IN THE LAST 11 YEARS, the number of pharmacists who have become board certified in a pharmacy specialty by the Board of Pharmacy Specialties (BPS) has doubled every five years, from roughly 3,600 in 2002 to more than 18,000 in 2013, with many pharmacists attaining dual credentials.
As care shifts toward a team-based approach and health care reform mandates accountability and affordability, board certification stands poised to expand in tandem with the profession as a whole.
“Pharmacists will have a bigger role in direct patient care in primary care settings, and organizations will be looking for pharmacists who have the knowledge, skills, and abilities to take care of their particular populations,” said David Witmer, Pharm.D., ASHP senior vice president and chief operating officer.
“Credentialing in general (board certification being one method) will become more important as pharmacists become increasingly differentiated in terms of the patients we take care of and the increasingly complex medication regimens our patients require.”
Currently, the largest pharmacy specialty for which the BPS offers certification is pharmacotherapy, with more than 10,000 pharmacists holding that credential, followed by oncology and ambulatory care.
“Pharmacotherapy is a broad-based credential that demonstrates a deep knowledge of medications and allows pharmacists to practice in a variety of settings,” said William Ellis, R.Ph., M.S., executive director of BPS.
Ellis noted that ambulatory care is the fastest-growing specialty and will most likely overtake oncology by 2015 as the second largest. “This is because care is shifting from inpatient settings to outpatient settings. A large number of individuals are ambulatory care patients with chronic diseases, and they need medication management.”
Certification Grows with Provider Status
In October, pharmacists won provider status in California, joining their colleagues in North Carolina, New Mexico, Montana, and Washington State. Pharmacists wishing to attain the designation of “Advanced Practice Pharmacist” in California must meet two of three criteria: completion of a pharmacy residency where at least 50 percent of the experience includes providing direction patient care, one year of providing clinical services to patients under a collaborative practice agreement or protocol, or certification in an area of clinical practice.
As provider status in California takes effect this month, there will most likely be an uptick in pharmacists seeking board certification, said Witmer. “In California and other states that may pursue similar approaches, certification will enable pharmacists to obtain recognition and make maximum use their training and education.“
Daniel B. Truelove, Pharm.D., BCPS (AQ-ID), BCACP, AAHIVP, clinical pharmacy specialist in ambulatory care/HIV and PGY2 residency coordinator at the University of Louisville Hospital in Kentucky, believes that provider status may lead specifically to increased numbers of pharmacists seeking board certification in general and ambulatory care certification, in particular.
“Recent health care reform is increasing the demand for primary care providers and providers in specialized areas of care,” said Truelove. “In the next five to 10 years, this will lead to expanded scopes of practice for pharmacists and provider status the same way that physician assistants and nurse practitioners have gained.”
Truelove added that in the ambulatory care setting, “there will be a need for providers to handle chronic disease states. Pharmacists can play an integral role as medication experts.”
For Abimbola Farinde, Pharm.D., M.S., BCPP, pharmacist at Clear Lake Regional Medical Center in Webster, Tex., and online faculty for Columbia Southern University, Orange Beach, Ala., becoming board certified was a natural step after her residency. She feels it is a way of communicating to other clinicians that she has a particular base of knowledge.
“When credentials are presented to medical and nursing staff, they can relate to it. The testing is similar to what they have, and it lends support to your recommendations and the contributions you can make to the team,” she said.
Farinde added that board certification puts patients at ease, as well.
“Patients often want to talk to someone who knows about the medications they’ll be taking and how they will work. There is a level of reassurance in knowing that the pharmacist is well-trained and has a deep understanding of what they are being treated for.”
A Good Way to Differentiate Yourself
Witmer notes that in a growing number of health systems, certain positions require board certification as a condition of employment. “As the shortage of pharmacists wanes, board certification in a specialty is a strong way of distinguishing yourself in the job market.”
Truelove can speak to that. “Where I work now, it’s pretty much an unwritten rule that you get board certified after your residency.”
Earlier this year, BPS approved certifications in pediatric pharmacy and critical care pharmacy. According to Ellis, BPS is also working on certifications for specialization in pain and palliative care, cardiology, and infectious diseases. He feels that pharmacy students should keep the changing nature of pharmacy specialization in mind.
“Evolving clinical roles for pharmacists will most likely require board certification,” Ellis said. “The number of specialties from which to choose should help pharmacy students and future practitioners in a job market that will become increasingly competitive.”
–By Terri D’Arrigo
Stay Tuned for More Stories on Specialty Certification…
ASHP offers specialty review courses and recertification programs to help new pharmacists and veteran pharmacists alike prepare for BPS certification examinations in the pharmacotherapy, ambulatory care, and oncology specialties. A fourth offering, core therapeutic modules, is a collection of on-demand, web-based activities that can help practitioners prepare for BPS exams. The modules can also serve as part of a staff development program.
Stay tuned for the second part of this InterSections series on the value of specialty certification that will explore how ASHP’s programs were designed and the advantages they offer, and share the experiences of those who have used them.