Ernest P. Gates, Jr, RPh, FASCP, FIACP

That was then

I remember the local pharmacy of my boyhood with great fondness. The pharmacist who owned the drugstore was a small business owner who oversaw the operation of a retail kingdom, selling everything from health and beauty aids to greeting cards and everything in between. The pharmacy of my youth included a lunch counter and a soda fountain where I could get a vanilla coke blended for me on the spot, a thank-you gift for my time from the pharmacist as I waited for my prescription to be prepared.

Today's pharmacy is different from the one I knew as a youth. It's even different from the one I owned earlier in my career. Yes, you can still get prescriptions and over-the-counter medications, but now you can buy a host of other products that rival those of the convenience store, not to mention the hardware store, photo shop, and all the rest of the now long-gone specialty stores.

With the intensification of the primary care shortage as fewer doctors choose primary care and more choose specialties, an array of healthcare professionals is helping to provide care on the front lines. Pharmacists, who are entirely up-to-date on newly developed drugs, drug interactions, and drug allergies, have assumed their rightful role on the patient-care team, particularly in the delivery of medication therapy management (MTM) services. This presents an opportunity that the pharmacy industry must leverage.

For large chains and independents, the savings realized by providing advisory services can be substantial. Pharmacists have been providing medication counseling for years, but in light of pharmacists' newly elevated role, the result of more education and in some cases changes in law, they are even more vital to the lives of their patients. By moving out from behind the counter, pharmacists can speak with patients one-on-one; develop an understanding of their medical issues; provide information about medications, dosage, efficacy, interactions, and side effects; and, if appropriate, after consultation with patients' prescribers, suggest money-saving generic alternatives.

In the case of either a doctor or pharmacist, nothing is more valuable than observing and interacting with the patient. You can get a better sense of whether the therapy is working or has created other issues. You also can get a sense of whether a patient is adhering to the regimen. These things do not occur when you're working eyes down on a bench.

By working with patients directly, you earn the opportunity to build trust and a personal relationship, and to provide a great experience that will have patients coming back for more. And in terms of our modern-day pharmacy, more means not only prescriptions, but holistic products, supplements, and all the other goods available in the front of the store.

The bottom line

Included in the pharmacist's ever-evolving role in MTM are such tasks as reviewing a patient's use of over-the-counter and prescription drugs, reconciling the patient's use of medications, and educating the patient in a way that improves the patient's health and reduces the nation's healthcare costs by taking advantage of money-saving generic drugs.

In the course of providing these services, pharmacies will generate good will and more business for the front of the store. Direct pharmacist-patient contact leads to better health, lower patient and insurer costs for medications, and in the long run more business for the pharmacy. As our healthcare system evolves, one can even see a day when insurance companies compensate pharmacists for the time they spend educating both patients and doctors.

Ernest P. Gates is the President of Gates Healthcare Associates ( http://www.gatesconsult.com/), a Massachusetts-based pharmaceutical and healthcare consulting firm.