The Doctor Shortage Is Crippling Health Care. Could Pharmacists Help?

With over 80 million people in the country, finding a primary care physician is difficult. But what if the doctor doesn't see you now ? Pharmacists can help.

"The lack of primary care is a huge problem," said Brian Musiak, director of Care New England's pharmacy system. "As a pharmacy leader ... we're trying to figure out where I fit in and where we can help."

Pharmacists can now administer injections, review and adjust medications, test for illnesses like COVID-19 and the flu, and even refer patients to specialists — anything that would otherwise send a patient to a regular doctor's office. Since last year, state laws have allowed pharmacists to prescribe birth control and HIV prevention drugs to eligible patients. Some pharmacists offer annual health visits for people on Medicare.

"The shortage of primary care providers in the United States poses a significant public health concern," said Rhode Island College of Pharmacy Dean Carrie LaPlante. "My relatives had problems with access, and my colleagues have problems with access. When I talk to my downtown colleagues and ask how our college can help, they say, 'Make an appointment with primary care.'

Could a new pilot program be part of the solution?

URI and life expectancy began to decrease in the summer. Their mission? Expanding access to health services.

Toward the end, the two groups announced plans for an as-yet-unannounced partnership, now in the form of a pilot program called RxSynergy.

The program increases access to health care for at-risk populations and allows pharmacists to practice at a higher level of their license. This means providing a full range of services to support their training.

Student pharmacists help the program by interacting with patients in the clinic, talking with them and learning about their medications, LaPlante said.

"I believe every patient in Rhode Island who takes 10 to 13 medications is immediately referred to a pharmacist to manage their medications and support their physicians," LaPlante said.

LaPlante notes that he has patients on 27 medications, and believes this should apply to them as well.

Read more : How can Rhode Island solve its primary care crisis? Here are some suggested solutions.

The American Medical Association is fighting pharmacist creep.

However, the American Medical Association has come out against what it previously called "the increasing role of non-physician health care providers in primary care shortages." The union's concerns range from nurses to physician assistants and pharmacists.

Last year, the AMA released an article, "Don't Expand Practices for Already Overburdened Pharmacists." The association sounded the alarm about the Drug Fairness Act introduced by Congress, which would allow Medicare to pay for certain vaccines, tests and treatments for chronic diseases such as COVID-19 and respiratory syncytial virus, or RSV. Public health hazard.

Also: "How did it happen?" Lack of primary care continues to affect the Republic of Ingushetia

"Because we're not accredited as a health care provider, we can't bill for the same services," says Michael Poirier, director of outpatient pharmacy services at LifeSpan. "That's why becoming an accredited service provider is one of the most important opportunities at the Rhode Island state and even the federal level."

But the AMA said in a letter to lawmakers that the bill "does not adequately allow pharmacists to provide services covered by insurance if they are provided by a physician."

URI's LaPlante described the association as "distorted and biased," putting doctors above the quality of patient care.

"We actually have hours of clinical training to treat patients," said LaPlante, who said he has 6,000 hours of training.

But do pharmacists do more work?

Pharmacists do not only give vaccinations, tests, etc. They don't say. Pharmacists involved in hospital systems, unlike chain pharmacies, may also request drug discounts for patients or require pre-authorization from insurance—surprisingly. A serious administrative headache for doctors.

Too much load?

"When we approved vaccines 15 years ago, pharmacists said the same thing: We don't want to add more," said Chris Federico, president of the Rhode Island Pharmacists Association.

Read more : Walgreens pharmacists walk out weeks after CVS workers follow suit

Last fall, pharmacists at CVS and Walgreens walked off the job to protest workloads and staffing shortages. Sources interviewed for this article do not currently see a shortage of pharmacists in the state, but one may be on the way.

"We are very concerned about the future shortage of pharmacists with the increasing public announcements of retail pharmacy attrition," said Christine Collins, Lifespan's senior vice president and chief pharmacy officer.

However, one fact remains inescapable: nearly 90% of Americans live within five miles of a pharmacy, making them easily accessible health options during a pandemic.

"Pharmacists continue to be the most accessible health care providers ... some things we think are important are continuing to move the profession forward," Lifespan's Poirier said. "Because pharmacists often have training beyond their advanced degrees ... we as physicians and other providers should be able to pay for some of the services we provide."

This article originally appeared in The Providence Journal: Pharmacists can help with doctor shortage, but some say more are needed.

Influenza, RSV, Covid are destroying the American health care system.