team member who can be trusted to deliver immunizations. The community pharmacy has evolved into the neighborhood health center, and society and the pharmacy profession accept this.

Right now, we are in the midst of a change in what pharmacists do and where they do it. Some innovative pharmacists are leading the way for the profession. The 2015 Pharmacy Benefit Management Institute reports that 57% of accountable care organizations employ or contract clinical pharmacists to help manage medication use. Perhaps in a few years, we will realize a similar drastic change when pharmacists are health team members in most community and ambulatory medical care practices. A recent article in the Business Insider (January 5, 2016) suggests that “pharmacists are trained to do much more than dispense medication, and they could help plug the growing gaps in chronic care management in the United States.”

Even as the profession works to (1) change laws to give pharmacists more authority to manage chronic disease and (2) promote provider status legislation to enable proper payment for this role, some pharmacists are already taking on an expanded role and branching out into different settings. A recent National Governors Association article (The Expanded Role of Pharmacists in a Transformed Health Care System) identifies some of the barriers and challenges that need to be addressed to allow the pharmacist’s role to expand. The article details how different states have addressed these barriers and challenges.

It has been encouraging to me that reports and articles such as these are coming from outside our profession. The important and expanding role that pharmacists can play is being championed for us by others outside pharmacy. When similar efforts were made 10 years ago regarding immunizations by pharmacists, incremental changes resulted in a major change. Ten years from now, things will be different: many more pharmacists will have an expanded role and will be practicing in many more settings. Current incremental changes are making this happen.

If my projection is accurate, it might affect many of you reading this today. You might disagree with me and, therefore, not feel a need to do anything different. But if you think there might be some merit to my observation, the question is: what are you doing today to get ready to take advantage of the new opportunities that will emerge tomorrow? Your future success in pharmacy will be determined by how you prepare today.

Mr. Eckel is professor emeritus at the Eshelman School of Pharmacy, University of North Carolina at Chapel Hill. He is also emeritus executive director of the North Carolina Association of Pharmacists. A lifelong 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.