Y’know. Enough pessimism for now. Yeah, the future of pharmacy is uncertain. And getting (taking) the initiative to get pharmacists where they need to be is our problem, not anyone else’s. Besides, there might be some light on the horizon…I recently did some judging for this year’s Commitment to Care and Service Awards. I have done this for a few years now (no one ever nominates me, so I can qualify as a judge [ED: Not true! Ken earned an honourable mention in the patient care category in 1998.] .I’ve noticed a couple of trends over the past few years that are a bit heartening for us pharmacists. One thing is the sheer volume of nominations. In the beginning, I was choosing between 6–10 individuals or groups working for the betterment of patient care and the advancement of pharmacy—usually by pushing the envelope a bit, trying new and innovative practices, working collaboratively with a broader spectrum of clinicians and endeavouring to integrate what pharmacists do with the other providers out there. The category I am reviewing this year has over 30 nominees (thanks for the warning, by the way).Another thing I’ve noticed is this: that some of the practice ideas that were unique and different and innovative a very few years ago have begun to spread. Among the entries I reviewed, there are several similar programs and initiatives and disease states in this diverse group— although, to be fair, they have all worked to accommodate the environment they are in.There are also a few initiatives trying some things that are still rare; but, as happened with the others, if these services are valuable to patient outcomes and show where pharmacists are a required piece of the puzzle, they too will multiply.But the best part of this growth, and what means the most to the future of the profession, is the things the pharmacists in these practices, programs and initiatives are doing. Medication reconciliation is becoming a given, as has been drug information and providing guidance on medication dosing, combinations and interactions, and measurement of effect. Pushing the envelope a little (actually, more than a little) are elements like pharmacists prescribing under their own initiative, contributing to patient care plans at initiation instead of later in the care process, monitoring outcomes, and even counselling and health coaching. These programs recognize our unique and special understanding of pharmacotherapy and how it interacts with the individual (not just the disease). Determining and monitoring patients’ feelings about treatment, their motivation to engage in therapy, their ability to fit it into their lifestyle on a permanent and regular basis, and the need for continuing evaluation of the effect are all important, and within the pharmacist’s professional purview.So, well done, pharmacists— and keep telling everyone about the important work you’re doing. After all, for every patient who receives the great benefit of pharmacist care, there are many, many more who are not. That is where the future lies.
