American College of Clinical Pharmacy
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ACCP Report

President’s Column

Knocking Down the Silos

Written by John E. Murphy, Pharm.D., FCCP

John E. Murphy, Pharm.D.,FCCP, FASHP

In my presidential address this past October, I promised that ACCP would work toward breaking down barriers and toppling silos that limit the organization and our profession from moving forward. At the time, I was thinking most about how we pharmacists tend to talk to ourselves about the valuable services we provide while often missing the boat on getting the message to our colleagues in other professions. Although this is common among all professions, pursuing opportunities to change this behavior is worthwhile, at least in my opinion.

One example of ACCP’s activities in this area that can help create change is the terrific paper prepared by the 2007 Task Force on Interprofessional Education (IPE) ( This document provides valuable background on efforts to develop programs that enhance the potential of health care providers to work together on high-performing teams to advance patient care. I am personally fortunate to be extensively involved in developing IPE programs and understand the many challenges associated with them as well as the potential for creating a new future health care delivery model.

ACCP has also been extensively involved with the medical profession this year through its efforts to include the pharmacist in the medical home model being discussed as part of the Administration’s current health care reform agenda. We continue to reach out to other professions and to the patient advocate community whenever possible to advance the value of pharmacists providing clinical care to patients.

However, the story I want to tell in this missive relates to breaking down silos within our profession. ACCP has always worked to be at the cutting-edge in advancing clinical pharmacy practice. Of course, we were not the only organization desiring to move the profession in a clinical direction, but we certainly have always pushed the limits. Unfortunately, the lack of formal recognition of pharmacists as health care providers has long hampered the full-fledged development of clinical pharmacy. Therefore, in addition to focusing on a variety of important issues related to advancing the delivery of direct patient care by clinical pharmacists, gaining provider status has been a major goal of ACCP for several years. This goal is not simple to achieve, and our chance of making it happen by working alone is unlikely.

Therefore, we have been working diligently with the other national pharmacy organizations for the past few years through collaborations such as the Joint Commission of Pharmacy Practitioners, the Leadership for Medication Management, and the Council on Credentialing in Pharmacy. These groups examine the best ways to communicate the dramatic changes occurring in the profession, which are allowing us to move away from a product focus and toward assuming responsibility for enhancing medication-related outcomes for our patients. I don’t think organized pharmacy has ever spoken so directly from the same page.

Our message remains difficult to sell because politicians too often observe limited patient care services when receiving their prescriptions. It is difficult to make the case that pharmacists should be paid for patient care services when they aren’t provided consistently. We in pharmacy often beat ourselves up about this, when the reality is that most pharmacists would be happy to switch from dispensing and minimal counseling to more extensive patient care roles if they were paid to provide them. I do not know of any other health care providers who work for free (excluding, of course, pro bono work), and we cannot provide patient care services without being compensated either.

For these reasons, ACCP has consciously chosen to work with pharmacy organizations across the entire profession to convince politicians that a new and better health care system would have to recognize the value pharmacists could provide to patients. In a recent example of this, Ed Webb and representatives of several of the major pharmacy organizations met with President Obama’s health care transition team. They stressed the importance of embracing change instead of continuing to pursue outmoded and unsuccessful models of care delivery. For this message to resonate and lead to change this year, pharmacists from all settings will have to stress to their legislators what could happen if we are given provider status. Therefore, I urge all members to break down any mental silos you might have toward other segments of the profession and band together to create the opportunity for pharmacy we all want to see in the new health care system that will emerge from current reform efforts. Please rest assured that ACCP will continue to seek ways to lead the evolution of clinical pharmacy, but our chances to do so will be dramatically increased if pharmacists receive their rightful recognition as health care providers. Down with the silos.