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    Prescribing rights: Worth it?

    Pharmacists are now recognized as providers nearly everywhere—now that they have the status, what does it mean?


    Physician resistance 

    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 Chart of VA initiativesFig. 1private 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.

    Related article: Pharmacy-physician partnership hikes efficiencies

    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.”  

    Related article: Collaborative practice gains

    “Physician friends” who can talk to patients about the value-added services pharmacists can provide are important, Day said. Eric MaroykaEric Maroyka“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

    Kathleen Gannon Longo
    Kathleen Gannon Longo is a Contributing Editor.


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    • Anonymous
      "Workload challenge" should be addressed as deplorable working conditions. "Operating at the top of our education level" when we can't even get the basics right is absurd. The study in Chicago that showed we don't even address the most basic drug interactions should have been a wake up call but what does Pharmacy do...add more to the plate to try to stay relevant. Our "profession" is notorious for providing all the services...Patient counseling..MTM...Vaccinations..Medicare-D guidance...while never addressing staffing or even renumeration to the Pharmacist that provides these services. Now we are talking about prescriptive authority which will have protocols that we will have to attest to even though we won't have time to adequately do it properly. Shame on the pharmacy leadership that does not take into account the working environment that 95% of us work in!
    • UBM User
      We need to "get real" :: We ALL know that there are too many drugs being prescribed. We ALL know that this is detrimental to the health of our patients. Why on earth would we want to become a piece of that Problem? {The same goes for vaccinations but that's a subject for another time. We've already stepped into that cowpie. What we need is the ability to UNPRESCRIBE. To take people OFF OF MEDICATIONS that they have been carelessly (yes, I said "carelessly") prescribed. A good example is the ACA / ACVP initiative called "Ditch Your PPI". That is a program to get people OFF of proton pump inhibitors because they are overprescribed, useless, and cause osteoporosis, hypymagnesemia, pneumonia, depression, B-vitamin depletion, and mineral depletion AT A MINIMUM! This is where we need to put the fulcrum. We would be heroes. Not only to our patients but to the government and to insurance companies. Let's get this started and quit talking about prescribing privileges. OMG. ~ mark Burger, PharmD Health First! Pharmacy and Compounding Center, Windsor, CA 95492