In April about 50 pharmacists met in Galveston, Texas, to start a movement with a compelling goal: to return professionalism to their lives. "We need to create working conditions that foster dignity, self-respect, and integrity in the personal, professional, and working lives of all pharmacists," James Plagakis, RPh, the founding director of The Pharmacy Alliance, said.

"The Alliance is born from a discomfort that has gotten progressively worse during the last three decades," he adds. "The unease that too many of us feel comes from unsatisfactory working conditions and a loss of professional control. We can change that by working together."

"We have to take back our profession from the insurance companies," Alliance member Ronald Benson, RPh, a pharmacist in rural Alabama who has been practicing for 26 years, said. "In the time I've been a pharmacist, conditions have deteriorated, and it is affecting all of us. And it's affecting the public health. It's a safety issue when you have the profession being run by people who are only worried about the bottom line."

The Alliance hardly lacks for energy or creativity. Its 14 core principles reflect a concrete agenda, addressing such matters as compensation, meal breaks, an increased professional emphasis on the role of pharmacists as counselors, and the proper function and staffing of drive-through areas. "This is certainly about more than money," Plagakis said. "It is about improving our professional lives, the profession itself, and the quality of care our patients receive."

One of the principles includes what the Alliance calls a "Dignity, Self-Respect and Integrity Sign-On Agreement." The demand for pharmacists exceeds the supply in the current market, so signing bonuses have become common, especially among chain pharmacies and health systems. "That offers an excellent opportunity for new pharmacists to speak up," said Plagakis, who writes a monthly column for Drug Topics. "Even a simple thing like a lunch break is too often a point of contention. It's a good idea to make things clear up front."

The signing agreement states that pharmacists should be allowed "to take a 30-minute uninterrupted meal/rest period for each eight hours of work and an additional 15-minute uninterrupted rest period during a 12-hour shift."

An element of the agreement that Plagakis said is especially important stipulates that pharmacists "will always be managed by a pharmacist. He/she will never be managed by a non-pharmacist."

Plagakis and other Alliance members point to Wal-Mart as an example of the deterioration of professionalism that can result when pharmacists are not in control of their professional lives. "Four-dollar generics, sold just down the aisle from toys, creates an atmosphere where we are basically just selling commodities," Plagakis said. "Patients lose vision of us as providing a highly valued service."

He and his colleagues see some hope in such recent professional developments as the Medicare Part D provision for reimbursement for medication therapy management. "But who is getting paid for that now?" Plagakis asked. "The chains. We need to create a professional environment that allows the individual pharmacist to be respected and individually compensated for the work they've been trained to do in six years of education."

That can happen only "if we solidify the profession's intellectual future," according to Paul Trusten, RPh, of Midland, Texas, a health-system pharmacist and a founder of the Alliance. To that end, he and other members would like to see state boards of pharmacy demand that licensing be moved from general state registries to health departments. "In most states now, licensing is handled as through we are tradespeople, not healthcare providers," said Trusten.

Regardless of state action, there are steps individuals can take, such as securing a national provider identifier number that is required for Medicare compensation. "That's not as a protest or a weapon," Trusten said. "It's simply something that is available to all pharmacists. It takes just a few minutes and there's nothing to lose and much to potentially gain in such a simple step." (Information about NPIs is available at https://nppes.cms.hhs.gov/NPPES/Welcome.do.)

"Basically, we are filling a void," Plagakis said of the Alliance. "We feel that a new paradigm is needed. We want to make ourselves available as agents of change."

See http://www.thepharmacyalliance.com/ for more information.