ASHP InterSections ASHP InterSections

January 27, 2020

Pharmacists use Running to Improve their Mental and Physical Health

Juan Hincapie-Castillo, Pharm.D., completes a half marathon.

THROUGHOUT HIGH SCHOOL and college, and into pharmacy school, Juan Hincapie-Castillo, Pharm.D., Ph.D., M.S., said he never did any physical activity. Instead, he spent his time studying, developing poor eating habits, and loading up on caffeine. Then, during Dr. Hincapie-Castillo’s third year of pharmacy school, his father passed away from a fatal heart attack at age 50. It was just the wake-up call he needed to make a change.

Running relieves stress

Dr. Hincapie-Castillo signed up for a half-marathon, giving himself a year to train. He joined a local gym and began jogging and walking on the treadmill for 15 minutes. Once he had enough endurance to run for an hour, he joined a local running club. His first outdoor run with them was for four miles, and he was so fearful of getting lost that he forced himself to run faster to keep up with the others. A few months later, he ran his first race, a 7K. The next spring, he completed his targeted half-marathon in under two hours.

Then, he said, “I got the bug.” Today he’s into ultrarunning, defined as anything more than a 26.2-mile marathon. He completed a 50-mile race in just under 11 hours and is now training for his first 100-mile race.

An assistant professor at the University of Florida College of Pharmacy in Gainesville, Dr. Hincapie-Castillo spends most of his time doing outcomes research, sitting at a computer, writing grants, or in meetings. Running, he said, “really helps with stress relief and overall health. It’s very mental. It’s a time to get away, get a break, and it helps me get in the zone.” He is currently establishing a running group for pharmacy students.

Great way to make friends

Kim Benner, Pharm.D., after finishing the Chicago Marathon in 2019.

Dr. Hincapie-Castillo isn’t the only pharmacist to reap the benefits of running. Kim Benner, Pharm.D., BCPS, FASHP, FPPA, a professor of pharmacy practice at Samford University in Birmingham, AL, and a pediatric clinical specialist at Children’s of Alabama, started running over a decade ago as a means to help lose weight after the birth of her second child. It’s helped her in numerous ways.

“There’s a physical benefit obviously,” said Dr. Benner, a member of ASHP for over 20 years. “It keeps the weight down, it’s good for bone strength, and my heart rate and blood pressure are super low. It’s great spiritually, and has given me a lot of time to reflect on the beauty around us.” Moreover, it’s helped her socially. She estimates that about 75 percent of her friends are people she has met through a running club.

Five to six mornings a week, Dr. Benner meets the group for 5:30 a.m. runs. During the week, they might go four to eight miles, while on weekends they tackle eight to 20 miles for those training for a marathon. After the runs, they socialize during their cooldowns over coffee or sports drinks. She also has gone to group dinners and movies with her running friends and traveled with them to cities like Chicago to run marathons.

“I’m a morning person, and one of the reasons I like to run then is I feel like it keeps me more active, engaged, and alert at work because I’m not really a coffee drinker,” Dr. Benner said. “It naturally wakes me up and gets me ready to tackle the day to work with my team, take care of my patients, and teach.”

Dr. Benner also has met running friends through ASHP. They often meet early in the morning to run and then attend conferences together, or look for local races occurring in the cities where meetings are held. “Every time I travel to a pharmacy meeting, I look to see if there’s a race anywhere around, just so I can get my miles in,” she said. “It helps me sit through a longer meeting better.”

Positive impact on lifestyle

Lisa Padgett, Pharm.D., celebrates with her family after finishing a race.

For Lisa Padgett, Pharm.D., BCACP, of Raleigh, N.C., running has been a tool to help maintain high energy and a positive outlook in stressful situations. Three mornings a week, Dr. Padgett rises at 5 a.m. to run a 5K route through her neighborhood.

“Right now is the most challenging season for us,” said Dr. Padgett, an ASHP member since 2007, who works in a community pharmacy. “We have a vaccine that’s been on backorder, we’ve got flu shots coming in, and our script volume has increased consistently over the last few weeks. We’ve also been short-staffed, and had one of our key team members move to another state.”

There have been more than a few mornings when Dr. Padgett said work was the motivating factor that got her out of bed. “I see part of my role as not only to provide safe and effective prescription processing and patient counseling, but to maintain a certain level of positivity. I feel like exercise is key to that—I do it as much for me as for my team.”

Part of the reason Dr. Padgett took on her current job, which she started in January 2019, was to be more active. In a prior position, Dr. Padgett said her role was to coach people to help set goals and maintain healthy lifestyles. Meanwhile, she was spending most of her days sitting, either in the car on the way to various sites or in appointments and meetings. “I was doing exactly what I was telling them not to do,” she said. “I had a really hard time reconciling that.”

Running for beginners

Looking to get started running? The pharmacists provided the following tips:

  • Invest in good running shoes. Go to a true running store and have them fit you properly. “A lot of running stores will let you test shoes for up to a week, or run with them in the store or right outside in the parking lot,” Dr. Hincapie-Castillo said. “Don’t feel pressured to buy the most expensive ones, and always go a little bit bigger in size than your regular shoes.”
  • Find a running buddy or support community. “It’s a lot easier to get up at 4:30 in the morning when you know you have friends waiting on you,” Dr. Benner said.
  • Consider safety. If you run early or in the evenings, pick an area that has good lighting, and watch for cars, Dr. Benner advised. If you run alone, always tell someone where you’ll be.
  • Find your rhythm. Some people prefer running early in the morning before work, while others perform better at lunchtime or after work. Some runners like racing, while others enjoy the social aspect or mental breaks. “There’s no prescription for how to do it right,” Dr. Padgett said. “You have to figure out what works for you.”

By Karen Blum


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August 27, 2019

Ohio ASHP Members Successfully Advocate for Provider Status

Jackie Boyle, M.S., M.B.A., BCACP, BCPS

ON APRIL 5, 2019, AN OHIO LAW went into effect that will help pharmacists practice at the top of their license by officially recognizing them as providers. This groundbreaking legislation occurred thanks to the dedication and persistence of pharmacists across the state, including ASHP members Jackie Boyle, Keith D. Posendek, and Mary Ann R. Dzurec.

Under S.B. 265, which was signed by Governor John Kasich on January 4, 2019, pharmacists are allowed to bill public and private insurance companies directly for the services they provide to patients. “As a result of having provider status and the ability to bill directly for their services, pharmacists will be able to create new and innovate ways of delivering patient care,” said Jackie Boyle, M.S., M.B.A., BCACP, BCPS, Associate Professor of Pharmacy Practice at Northeast Ohio Medical University. She is also the Immediate Past President of the Ohio Society of Health-System Pharmacists (OSHP). “Several healthcare models already exist—the traditional hospital model, the clinic model, and the community pharmacy model,” Boyle explained. “As we see more and more technology moving into healthcare like telehealth and artificial intelligence, we can create care models that are more convenient for patients.”

A Passion for Advocacy
Boyle, an ASHP member since 2008, has always been interested in advocacy. She completed an elective residency experience during her PGY2 with the ASHP Government Relations Division in 2014. During that time, Boyle had the opportunity to review several new pieces of legislation that were being introduced, including one concerning biosimilars. She also visited Capitol Hill to talk with legislators about provider status and the role of the pharmacist on the healthcare team—all of which fueled her passion for advocating on behalf of her colleagues and profession.

Keith D. Posendek, Pharm.D., BCPS, BCGP

Since cultivating this interest, Boyle has become a voice for pharmacy in Ohio. When the opportunity arose to advocate for provider status for pharmacists, she jumped at it. Boyle testified in front of the Ohio Senate in support of S.B. 265, where she stressed the importance of provider status. “I explained that this bill is critically important to the public health of the state. It expands pharmacists’ ability to work in direct patient care roles and use their expertise to achieve positive health outcomes,” Boyle said. “This change would increase patient access to pharmacist-provided care.”

Boyle included several anecdotes about how pharmacists can impact patient care in her testimony. For example, she explained how one of her patients recovering from a heart attack was prescribed a medication that influenced his heart rate. Boyle identified a more appropriate medication. A few years later, the patient came back to tell her about the progress he had made and thanked her for changing his life.

A Team Effort
Although Boyle was instrumental in pushing S.B. 265 forward, she stressed that getting the law passed was very much a team effort. Many pharmacists in Ohio, including ASHP members, contributed to the cause.

Keith D. Posendek, Pharm.D., BCPS, BCGP, Clinical Pharmacist Specialist at Adena Regional Medical Center in Chillicothe, participated in a letter-writing campaign, including emails and handwritten notes, in support of S.B. 265. He also called politicians’ offices. Although he didn’t speak to legislators directly, he talked to staff members about the services pharmacists provide.

Mary Ann R. Dzurec, Pharm.D., BCACP

Dr. Posendek, who has been an ASHP member since 2015, noted that another valuable part of his advocacy was to spread the word about S.B. 265 to other pharmacists. He urged his pharmacy colleagues to remind lawmakers that pharmacists make vital contributions to the community and improve the health of the constituents politicians represent.

“Anything helps, whether it’s writing to your politician, calling them, visiting them, or going to local political action committee meetings,” Dr. Posendek said. “It’s nice to remind [your local lawmakers] that you are a constituent and part of their community. Tell them that you are advocating for an issue because you’re a pharmacist and also because you’re part of the community and can make a difference.”

A Seat at the Table
Mary Ann R. Dzurec, Pharm.D., BCACP, Ambulatory Care Pharmacy Specialist at MetroHealth, a safety net health system providing inpatient and outpatient care to the underserved in Cleveland, also lobbied legislators by sending letters encouraging them to support S.B. 265.

Dr. Dzurec, who has been an ASHP member throughout her nearly 35-year career, precepts a longitudinal advocacy rotation for pharmacy residents at MetroHealth. Throughout the year-long rotation, she teaches the residents about the importance of working with state lobbyists and directly reaching out to legislators. Dr. Dzurec and the residents review pending legislation and Ohio Board rule proposals, and provide formal written comments.

She believes that pharmacists are well-equipped to create a pathway to better healthcare for patients. “My advice to pharmacists and pharmacy students is to take a leadership role in promoting the pharmacist’s role in a health care setting. You’ll find a great deal of satisfaction in your work, and your patients will appreciate you for it,” said Dr. Dzurec.


By Kenya McCullum


June 28, 2019

Advocacy in Action: Utah Pharmacists Make Contraceptive Provision a Reality

David C. Young, Pharm.D.

A NEW LAW THAT WILL CHANGE the way Utah pharmacists work began with a question that was part of a classroom assignment: “If you had one wish for a pharmacy dream bill, what would it be?” At the time, Wilson D. Pace, Pharm.D., was a University of Utah College of Pharmacy graduate student in the school’s leadership and advocacy class taught by David C. Young, Pharm.D. He immediately thought of the need for broader access to contraception and how pharmacists can fill that gap.

This issue hit home for Dr. Pace because his wife had experienced problems obtaining a prescription for a contraceptive from an obstetrician since a shortage of providers made her wait several months to get an appointment. As he further looked into the challenges women face getting contraception in a timely manner, he found that his wife’s experience was far from unique. As a result, Dr. Pace came to the conclusion that if there were a law that gave pharmacists the power to provide contraception without a new prescription, it would go a long way toward advancing women’s health in the state. This idea moved Dr. Pace to seek out other student pharmacists to form a working group. Together they started an advocacy campaign that would make this dream bill a reality.

Garnering Support from Medical Stakeholders

Wilson D. Pace, Pharm.D.

Dr. Pace and his working group began by reaching out to pharmacist mentors about their desire to take action on this idea in the hopes that the legislature would act on it. The pharmacists discussed how the advocacy process would work, and based on his prior experience, Dr. Young knew they first had to gain the support of various stakeholders in the state. Although groups such as Utah Board of Pharmacy, professional pharmacy organizations, the Utah Medical Association, and nursing organizations agreed that it was essential to address the issues women face while trying to obtain contraceptives, they had yet to agree on the exact role pharmacists should play in solving them. Specifically, whether or not pharmacists should be able to provide contraceptives without a prescription from a doctor.

As a result, Dr. Pace’s original vision of pharmacists having prescribing power was a point of contention during the discussions and ultimately something on which Drs. Pace and Young needed to compromise to get the groups’ support and move forward. In the end, the stakeholders all decided it was best for pharmacists not to have full prescribing power, but to be able to provide contraception without a prescription on a limited basis.

“We didn’t sit around the fire singing ‘Kumbaya,’” said Dr. Young. “We had very healthy, open, and honest discussions about what the idea for a new law meant, how we were going to accomplish it, and how we were going to work together.”

Hammering Out the Details

After completing discussions with all of the healthcare stakeholders and getting their support, it was time to work with the legislative research office to refine the language of the bill. This was a complicated and lengthy process because it required that every interested group sign off on each revision that was made to the draft.

“Any tiny change had to have buy-in from all of the different groups,” Dr. Pace said. “So the next big step was working out all the nuts and bolts and then coordinating to make sure everybody was on the same page.”

Legislative Support

Karen M. Gunning, Pharm.D., BCPS

Once the language of the bill was finalized, it was time to get legislative support. Finding the right sponsor was vital. Sen. Todd Weiler agreed to sponsor the bill, and Rep. Ray Ward, M.D., a family physician with a history of working on legislation related to improving public health, co-sponsored the bill. “We actually had no opposition. We were concerned that there might be different groups testifying against us or they would push back, but there was none of that,” said Dr. Pace.

The process went so smoothly that there were no opposing testimony delivered when the bill was in committee and no opposing votes in the Utah Legislature. In March, Gov. Gary Herbert signed S.B. 184.

Thanks to the efforts of Dr. Pace, the other student pharmacists involved, and guidance from their mentors, women in Utah can now get contraception from pharmacists for two years before being required to check in with a doctor for a new prescription.

“I believe this law will allow pharmacists in the state of Utah to demonstrate the value they bring to patient care, and also the team-based approach to care that pharmacists have,” said Karen M. Gunning, Pharm.D., BCPS, a Professor (Clinical) at the University of Utah College of Pharmacy, who provided expert knowledge and support to Drs. Pace and Young as they navigated the legislative process. “There is great potential for pharmacists to work with medical providers in their communities to improve access, and to ensure that patients who need contraceptive care from a non-pharmacist medical provider are referred promptly to one.”

A Future of Advocacy

With this significant advocacy win under his belt, Dr. Pace admits that he’s been bitten by the political bug and will continue working toward furthering the interests of the pharmacy profession. Drs. Pace and Young, now co-chairs in the legislative committee of the Utah ASHP state affiliate, have already begun exploring new issues to tackle in the current legislative session.

“Whatever job I end up being in, I can’t imagine not being involved in some way in the advocacy process,” Dr. Pace said.

Although at first blush many pharmacists may shy away from doing advocacy work, Dr. Young urges all pharmacy professionals to consider getting involved because of the tremendous impact it can have on the way they work in their state.

“If you’re not interested in advocating for your profession, other people may change the laws and rules on you, and you may not like it,” he said. “If you want to control your outcomes, you’ve got to get involved. The best way to control your destiny is to create it — and that’s what happened with this bill.”


By Kenya McCullum


April 22, 2019

Overcoming Burnout: Advice from Your Pharmacy Peers

MORE THAN 50 PERCENT OF PHARMACISTS WHO PRACTICE IN ACUTE AND AMBULATORY CARE SETTINGS EXPERIENCE BURNOUT, which is characterized by exhaustion, cynicism, and/or a low sense of personal accomplishment. While burnout is devastating on a personal level, the syndrome can also affect a pharmacist’s ability to fulfill their duties, which can negatively impact patient care.


Often when we have a problem, we turn to our peers for support and guidance. ASHP InterSections asked a student pharmacist, a new practitioner, and a pharmacy leader to share their thoughts on resilience and burnout. Here’s their advice.


ASHP InterSections: What have you found most challenging about thriving at work or school?


Sydney Stiener

Sydney Stiener

ASHP member since 2015

Student Pharmacist and Pharm.D. Candidate (May 2019)

University of Wisconsin-Madison School of Pharmacy

“The biggest challenge for me has been finding the right balance between meeting school-related priorities and dedicating myself to hobbies that help me recharge and be efficient and successful. As a pharmacy student pursuing a residency and facing a competitive job market, there is a constant expectation to do more. On top of rigorous course work and other demands of pharmacy school, students spend many hours a week involved in student organizations, taking on leadership positions, participating in research — and the list goes on and on. Beyond these extracurricular activities, it’s a challenge to find time to care for ourselves by doing things that make us happy outside of school. Without these things, it’s easy to lose perspective and forget the reasons you wanted to become a pharmacist in the first place.”


Shannon Kraus, Pharm.D., BCPS

Shannon Kraus, Pharm.D., BCPS

ASHP member since 2015

PGY1/PGY2 MS/Pharmacy Administration Resident

Riverside Methodist Hospital, Columbus, Ohio

“It’s been challenging to me as a new practitioner to balance providing quality care with the realities of needing to do so in a cost-effective way, both across the organization and within the pharmacy service line. For example, while I try to provide optimal patient care and work toward outcomes like decreased readmissions through pharmacist-led counseling at discharge, having limited resources has certainly tested my resilience.”


Paul Bush, Pharm.D., M.B.A., BCPS, FASHP

ASHP member since 1975

Chief Pharmacy Officer and HSPA/MS Residency Program Director

Duke University Hospital, Durham, N.C.

“I currently lead a large pharmacy program that includes 428 staff and complex pharmacy operations, so there are many moving parts that I need to be thinking about. It can be challenging to manage the many details and the demands of my job.”


ASHP InterSections: How do you ensure your well-being and resilience?


Stiener: “I can’t always control the challenges that can lead to symptoms of burnout but I can control my attitude toward those challenges. A philosophy that’s helped me bounce back from a bad exam grade, get through long hours of studying, learn from mistakes, and ultimately excel in my program is Hal Elrod’s 5-Minute Rule, which says it’s OK to be upset, angry, frustrated, or negative when something unfavorable happens to you, but you get only five minutes to feel that way. So, I allow myself five minutes to feel those emotions, but then I force myself to put it behind me, learn from it, and move on with my day with a positive attitude and a smile on my face.


“I also prioritize activities that make me happy and recharge my overall well-being, like running outside in the fresh air and spending time with friends and family.”


Dr. Kraus: “Every morning at 4 a.m., I fill up my resilience bucket by first reflecting on what I am grateful for from the previous day. After that, I go to my local fitness studio. Exercising strengthens me both physically and mentally.


“Throughout the day I try to spread my positive energy with my residency family. I’ve even developed Wellness Wednesday, where I send an email focused on physical, emotional, intellectual, spiritual, or financial health with the hope of providing others with an uplifting moment and helping them build resilience.”


Paul Bush, Pharm.D., M.B.A., BCPS, FASHP

Dr. Bush:I think the key to stepping up and leading in challenging situations is simply to stay focused. A book called The 7 Habits of Highly Effective People by Stephen Covey — and specifically the idea of putting first things first — has helped me get through the week and stay focused.


“I go full speed for five days a week, 10 hours a day, so recharging over the weekend with family is very important to maintaining well-being. During the week, I get on the treadmill for 20-30 minutes a day, which is both physically helpful and a good diversion. I also eat a healthy diet and try to sleep for seven hours a night. And I watch my favorite TV series and sports.”


ASHP InterSections: What advice would you give others in your position to help them thrive and rebound from burnout?


Stiener: “Surround yourself with positive and supportive friends, classmates, mentors, family members, and others who can see you through stressful times and help you maintain perspective. Also, make time for your own hobbies outside of school. It’s amazing how much easier it is to focus and stay engaged when you invest a little time in yourself.”


Dr. Kraus: “The triggers of burnout are often our own self-limiting beliefs. However, we can also choose to cultivate joy in our everyday life and remember that, as E.E. Cummings said, ‘The most wasted of all days is one without laughter.’”


Dr. Bush: “Give yourself time to recover from stressful events and reduce your workload when these things happen. Maintain a sense of hope, optimism, and self-efficacy and focus on feeling joy at work. Joyful activities such as ensuring patients have positive experiences and improving patient outcomes are healing, create connections, and add meaning and purpose. Make sure you have strategies for self-care and draw on your social safety nets and support from your organization and your peers.”


By David Wild








April 8, 2019

ASHP Is Taking Government Relations and Advocacy to the Next Level

Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP

I am happy to announce our plans to further strengthen ASHP’s government relations activities in Congress, federal agencies, the White House, and the states. Further, to enhance our advocacy initiatives and communications regarding our government relations efforts.

To that extent, we have made some important strategic changes to ASHP’s government relations area. First, we have added a Vice President of Government Relations to our Senior Leadership Team who will also complement our exceptional Government Relations staff. We announced last week that we have hired Tom Kraus, M.H.S., J.D., as ASHP’s new Vice President of the Government Relations Office. Tom is a leader with incredible experience. He has a sincere passion for improving the health and well-being of patients, and he understands that pharmacists play a critical role as patient care providers — and can do even more.

Tom is a former Food and Drug Administration (FDA) Chief of Staff and FDA Associate Commissioner. He also served on the U.S. Senate Health, Education, Labor and Pensions (HELP) Committee as Staff Director, working under Senators Kennedy and Harkin. During his time on the HELP Committee, he was instrumental in the passage of key legislation, including FDA drug and food safety reforms and user fee legislation, the American Recovery and Reinvestment Act, and the Affordable Care Act. While at the FDA, he was a top advisor to the FDA Commissioner, a key leader among FDA’s over 14,000 employees, and FDA’s main liaison and advocate to Congress.

Tom has also served as a health policy, management, and life sciences senior executive for Ernst & Young, McKinsey & Company, Avalere Health, and, most recently, the Boston Consulting Group. In these roles, he engaged with virtually every major component of U.S. healthcare, including agencies within the Department of Health and Human Services, state agencies, the pharmaceutical industry, health insurance companies, and many others. Tom earned a Bachelor of Science in Biology from the University of Michigan, a Master of Health Science in Health Finance and Management from Johns Hopkins University, and a Juris Doctor from Georgetown University Law Center.

Tom will be joining the ASHP team later this month, and we are looking forward to introducing you to him at the ASHP Summer Meetings in Boston.

Secondly, ASHP has also hired Doug Huynh, J.D., as our new federal lobbyist and primary legislative advocate on Capitol Hill. Doug comes to ASHP with extensive experience from the Society of Interventional Radiology, where he worked for 12 years as Director of Government and Policy Affairs. Doug also served as a lawyer and lobbyist in a number of other healthcare-related organizations. He has an in-depth understanding of the healthcare landscape and the issues that impact pharmacists, physicians, healthcare organizations, and other providers, as well as excellent relationships on Capitol Hill and a strong knowledge of the political process. Doug graduated from Virginia Commonwealth University with degrees in Communications and Political Science, and he earned his law degree from Quinnipiac University. Doug joined our team earlier this month, and we also look forward to introducing you to him at the ASHP Summer Meetings in Boston.

We are confident that these important enhancements to our already strong Government Relations team will be of great value to ASHP members and their patients, and will help us further advance pharmacy practice by better educating policymakers and other important healthcare stakeholders. We look forward to sharing more about the many new things we will be doing through ASHP’s enhanced government relations and advocacy program.

Thank you for being a member of ASHP, and for everything that you do for your patients.




November 28, 2018

Clinical Privileging Paves the Way for Expanded Pharmacy Services

This opinion column was authored by ASHP member and InterSections guest columnist Ryan Mills, Pharm.D., M.B.A, M.H.A., BCPS. Dr. Mills is the Pharmacy Manager at Novant Health Kernersville Medical Center and Novant Health Clemmons Medical Center in North Carolina. He is a passionate pharmacy leader who believes that bringing pharmacists to the forefront of patient care will have a significant impact on chronic disease management and population health issues.


Ryan Mills, Pharm.D., M.B.A, M.H.A., BCPS

HEALTH SYSTEMS TODAY STRUGGLE WITH RISING COSTS and lower reimbursement coupled with expectations for greater safety and quality of care. Failing to adapt to these changes and position your pharmacy enterprise for the future will result in fates similar to those of  Blockbuster and Kodak. As hospitals and health systems shift toward a value-based reimbursement model, we must promote a progressive pharmacy practice model with pharmacists working together with providers in collaborative practice agreements.


Leveraging Pharmacists’ Expertise

My colleague, Matthew Gibson, Pharm.D., M.S., BCPS, is the Clinical Pharmacy Manager for Ambulatory Services at Novant Health. He has many years of experience with implementing collaborative practice agreements, pharmacist credentialing, and expanding pharmacy services. His pharmacy team delivers the highest-quality clinical care to our patients throughout the continuum of care.

It takes more than interprofessional collaboration throughout the patient’s hospital stay to improve patient care. Pharmacists need to be officially recognized for their expertise. North Carolina state medical and pharmacy boards have recognized pharmacists as practitioners since 1998, under the designation of clinical pharmacist practitioners (CPPs). Like other midlevel providers, CPPs enter into collaborative practice agreements with physicians, whereby the physician grants authority to the pharmacist to provide specific patient care services. The North Carolina Board of Pharmacy requires a protocol agreement between the supervising physician and CPP. This agreement details the CPP’s scope regarding disease state, medication therapy, and monitoring privileges.


Know Your Medical Staff Bylaws

At Novant Health, Dr. Gibson has partnered with physician leadership to successfully add CPPs to the medical staff bylaws. This means CPPs are now considered advanced practice clinicians, which is the same designation as nurse practitioners and physicians assistants. At a high level, medical staff bylaws describe how the medical staff governs itself. The bylaws explain the rights of the medical staff, the qualifications for medical staff members and advanced practice clinicians, and the necessary steps in the appointment, reappointment, and clinical privileging processes.

Every health system has its own credentialing and privileging process. Our credentialing and privileging process occurs through our central verification and medical staff offices, which determined that our CPPs would complete the same rigor of credentialing, privileging, and oversight process as our medical providers.

North Carolina laws have established a quality assessment schedule for CPPs to meet with their supervising physician on a regular basis to review clinical performance. Since the training of pharmacists has rapidly progressed over the past 10 years resulting in a spectrum of clinical skill sets among pharmacists, we decided to adopt more stringent eligibility requirements than the state, such as Board of Pharmacy Specialties certification and two years’ clinical pharmacy experience.


Successful Use of CPPs

Novant Health first used CPPs in the acute care setting to support optimal medication management in the neurology service line and is in the process of expanding into other venues of care, such as medication reconciliation at admission and discharge, emergency department culture review, and high-risk chronic disease state management.

The role of the pharmacist has drastically changed over the years from dispensing and verifying orders to direct patient care in partnership with all other disciplines. Our pharmacists play a crucial role in ensuring that our patients receive the highest-quality care and safest experience possible every time.

One of the most cost-effective investments any health system can make is leveraging its pharmacists in collaborative practice agreements throughout every venue of care to deliver a remarkable experience.

By Ryan Mills, Pharm.D., M.B.A., M.H.A., BCPS


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