It is a distinct honor to serve ACCP as its 29th president. In this column, I would
like to talk about some of the important issues we will address this year to advance
ACCP and our members’ potential to improve the outcomes of the patients we serve.
I realize it isn’t common to memorize mission statements, so I’d like to refresh
everyone on ACCP’s: “The American College of Clinical Pharmacy exists to advance
human health and quality of life by helping pharmacists expand the frontiers of
their practice and research.” The theme I have chosen for this year matches ACCP’s
desire to expand frontiers and indicates our unwillingness to let obstacles get
in the way.
Allow me first to address the thematic aspect of “Clinical Pharmacy Across the Continuum
of Care.” Pharmacy will never achieve its potential if the practice of clinical
pharmacy is not evident everywhere that direct patient care is provided. We must
be visible in every medication therapy decision, not hiding behind walls and counters,
when it is time to ensure that patients make the best use of their medications.
It is past time to take away the focus from the dispensing process and move it emphatically
to patient care. Pharmacy academicians do little to train students in dispensing
processes, yet many pharmacists are happy to take on this role after graduation
and then shy away from the pharmacist’s most important role, that of ensuring optimal
medication outcomes for his/her patients. Of course, the dispensing system must
be safe, but automation and technicians can handle most, if not all, of this process
safely, given the proper oversight. ACCP is fortunate to have many members working
in ambulatory settings, where they affect patient care in important ways, but we
need to increase their numbers across all ambulatory care settings.
Regarding silo-busting, it is time for pharmacy professionals to speak with other
health professionals and patient groups on a routine basis. We can all be more effective
working together than apart. The Institute of Medicine was clear in its directives
for interprofessional education (IPE) and team building, and I am fortunate to spend
about one-quarter of my teaching and university service time developing IPE programs
at the University of Arizona. It is exciting to be able to work with colleagues
dedicated to IPE and teamwork. Of course, there are many challenges and not everyone
is supportive, but I have seen the potential of what can be accomplished.
ACCP is preparing a position statement to accompany its recently completed paper
on IPE, which will also comment on the need for all colleges and schools of pharmacy
to develop relationships with other health professions to educate students in IPE.
We cannot wait until students graduate to develop this team-based behavior.
In another approach to silo-busting, the Organizational Affairs Committee will look
at how we might develop joint initiatives with PhRMA and BIO to optimize patient
care. And, of course, we will continue to work with other pharmacy organizations
to advance the role of pharmacists as direct patient care providers who receive
appropriate reward for their clinical services.
Let me now address the notion of “no boundaries” in the theme. ACCP was founded
almost 30 years ago, the same year I graduated with my postbaccalaureate doctor
of pharmacy degree. The rabble-rousers who formed this organization 30 years ago
believed that clinical pharmacy needed to exert a dominant position in the practice
of pharmacy; they also believed that not enough was happening and that, for the
inroads that were being made, the pace was insufficient. ACCP’s founders saw beyond
the boundaries that many espoused at the time, and they were willing to put their
hard work on the line to bring about change. Winston Churchill observed that “a
pessimist sees the difficulty in every opportunity; an optimist sees the opportunity
in every difficulty.” I am thrilled to be serving an organization of talented individual
members and staff who routinely continue the optimistic pioneering tradition of
our founding members and help move forward this venerated and sometimes reticent
profession. I liken ACCP members and staff to that great space ranger (and accidental
humorist) Buzz Lightyear, who acknowledged no limits when he stated: “to infinity
and beyond.” Our number one job is to continue to lift the boundaries of our
profession so that we can accomplish our mission of improving the health and quality
of life of the patients we serve.
ACCP’s committees will be focused on removing boundaries, largely based on the direction
created in our current strategic plan. Unlike many strategic planning endeavors
I have seen, ACCP’s is clearly directed with timelines and expected outcomes, another
assurance that we will continue to be leaders of change in the profession.
One of the boundaries that ACCP has worked vigorously to break through is the ability
of pharmacists to provide direct patient care across the continuum. To ensure that
we are best able to serve our patients, we have stated that by 2020, all pharmacy
students planning to provide direct patient care should enter a residency after
graduation. This bold statement resonated with some members of the profession but
encountered significant pushback from others. Resistance was to be expected, but
ACCP will not be deterred in its goal. However, for this to become a reality in
the near future, we need to increase the number of residency programs and positions
at an almost exponential rate. I would like to ask each member to join a residency
development and expansion army—and to do everything you can to start a program,
expand the number of positions at your place of employment, or help another institution
start a program. To use another Churchill quotation, “It is no use saying, ‘We are
doing our best.’ You have got to succeed in doing what is necessary.” I believe
success in our endeavor is absolutely necessary for the future of our profession,
and ACCP will be there to help. One of our committees has been charged with creating
a primer on residency program development, and the members are to include descriptions
of viable economic models that will facilitate the creation of new programs and
the expansion of existing programs across all pharmacy practice settings. Their
work will be made available as a publication so that it can be used across the entire
profession.
Another boundary breaker that ACCP will be involved in is continuing to advance
research in the pharmacy profession. Past work by the Research Institute and recent
ACCP program offerings have helped to expand the capabilities of current practitioners.
This year, two committees will focus on enhancing research interests among pharmacy
students. One committee will examine how ACCP can help the pharmacy academy increase
the number of students who pursue a research career, and the second committee will
develop an ACCP commentary recommending the essential research curriculum that should
be included in professional programs leading to the doctor of pharmacy degree.
Within the pharmacy profession, we often talk only to ourselves, staying within
the pharmacy silo. Two committees will push boundaries related to advocacy for patients
both inside and outside the profession. These include (1) ensuring cost-effective
pharmacotherapy and (2) ensuring the quality of pharmacotherapy outcomes. A previous
committee examined access to care issues. It is envisioned that the papers from
these new committees will be published as official ACCP statements and that each
will spawn an op-ed piece (or letter to the editor) for submission to major lay
publications (such as The New York Times or The Washington Post).
I am committed to carrying out this year’s committee charges, and I know their outcomes
will be important. I am particularly excited about a new group formed this year
and its charge. I have asked a particularly well-seasoned group of ACCP members,
a collection of ACCP past-presidents, to reflect on the future of pharmacy practice.
As you know, many of our members essentially prescribe medications in some type
of arrangement with physicians and other providers. I did the same almost 30 years
ago in the private practice pharmacokinetic consulting group that two colleagues
and I operated for 10 years. This committee will consider whether pharmacists should
move to assume the role of prescriber, with physicians as the diagnosticians, and
then what implications this would have if pharmacists remained tied directly to
the sale of medications. As you know, the pharmacy profession has long held that
one who prescribes a product should not also sell that product. It is highly likely
that the conclusions of this committee will be controversial, but as Churchill also
said, “Kites rise highest against the wind, not with it.” I expect great things
in 2009 from the ACCP past-presidents committee as well as all of our other committees
and task forces, and I urge you all to be at the leading edge of change.
StuNet, our Student Advisory Committee, will have much on its plate this year. First,
it will be developing a clinical pharmacy resource kit for first-year students so
that students can be reached as early as possible to stoke their interest in a direct
patient care career. The second task of the committee will be to develop a new and
unique student pharmacist competition, whose national finals will be held at an
ACCP national meeting. We have encouraged them to think outside the box and, though
I won’t be proscriptive, it would be exciting if the competition were to have an
interprofessional aspect.
We have also added students to our standing and special committees where their service
is appropriate, based on our interests in continuing to develop students in ACCP
and on the overwhelming interest of students in volunteering for ACCP activities.
For my final Churchill quotation, I offer the following: “We make a living by what
we get, but we make a life by what we give.” We are blessed in pharmacy to make
a very good living. I urge each of you to give back mightily to our profession so
we can best serve the patients who put their trust in us. Thanks very much for the
opportunity to serve you this year as president of this wonderful organization.