The discussions have gone on for years. Even though the Supreme Court has now ruled on the Affordable Care Act, the healthcare debate will continue in Congress with the typical partisan rhetoric.The primary focus of the healthcare debate thus far has been “provision of coverage.” That said, what happens when 30-50 million more Americans have coverage of some type? How will the system accommodate them? The pool of direct patient care providers is already insufficient to care for the patients we have.
At the same time, the physician population is graying at an alarming rate and projections of serious deficits in physicians and midlevel practitioners become very real issues for the entire healthcare system over the next 10 years.
One way to remedy this dilemma is to better utilize pharmacists in healthcare settings.
Pharmacists can provide medication therapy/chronic disease state management under protocol to help fill some of this void. Pharmacists can be instrumental in manipulating complicated medication regimens and in chronic disease medication management, but after diagnoses have been made and after initial treatment plans and protocols have been established based on physician extension principles. These kinds of processes capitalize upon the talent pool that organizations already have through reallocation of personnel assets.
In January of this year, Dr. Regina Benjamin, the U.S. Surgeon General, verbalized support for these principles. Some of her recommendations include:
1. “Health leadership and policy makers should further explore ways to optimize the role of pharmacists to deliver a variety of patient-centered care and disease prevention, in collaboration with physicians or as part of the healthcare team. These collaborative pharmacy practice models can be implemented to manage and prevent disease, improve health care delivery and address some of the current demand on the health care system.
2. “Utilization of pharmacist as an essential part of the healthcare team to prevent and manage disease in collaboration with other clinicians can improve quality, contain costs, and increase access to care.
3. “Recognition of pharmacists as health care providers, clinicians and an essential part of the healthcare team is appropriate given the level of care they provide in many healthcare settings.”
The ability of the pharmacist to extend the reach of physicians can be an important aspect of a comprehensive overhaul of patient management workflows inside healthcare systems. This allows organizations to enhance efficiency by delivering care to more patients per unit of time with current staffing levels, while potentially improving outcomes.
Allocating pharmacists’ talents in ambulatory care areas can also pay tremendous dividends. Pharmacist-led ambulatory clinics have proven for years they can positively impact readmission rates, compliance and patient outcomes in diabetes, anticoagulation, COPD and asthma.
Pharmacists are currently being utilized as physician extenders at many large or government institutions, often informally. However, incorporating this practice is especially important at small- and medium-sized institutions where manpower is at a premium and patient access issues are so dire.
To be successful in the future, healthcare providers need to be innovative and resourceful, taking advantage of all their assets. By utilizing pharmacists in a physician extender role, healthcare providers will be better able to meet the challenges of today and the future.
