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Commentary

The Health-System Pharmacist: Out of the Cellar and into Direct Patient Care


November 18, 2013

The role of health-system pharmacists continues to expand—the days of working in the basement of the hospital, verifying doctor’s medication orders and then correctly dispensing the appropriate dose to the floor are well behind us. We now enjoy greater responsibility in improving quality outcomes in direct patient care, while also ensuring the delivery of cost-effective, evidence-based pharmacotherapy treatment plans.

Among the drivers in the evolution of health-system pharmacists is our advanced level of education—which became a necessity in 2001 when the sole professional degree for our vocation became the Doctor of Pharmacy and continues with the increase of PGY1 and PGY2 residencies, as well as specialty board certifications.  In addition, Collaborative Practice Agreements between physicians and pharmacists have allowed qualified pharmacists working within a defined protocol to perform patient assessments, order lab tests pertaining to specific drug therapy, and choose, initiate, monitor, adjust, and continue drug therapy regimens in a wide variety of practice settings.

Most recently, on October 1, 2013, the Governor of the State of California signed the landmark Senate Bill 493 which officially recognizes pharmacists in the State of California as healthcare providers and established the designation of the Advanced Practice Pharmacist (APP) to those pharmacists who meet defined experience/certification eligibility criteria. Pharmacists wishing to establish APP recognition must meet two of the three following criteria: certification in their area of practice; completion of an accredited postgraduate residency program; and provision of clinical pharmacy services to patients for at least 1 year under a collaborative practice agreement with a physician, other APP pharmacist, or health system.  This legislation, along with similar bills in other states, will likely pave the way for nationwide recognition of pharmacists as direct patient care providers and encourage the enactment of similar bills allowing for the pharmacist to charge for services provided and greatly expand the roles for health-system pharmacists.

As health-system pharmacists, we are an exclusive source of drug information and willing educators for both healthcare providers and patients alike.  Given our involvement in direct-patient care and standing as members of a complete health-care team, it’s appropriate that recent legislation is allowing pharmacists to be recognized as health care providers. However, with this newly increased responsibility and the continuing evolution of our role as health-system pharmacists, I think it’s vital that we persist in remaining up-to-date with the most recent advances in pharmacy practice and evidence-based medicine to remain a viable and trusted partner on the healthcare team.  

What do you think is essential to the continued growth of our roles as health-system pharmacists? How do you feel about your evolving standing as contributor to direct patient care?

 

Randolph V. Fugit, PharmD, BCPS is internal medicine clinical specialist, Denver VA Medical Center, Denver, CO. He is also Associate Professor of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO.

 

 

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