Magazine article Drug Topics

Pharmacy Foes

Magazine article Drug Topics

Pharmacy Foes

Article excerpt

Pharmacy's struggle to redefine its mission and secure an expanded role in patient care is drawing resistance from physicians, the brand-name drug industry, and the manufacturers of over-thecounter medicines.

Take, for example, the effort to allow diabetic Medicare beneficiaries to use community pharmacies to get the education and training they need to better manage their condition. The American Medical Association's house of delegates recently considered a resolution that explained in part "certain national pharmacies are developing diabetes education programs that ... can circumvent or obstruct a physician's relationship with the patient" (Drug Topics, July 21).

The policy finally adopted at the AMA annual meeting is not limited to diabetes. It added education to the list of concerns physicians and patients should consider when a health-care plan "places any patient care at risk by substitution of a non-physician." The resolution went on to resolve that "the AMA work with state and federal agencies, which have regulatory responsibility for pharmacists to review patient education programs for identification of appropriate requests for release of patient information and delineation of more clearly detined limits on release of such information, the purpose being to clarify the appropriate scope of practice of pharmacy."

Pharmacy groups, who say they keep trying to improve relations with organized medicine, were not happy with the physicians' action. Observed John Rector, general counsel for the National Community Pharmacists Association: "They seem increasingly concerned with the potential that pharmacists have, and they don't like it." David Schulke, director of policy and regulatory affairs for the American Pharmaceutical Association, called the resolution a "political placebo. It says nothing about the patient's needs and says everything about the AMA's needs." He added, "It's a very sad commentary on what a professional society should not be doing with its resources." Phillip Schneider, a spokesman for the National Association of Chain Drug Stores, pointed out that the diabetes program envisioned by Congress retains physician oversight and "can help enhance patient care in the traditional partnership of the pharmacist and physician."

That's not the only jab organized medicine has taken at pharmacy in recent months. Late last year, the AMA and two other physician associations told federal officials that "there is little evidence that retail pharmacies are routinely providing cognitive [patient counseling] services or, in fact, are capable of providing these services."

The AMA, joined by the American Academy of Family Physicians and the American College of Obstetricians & Gynecologists, suggested that pharmaceutical care is an effort by pharmacists to supplant physicians as the primary drug counselors. The groups made their comments in a private-sector plan on patient prescription drug information that the Department of Health & Human Services accepted as an alternative to the Food & Drug Administration's proposed MedGuide program. (Drug Topics, Jan. 6). They declined to support the plan because of the pharmacy provisions.

The practice of medicine versus the practice of pharmacy also was seized on by the Pharmaceutical Research & Manufacturers of America in its opposition to proposed revisions of Pennsylvania's pharmacy act. …

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