Magazine article Drug Topics

Opportunity Knocks

Magazine article Drug Topics

Opportunity Knocks

Article excerpt

Managed care spurring M.D.s to seek the R.Ph.'s counsel

Like politics, managed care is making for some interesting bedfellows. As health plans continue to shift more of the risk burden to health providers, physicians are banding together to form medical groups, and those groups are looking for assistance in managing cost, capitation, and a host of other pharmacy issues.

Enter the physicians' new partner, the pharmacist.

Jack Raber first heard the call 10 years ago, when he started his own pharmacy consulting company while still working as a hospital pharmacist. Since 1992, he has devoted all his working hours to that consultancy, Clinipharm Services.

Raber works with a wide range of professionals, in and out of the healthcare arena. His client roster includes physicians, other pharmacists, hospital administrators, insurance companies, even attorneys who need expert witnesses in court. The strongest contingent, though, is physicians.

"I help them manage their drug capitation. In managed care now, the physician is not only writing the prescription but may have to pay for a portion of it out of a capitation pool," he explained. "I also do educational programs for them; I do some consulting for them; I help them with contract negotiations, if they need that."

While much of that work is clearly physician-oriented, it's generally not the physicians themselves who decide they're in need of help with pharmacy issues. Like many in pharmacy, Raber is somewhat confounded by the fact that physicians often don't see the benefits of including pharmacists as equal members of the health-care team. "I've often spoken with physicians who kind of obliquely say, 'Gee, it's really neat,' but they really can't get down to saying, `Yes, I want to hire you."' It's usually "someone else who sees the big picture, like a chief financial officer or an administrator," he said.

Still, the idea is something physicians are beginning to accept-and something pharmacists had better be prepared for, according to Joan Siegel-Birnbaum, director of marketing for Express Scripts/ValueRx, a pharmacy benefit management company, and a former institutional longterm care pharmacy consultant. …

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