While am certain that Bob Dylan was not referring to health care reform when he wrote the first verse to this prophetic song in 1963, it has certainly stood the test of time when it comes to the major changes we’ve seen in health care since he penned it. And I’m pretty sure that Walgreens was not thinking about Dylan’s classic song when it announced last month that it had been approached by the UnitedHealth Group to be a founding partner along with YMCA of the USA in offering its patients with type 2 diabetes access to its new Diabetes Control Program. And while Walgreens is not the first pharmacy to offer a program to counsel and monitor patients with type 2 diabetes, this does represent the first time a major national pharmacy chain has taken more than a dip into the waters of utilizing its pharmacists to play a major role in medication therapy management.
I applaud UnitedHealth and Walgreens for creating a comprehensive program that will utilize Walgreens pharmacists to offer personalized coaching and counseling to help patients diagnosed with type 2 diabetes manage their condition and improve adherence to their physicians’ treatment plans. I’ve always maintained that pharmacists’ involvement in such a program was not revolutionary but evolutionary, and that it would take a major chain like Walgreens to send the message to the rest of the retail pharmacy universe that you “better start swimmin’ or you’ll sink like a stone.” According to a little-publicized press release last month, Walgreens will train pharmacists in select markets to “provide diabetes education and behavioral intervention, risk-factor reduction, health promotion and regular examinations for early signs of complications, all in the convenient setting of a local pharmacy.” Most important, UnitedHealth, a major provider of employer health care plans, “will cover these services at no charge to plan participants enrolled in employer-provided health insurance plans…marking the first time in the country that a health plan will pay for an evidence-based diabetes prevention and control program.”
Although details of what that payment will be and how Walgreens pharmacists will ultimately benefit from those payments are still unknown, I perceive the program as a huge step in taking pharmacists out from behind the counter and utilizing them for what they were best trained to do, face-to-face consultation. I also view this as a significant leap for pharmacists in reforming health care in this country. I am sure some cynics in the profession will see this program as just another way for big chains to abuse pharmacists for their own financial gain; I certainly hope that is not the case. Instead, I prefer to envision this effort as the first step in creating a new professional model for retail pharmacists. When it comes to retail pharmacy and whatever health care reform has in store for pharmacists, I agree with Bob Dylan that “the times they are a-changin’” and that as a profession we need to agree that the professional waters around us have grown and to “accept it” or get “drenched to the bone.”
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