Pharmacists gain wider role in health care

As demand for health care grows, pharmacists are providing services that stretch the historical boundaries of their profession.

The era of pharmacists simply dispensing pills into child-safe bottles is over. Now they’re just as likely to be found administering preventive vaccines against everything from influenza to shingles, or having detailed discussions with customers about how to use prescription or over-the-counter drugs safely and effectively.

“Our customers know we’re accessible,” said Andi Sandford, a pharmacist at Hartwell Drugs in Hartwell, Ga. “They know they’re not just another number.”

Small towns such as Hartwell aren’t the only places that pharmacists’ roles are expanding,  according to Mitch Rothholz, chief of staff of the American Pharmacists Association (APhA). The trend is nationwide, he says.

Immunization, medication management, cholesterol screening, patient monitoring and helping detect patterns of disease are some of the ways pharmacists are contributing to better community health, experts say.

Both independent and chain pharmacies now collaborate with physicians and health departments to bring education about prevention and self-care, among other services, to more people.

Access, proximity and extended hours put pharmacists in an excellent position to improve public health, says Rothholz.

More than 90 percent of Americans live within five miles of a community pharmacy. Such facilities far outnumber hospitals and clinics. And availability is important for vulnerable populations with limited access to health services.

“Hundreds of people come in here a week,” says John Moorhead, a pharmacist and owner of Economy Drug Store in Hartwell. “We’re in a good position to reach the public.”

Convenience and personalized care are the major selling point.

Patients prefer coming to a pharmacy for services “because it keeps them out of a waiting room,” says Moorhead.

“Physicians are able to see patients on a periodic basis,” says David Pope, a pharmacist at Barney’s Pharmacy in Augusta. “But they aren’t able to hold them accountable.”

Pope has created two disease management programs, the Sweet Spot for patients with diabetes and the Healthy Heart Club, available in independent pharmacies across the country.

The Healthy Heart Club allows patients to enroll and connect with their pharmacists via the Web to share progress, ask questions and get feedback and resources like healthful meal plans.

“We found that people were desperate for this and flooded to it,” Pope says. “We’re able to become health coaches within the workflow of the pharmacy.” His website, Creative Pharmacist, offers an online curriculum for pharmacists to learn how to provide these services effectively to their customers.

Jimmy Maret, a pharmacist at Scotties Discount Drugs in Hartwell, stresses that individual care and clear explanations are especially important for patients who are prescribed medications by several doctors.

For all that, Rothholz believes pharmacists aren’t as well integrated into health care as they could be. “With the knowledge and education pharmacists have,” he said, “we would like to be utilized more by the health care system as part of the health care team.”

For this to happen, pharmacists must build relationships with physicians, public health officials and other health care professionals.

And that’s where things can get complicated.

Many physicians see such efforts as a threat to their turf, says Rothholz.

“Every health care provider obviously plays a role,” says Donald J. Palmisano, Jr., executive director of the Medical Association of Georgia, the state’s largest physicians’ organization. “But physicians should be directing the delivery of health care; the safety of the patient is what we’re really concerned about.”

Rothholz emphasizes, however, that pharmacy involvement doesn’t mean competition, but working together for the benefit of the community.

“This needs to be a team approach, and it shouldn’t matter who’s on the team,” he says.

This is where Hartwell and other rural areas may have the advantage.

“In a small town, you’re lucky to have any physicians,” says Moorhead of Economy Drug Store.

Large patient loads and staff shortages make small-town physicians more receptive to working with pharmacists. Moorhead provides flu shots as needed, as well as shingles vaccines by prescription. Medical office practices often don’t stock the latter because there’s not enough demand or because they don’t accept payment from Medicare Part D, which covers the vaccine.

But willingness to collaborate and expand services for better patient outcomes isn’t restricted to independent pharmacists or those in small communities, says Rothholz.

“We need to look at this as an opportunity to enhance services, work together and make more efficient use of health care dollars,”  Rothholz says. “We [pharmacists] have the capacity to do more than we’re being asked to do today.”