August 12, 2025
Jo Ellen Rodgers, Pharm.D., FCCP, FHFSA, FAHA, BCCP, BCPS
Community First: Elevating Clincial Pharmacy to Meet the Moment
As the US population continues to age and the demand for health care services outpaces the supply of providers, communities across the country are facing a daunting reality: we are on the brink of a health care access crisis. The number of patients with chronic diseases and complex medical conditions is rising at an unprecedented rate, with chronic diseases such as heart disease, cancer, and diabetes serving as the leading causes of death and disability and the primary drivers of the nation’s health care costs.1 Six in 10 Americans have at least 1 chronic disease, and 4 in 10 have 2 or more chronic diseases.1 As a result, 68% of Americans report taking at least 1 prescription medication daily, and as many as 26% report taking 4 or more prescription medications daily.1,2 At the same time, the Association of American Medical Colleges projects a shortfall of up to 124,000 physicians across primary and specialty care sectors by 2034.3
Of importance, most of the care for patients occurs not in academic medical centers or tertiary care hospitals, but in the community setting. Moreover, chronic disease management has shifted from physicians’ offices to more accessible sites in the community.4 As the role of local hospitals, outpatient clinics, and community pharmacies in chronic care continues to evolve, the increasing strain on these systems is immense. Not surprisingly, the burden is greatest in rural and underserved communities, where health disparities are widening and access to timely, affordable care is increasingly difficult to secure. Compounding these pressures is the rapid decline in access to a pharmacy, given that more than 1 in 3 retail pharmacies in the United States have closed since 2010.5
Within this pressing context, the role of “community” has never been more vital to the success of our national health care system. Community hospitals, community clinics, and community pharmacies each serve as indispensable access points for care. Clinical pharmacists’ unique skill sets position them to address the systemic care gaps facing community-based patients—particularly in areas where physician shortages and pharmacy deserts converge. Their presence is not a luxury—it is a necessity for sustainable, high-quality health care in the community.
Comprehensive Medication Management: A Framework for Community-Based Care
To fully realize the potential of pharmacists in bridging care gaps, especially in community settings, comprehensive medication management (CMM) offers the most effective and scalable framework and can be successfully implemented in a wide range of care settings: safety-net clinics, integrated health systems, health plans, community pharmacies, free clinics, and even mental health facilities. Delivered in collaboration with the broader care team and the patient, CMM considers every aspect of a patient’s medication regimen—prescription drugs, OTC products, vitamins, supplements, and traditional or alternative therapies—and ensures that each patient’s medications are individually assessed for appropriateness, effectiveness, safety, and adherence. More than a service, CMM is a whole-person process that begins and ends with the patient.
The 2024 GTMRx Review of the Evidence on Quality, Access and Costs provides further validation of CMM’s effectiveness. The report summarizes recent studies demonstrating the successful integration of CMM into team-based care across multiple health settings—including individual provider offices, nonprofit value-based care systems, and clinics serving patients with complex medical conditions. Regardless of setting, population, or location, the findings are consistent: when integrated into team-based care, CMM enhances therapeutic outcomes, supports chronic disease management, reduces health care use, and elevates the overall quality of care.
Burnout in the Community Care Workforce
In parallel with the growing demand for and complexities associated with health care delivery, burnout among community-based providers has reached alarming levels, jeopardizing both workforce sustainability and care quality. Physicians, nurses, and pharmacists practicing in community settings—especially rural or underserved areas—often face overwhelming caseloads, inadequate staffing, administrative burdens, and limited resources to support patient care. A 2022 report from the National Academy of Medicine highlighted burnout as a public health crisis, noting that 35% to 54% of health care providers surveyed reported symptoms of burnout.6 Community-based clinicians may be even more vulnerable because of greater isolation, limited access to mental health services, and narrower care teams. Pharmacists experiencing high rates of burnout also cite excessive workload, understaffing, and performance metrics as key contributors.7
This chronic stress not only affects clinicians’ mental health and job satisfaction but also leads to higher rates of turnover, reduced clinical effectiveness, and diminished patient trust and safety. Empowering clinical pharmacists to contribute more impactfully to patient care—particularly through meaningful roles in team-based care and CMM—can help alleviate some of these pressures, redistribute responsibilities, and improve outcomes for both patients and providers. Therefore, as we advocate for integrated, community-centered care models, addressing workload and burnout must be a parallel priority.
Call to Action
As we continue to elevate the role of clinical pharmacists in community-based and nonacademic settings, ACCP is taking intentional steps to better understand and support your work. The 2025 Member Relations Committee will soon launch a survey aimed at identifying the unique needs, challenges, and opportunities facing clinical pharmacists practicing outside formal academic affiliations—including those in rural hospitals, community clinics, and underserved settings.
Your voice is essential. We encourage you to participate in this survey and help shape the programs and services ACCP can offer to support your practice, enhance your impact, and advance equitable care for the communities you serve.
References
1. Centers for Disease Control and Prevention. About chronic diseases. Centers for Disease Control and Prevention; 2024. https://www.cdc.gov/chronic-disease/about/
2. CivicScience. Trend to watch: the percentage of Americans taking four or more prescription medications daily continues to rise. CivicScience; 2025. https://civicscience.com/trend-to-watch-the-percentage-of-americans-taking-four-or-more-prescription-medications-daily-continues-to-rise/
3. Association of American Medical Colleges. The complexities of physician supply and demand: projections from 2021 to 2036. Association of American Medical Colleges; 2024. https://www.aamc.org/media/75236/download
4. Bond AM, Schpero WL, Civelek Y, et al. Changes in primary care practice setting and practice type for Medicare beneficiaries. JAMA Health Forum. 2025;6(4):e250445. https://doi.org/10.1001/jamahealthforum.2025.0445
5. Guadamuz JS, Alexander GC, Kanter GP, Oato DM. More US pharmacies closed than opened in 2018–21; independent pharmacies, those in Black, Latinx communities most at risk. Health Aff (Millwood). 2024;43(12):1703-1711. https://doi.org/10.1377/hlthaff.2024.00192
6. National Academy of Medicine. Taking action against clinician burnout: a systems approach to professional well-being. National Academy of Medicine; 2020. https://nam.edu/wp-content/uploads/2020/09/4.-NAM-Taking-Action-Against-Clinician-Burnout-systems-approach.pdf
7. El-Ibiary SY, Yam LT, Lee KC. Assessment of burnout and associated risk factors among pharmacy practice faculty in the United States. Am J Pharm Educ. 2017;81(4):75. https://doi.org/10.5688/ajpe81475