State of the Profession.....Unity

For the past nine months, I've been writing this blog to attempt to get pharmacists to look at where the profession has been, where it is currently, and where the future lies. I've shared my commentary on some issues that have popped up, thrown in some posts for a laugh, and griped some.

The medical fields are changing quickly. We, as pharmacists, need to know where we are and where we are going. If we don't adapt to the changes that are occurring, we may find ourselves to be extinct.

Over the next few weeks, leading up to American Pharmacists Month, I'm going to run a series of posts on issues that I perceive to be important as we move forward. Be forewarned, my experience has been in the retail environment for the past 15 years so my writing will be biased towards those who practice in the retail setting. I don't have the numbers, but I believe that most pharmacists work in a retail setting so I believe that we should address issues facing those in retail first.

That being said, the first topic in my state of the profession series is...

UNITY.

When you describe your occupation to somebody that you just met, what do you say you are?

• Retail pharmacist?

• Clinical pharmacist?

• Consultant pharmacist?

• Hospital pharmacist?

• Nuclear pharmacist?

All of these are valid answers to the question. But the answers are part of one of the problems we face as professionals.

We fragment ourselves.

By identifying with the particular practice setting we are involved with, we break ourselves down into, for lack or a better term, special interest groups. Me, I work in a community retail setting. If I view myself as a retail pharmacist only, I'm not going to concern myself with issues that affect other practice settings. By self-segregating ourselves into these groups, we lose the ability to speak as a whole profession.

I still have my dictionary from college. One of the definitions of unity in my dictionary is the quality or state of not being multiple : ONENESS.

Do you feel that the profession of pharmacy is unified? If not, what can you do to bring the profession into a state of unity?

I'm going to offer a simple solution that will hopefully start to bring unity to the profession. The solution lies in the answer to the question that I posed earlier.

When somebody asks you what your profession is, there is one and only one answer:



I am a Registered Pharmacist.

Starting tomorrow...

State of the Profession series.

Out of the Box

There's a nice discussion going on over at the MTM e-community portion of the APhA website about pharmacists being recognized as providers by medical insurance companies in order to be reimbursed for providing MTM services.

I read the first few comments on the thread and decided that I had to share my two cents. Since that section of the pharmacist.com site is members-only, I thought that I would share the comments that I left. I believe that my comments should be considered for every new venture that pharmacists pursue.

My comments were the following:


We, as pharmacists, have grown accustomed to being contracted with insurance companies as a result of the dispensing function. We are comfortable having that contract with the insurers. It gives us security.

Over the years, the insurers have chipped away at the reimbursements to pharmacies. So pharmacists have looked for alternative methods to generate income. MTM is one method where we can utilize our professional expertise and see the impact that it has while getting reimbursed at a decent rate.

So why are we in a rush to get contracted with an insurer?

The insurance companies have people whose sole job responsibility is to reduce costs for the insurer. Don't you think that they will reduce payments to MTM providers? They are doing it to physicians. Do you think pharmacists will get treated any better?

Maybe we need to take a step back and talk to physicians about how the insurance companies have treated them over the past 10 years. Maybe we don't want to jump into bed with the insurance companies right away. Just looking at the EOBs that I receive from my medical insurance company shows me how much the providers discount their professional services. I'm not sure that I want to do the same. I'm not willing to bill an insurer my U&C only to see them discount it 40 percent.

Maybe we should take a look at how dentists have set up their contracts. They seem to be sitting pretty on the reimbursements.

I just think that if we are going to pioneer a new practice in the field of pharmacy, we need to be careful to not give away the farm in order to say that we are a provider for XYZ Insurance Company. I like what Don has said that he does...bill the patient directly and take payment, then provide the patient the form to submit to their insurer. We protect our fees this way. As insurers see more people seeking reimbursement for our services, they may approach us about being providers. We can control the reimbursements better this way. I don't like the idea of submitting claims and hoping to be reimbursed. Collect from the patient and let them worry.

* * * * *

I started pharmacy school twenty years ago. I didn't have an internship until late in my schooling, so I only have about sixteen years behind the counter. In those sixteen years, I really haven't seen too many new ideas for pharmacy. Immunizations and MTM are the only new things.

The sad thing about this lack of change is that most pharmacists that I talk to really don't care to see the profession evolve. They are there to collect a paycheck and go home. Get up tomorrow and repeat. They are literally trapped inside the box.

Pharmacists need to get out of the box. One of the other comments on the thread was the following: Many times our biggest obstacles are other resistant pharmacists who can only think of why we shouldn't expand our cognitive services and recognition for those services or colleagues who cannot visualize us as anything other than what we have traditionally been in the past professionally (i.e. the "in-the-box" thinkers).

As a pharmacist (or student), you need to step back and do a little self-evaluation. Are you an in-the-box pharmacist? Are you okay with allowing your professional practice to be dictated to you by others, many times non-pharmacists?

Or are you going to step out of your comfort zone and start to think outside of the box? There are limitless opportunities to expand your practice if you take a look outside of the box. Are you going to be the pioneer to lead pharmacists into a whole new world of pharmacy?

I fear that 99 percent of the people who read this will think it sure would be nice to see the profession evolve, but then do absolutely nothing about. I encourage the other one percent to voice their thoughts and ideas, preferably as a comment (so everybody can benefit) rather than as an email to me.

We, as pharmacists, need to set the agenda for the pharmacist organizations. Rather than follow along with (or gripe about) whatever the organizations are proposing, we need to get our own ideas out and discussed. If we get enough chatter going, it might, just might, get heard by the organizations and get acted on.

Even if the organizations don't listen, that doesn't mean that we can't share our ideas about the profession of pharmacy and how we can expand the roles of pharmacists.

Personally, I'm aiming big. I want to build a self-sustaining medication therapy management business that is not affiliated with a dispensing pharmacy. I want to be recognized for the medical services that I provide, not the product that I put in a bottle. It's going to take some time, but I believe that the effort is going to pay off.

I hope to see other pharmacists join me in taking the profession to another level. I'm tired of dealing with third-parties and junkies and ungrateful people. That's the stuff I've seen from inside the box for the past sixteen years.

Come join me outside of the box, it's going to be fun.