May 9, 2012

Pharmacists Aren't Health Care Providers? Really?

Washington, D.C.—Pharmacists seeking to expand their scope of practice have some powerful allies in the U.S. Public Health Service (USPHS), but progress is likely to be limited until another branch of government, Congress, changes some laws.

In the new report, "Improving Patient and Health System Outcomes through Advanced Pharmacy Practice," the U.S. Public Health Service wholeheartedly endorses the idea of expanded practice by pharmacists to improve quality and lower costs of health care delivery.

The recent report was written by USPHS pharmacists with the support of the Surgeon General of the United States and argues that expanding the roles of pharmacists in the private sector, as already has occurred in government systems such as the Veterans Administration and Department of Defense, can help meet growing demands on the nation's health care system.

"Healthcare delivery (including preventive or supportive care) in the United States is challenged by demands of access, safety, quality and cost," the report states. "These challenges are amplified by provider work-force shortages and dramatic increases in primary- and chronic-care visits. Projections suggest worsening of this situation. New or additional paradigms of care must be implemented to reduce these burdens."

Federal pharmacists often have the authority to perform physical assessments, order, interpret and monitor laboratory tests, and provide care coordination for follow-up care.

The big barrier in the private sector is that pharmacists are not recognized as health care providers under the Social Security Act, although physician assistants, clinical nurse specialists, nurse practitioners, certified registered nurse anesthetists, clinical social workers, certified nurse midwives, clinical psychologists, and registered dietitians or nutrition professionals all have that status. That means pharmacists cannot be reimbursed by Medicare for therapy management and patient consultation services.

Congressional legislation to include pharmacists as health care providers in the Social Security Act has been introduced over the years but not passed.

Sandra Leal, PharmD, CDE, a Tucson, AZ, pharmacist, is using the Web site to petition Congress to change the Social Security Act to include pharmacists as health care providers. The petition had more than 20,000 signatures, as of early May.

"By changing the compensation structure allowed under Medicare, we can ensure that patients have access to the medication expertise of pharmacists," the petition states. "Studies have shown that, when a pharmacist is directly involved in patient care, patients have fewer adverse drug reactions, experience improved outcomes, and health care costs are reduced."

U.S. Pharmacist Social Connect