June 23, 2025
Jo Ellen Rodgers, Pharm.D., FCCP, FHFSA, FAHA, BCCP, BCPS
Shop Local and Maintain Your Optimism: Why the Future of Pharmacy Depends on State-Level Advocacy—and a Dose of Hope
At first glance, “shop local” might sound like a bumper sticker slogan for supporting small businesses. But in pharmacy, it speaks to something deeper: a call to action to invest in and empower community-rooted, state-driven change. Pair that with a mindset of optimism—not blind hope, but the determined kind as reflected in Christian D. Larson’s The Optimist Creed—and you begin to see a path forward for a profession facing transformation fatigue.
Last month, the National Academies of Sciences, Engineering, and Medicine hosted a pivotal workshop titled Innovations in Pharmacy Training and Practice to Advance Patient Care. Leaders from across the country convened to share practical strategies for building a pharmacy workforce that meets modern health care demands while maintaining pharmacist well-being. Topics ranged from workforce development in pharmacy deserts to new training models and sustainable reimbursement pathways.
Among the many compelling voices, one stood out: that of Dr. Krystalyn Weaver, executive vice president and CEO of the National Alliance of State Pharmacy Associations. Her message: Sustainable progress in pharmacy practice starts local—and requires not only bold policy but also steadfast optimism.
Weaver likened pharmacy’s evolution to climbing a steep and rocky mountain where each hard-won gain—be it OBRA ’90 counseling requirements, Medicare Part D MTM programs, or pandemic vaccine response—has brought the profession higher, but not yet to the summit. She pointed out that despite state-level victories like Washington’s 2015 payment parity law and California’s SB 493, implementation lags. Pharmacists are taking on more clinical responsibilities; however, with outdated infrastructure, limited reimbursement, and increasing burnout, the climb remains difficult.
This is where the “shop local” mantra takes on new meaning. Weaver emphasized that state-level advocacy—driven by state pharmacy associations—is one of the profession’s most powerful levers. Unlike sweeping federal change, state advocacy allows for tailored, nimble responses to local needs and politics. It also creates pilot opportunities that can model scalable national solutions. Weaver recognized state pharmacy associations as “lean, mean fighting machines” supported by small staff sizes and wholly volunteer led:
As a profession, we need to leverage this valuable asset and support state pharmacy association efforts to advance reforms on both the business side and the practice advancement side…. [Moreover, by] allowing the full profession to advocate at full volume and in lockstep, the influence and strength is even greater.
The core advocacy strategy is a shift toward the standard of care model—an approach that aligns pharmacists’ scope of practice with their clinical training, much like nurse practitioners and physicians. By adopting this model, states can modernize their regulatory frameworks, which currently limit pharmacists’ full potential. This isn’t just about achieving legislative wins—it’s about changing culture and perception.
Yet, as Weaver underscored, policy wins alone are not the finish line. Once laws change, a gauntlet of implementation barriers follow: credentialing, billing, contracting with payers, documenting workflows, and integrating systems. Community pharmacies—especially independent ones—often lack the administrative capacity to navigate this complexity, even if they are legally allowed to provide reimbursable clinical services.
That’s why pharmacy must not only shop locally for advocacy but also collaborate locally—across associations, academics, vendors, and practitioners—to remove these friction points. Without a shared infrastructure and shared vision, the system still fails to provide coverage for pharmacist care services for patients in much of the country.
Still, as heavy as these challenges may seem, the mood of the workshop was not one of resignation, but of resilient hope. Weaver’s message aligned beautifully with Larson’s words: “To think only of the best, to work only for the best, and to expect only the best.” That’s not naive optimism; it’s purposeful optimism. It’s a refusal to be discouraged by bureaucracy or delay and a commitment to keeping pharmacy’s promise to patients front and center.
This is the kind of optimism that fuels the long game. It’s what sustains grassroots advocacy when meetings get rescheduled, legislation stalls, and pilot programs struggle. It’s what empowers local leaders to keep showing up—not because change is guaranteed, but because it is “possible.”
And now, perhaps more than ever, the profession is nearing a tipping point. Pharmacists have proven their value time and again—during flu seasons and pandemics, in chronic disease management, and in underserved areas where they’re often the most accessible health care provider. The public trusts them. The policies are moving. The only thing left is to operationalize that trust and capability into sustainable care models. To do that, we must shop local—in our advocacy, alliances, and investments. We must maintain our optimism—not as a wishful ideal, but as an unwavering strategy going forward.
“To make your optimism come true,” wrote Larson, “press on to the greater achievements of the future.”