March 28, 2012

Pharmacists Could Be Health Care Providers


This is a great article and everyone should read this. Will it work? This will depend on many factors and largest problem is the patients themselves. Why, you ask? Because many patients fill one prescription at one pharmacy and then go to another pharmacy to fill a second prescription. This is so common it is scary. I see it all the time. I asked a couple not too long ago, why they would do this. I was not surprised by the answer as I have heard it before.

They said it was not the business of the pharmacist to know all their medications. The husband goes to several doctors and goes to the three pharmacies in town to fill prescriptions from different doctors. The wife sees four different doctors and does the same. Each takes more than five different medications. I asked if they had time to talk, but they were in a hurry to get the next pharmacy.

As they walked away, I could not help but think that they are living very dangerously. They are the ones putting their health and lives in jeopardy. I wonder if they had the same attitude about keeping the supplements they take from their doctors. They were both older than me, and the wife was using a walker, but they were as unconcerned about my question and more concerned about keep information away from the pharmacist.

I am concerned about my privacy as much as the next person, but when it comes to my health, I want to make sure my doctors know and that my pharmacist knows. Granted I do business with two pharmacies, one a military pharmacy and the other a local pharmacy. You bet I make sure the local pharmacy has a list of all medications I am taking plus any supplements. I try to update the list at least quarterly with the local pharmacy.

Only once has the local pharmacy asked me to stop taking a supplement and one prescription when the two would have conflicted with the new medication I needed for ten days. I was asked several questions and the reason for the new prescription and then she told me which supplement and prescription to stop and for how long. This was most reassuring to me and let me know that I was doing the right thing by having my list of medications and supplements on file with the pharmacy.

This interview with Rear Admiral Scott F. Giberson, RPh, PhC, MPH, US Assistant Surgeon General and chief professional officer of pharmacy at the US Public Health Service in Rockville, Maryland is very interesting about moving pharmacists into the healthcare profession legislatively.

The model Dr. Giberson is proposing would compensate pharmacists (as healthcare providers) based on the level of service they provide. Much like other health professionals, as the complexity of care increases, so too would the compensation. It may include both Medicaid Part D and Medicare Part B. Currently, pharmacists receive compensation within Medicare Part D for services provided through Medication Therapy Management (MTM). However, this is limited by considerable restrictions, including the number of medications (at least seven) the patient takes and the number of chronic conditions (two or three).

This subject I am sure will continue to be put before professionals and congress.
There are even greater ramifications not mentioned here. First, most doctors are being required to submit prescriptions electronically which should help eliminate some of the pharmacy hopping done by many people. As they get closer to issuing all prescriptions electronically, it will become evident to the doctors what patients are doing and may help the doctors to avoid conflicts in medications and even supplements.

This country still has a long way to go in this arena, but progress is being made. More doctors as beginning to ask the right questions about prescriptions and supplements and some are beginning to insist on a complete list from their patients. Some even are requiring that patients bring the actual medications with them to the appointments. A few doctors are even asking to see the supplement bottles as well. Patient medication safety is on the move and will be slowly implemented. Now is the time and next the clinics in many communities will be brought into this.

1 comment:

Anonymous said...

I consider pharmacists to be a major part of the health care team. If they make errors in dispensing then their patients suffer. They have a wealth of nowledge that is under-tapped. Your article is excellent. Congratulations..Diane