Michael S. Langan, MD
Assistant Professor-Clinical and Lead Physician at CarePoint East
The Ohio State University Wexner Medical Center
Division of General Internal Medicine
543 Taylor Avenue #3176
Columbus, OH 43203
(614) 688-6470
Testimony of Michael Langan, MD
IN SUPPORT OF HB 188:
Pharmacists-consult agreements/dispense drug-no Rx
Before the Senate Health & Human Services Committee
October 21, 2015
Good Morning Senate Health & Human Services Committee, thank you for taking the
time to read my testimony. My name is Dr. Michael Langan and I am here to show my
support for House Bill 188. Everyday, I practice as a primary care physician within the
patient-centered medical homes of The Ohio State University Division of General
Internal Medicine. I also serve as the lead physician at CarePoint East, a primary care
office in Central Ohio. I am fortunate to work alongside a multitude of healthcare
professionals daily, and have had nothing but positive experiences from working with
pharmacists. Today I urge you to support House Bill 188.
I wanted to:
First: Highlight some current problems in Ohio’s health care
Second: Describe my personal experiences working with pharmacists
Third: Explain why we have not yet engaged with formalized collaborative drug therapy
management
Fourth: Rationalize how this bill can benefit the state and the patients within it
To start, I wanted to remind you all of some staggering statistics. Currently our state
spends more on healthcare than all but 17 others. Unfortunately, our clinical outcomes
Michael S. Langan, MD
Assistant Professor-Clinical and Lead Physician at CarePoint East
The Ohio State University Wexner Medical Center
Division of General Internal Medicine
543 Taylor Avenue #3176
Columbus, OH 43203
(614) 688-6470
don’t correlate; we rank 40th in the country. It has been known that poorly controlled
chronic disease is the real clinical and economic burden of our healthcare system today.
As a physician, I can diagnose, triage, and choose what I feel to be the best option of
treatment for a patient. Unfortunately, once the patient walks out of the door, the choice
to engage in the treatment plan is up to them. Research shows that over 1 in 4 patients
stop one important medicine after a heart attack. Research also shows that patients who
have poor adherence to their diabetes medications are 2.5 times more likely to end up
with a hospitalization. Drug related morbidity and mortality is estimated at over 177
billion dollars annually. Clearly medication management is a huge concern.
Next, I wanted to tell you about my experiences working with pharmacists. The closest
that I have worked with pharmacists has been within my current role. I was able to be a
part of overseeing an interprofessional diabetes clinic, where first year medical residents
work right alongside pharmacists in order to manage diabetes for complex patients. It is
evident that the pharmacists are up to date on clinical diabetes guidelines, evidence for
therapies, and really are able to develop relationships with patients. Patients have
improved outcomes, are more satisfied, and the physicians are able to spend their normal
office visits with these patients focused on their other health care concerns. The medical
residents are actually put into this clinic as part of their education in order to learn from
the pharmacists about how to care for this chronic disease in a patient-centered manner. If
Michael S. Langan, MD
Assistant Professor-Clinical and Lead Physician at CarePoint East
The Ohio State University Wexner Medical Center
Division of General Internal Medicine
543 Taylor Avenue #3176
Columbus, OH 43203
(614) 688-6470
collaborative drug therapy management were to be expanded, pharmacists could touch
more patients within the clinic more efficiently. This is just one example of the many
ways in which pharmacists provide care to my patients.
I consider the pharmacists at our clinics to be invaluable resources of drug information,
safety concerns, and complex medication management. They are able to identify and
resolve drug therapy problems, help to optimize medication regimens, counsel patients on
adherence and proper medication administration, and more. Patients see real benefit and
are satisfied from the interprofessional team environment; it becomes more patientcentered and results in safer and more effective outcomes. It cannot be argued that
pharmacists are the most accessible healthcare providers in the state. They have the
largest ability to make an impact on medication adherence as they learn more about
medications than any other health care provider.
Currently at our practice site, we do not follow the formal collaborative drug therapy
management agreements under consult agreement statute ORC 4729.39 but that is in no
way because we are not trusting of the medical decision making of the pharmacists with
whom we work. It is strictly due to the cumbersome amount of paperwork that this entails
for our practice. The changes outlined in House Bill 188 would simplify the consult
process for those who welcome assistance from pharmacists. As with all legislation, there
will be opposition. Physicians who do want to participate can still do so up to the point
Michael S. Langan, MD
Assistant Professor-Clinical and Lead Physician at CarePoint East
The Ohio State University Wexner Medical Center
Division of General Internal Medicine
543 Taylor Avenue #3176
Columbus, OH 43203
(614) 688-6470
that they are comfortable with. The bill allows for an immense amount of flexibility in
how physicians may incorporate pharmacist collaborative drug therapy management into
their practice. It can be as general or as specific as one if comfortable with. If there are
physicians who do not support expansion of this bill, they are by no means required to
participate in collaborative drug therapy management pending its passing.
What I find to be the biggest assets of passing House Bill 188, are the improvements in
productivity and time that it can provide for physicians along with the improvement in
care and patient satisfaction. With physician time freed up for acute care concerns,
diagnosing, triaging, and more, I will be able to care for more patients in a more
comprehensive manner if chronic disease management concerns are left up to those that
know the medications the best, the pharmacists. Medications can be used in a safer and
more effective manner, saving costs and improving clinical outcomes. I truly believe that
this bill can help to enhance patient care, leading to reductions in healthcare costs,
improved clinical outcomes, and improved patient satisfaction within the state of Ohio.
Therefore, I urge the committee to support House Bill 188. Thank you again for your
time and consideration.