Healthcare legislation is a complex process with the potential to affect millions of Americans. With many “moving pieces” in the healthcare team– including pharmacists, physicians, nurses, payers, patients, manufacturers, employers, lawyers, etc– small changes to one profession often may domino into other professions. On top of the complexity of the legislation, there are varying moral and philosophical views concerning health equity, health ethics, and the very basis of a capitalistic healthcare model. On top of differing thoughts, the legislators who implement these laws are rarely healthcare experts, and often are pulled along by biased lobbyists.

Mandatory Counseling for Pharmacists is an idea to require pharmacists to speak with patients when they recieve a new prescription (ie: not a refill). In Advocacy in Pharmacy class earlier this week, we discussed the benefits of implementing versus not implementing this law, as well as any questions or conditions we would have of the bill. It was a great discussion with ~20 completely different professional/political viewpoints weighing in– ranging from first year BSPS students to professors with years of experience. These different perspectives helped greatly in the discussion, allowing our group to evaluate nearly every angle of potential mandatory counseling legislation.

Overall, this format was pretty enjoyable. I love talking politics, especially when both the moderation and format of the discussion are balanced. The atmosphere in the room was positive as well, allowing everyone to voice their opinions and be heard.

I entered the discussion being in favor of mandatory counseling in theory, but against it in practice. What I mean, is that in an ideal pharmacy environment where pharmacists have unlimited time for every patient, mandatory counseling would be a great thing to encourage pharmacists to care more for individual patients. However, in a chain pharmacy checking 5000+ prescriptions per week with no pharmacist overlap and little-to-no technician hours, mandatory counseling is an impossibility.

But the discussion certainly challenged my views. With so many advantages to both sides, my views changed multiple times during the discussion. My personal politics tend to center on patient advocacy (health equity, minority health rights advocacy, etc) mixed with professional-realism (“This sounds like a great idea but realistically it couldn’t happen”), so hearing other views based from completely different mindsets was refreshing. It wasn’t terribly hard for me to change my view since my “sounds good– wouldn’t work” mentality was already sort of a middle ground. I think most people in the room tended to be open to discussing both sides as well– there didn’t seem to be anyone pressing on one side exclusively and sending dismissive body language to the other, which certainly aided to the inclusivity of the discussion.

To be honest, I’m still not heavily leaning one way or another. For that reason, I’m against mandatory counseling implementation, mostly from a status quo continuation. If a bill was developed with specific language, I would be open to reading it, but until then the idea is just an idea.

I would love to see this discussion-style continue into the future. Shouting matches and presidential-debate-style horrors accomplish nothing, but this discussion was civil, shed new light for everyone in the room, and had great energy.  One thing I would suggest for future discussions is more definitions and clarifications for the audience. I remember when I was a BSPS student, I had no idea what ‘reimbursements’ were, or even what the current federal guidelines for counseling were. I imagine some may have felt intimidated to ask what some things were given the rest of the audience’s knowledge level, but I was really impressed with their knowledge and research for the discussion.