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    Pharmacy schools and 21st century healthcare

    What if our profession turned the "glut" of pharmacy schools to our advantage and used the schools to address the unfolding challenges of 21st century healthcare delivery?

    As long as students feel they want to become practicing pharmacists or want to use their pharmacy education as the basis for a science-based career, there will be a demand for pharmacy schools. It goes without saying that pharmacy schools cost money to open and money to keep running. Eventually, when they reach the point of lacking sufficient enrollment, the pharmacy "glut" will force the schools to dry up.

    I can see where the chains would want to encourage an increase in the numbers of graduating pharmacists. They can't open up stores without them. They claim that they cannot afford to pay pharmacists the salaries we demand for the work we currently perform at most chain stores. Presumably the chains think that greater competition among pharmacists for available positions will drive down pharmacist salaries.

    More to pharmacy than filling Rxs

    I feel that this whole issue is skewed. As a profession, "pharmacy" is going in the opposite direction from where we want to go. In fact, with more pharmacists available, we can provide more services that will enhance patients’ lives. We know we'd like to provide these services, but we can't, in light of the miniscule profits presently gained from dispensing (selling) prescriptions.

    From the point of view of retail pharmacy, at the present time we're knocking ourselves out filling as many Rxs as possible as fast as possible, in an effort to keep up with the ever-increasing volume of work. At the end of the day, did we make enough gross profit to cover costs and make a profit? Maybe yes, maybe no. And in addition to financial considerations, there is also the question of whether we want to endure the stress of filling so many prescriptions — not to mention the attendant responsibility and liability.

    New competencies, new niches

    This is where MTM comes in. If we can demonstrate (and document) that MTM is a professional specialty that can both improve the overall system of healthcare delivery and decrease medication costs enough to pay for itself, we have a chance to put pharmacists to work using their education and experience. No profession is better suited than pharmacy to do this.

    To begin the process of making MTM a formal part of our logistics, we must educate pharmacists first about its value to the bottom line and then see whether they can develop the algorithms to execute that function in an efficient and profitable manner.

    The pharmacists providing MTM must also be capable of doing the job. We know that many older pharmacists don't keep up with professional developments to the point that they're competent enough to do the job as well as they should, and they can jeopardize the practice for those of us who do make a point of keeping up so that we can do the job properly.

    Extend pharmacist skills

    I suggest that we certify consulting as a specialty niche, just the way ASCP does with certified geriatric pharmacists, who undergo rigorous testing to make sure they keep up with those skills. For example, Florida has (or used to have) testing for licensed pharmacists who consult in extended-care facilities.

    There are courses that pharmacists can take to bone up on the necessary skills. And this is precisely where the glut of pharmacy schools can help propel the profession into the 21st century.

    Pharmacists who have been in practice for a lengthy period could take courses over a period of several months that would enable them to sharpen their skills and keep up with contemporary developments. Curricula could be structured in a way that would take into account their year of graduation, or perhaps pharmacists could take an introductory test to see where their knowledge might be deficient and what courses they might need to take to maintain their edge.

    Prepare to meet a growing need

    We must find a way to bring our fellow pharmacists, young and old alike, into the 21st century, the century of pharmacist-based healthcare. Let’s face it. The need for our services grows by the day. Doctors are too busy. Nurses don't have the necessary breadth of knowledge. It is pharmacists who can fill the gap in service delivery — and in so doing, contribute to a team effort that will serve the public more efficiently and economically than we see today, as the different camps of healthcare providers pursue their various self-interests.

    While Tony Mavrantonis has retired from the practice of pharmacy, he maintains an active interest in the profession. He lives in Tiburon, Calif., and can be reached at [email protected]