Michael D. Hogue, PharmD, FAPhA, FNAP, FFIP

Michael D. Hogue, PharmD, FAPhA, FNAP, FFIP

Michael D. Hogue is the 15th Executive Vice President and Chief Executive Officer of the American Pharmacists Association (APhA).

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Published on Friday, February 16, 2024

AMA statement on pharmacists is arrogant, self-centered, and out of touch

This blog was co-written by Lee Vermeulen, B.S.Pharm., M.S., FCCP, FFIP, Executive Vice President and CEO of the American Association of Colleges of Pharmacy.

Everybody knows that bullies don’t care about what’s in the best interest of anyone else around them, they are simply focused on their own insecurities and self-interests. While we’d like to think that the author of a recent diatribe comparing pharmacist and physician training is simply uninformed or misguided, the continued harsh and unprofessional language published by the American Medical Association (AMA) confirms for us that AMA has become a bully: unprofessional, completely disconnected from reality, and intent on getting their way no matter what is in the best interest of patients. This may explain why it is very difficult to find a practicing physician who agrees with the current AMA position on non-physician health care team members, much less one who is even a member of AMA. In fact, what we have discovered is that most physicians’ reactions to recent AMA statements on what they call “scope creep” has been largely one of embarrassment with many physicians on social media platforms openly criticizing AMA for being out of touch.

Both of us have served on medical school faculty.

We’ve seen both pharmacy and medical education in action. We can attest that pharmacists and pharmacy educators took very seriously all the clarion calls of the National Academies of Medicine to meet the challenges of our future health care system and society. Virtually every assertion made by AMA in this piece about the background and training of pharmacists—both as a part of their Doctoral-level training and of their continuing professional development—is blatantly false and misleading. Pharmacists are trained in systems-oriented management of patients throughout their lives, from infants to seniors. Pharmacists receive training in comprehensive physical assessment and must engage in systems-oriented physical assessment to determine the effectiveness of prescribed medications and adjust those therapies to a desired therapeutic effect. Almost one-third of pharmacists currently practicing have completed at least one year of postgraduate residency, and many have completed a second year of specialty residency and fellowship training. The Board of Pharmacy Specialties currently reports that 60,000 pharmacists across the United States (out of the 340,000 in practice) have achieved board certification in one or more of 14 specialties through a rigorous process that ensures clinical competency in direct patient care. These board-certified pharmacists in oncology, psychiatric care, nutrition, cardiology, infectious disease, critical care, emergency medicine, ambulatory care, pharmacotherapy, and many more work alongside physicians in acute care hospitals, outpatient clinics, and yes, even in community pharmacies.

It is in the community setting where pharmacists play perhaps their most critical role. American Medical News estimates that, in 2023, the average time to see a family practice physician in Boston was 50 days; to see a cardiologist in Portland, Oregon, patients wait 49 days; and for patients seeking care from OB/GYN physicians in Philadelphia, the wait is 59 days. The shortage of primary care and family medicine physicians in rural areas of our country currently puts huge portions of our population at risk of not being able to access essential care. This situation is not improving—the Association of American Medical Colleges (AAMC) estimates that the mounting physician shortages could hit as high as 125,000 in the next few years, deepening the current crisis in access to care for our patients. Physicians, and the patients they care for, need the help of pharmacists.

The good news: Pharmacists demonstrated to the world during the COVID-19 pandemic that they are well-trained and capable of conducting point-of-care testing, with hundreds of thousands of COVID-19 tests administered in pharmacies, and direct patient care, administering 7 of 10 COVID-19 vaccines in the United States. Influenza, also easily diagnosed with a point-of-care test, requires therapy to be initiated within 72 hours. Good luck getting into a physician’s office in time to make an impact on outcomes. Yet, pharmacists can, and do, step in with treatment quickly to reduce morbidity and mortality. Patients want this level of access and are demanding it from our health care system.

Those of you further along in your careers may remember a similar situation in the 1980s, when chiropractors beat AMA in the Supreme Court over a very similar issue, teaching AMA a humbling lesson in the value of interprofessional care.

We’re calling on AMA to apologize for its unprofessional article and retract it entirely. Other organized medical associations, many of whom APhA and the American Association of Colleges of Pharmacy (AACP) work very closely with, must condemn AMA for its bullying tactics and urge them to focus on addressing health care disparities and improving access through interprofessional practice, as called for by the Interprofessional Education Collaborative, to which both AACP and AAMC belong. Individual practicing physicians—who acknowledge that they could not safely or effectively care for their patients without the help of pharmacists—must also condemn the AMA statements. It’s time AMA put the needs of their patients above the notion that pharmacists, and other health care team members, are competing with them. Unfortunately, AMA continues to subscribe to an outdated notion that the physician must be in control of everything—in control of the health system, in control of other health care providers, and in control of patients. The rest of us have moved on to patient-centered care. AMA, isn’t it time for you to move on, too?

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Author: Jamila Negatu

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