Collaboration among pharmacists

Abstract

The Journal of the American Pharmacists Association (JAPhA) is celebrating its 100th anniversary this year, and that has prompted me to spend several hours looking back at the challenges and opportunities faced by the profession over the past 10 decades. It’s been amazing to read how the profession matured and differentiated, and then began to coalesce again. In the spirit of looking back to look forward, consider a little history. Just as today, counterfeiting was a big issue in the years following the 1912 start-up of JAPhA. In the 1920s, APhA member K. K. Chen isolated ephedrine from ma huang during a long stay in China; FDA banned this alkaloid ]ust a few years ago. The influence of the hospital pharmacy movement was strong in the 1930s and 1940s, as Harvey A. K. Whitney and Don Francke rose to professional prominence and produced advances far outside the institutional setting in which they practiced. The 1950s were dark days professionally for pharmacy. The Durham-Humphrey amendment, passed in 1951, created the Rx/OTC split. A third class of pharmacist-only drugs did not make it into the bill, but we hope that a March 22–23 FDA hearing will address that omission. The profession’s code of ethics forbade much of what we now call patient counseling. But soon the pages of JAPhA came alive with the signs of clinical pharmacy: drug information centers, starting at the University of Kentucky; the Ninth Floor project at the University of California, San Francisco; and drug interactions and the emergence of pharmacokinetics as a specialty. The code of ethics was overhauled in the late 1960s. Drug product selection, generic drugs, and patient counseling emerged, setting the stage for pharmacy’s growth and maturation over the last third of the 20th century. George F. Archambault was in the APhA leadership in the early 1960s. By the end of that decade, with pharmacists moving into the nation’s nursing homes to address medication- related problems, he saw the need for another pharmacy group. He became a founding member of the American Society of Consultant Pharmacists. Shortly after taking the helm at APhA in the late 1950s, Bill Apple wrote of the need for “one voice for pharmacists.” That challenge remains. We are fortunate to have so many strong pharmacy organizations representing the various settings in which pharmacists practice and at the state and local levels. We are stronger today because those groups pool their collective resources when they need to address important professionwide issues such as health care reform. We can then present ourselves in a united fashion to legislators, other health professions, payers, employers, and, most important, patients. The lines that once defined pharmacists’ practice settings have been blurring for a couple of decades now, and patients move quickly from home to hospital to nursing home and back into the community. Pharmacists with professional roots in these various practice silos have developed unique skills and knowledge, cultures and norms, and expectations and realities. With transitions of care now recognized as critically important in patient care, pharmacists must work with colleagues in other settings, enabling them to help with tasks that have not been emphasized in one’s own practice. A perfect example of such cooperation is on pages 81 and 82 of this issue. Community pharmacists who operate the outpatient pharmacies in several hospitals are performing discharge medication counseling, thereby making sure that patients have the medicines they need and know what to do with them when they leave the hospital. Those of us who grew up professionally in community pharmacy know only too well the challenges patients face with getting to the pharmacy, affording their medications, and understanding the instructions on a new set of medications. Cooperation like this is refreshing. Might we even call it collaboration among pharmacists? I like that, for one clear message in pharmacy’s recent history was that a rising pharmaceutical tide lifted all boats. As medicines became more powerful and useful, pharmacists were increasingly important across practice settings. Apple was right—we need one voice, because we are one profession. We may have developed unique niches for ourselves in various practice settings, but we must recognize that pharmacists in other settings have also developed special skills and knowledge. By working together, we will push the profession forward, all to the benefit of the patients we serve. Enjoy your March Today.