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Drugs in the News - April 20, 2009 - Does the Shoe Fit?

Health Care Reform: What are we up against?

Make sure your role as a health care provider is recognized.

Feedback from Capitol Hill:

• Nurses can coach patients to be compliant; we don't need pharmacist-provided medication therapy management services.
• Pharmacists just use an algorithm to do medication management; medication management can be done by computers.
• Pharmacists are just looking for more money. Patients don't need help managing their medication therapy.

Assuming that the "Feedback from Capitol Hill" quotes are accurate the message to pharmacy is forceful and blunt. Nurses or others with less education than pharmacists, armed with electronic algorithms (e.g. clinical practice guidelines) can be substituted for pharmacists at a much lower cost with no measurable difference in quality. Medication Therapy Management (MTM) programs are just another commodity to sell for a profit according to those on The Hill.

Inside the Beltway the image of pharmacy, not individual pharmacists, is about the same among groups representing the interests of patients as it is on Capitol Hill. Despite those who may think otherwise what takes place inside the Beltway is the real world. This is where the decisions are made.

Maybe someone is trying to tell pharmacy to find a role that is different from that of nursing. Returning to a function for pharmacy advocated by many outside the profession to inject science into therapeutic decision making at the bedside would be one thought.

There should be a role for one of the health professions that could have an effect on, for example, the fact that the top selling SSRI antidepressant is only one of the optical isomers of an older racemic mixture that has not been shown to be safe and efficacious in children and teenagers with major depressive disorder.

Does pharmacy's image shoe fit? If not are there any suggestions for solutions if they are needed?

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