Chronic diseases affect nearly half of the population, yet physician shortages and unbalanced distribution of health care providers mean that as many as 56 million Americans do not have adequate access to primary health care in their communities. An elegant solution to this problem is suggested in a report entitled “Improving Patient and Health System Outcomes through Advanced Pharmacy Practice” presented by the U.S. Public Health Service to the U.S. Surgeon General. The easy fix, they conclude, is to expand the role of pharmacists in the delivery of health care.
This report outlines a solid case for why pharmacists should be more integrated into the patient care process. In fact, as the report notes: there is already extensive performance data demonstrating that “patient care services delivered by pharmacists can improve patient outcomes, promote patient involvement, increase cost-efficiency, and reduce demands affecting the health care system.” I couldn’t have said it better myself.
This report reads like music to the ears to patient-oriented pharmacists everywhere, confirming the message that pharmacists have been trying to get out. Which is this: The more involved pharmacists are in patient care, the better the health outcomes will be for patients.
The report outlines the argument in favor of pharmacist-delivered patient care through four focus points:
1. Pharmacists already play a role in primary care as health care providers in many practice settings. Yet, as the report wryly comments: “pharmacists may be the only health professionals…who are not recognized in national health policy as health care providers.” After an initial diagnosis, pharmacists are already managing disease and providing patient care.
2. Medications play a role in 80 percent of all disease treatment, which means that pharmacists are already part of the care team for the majority of patients. However, without legislation and policy changes, pharmacists cannot serve as health care “providers” since there are barriers in the payment models.
3. The medication therapy management services provided by pharmacists should be expanded so that pharmacists can be considered providers. When this happens, pharmacists will be able to improve patient and health system outcomes.
4. There are numerous studies demonstrating the potential benefits for expanding the role of pharmacists. “Pharmacists with larger roles in patient care improve outcomes, increase access to care (especially for medically underserved and vulnerable populations), shift time for physicians to focus on more critically ill patients in need of physician-based care, improve patient and provider satisfaction, assure patient safety, enhance cost-effectiveness, and clearly advance and improve health care delivery,” concludes this report.
I have spent over 30 years in acute care in hospitals, intravenous homecare, and in specialty pharmacy practice demonstrating that a clinical- or patient-oriented pharmacist can manage pharmaceutical care and improve patient outcomes. It is an easy fix that saves lives and saves money.
Stephen C Vogt, PharmD
President and CEO
Giberson S, Yoder S, Lee MP. Improving Patient and Health System Outcomes through Advanced Pharmacy Practice. A Report to the U.S. Surgeon General. Office of the Chief Pharmacist. U.S. Public Health Service. Dec 2011.