So there was some interesting breaking news this week from the American Medical Association (AMA) who seemingly has deemed it within their purview to define and describe the scope of practice for every other health professional group.

The reference and details of this story can be found at the ACCP website:

This month was pharmacy’s turn to have its own scope of practice determined by the professional association for another profession …

Why does the AMA feel that it can determine what the role of every other health profession is? The American Pharmacist’s Association does not define the scope of practice of physicians, nurses, respiratory therapists, and so on … Though those in the AMA, whom most (if not all) have never practiced or studied pharmacy, feel that they have the authority to define the entirety and boundaries of what pharmacists are qualified to do.

Not only have they defined for us what our role is, they do not make that definition available to us. They define the roles of every health profession but only make those documents available to AMA members.

I am thankful we have our  pharmacy organizations to send corrected facts to them regarding the practice of our profession.

But … this does provide opportunity to examine how some in the medical establishment view pharmacists:

1. The response letter suggests that the original document suggests that pharmacy involvement in medication management services is simply to compensate for the increasing utilization of technology and automation in the dispensing process. (1) As health care professionals, are not pharmacists creating medication management services to help patients live healthier and longer?

2. The recommendation document further states the below statement is mentioned by the AMA:

“To protect patients’ health and safety, physicians considering entering into CPAs with pharmacists should assess whether the education, training, and expertise of a pharmacist adequately equips him or her to initiate, monitor, and/or modify
therapeutic regimens prescribed by physicians,” (2)
Pharmacists get much more training, education, and practice with therapeutic, pharmacologic regimens than do most physicians. This sounds like a warning to physicians to avoid collaborating with pharmacists and utilizing pharmacists in a team-based approach to care. There is a wealth of research showing the pharmacists are more than capable of assisting in the modification of therapeutic regimens for chronic diseases. These modifications almost universally show a significant benefit to patients from this team-based approach to medical care. And I can provide citations to those who would like :).
3. The recommendation document also states the following is stated:
“To provide comprehensive CDTM [comprehensive drug therapy management], the pharmacist must secure the consent of all the physicians who prescribe medications for the patient,” (2)
Is not drug therapy the specialty of pharmacists? Do we need to seek permission from all other providers for a patient before educating patients about their medication therapy? Or before proactively seeking ways to optimize a patient’s therapy?
Granted, we are not able to see the original document, thus all of these impressions are garnered from pharmacy’s response to it. But it shows a disturbing tone. Why can we not continue moving towards team-based care utilizing each profession’s strengths? Why is medication therapy management seen as a threat rather than a benefit to society?

Let me know what you think!

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