by Alexandra Sharp, MD, and Alison Knutson, PharmD
“Clinical pharmacists are among the least understood and most underrated members of health care teams. The duration of their education and clinical training surpasses that of nurse practitioners and physician assistants, yet clinical pharmacists are too often relegated to episodic consultations for individual patients or tinkering at the edges of clinical care in supply-based assignments calibrated below their doctorate degrees” (1).
Physicians working in collaboration with pharmacists operating at the top of their training can extend and enhance the services a clinic offers by being the change agent in team-based care that reduces costs and helps your community of patients achieve better health.
What are some key tasks that can be delegated to integrated pharmacists (2)?
- Medication education and patient outreach:
Examples: Teaching your patients with frequent COPD (chronic obstructive pulmonary disease) exacerbations and new pediatric asthma patients how to properly and effectively use their inhalers OR helping with CGM (continuous glucose monitor) management for your type I diabetes patient with poor specialty access.
- Deprescribing:
Example: Coaching your geriatric patient with significant polypharmacy and their family how to reduce their medications, slowly and safely, by developing a plan and counseling on expected effects.
- Population health and chronic disease management
:
Example: Performing outreach to your panel of patients with depression to check in on medication effectiveness to help meet value-based payment goals.
- Drug monitoring:
Example: Ensuring that your patients on amiodarone are having their thyroid levels or hepatic labs checked for those on concomitant long term antifungal therapy.
An integrated pharmacist also does not need to be seen as a cost burden for a health system or an individual clinic:
- They can bill for their services with pharmacist-specific CPT codes.
- They can help meet your organization’s goals for value-based payments with patient outreach and population health metric achievement.
- They can keep patients out of the hospital by increasing safe prescribing and patient education improving self-management of their own medications.
Our professional organizations also strongly support pharmacist collaboration and integration. At the 2023 Minnesota Academy of Family Physicians (MAFP) House of Delegates, a resolution was passed that greatly encourages this practice (3). The American Academy of Family Physicians also strongly supports integrating pharmacists, quoting in their position paper: “The pharmacy professional and physician can and should work collaboratively so that their combined expertise is used to optimize the therapeutic effect of pharmaceutical agents in patient care” (4).
Overall, pharmacists are underutilized and can be the true change agents in your family medicine clinical practice. In collaboration with your physician expertise, they can greatly reduce your practice burden with little to no additional cost to your clinic and markedly improve patient outcomes.
Interested in how to integrate a pharmacist into your clinical practice and where to start, or want to simply know more? Email office@mafp.org to get connected to family physician Alexandra Sharp, MD, and clinical pharmacist Alison Knutson, PharmD. No question is too complex. We want to help!
References:
- Teichman P, Wan S. How to integrate clinical pharmacists into primary care. Fam Pract Manag. 2021;28(3):12-17.
- Family Practice Management editors. Five tasks to delegate to a clinical pharmacist. Quick Tips: A Blog from FPM Journal. June 7, 2021.
- Resolution 2023-02. Encouraging Access to Medication Therapy Management Services. Minnesota Academy of Family Physicians House of Delegates. 2023.
- American Academy of Family Physicians. Pharmacists position paper.
- Ponushis A. Embedding pharmacists with physicians: New tools connect physicians and pharmacists to build stronger collaborative relationships. American Association of Colleges of Pharmacy.
About the Authors:
- Alexandra Sharp, MD, is on the Board of Directors of the Minnesota Academy of Family Physicians (MAFP) and authored the resolution, “Encouraging Access to Medication Therapy Management Services,” adopted at the 2023 MAFP House of Delegates.
- Alison Knutson, PharmD, is a consultant for the Center for Leading Healthcare Change at the University of Minnesota College of Pharmacy.
Views and opinions expressed are that of the authors and do not necessarily reflect that of the Minnesota Academy of Family Physicians (MAFP).
