Clinical Pharmacists Practitioner Act

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This was another major reason why I chose to apply to school in North Carolina. I believe NC is the only state to give pharmacists the opportunity to prescribe like physician assistants and nurse practitioners.

😎

http://www.ncpharmacists.org/displaycommon.cfm?an=13

...
The credentials required for CPP registration were developed after discussion and input from many sources, including the North Carolina Center for Pharmaceutical Care (NCCPC). Requirements include a North Carolina pharmacist license, agreement with supervising physician and:

* certification (BCPS, CGP) or ASHP Residency including two years clinical experience or ...
* PharmD degree with three years experience, plus completion of one NCCPC or ACPE Certificate Program or...
* BS degree with five years experience, plus completion of two certificate programs.



A Clinical Pharmacist Practitioner is defined as a "licensed pharmacist in good standing who is approved to provide drug therapy management under the direction of, or under the supervision of, a licensed physician who has provided written instructions for a patient and disease specific drug therapy which may include ordering, changing, substituting therapies or ordering tests." The Supervising Physician is held accountable for on-going supervision and evaluation of the drug therapy management performed by the CPP as defined in the physician, patient, pharmacist and disease specific written agreement that is submitted with the CPP application.

...

Of the 23 survey responders, seven CPP's practice in a physician's office, six in a hospital clinic, two in a long-term care practice, with the majority practicing in ambulatory care settings. The most common credentials for CPP approval include the BS in Pharmacy degree with five years of clinical experience and completion of two approved certificate programs. Seventeen CPP's have earned the PharmD degree and nine have completed residencies.

Tacking on another career choice for pharmacy. 👍

 

[patmcd]

This was another major reason why I chose to apply to school in North Carolina. I believe NC is the only state to give pharmacists the opportunity to prescribe like physician assistants and nurse practitioners.

😎

http://www.ncpharmacists.org/displaycommon.cfm?an=13



Tacking on another career choice for pharmacy. 👍

Very cool. It seems like many states are starting to consider things like this to help improve the quality of drug therapy management.

 

[Trancelucent1]

You also have prescribing rights if you work for a VA hospital/clinic in any state 🙂 That's what I'm interested in doing.

 

[ultracet]

all this sounds like is a collaborative practice agreement....

there are many MANY states that allow these (and in fact... many states that allow these without the restrictions that NC has apparently put on them)

so i'm not really cool with all of the restrictions 👎

 

[kwizard]

all this sounds like is a collaborative practice agreement....

there are many MANY states that allow these (and in fact... many states that allow these without the restrictions that NC has apparently put on them)

so i'm not really cool with all of the restrictions 👎

Yeah, they are all various types of collaborative practice agreements. The one in North Carolina was one of the first and possibly w/ more autonomy than other states. However, you'd probably be best to compare and contrast the pro's and con's of each agreement within each state. Neither of these collaborative agreements are as liberal to the expanded scope of practice in the VA setting, but reality is we all can't work in the VA so progress needs to be made in private sector for avg everyday person can appreciate and grow to expect pharmacist functioning in this expanded role.
The second role is to be able to position oneself to setting where you can develop at collaborative practice. This can be kind of hard in a straight retail setting depending on staffing and/or just as difficult in a hospital setting if necessary resources aren't being devoted to ambulatory settings (i.e. initially w/ an anticoagulation and/or medication management clinic).

May want to check out:
Pharmacist Provider Coalition http://www.improvingmedicationuse.com/

Position statements at ACCP out collaborative practice agreements amongst the various states http://www.accp.com/position/pos2309.pdf
(I think there may be a more recent version but can't remember right now, but either way Table 1 lists most of the agreements)

Other ACCP position statements: http://www.accp.com/position.php

 

[ultracet]

Yeah, they are all various types of collaborative practice agreements. The one in North Carolina was one of the first and possibly w/ more autonomy than other states. However, you'd probably be best to compare and contrast the pro's and con's of each agreement within each state. Neither of these collaborative agreements are as liberal to the expanded scope of practice in the VA setting, but reality is we all can't work in the VA so progress needs to be made in private sector for avg everyday person can appreciate and grow to expect pharmacist functioning in this expanded role.
The second role is to be able to position oneself to setting where you can develop at collaborative practice. This can be kind of hard in a straight retail setting depending on staffing and/or just as difficult in a hospital setting if necessary resources aren't being devoted to ambulatory settings (i.e. initially w/ an anticoagulation and/or medication management clinic).

May want to check out:
Pharmacist Provider Coalition http://www.improvingmedicationuse.com/

Position statements at ACCP out collaborative practice agreements amongst the various states http://www.accp.com/position/pos2309.pdf
(I think there may be a more recent version but can't remember right now, but either way Table 1 lists most of the agreements)

Other ACCP position statements: http://www.accp.com/position.php

i'm currently on an am care rotation at a VA and let me tell you ..
its awesome

their regulations are very interesting as for anything they complain of you have to have a dx code in the computer by a pcp... no controls and they frown on abx but other than that...

any labs, meds etc
good stuff

 

[kwizard]

i'm currently on an am care rotation at a VA and let me tell you ..
its awesome

their regulations are very interesting as for anything they complain of you have to have a dx code in the computer by a pcp... no controls and they frown on abx but other than that...

any labs, meds etc
good stuff

Agreed, I did my residency training within the VA and it is really great. Especially when you factor in VA benefits and those VAs that work hard to pay clinical pharmacists salaries comparable to private sector.

VA practice agreement can be found at: http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=227

or just generally: http://www1.va.gov/vhapublications

The right for clinical pharmacists w/ a defined scope of practice continues to be evaluated on a periodical time period (typically every 3-5yrs) but will probably never be taken away given pharmacists have been maintaining AC clinics (in addition to other services) for so long.

 

[sdn1977]

I agree...collaborative practice agreements are pretty common. Not much new here and really its been done for a long, long time I was writing TPN orders & monitoring in the 70's - done as a "phone order" but actually was on my initiation since the MD's wanted the pharmacists (I didn't mean to imply it was just me - the whole pharmacist staff) to follow & monitor the therapy. This was an advantage for all of us...the MD didn't have to do the tedious part of TPN management & we were able to get orders in a timely fashion & didn't have any waste. Now...we have lots of these agreements - anticoagulation, pain management, etc...

But Kwizard...are VA salaries really competitive? Last time I checked - awhile ago for sure, they were much lower than comparable CA rates? I'd be interested since they are always still looking for pharmacists here. One advantage for the VA - you don't need a CA license so it allows employment for those folks who live here for a short time & don't want the hassle of having to sit & pass the CA state board exam.

 

[kwizard]

I agree...

But Kwizard...are VA salaries really competitive? Last time I checked - awhile ago for sure, they were much lower than comparable CA rates? I'd be interested since they are always still looking for pharmacists here. One advantage for the VA - you don't need a CA license so it allows employment for those folks who live here for a short time & don't want the hassle of having to sit & pass the CA state board exam.

Well...the VA is truly an enigma as it is hard to stay in after residency training unless you are willing to move all over the US to find those handfull of VAs that may have budget approval for hiring. Anyways, the salaries tend to vary a little w/ each VA. Many of the VAs pay very well compared to private sector (typically 85-110k/yr). However, for every VA that is paying well there are as those VAs that are still paying 10-20k/yr less than avg private sector. Just for informational purposes salaries are typically listed on job postings at various websites (www.vacareers.va.gov and www.usajobs.gov). So depending where you are, the salaries may be competitive. Another main factor in pay is how progressive the clinical pharmacy services are. The VA is one of the few entities that rewards pharmacists for being clinical (possibly increase in pay grade) and they also increase pay grade for board certification. Most places in private sector just reimburse you for the test.

Don't get me wrong the VA isn't all fantastic. Pay does indeed vary, but benefits are great as well. Downside is new faces are hard to come by so get used to working w/ the same people for the next 20 yrs (good or bad thing?) and if management isn't very progressive it may be a while before things change as no one gets fired and few voluntarily give up there job so if you are working in a VA w/ great people and vast clinical services it can be great. On the other hand you could be stuck in a bad situation if the dept isn't in your favor. Secondly it is a little hard to move up the ladder as turnover is slim to none.