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Supporting provider status during American Pharmacists Month
REINA MUNSCH
Next month is American Pharmacists Month—31 days in October to celebrate all of the hard work and dedication of pharmacists and
student pharmacists across the country. American Pharmacists Month serves as a wonderful reminder of all that you do to give back to
your communities, your patients, and your profession. It is a time to show pride in and spread the word about the pharmacy profession, and
the number one way to do that is to help advocate—loudly and proudly—for pharmacists’ provider status!
What is provider status?
Pharmacists and their patient care services are an integral part of the patient’s health care team because of the value they bring to patients
and the health care system. When pharmacists are included on the health care team, outcomes improve and costs go down.
For decades, pharmacists have been one of the few health professions whose value as health care providers has not been acknowledged
in federal law. Nearly all other health professionals’ services are rightfully covered under Medicare laws, including chiropractors, midwives,
and dietitians—but not pharmacists. Federal acknowledgment of the value of pharmacists and their services is critical not only to patients but
also to the future of the profession—by providing new job opportunities and greater professional fulfillment for those wishing to provide
additional patient care services.
Current legislation in Congress—Pharmacy and Medically Underserved Areas Enhancement Act (H.R. 592/S. 314)—would, if passed,
provide Medicare beneficiaries in medically underserved areas with access to health care through pharmacist-provided services under
Medicare Part B.
What’s the next step?
Having federal legislation is an important step toward better recognizing pharmacists’ patient care services. But for the movement to advance
further in the legislative process, APhA needs your help. Members of Congress are more likely to support and vote for a bill if they know lots
of people around the country want it. So to help advance provider status legislation—H.R. 592 in the House and S. 314 in the Senate—
pharmacists and student pharmacists need to show Members of Congress that this issue is important to their constituents. The more we
send our message to Congress, the more likely Members are to move the bill forward for a vote—and pass it!
How to help
American Pharmacists Month provides a great opportunity to advocate for the profession and for provider status. One method of doing so is
to write a letter to Congress. Communication to Members of Congress and their staff from constituents is critical.
APhA knows that it can be a bit intimidating to write a letter to Congress on your own, so we’ve made it easy for you. If you go online to
PharmacistsProvideCare.com and click on “Take Action,” you’ll be directed to our automatic letter form. You don’t need to know who your
Member of Congress is—the website does it for you. All you need to do is fill in your home or business address, and we’ll provide a
prewritten letter about provider status to both of your senators and your representative. And if one or more of them has already signed on to
cosponsor the legislation, that’s great—we’ll provide a thank-you note for you to send!
If you’ve already sent a letter to your Members of Congress and are looking to make a bigger impact, there are other ways to get involved
as well. When your Member of Congress is home in the district, it’s a great time to schedule a visit with them or invite him or her to your
pharmacy or practice site. A pharmacy visit would be a wonderful opportunity to show the benefits of pharmacists and their services
firsthand. Check out our guide to scheduling a local pharmacy visit at www.pharmacistsprovidecare.com/guide-scheduling-local-pharmacyvisit.
Sending letters and meeting with your Members of Congress go a long way in spreading the word about provider status and helping
Congress realize just how much pharmacists contribute to patient care. So while you’re celebrating all the hard work you do for patients
during American Pharmacists Month, make sure you take a moment this month and help advocate for provider status. Doing so will help
patients gain access to health care through pharmacists’ services while also improving the future of the profession!
Reina Munsch, APhA Senior Director of Marketing
Community pharmacist makes big impact with one small swap
SONYA COLLINS
“Pete” was on liquid potassium to replace the potassium he was losing due to his blood pressure medication. But when Pete’s insurance
plan stopped fully covering a monthly supply, Pete started to ration. He took a teaspoon of the liquid every day rather than the prescribed
tablespoon. The results were apparent in his routine potassium monitoring that he underwent with his primary care physician.
“You have to have potassium to make your heart beat,” said Nicole Sangalang, PharmD, Pharmacy Manager at Ralphs Pharmacy in Costa
Mesa, CA. Since Pete’s levels were low, the doctor kept prescribing more and more. “I could see he was distressed about this when he came
into the pharmacy to pick it up. I pulled him aside to the consultation window so we could talk about it.”
Sangalang soon learned that Pete had diabetes, and the liquid potassium presented more problems for him than just the price. After
talking to Pete, looking at his history, and consulting Pete’s doctor, Sangalang was able to uncover and solve several potentially lifethreatening problems for the patient.
Many people ration medications or otherwise take them incorrectly, and could benefit from medication therapy management with a
pharmacist. But as other stories in this series show, this type of service often isn’t covered by health insurance.
Price, taste of medication
When Sangalang learned Pete had diabetes, she asked about his blood glucose control. “He admitted that it could be better, and that he
had no idea liquid potassium would raise it,” Sangalang recalled. “He also really hated the taste of the potassium.” Essentially, the price
and the taste of the medication were motivating Pete to take as little as possible.
Searching Pete’s records for any reason he might have been prescribed liquid versus the cheaper, sugar-free pills, Sangalang found
nothing. Pete didn’t know why he was on the liquid either. “He was surprised to know it even came in pills and glad that it would be so
much easier to take. Pills are easier to count than milliliters.” Sangalang called Pete’s doctor and asked permission to make the switch.
“The doctor happily agreed. He said he was grateful I had taken a look at the big picture and had recommended a therapy that would
increase compliance for his patient,” she said.
Soon Pete’s potassium levels were consistent and on target. “That minor change made a big difference,” Sangalang said. “We got his
potassium and his sugar under control by switching him to a medication that was cheaper and made him more compliant. And with
medicine that’s playing with your heart, we saved him some trips to the emergency room.”
‘Personal health care provider’
Pete now considers Sangalang his personal health care provider. He often calls the pharmacy to ask her for a second opinion on his
doctor’s most recent advice. “Honestly, he won’t speak to anyone else but me. He’s always willing to share what’s going on with his health
and asks how he can improve it.”
Sangalang wishes she could spend more time with all the patients who are misusing their medications. “Just yesterday, I had another
patient who was doing the same thing—rationing her medication. She was cutting her estrogen patches in half to make them last longer.”
In a health care system that fragments care across numerous specialists by design, Sangalang sees a clear role for pharmacists.
“Patients get specialty care from several providers at any given time, and the communication between these providers is usually
nonexistent,” she said. “It’s like a puzzle and the pharmacist is in a position to be the glue that holds all the pieces together. Without that
glue, the puzzle ultimately falls apart.”
Sonya Collins, MA, MFA, contributing writer
Photo Caption:
Nicole Sangalang