Recently, in a blog I receive from Doximity my attention was drawn to an article headline: How Pharmacists Lost Control of Their Profession and Why You Should Care. In the article, the author alluded to the fact that pharmacist’s had lost their standing as health care professionals when they began referring to patients as customers when corporate types began insinuating themselves into the healthcare environment. I took the time to read several of the comments that accompanied the blog. One of the commenters even qualified the authors reference to pharmacists having become ‘whores’ to the corporate world by saying we were actually ‘prostitutes’ since we did get paid for our service Suffice to say, I was moved to post a comment about the article. However, knowing my professional fervor, I decided to wait a while to consider my reply carefully and be as concise as possible. Below you will find my effort to take up the mic and stand on the soap box……..

Fellow Colleagues, The first time I read the comments and this article, I was ready for a diatribe of my own.

Rather than that, I considered a careful approach better. I practiced pharmacy for 40 years in California and in most of the environments possible ( hospital, community and managed care).

I would be remiss to not say that I had similar experiences to all of you, whether it was being told by a practitioner “that is why I am the doctor and you are the pharmacist” early in my career, to being harangued by various patients about wait times, prescription costs and threats of lawsuits.

However, I was never referred to as a ‘whore.’ When I began, ‘clinical pharmacy’ was attempting to establish a relationship with a physician so I could take a drug history when their patient was admitted to the hospital.

Fortunately, since then the definitions have changed and training being provided to our next generation is way beyond my educational foundation.

None of us like the idea of being passed by, and I believe my generation has much to impart to patients and future colleagues by the way of wisdom we gained through our experiences.

I do believe that the ‘corporate takeover’ of the profession will do little to improve the health of our patients, because it is driven solely by the profit motive.

I would differ from the author as to when our demise as a health professional began. Saying it took root in referring to patients as customers is a little simplistic……there is that horrific ‘counting tray image’ that will forever portray the profession as purveyors of a commodity vs. reliable sources of health information. I cringe every time I see it in pharmacy stories on TV.

Some problems have been self inflicted over the years, due to a lack of a cohesive vision as to what type of practices would yield the best health care benefits for patients.

Enter the concept of pharmaceutical care in the late 90’s which seemed to unify the profession as a singular method to achieve many of our professional goals.

For me the erosion started when nurses moved to become providers as NP or PA with the ability to bill for services. No disrespect for their efforts; the pharmacy profession needed to either be in front of them seeking the same status, or pushing our way in the door from behind.

I have worked the last 5 years in retirement to develop a medication management program, and the first question from providers is “who will pay?” With provider status, I would have a better answer.

On that subject it appears that we have enough support to get the national provider status initiative to the floor for a vote. However, I fear that in the current health care environment, both bills may not see the light of day.

OK, so now I have added my frustrations to the other previous comments. But that is not enough!

At this point I am driven by wanting to leave a professional legacy. I must work to find a solution to these issues, and not be labeled ‘just a complainer.”

I must create a learning environment/professional opportunity for the students at the new pharmacy school in Fresno where I currently live.

Our future colleagues need to be motivated to practice in Fresno to improve the health of the community.

I am attempting to establish a relationship with the school and have them help me get my program affiliated with a local physician.

Hopefully, that will show students there is an entrepreneurial element to the profession that will utilize their acquired clinical skills.

I give presentations in the community extolling the virtues of this “new pharmacy” to increase their awareness of our abilities vs. only counting and pouring as always depicted in the media.

I have participated in local health fairs and other student activities.

My challenge to others who commented or will comment about this.

It is easy to complain and harder to offer solutions. What one or two things can you do to create a solution moving forward?

At a legislative day, rather than debating the merits of a bill, can you perform MTM during your visit, create a med list, develop a MAP, evaluate their list for interactions/ADE and bring it back to discuss it with them?

If you have a longstanding relationship with a community physician in your practice, will they allow you to perform MTM for their office staff.

Do you work in a chain store or corporate environment and want to develop a clinical program?

Do so and do not take NO for an answer from the corporate higher ups. I started with a newsletter at a small hospital that eventually led to a corporate drug information service.

Starting small may lead to big things! That is better than zero effort.

We need to support the profession and our future practitioners more strongly now than ever before.

Dropping the mic and stepping off the soap box!

You can direct your comments to me at the InnovaRx website at innova-rx.net or via email at drneal@innova-rx.net

Respectfully,

Neal S. Howard, Pharm. D

InnovaRx

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