Baby, We've Come a Long Way.

As long as there have been societies and physicians to treat them, there have been specialists whose sole purpose was to prepare and administer medicinal treatments.  Pick any ancient civilization, and there will be evidence of organized and skillful application of pharmaceuticals.  The modern drugstore varied significantly from its ancient counterparts, in that the proprietors were often making medical decisions by diagnosing and treating patients without the consultation of physicians.

And the pendulum swings again...  Pharmacists in today's drugstores are tasked with the responsibility of evaluating the appropriateness and managing the dispensation of pharmaceuticals prescribed to patients under a doctor's care, assuring - most importantly - that the patient is safe from interactions or adverse reactions.  Although dispensing responsibilities remain the same, we're beginning to see more clinical, preventative, patient care focused services available in the most convenient setting - the store on the corner.

I think everyone will acknowledge that this is possible because pharmacists, every day, are becoming a much bigger part of total health care - of total patient care - than ever before.  It's exciting to realize that the pharmacist role today and going forward has an opportunity to affect real, valued change in patient outcomes and the health care industry in the U.S. as we know it.  The glass half-empty side?  We're still chained to the verification computer.  But we're working on that.

Alas, The Wellness Experience has arrived.  The pharmacist is in front of the pharmacy, available to answer questions, provide valuable counseling, Medication Therapy Management, adherence solutions, immunizations, and preventative health care screenings.  A "Health Guide" is on duty to help patients navigate the store and their health care options, and enroll patients in upcoming health and wellness programs in the new "Health Corner".  In our mind's eye, we see better patient outcomes, the prevention of hospitalizations, and savings for patients, employers, insurers and - as a whole - the health care industry.  We also see the pharmacist practicing at their most valuable level.

For more than several years, pharmacists have been proving they are capable of much more than safely dispensing.  Health care reform is imminent.  Today it's hard to imagine a picture that includes mandatory insurance, wellness benefits to employees and employers, tax credits and cost-sharing, Medicare bundle payments to better coordinate patient care, annual fees for drug manufacturers based on market share, and incentives to participate in health and lifestyle programs to reduce the risk of chronic disease.  But I'm sure society will learn the new ways and adapt.

Reform will push the pharmacy profession to adapt as well.  It is predicted that pharmacists will provide patient-centered and population-based care that optimizes medication therapy, where the patients health outcome is the product, not the medication.  Some foresee pharmacists having the authority and autonomy to manage medication therapy and be accountable for patients' therapeutic outcomes, while working cooperatively with practitioners of other disciplines to care for patients.

When the pendulum swings again, we'll see.  I've only met one person in my life who likes change - Kelly Demitt.  The rest of us will be anxious, then able to tolerate, then understand, and then adapt.  We've kicked up a whole lot of dust behind us, but there's a whole lot of trail left in front of us.  Hold steady the course.  We'll make it.