Prescribing Rights: Worth it?
Pharmacists are now recognized as providers nearly everywhere—here’s a look at what this could mean for you.
While state boards of pharmacy around the nation are expanding the pharmacist’s scope of responsibilities, some physicians are still resisting pharmacists taking on these expanded duties, said Eric Maroyka, PharmD, BCPS, Director, Center on Pharmacy Practice Advancement, ASHP. “Pharmacist prescribing has been embraced more in the public sector than in the private sector.” In the VA health system for example, the pharmacist has long been accepted in this expanded role (Figure 1).
“Some states such as Washington, Wisconsin, and Ohio offer good advocacy for the pharmacist through the state legislatures," Maroyka explained; this has helped the pharmacist earn the physician’s trust and develop collaborative relationships.
Jalloh, an Assistant Professor, Clinical Sciences Department, Touro University California College of Pharmacy, agreed that it’s important for the profession to advocate for itself at the state legislature level.
To establish trust with physicians within a health-system, Maroyka said it’s not a good idea to be defensive. “Don’t shove it in his or her face that you are now able to initiate or modify therapy. Start with small wins, such as approval for reviewing maintenance medications,” said Maroyka. She added that as pharmacists establish good rapport with physicians, they will see their scope of practice expand.
“Pharmacists need to educate other health-care professionals about the value of the services a pharmacist can provide. “We need to clarify the letters next to our name, and let people know we’re certified in a certain area,” said Jalloh.
In addition, Jalloh urged pharmacists to attend conferences, and not just pharmacy conferences but conferences hosted by other health-care professionals. “Do presentations and let other members of the health-care team learn the value of the pharmacist,” he said.
Establishing a good relationship with physicians, noted Day, can yield acceptance by patients. “There will always be patients in some communities who will be less accepting of the pharmacist in a prescribing role,” said Day.
Jalloh agreed that some patients only see pharmacists “in a traditional role.”
“Physician friends” who can talk to patients about the value-added services pharmacists can provide are important, Day said. “Physicians need to talk to patients and explain that the pharmacist is part of the health-care team. If the physician says: ‘I trust the pharmacist,’ then the patient will [most likely] be open to the pharmacist,” he said.
“Patients can be great advocates,” for the pharmacist, Maroyka asserted. If the patient is able to say “the pharmacist has been helpful to me,” other members of the health care team will take notice.
“And as the need for services and access increase along with the number of insured individuals, physician resistance is lessening,” said Bobbie Riley, RPh, Vertical Market Lead for Pharmacy for LexisNexis Risk Solutions, Health Care. Recently, she said: “as pharmacists have stepped up to provide naloxone, resistance lessened, and the ease-of-access to pharmacists for additional services was viewed by physicians, patients, and caregivers in a different light.”
Up next: More barriers for pharmacists