Why would you want provider status? If so go back to school and be an MD, PA, or NP. You can provide/prescribe all day long.
The reason I post this information is merely to provide information.
One pharmacist transitioned from retail already became a Physician Assistant (PA): PA-C in Cardiology. That person spent 9 years in retail, provided pharmacist consulting services for 3 years, then matriculated into a Provisionally-Accredited PA School: Florida International University (FIU). Now they work in Orlando, FL as a PA. Other pharmacists transitioned from pharmacist to PA as well. They probably anticipated where pharmacy was (truly) going and got out when they could while we sit here and talk. There is also a greater scope of practice associated with a PA as opposed to a pharmacist (diagnosis and treatment of diseases), but it is more limited than that of a physician.
Currently, only two schools I know of in FL take "pharmacist" as part of their Direct Patient Experience (DPE) hours as part of their PA admissions requirements: University of Tampa (UT) and FIU. I am not aware of the position other schools are taking with regards to pharmacist experience and its documentation, but I am looking into it myself. My previous posts listed the idea of MDs becoming pharmacists and vice versa so I do not need to touch on that subject.
The University of Tampa - Physician Assistant (PA) - Master of Physician Assistant Medicine (MPAM) Degree - Admissions
Frequently Asked Questions | Herbert Wertheim College of Medicine | Florida International University | FIU
There are a few drawbacks that I am seeing here only based on my own research: the physician must designate authority to that particular PA in order to prescribe (FL law). Kind of like a hand-me-down for healthcare practice privileges. Keep in mind that 3-hour Continuing Education (CE) course all PAs and healthcare professionals must take for PAs to prescribe controlled substances; it must be taken for EVERY RENEWAL of the practice license. The title is on the link for those who are curious.
FAQ - Prescribing Rights and Formulary - Florida Academy of Physician Assistants
Keep in mind other states vary in their practices and laws. This is Florida's link through their organization for Physician Assistants.
My ASDAA (Heather Petrelli) at USF asked me to participate with our Dean to promote Provider Status: I said no because of the reasons mentioned by members on SDN (on this thread and others), by learning from other professionals how the healthcare reimbursement system really works (SDN, talking with providers, shadowing physicians, and Google searches), and from my pharmacy school studies on my Managed Care rotation. I have no interest in promoting a healthcare concept that will only benefit a select few pharmacists and neglects one critical aspect: access to care. Also, if you find articles on Provider Status, there are no negative consequences mentioned with its approval, which makes me siding with this issue very difficult. We need to balance the positive with the negative to make an informed decision and APhA does not provide that information to us.
https://www.pharmacytoday.org/article/S1042-0991(18)30155-5/fulltext?rss=yes
I anticipate the nationwide approval of Provider Status will put us in the same reimbursement "pot" under CMS as every other healthcare professional, with a specific percentage dictated by the insurance company and the value of the service itself. Fee-for-service (FFS) is obviously no better in terms of health outcomes for patients, but is Provider Status (or whatever else it may be renamed in the future) the best option we have as pharmacists? I think Provider Status approval will be forced upon retail pharmacists where they will have no choice but to accept it as the new "status-quo." I have been saying this since I was in pharmacy school, but nobody listened. If pharmacists truly want this, then they need to be informed about what the reality is (positive and negative consequences) before ascribing to it and before lobbying for it.
Even if dependent prescriptive authority and the eligibility for reimbursement for pharmacists are allowed, we will still legally be prescribing under the direction of a physician as far as the terms listed in the Collaborative Drug Therapy Agreement (CDTA) we sign. One of my preceptors in Ambulatory Care pharmacy subjected themselves to such an agreement. In signing the CDTA, we subject ourselves to those terms whether Provider/Prescriber status is approved or not. We are also subject to the provider or organization we choose to work for as well as their series of healthcare outcomes measures designated by the facility or prescribing practice we work for. We will be judged based on those healthcare outcomes: judged on what patients do more than what we as individuals do. We as pharmacists may earn a percentage, but it will be based on the value of that particular service (or medication). Furthermore, it is debatable what outcomes will be assessed on part of pharmacists and physicians, making the reimbursement system even more complicated. From what I read on SDN and from my own sources, most practicing pharmacists are not ready for that level of clinician-directed responsibility. General pharmacy school training and even residency and pre-existing practice experiences do not prepare anyone for such a major shift (unless someone else who is already doing it lets them in). Provider Status, in my evidence-based opinion, is another prison for most pharmacists.
The information I provide is probably not news to practicing pharmacists, but it does enlighten the "pre-pharmers" and "new practitioners" who think they can just waltz into a job and change the dynamic of a pre-existing practice during the first 3-5 years after graduation (regardless of generation or age designation). The "new practitioner" term includes those pharmacists that are residency-trained (PGY-1). That very high level of prescriptive trust from provider to pharmacist does not happen the first day on the job, regardless of the level of training anyone receives (residency, BCPS, both, or lack thereof); it takes time to integrate with a new team and a new job as any professional from any discipline will tell you.
To expect prescriptive trust to be gained in one day or in one encounter is unrealistic. We may not live in a "permission society" (quoting Alex Barker) to choose alternative careers, but prescriptive authority requires permission from a licensed provider.
I am tired of these updates myself. Would anyone care to "stress test" my opinion on Provider Status?
