US Pharm. 2013;38(6):4.

One of the perks of being publisher and editor-in-chief of U.S. Pharmacist is that I get to write this monthly column. I am able to express my thoughts on a myriad of issues facing pharmacists daily. While you may not agree with everything I have to say, hopefully I’ve successfully started a discourse on topics that are crucial to you. Not surprisingly, I get e-mail responses to what I have written. I read and often respond personally to every e-mail I receive. Since space does not permit me to reproduce these e-mails in their entirety, here is a sampling of some of them.  

A recurring theme in many of my columns is how pharmacists can reduce health costs and make the U.S. health care system more efficient by regularly counseling patients and managing their drug therapies. One pharmacist had his own solution: “All pharmacists have to do is to find the least expensive and best medication [to treat] a patient’s disease state…then discontinue all of the duplicate therapy. After that we have to monitor the patient’s progress...communicate with [the] patient and tweak the medications to achieve the best outcome.” Then this message took a bit of a cynical twist, expressing a sentiment that has become a recurrent theme in many other e-mails I receive. The pharmacist said the money saved by insurance companies should be shared with the pharmacists, but that this will never happen because of all the “backroom deals” being made between “the pharmaceutical companies, insurance companies, the government, [pharmacy benefit managers], and the chains.” It sounds as if he is encouraging pharmacists to treat patients without physician intervention. I think that is a bad idea. I do, however, think pharmacists should get paid for their consultation services. Let the doctors prescribe; pharmacists should be the medication specialists they were trained to be.

Another pharmacist wrote that he took issue with an article we published stating that “patients should consult their physician before taking aspirin to prevent stroke and heart attack.” Again, pharmacists should not be in the position to “give permission” to patients to take any medication without knowing their full medical history. Leave that to the physician. This writer went on to say that pharmacists need to quit being so passive if they expect the recognition they deserve. No argument here!  

And speaking of being passive, a pharmacist from New Hampshire commented on a piece I wrote declaring that pharmacists should be more vocal with state and federal legislators in order get paid regularly for their consultive services. This pharmacist basically stated that pharmacists should not treat the medications they dispense as commodities and should embrace their professional abilities by offering medication therapy management and other consultive services. In conclusion, he said, “I would love to see pharmacy restored to its once proud traditions.” To that I say, “Me too.”

In one column I recalled an experience in helping a sick patient at 36,000 feet aboard a coast-to-coast flight.   As I anticipated, I received many e-mails from other pharmacists who had also volunteered to leave their airplane seats and aid in a medical emergency. This just affirmed my conviction that we are pharmacists all the time, not just when we are behind the counter.

And there was no shortage of negative commentary on my column in support of the FDA and what it does to keep our drug supply relatively safe. One pharmacist called me “very naïve” if I really believe all that. He continued by saying that hundreds of thousands of U.S. citizens die each year from taking FDA-approved drugs. Despite the skepticism expressed by numbers of pharmacists about the FDA’s role in approving drugs, I’ll stick to my opinion that the FDA is an essential component in ensuring that prescription drugs in this country remain safe and effective.

Thanks to all of our loyal readers, and especially to those who take the time to communicate with us. Your comments, both positive and negative, are always appreciated. Discussion is healthy, and I aim to keep the discourse going. Hope you will too.  

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