This semester, I attended the student-night at the Ohio Pharmacists Association (OPA) headquarters. I chose to attend this event since I didn’t know much about the organization, and since the three speakers that were scheduled are local leaders in pharmacy.

The meeting started with students congregating and mingling with the OPA staff. I enjoyed the relaxed environment– since so many students may be wary of being politically involved, it was a pleasant and welcoming start that may have swayed some to continue their OPA involvement. Once a few opening remarks were made, the three speakers each spent time detailing their pharmacy careers thus far.  Each speaker held unique experiences– both how/why they got into pharmacy, and where their jobs have taken them. I don’t know if it was intentional or not, but it was a neat way to sort of “showcase” the profession to some of the younger audience members (ie– that not all pharmacists come from a pharmacy-centric background or work in certain settings). After the speakers, there was more time to mingle before leaving and continuing our pharmacy journeys.

If there’s one thing I really took away from the event, it was part of Antonio’s talk on profession-centric advocacy. Generally speaking, I’m more patient-centric in my advocacy (with examples including access to clean syringes, transparent pharmacy pricing structures for patients, medicaid/medicare expansion, etc). It’s not that I don’t “care” about the profession, it’s just that my interests lie more with patients who will literally die if they don’t have access to care and less with discerning between average pharmacist salaries of $80,000 and $120,000/year. I care about patients. If there’s anything Antonio imparted on me, it was that there’s a chance my interests may grow to envelop profession and patient advocacy, since there are so many bills and ideas thrown around the statehouse that would “kill” pharmacy.

It was an interesting event, and I anticipate attending more in the future. I’m not sure if OPA is necessarily the “organization for me” in terms of politics, but perspective is perspective; echoing chambers get us nowhere.

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.

What is Pharmacy?

It’s weird to think that we as a culture know so little about something that effects nearly half of all Americans. It’s so strange that an industry can spend hundreds of millions of dollars on yearly lobbying, yet still be stereotyped as old, white men counting tablets behind a counter at a neighborhood drugstore.  It’s true– in reality, many Americans aren’t aware of the training and expertise pharmacists have.

So, just what is pharmacy? 

Everyone knows the CVS and the Walgreens convieniently found a few blocks from their homes. Near everyone has heard of Ibuprofen or these “statins” that can somehow help your heart and cholesterol (whatever that means). Not everyone knows that pharmacists are usually trained Doctors, having anywhere from 6 to 8 years of specialized training in health and medicine. In the same way psychiatrists are physicians who have specialized in mental health, pharmacists are prescription medication specialists. However, while psychiatrists are found in mental health facilities and private offices, pharmacists can be found nearly anywhere patients access healthcare.

OK, but you’re just referencing pharmacists in the basement of hospitals counting IV bags and syringes, right?

Well yes, one aspect of hospital pharmacy includes managing the hundreds of patients and their advanced medications from a variety of health conditions. But pharmacists now round with physicians on patient floors and are important for decision making. Since the average physician may only have one or two pharmacology courses, having an expert in the field is critical for patient care and generally well appreciated by other members of the healthcare team.

OK, but that’s still just drugstores and hospitals. I go to my family physician and specialists all the time! 

More recently, pharmacists have expanded into ambulatory care settings. At most academic medical centers, pharmacists follow patients in speciality clinics. In family medicine, a pharmacist may be consulted about therapy selection or disease control. Plus, accessing family physicians and specialists usually requires insurance. Most insurance companies use pharmacists for help designing their formularies.

OK, well what about people who can’t afford to pay both a physician and a pharmacist? Does pharmacy “care” for the little people?

Pharmacists care about outreach (it’s even in our code of ethics). This is shown at free clinics and health screenings. This is shown through pharmacists who help people apply for government programs, like Medicare and Medicaid. This is shown through medication safety programs. Pharmacy “cares” for low socioeconomic status folks, but there is always room for improvement.

OK… Pharmacists are everywhere. What else do I need to know?

Community pharmacists (often called “Retail Pharmacists”) are the first line of defense for much of healthcare. Patients are comfortable asking these accessible providers questions about everything from “Can you look at this weird rash on my arm?” to “My mom was prescribed an ophthalmic prostaglandin for her glaucoma… will that interact with the tree bark she takes orally?”

In summary: Pharmacists are everywhere in healthcare, and well respected by other providers. In a changing healthcare climate, pharmacists represent the future of care.

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