Call to Action: Expansion of Pharmacy Primary Care Services in a Reformed Health System

American Journal of Pharmaceutical Education, December 2010 | Go to article overview

Call to Action: Expansion of Pharmacy Primary Care Services in a Reformed Health System


INTRODUCTION

The AACP Argus Commission is comprised of the five immediate past AACP presidents and is annually charged by the AACP President to examine one or more strategic questions related to pharmacy education often in the context of environmental scanning. Depending upon the specific charge, the President may appoint additional individuals to the Commission.

The 2009-10 Argus Commission was charged to examine the topic of the pharmacist's contribution to primary healthcare delivery in the context of national healthcare reform and identify the resources of the Academy and the profession needed to engage in the national conversation. The charge further requested the Argus Commission to scan the environment to determine the opportunities for expansion of primary healthcare capacity to include pharmacists' unique contributions to quality, cost, and access as medication use specialists on the team.

President Baldwin invited representatives from education associations of various disciplines recognized as primary healthcare providers to meet with the Argus Commission. This included the following individuals: Sandra Carlin Andrieu, Ph.D., President-elect of the American Dental Education Association and ADEA Executive Director Richard W. Valachovic, D.M.D., M.P.H.; Carol A. Aschenbrener, M.D., Executive Vice President, Association of American Medical Colleges; Timi Agar Barwick, Executive Director, Physician Assistant Education Association and Dana Sayre-Stanhope, Ed.D., PA-C, Physicians Assistants Program Director, Emory University School of Medicine; Jean E. Johnson, Ph.D. (representing American Association of Colleges of Nursing), Senior Associate Dean for Health Sciences Programs, School of Medicine and Health Sciences, The George Washington University; and Harrison Spencer, M.D., M.P.H., President and CEO, Association of Schools of Public Health. Stephen Shannon, D.O., M.P.H., President and CEO, Association of American Colleges of Osteopathic Medicine provided input for the meeting but was unable to attend.

The Argus Commission drew upon the issue brief prepared by Manolakis and Skelton and a copy of the paper was also distributed for review by the invited guests prior to the meeting. Argus Commission members recommend that all individuals who have interest in the pharmacist's role in primary care should review this document. (1) Participants discussed a variety of issues related to meeting the demand for primary care services, reasons why those traditionally prepared for primary care roles were moving toward more specialized patient care services (e.g., emergency medicine, surgery), and the problems of compensation for primary care services and the challenging lifestyle issues faced by these providers. All participants agreed that medication use factors were an important element of quality primary care, including patient education, monitoring and safety considerations. The conversation also included discussion of communications/health information technology, collaboration, scope of practice/regulatory issues, and accountability/ legal considerations.

The conversation turned quickly to the imperative of equipping current and future clinicians to function as members of interprofessional teams. All of the disciplines represented at the meeting embraced interprofessional education (IPE) and practice, and specifically recognized the importance of IPE in addressing deficiencies in the chronic care patient management model.

A REFORMING HEALTHCARE SYSTEM?

At the time the Argus Commission met, reform legislation had passed the U.S. House of Representatives and was pending in the Senate. Since January 2010, the dynamics that made passage of health insurance reform a strong possibility in late 2009 have changed substantially, however, in late March the House passed the Senate health insurance reform bill and the President signed it into law on March 23rd. While there are miles of regulations to be written and other legal challenges to navigate, without a doubt the actions of the 111th Congress to pass health legislation will increase access to health insurance coverage for millions of Americans. …

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