The vital role of community pharmacists in today’s healthcare environment
By Trevor Bertsch, PharmD, MBA
The role of community pharmacists has expanded in recent years. We offer our communities essential services like point-of-care testing, immunizations, medication advisory services, and even self-care recommendations for minor ailments. Simply put: we’re there for our patients beyond simple medication refills. The COVID-19 pandemic has only shined a spotlight on the importance of these practices.1
On average, Medicare beneficiaries visit their local pharmacist approximately twice as often as they see their primary care physician. Given our additional clinical responsibilities, there has been a recent push for pharmacists to be reimbursed appropriately for provider services, with advocacy efforts geared toward obtaining provider status under Medicare Part B.2,3,4
Pharmacists are a crucial part of the healthcare continuum and vital to medication safety in the long run. We provide an important clinical resource for prescribers and patients and must continue to build a foundation of trust within our local communities.
The evolving role of pharmacists has changed pharmacy business models.5,6 Our primary focus is no longer on dispensing medications based on prescriber recommendations. Instead, we now work with providers and patients to make clinical recommendations for safer medication practices.7 As we take on these increased responsibilities, patient trust is key.8,9
While larger pharmacies can utilize a network of clinical resources, smaller community pharmacies are embracing their relationships with their local communities.6,9 As a local pharmacist serving a smaller population, I have developed relationships with my patients over many years. Because of this, many of them choose to visit my pharmacy over larger chains.
These personal relationships have also helped me to better serve my community. For example, I had gotten to know one of my younger patients since he started visiting my pharmacy. After falling on some hard times, he overdosed. Luckily, he felt comfortable calling me for help, and I was able to reach an ambulance in time. Without the trust we’d built over that longstanding relationship, that call may not have happened.
Identifying and mitigating risk
Often, patients will be prescribed multiple medications from different providers who may not be in touch with each other.10 As community pharmacists, we can identify any medicated-related risks and help to mitigate them. Helping our patients understand and improve their medication regimens empowers them to take charge of their health.1,8
In my experience, determining a patient’s level of medication-related risk comes:
- Clinical judgement based on patient conversations and interactions
- Notes from providers
- Patient observations from their caregivers
- Personal feedback from patients
- Medication review tools like PrescribeWellness and MedWise Risk ScoresTM
A thorough medication review can help assess short- and long-term risks. For example, one of my long-time patients had been experiencing confusion and forgetfulness. At 52-years-old, she had been diagnosed with dementia and required a cane. But her side effects were not due to cognitive impairment. Instead, they were the result of an adverse reaction to her prescriptions. After a simple adjustment to her medication regimen, she no longer needs assistance when walking; she isn’t confused or forgetful; and she seems much happier, healthier, and more comfortable consulting with me.
Our role as a patient resource will be crucial to the evolution of pharmacy practice. Many pharmacists have already taken on clinical responsibilities such as providing vaccines, screening for cardiovascular disease, and testing and self-management training for diabetes.11 These responsibilities are increasing and require appropriate compensation with provider status under Medicare Part B, especially in the face of burnout due to the COVID-19 pandemic.1,2
As our place in the industry continues to develop, resources like PrescribeWellness and MedWise Risk Scores can help us optimize our patients’ medication regimens, minimize risks, and ultimately improve outcomes. By leveraging these tools to work with patients and ensure their safety, we can build and maintain trust in our local communities.
Beyond the Script: Key Takeaways
The role of pharmacists has evolved as a clinical resource for patients and prescribers
With unique tools and knowledge, pharmacists can review and optimize medication regimens and foster trust within their communities
The maintenance and development of these trusting relationships is essential to the growing role of pharmacists
Obtaining provider status under Medicare Part B will help support fair compensation for additional responsibilities
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1. Community Pharmacists Roles During the COVID-19 Pandemic, Journal of Pharmacy Practice
2. Evaluation of Frequency of Encounters With Primary Care Physicians vs Visits to Community Pharmacies Among Medicare Beneficiaries, JAMA Network
3. Pharmacy’s Top Priority: Medicare Provider Status Recognition, APhA
4. Provider Status, ashp
5. The Future of Community Pharmacy: Direct Patient Care, AACP
7. Reflections on the Pharmacist-Patient Covenant, NCBI
8. Understanding public trust in services provided by community pharmacists relative to those provided by general practitioners: a qualitative study, BMJ open
9. A piece of the pie: Independents build new business models, DSN
10. The Impact of Provider Networks on the Co-prescriptions of Interacting Drugs: A Claims-based Analysis, NCBI
11. Preventive & screening services, Medicare.gov