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Not sure if this would help pharmacy students or pre-pharms more, but here is an article that a classmate of mine recently posted to our class through the email listserv. Talks about a lot of the new services pharmacists are providing and how the role of the pharmacist is expanding. A lot of this is probably old news to most current pharmacy students, which is why it may be more beneficial for pre-pharms, but I'll leave it to the moderators to move it to the pre-pharm forum if they feel its better suited there.
Druggists reach out for new business
Specialized services draw more patients, profits
Sacramento-area pharmacists are stepping out from behind the counter to give birth control injections, flu shots, vaccinations, and other medical services once the province of nurses and doctors.
It's all part of pharmacies' push for more patients and profits. Americans today spend more than $200 billion each year to fill more than 3 billion presciptions, but pharmacists typically make pennies on the dollar from each pill bottle they fill.
Cheaper drugs are everywhere - Canada, the Internet, mail-order services, discount stores.
"We are constantly talking now about how we can come up with more things we can do for patients so they will come back to us and recommend us to their friends," said Soña Frausto, a pharmacist at Rite Aid in Sacramento.
A year ago, Frausto was one of the first local pharmacists to start giving emergency contraception to women who walk into the drugstore without a prescription. When taken within 72 hours after unprotected sex, the "morning-after" pills can prevent pregnancy.
Frausto offers injections of Depo-Provera, a birth control shot taken four times a year as an alternative to daily contraceptive pills. Frausto also does flu shots. And starting this spring, she plans to provide many of the vaccinations sought by people traveling abroad.
She needed certification for each new skill.
Every time Frausto stops counting pills to give patients this specialized care, Rite Aid collects a dispensing fee on top of the payment for medication. Rite Aid did not disclose the price of its dispensing fees, but typical fees in the pharmacy industry range from $15 to $30.
"The main reason we are offering our pharmacists training to provide these services is to differentiate ourselves from our competitors," said Rite Aid Corp. spokeswoman Jody Cook.
Walgreens, Longs Drug Stores and independents such as Whitney Village Pharmacy in Carmichael are among drugstores encouraging pharmacists to add patient care to their daily duties.
Customers can get flu shots from pharmacists at nearly all chain drugstores in the region, as well as at many supermarkets and independent pharmacies. Emergency contraception is also readily available.
Walgreens is experimenting with having its pharmacists make house calls to infirm patients in seven states, including Arizona and New Mexico. The visits, aimed at helping patients use complex medical equipment, could come to California soon if patients respond well to the service, said Walgreens spokeswoman Tiffani Bruce.
Advances in technology, shortages of nurses and primary care physicians, and changes in state law all help pharmacists provide more patient care.
The new Medicare drug benefit will allow seniors with chronic health problems, such as asthma or diabetes, to seek detailed medication counseling from pharmacists. Medicare officials are expected to soon create special reimbursement fees for pharmacists who sit down with patients to discuss managing medications.
Darrell Cavalari, an independent Sacramento pharmacist with a long career in geriatric health, already spends much of his day advising patients about the best and cheapest therapies. He said the new money from Medicare will make it easier for him to profit from services he has long wanted to offer elderly customers at Manor Drugstore on Northgate Boulevard.
"I got into this business because I have a special interest in helping the elderly," Cavalari said.
He took special training so he could administer flu shots. He gave shots to six patients before donating his vaccine to a local nursing home during the severe flu shot shortage.
Cavalari is the lone pharmacist at a small store in a neighborhood where many patients are poor. He would like to provide more care to patients who have difficulty taking public transportation to doctors' offices.
"If there were fees for us to provide more services to seniors, we would do that," he said.
Doctors support the pharmacists' push to provide patient care - up to a point, said Jack Lewin, chief executive of the California Medical Association.
Doctors approve of the state laws that allow pharmacists to give flu shots and distribute emergency contraception, Lewin said, because these "essential public health services" are more accessible to patients when pharmacists also provide them.
But there is a limit to how much pharmacists should be permitted to perform traditional doctors' duties, he said.
"There is the potential for conflicts between pharmacists and doctors," Lewin said. "Pharmacists want to begin providing education and lab tests for patients and collecting reimbursements that are similar to visits with a doctor. Clearly that would create an atmosphere of competition we would not support."
The California Pharmacists Association, a trade group that has trained pharmacists on the new services, plans to continue to push for an expanded role for drugstores in patient care.
Association Executive Director Lynn Rolston said most pharmacists currently are trained in school to do far more than they do on the job. In addition to Medicare drug counseling, area drugstores will soon do cholesterol checks, glucose checks for diabetics and other lab services, Rolston said.
"It used to be a lot easier to drop by the doctor's office just to get your blood pressure checked, but that's not the way medicine works anymore," she said. "Today, pharmacists are the most accessible and convenient health care providers, and it makes sense for patients to get more care at their neighborhood drugstore."
Credit: Sacramento Bee (California)
Author: Lisa Rapaport
Date Published: January 23, 2005
