Y’know. There’s a reason why pharmacists need to be in control of our destiny. In pharmacy school, we learned about the physiology of the human body and the pharmacology of things we use to get the body to work more normally when something in that physiology goes wrong. We also learned about the complexities of finding what the best choice is, and what could go wrong, and hence we learned the pharmaceutical care (PC) process. We were also taught to understand that there is a lot going on, not just in the patient’s body, but in their world— myriad other factors that impact the effectiveness of treatment—including things like adherence, concordance, and persistence as necessary elements of successful pharmacotherapeutic interventions of medication therapy management (MTM). Non-pharmacists don’t know this, don’t get it, don’t appreciate it, and especially don’t recognize the value and impact of the application of this knowledge. They particularly don’t understand that the PC and MTM processes have come nowhere close to being fully engaged and implemented in most practice sites, with the biggest gap between what is possible and what is happening is found in community practice.This is not to say that pharmacists are not doing these things—they are doing the best they can with the resources they are given. The problem is that they lack a few key tools: access to information, decision support, integration with other clinicians, an environment conducive to a meaningful and useful interchange with patients, the time needed to do the job properly, the compensation that befits the value of this service, and respect for that value that is understood and engaged by the public, payers, and, sadly, even their employers. If we are often being denied what we need to fulfill our promise, perhaps it’s time to talk about what, as a result, our patients are being denied. Our patients are not receiving the full benefit of our training and skills, and as a result their health and quality of life suffers.There is no shortage of data that tells us that pharmacists improve both, and significantly, and that the payback has pecuniary (increased productivity, decreased need of other health interventions), health (slowed progression of disease, improved quality of life) and societal (affordable healthcare and a healthier population contributing to our society) benefits. So let’s start a conversation about how giving pharmacists control of their own destiny is better for the people we serve. After all, that’s why we’re here; why we spent the time and effort to study and practice our craft and profession, and why we are sorely needed.Talk about what we do, and talk about what we could do more of, if we were given all of those things we are missing. There are people who are sicker and, even dying, because each one of us has not been engaged as fully as we could be. That is a statistical and scientific reality brought home by all the data that proves that having a pharmacist do something is better than having them not do it. Yet still, the majority of the time, they are not in a place to do it. We will have to explain how this is anathema to the retail paradigm. Retail is not bad, it just doesn’t match up with our expectations of health service and the caring that must accompany our service—in other words, we cannot draw a line that stops where we care, and retail is all about drawing that line, and the shorter it is, the better for retail.Don’t fight that reality, don’t argue that it doesn’t exist. Just give pharmacists back the autonomy that states clearly that the clinician and the patient working together as part of a team is a valued and valuable relationship cannot be choked by someone, or something, that is not part of that relationship.
