Evolving health care environments present opportunities and challenges for clinical pharmacists to become increasingly more pivotally integrated as critical members of interprofessional care teams. Optimal medication therapy prescribing and management is best characterized as a process that results in safe, effective, efficient, and culturally sensitive medication ordering, order fulfillment, administration, and monitoring, which achieves desired clinical outcomes for a specific patient. Bringing together the knowledge, skills, and perspectives of an interprofessional team of physicians, nurses, physician assistants, nurse practitioners, pharmacists, and others where appropriate provides the expertise and synergy to optimize medication therapy decisions, educate patients, implement and monitor medication therapy, enhance adherence, and achieve and measure quality clinical outcomes. Although there are well‐defined barriers to overcome, we, the members of the 2009 American College of Clinical Pharmacy Presidential Task Force, envision optimal medication therapy prescribing and management functions ideally to occur in health care settings with adequate resources to deliver high‐quality care. In the presence of financial pressure, safeguards should be developed between practice activities and economic and accounting procedures to mitigate conflicts of interest that could otherwise occur in drug selection and overuse. In the future, clinical pharmacists will participate prospectively as essential full‐time members of interprofessional care teams. Although it is anticipated that pharmacists will be embraced in these roles in all managed care and government‐based systems, virtual or remote participation in medication therapy management may remedy access to pharmacists in settings and locales where they cannot be physically present or where economic models necessitate virtual care delivery.