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Interprofessional Collaboration: ASHP’s Response to the AMA

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

In June of this year, the American Medical Association (AMA) passed a resolution that caused concern among many of us.  At first glance, it’s no wonder why the policy gave us pause, as it states that “a pharmacist who makes inappropriate queries on a physician’s rationale behind a prescription, diagnosis, or treatment plan is interfering with the practice of medicine.”

While this statement seems to throw up a barrier to the good, productive collaborative relationships that best benefit patients–and that pharmacists, physicians, and patients have all grown to appreciate–it’s important to look at what was at its root: this nation’s drug abuse problem.  The AMA’s statement is a response to the efforts of some pharmacies in light of the federal government’s stepped-up enforcement to prevent diversion and better control the epidemic of prescription drug abuse.

Certain pharmacies, in response to enhanced scrutiny and enforcement efforts by the Drug Enforcement Administration, are calling and faxing to verify the legitimacy of every controlled substance prescription before filling. The burden this has placed on some physicians’ offices gave rise to this new AMA policy.

I recently wrote a letter to the CEO of the AMA that stressed the long history of collaboration that exists between pharmacists and physicians in hospitals, health systems, and ambulatory clinics. My letter confirmed that ASHP would be pleased to work with the AMA and other stakeholders to find solutions to the broader problem of prescription drug abuse, which ideally would include more effective communications and interprofessional collaboration among pharmacists, physicians, other health care providers, policymakers, and law enforcement.

The nature of today’s health care delivery system depends on professional collaboration to make sure our patients are getting the best health care possible.  Over the course of my 35-plus years in practice, and here at ASHP, I’ve seen firsthand how that collaboration has grown exponentially,  and is now widespread, not only in our nation’s hospitals and clinics, but with our community pharmacy partners.

And, indeed, we hear the same from our physician colleagues. In fact, Richard Pieters, M.D., the physician who wrote the draft for the AMA resolution, described his working relationship with pharmacists as “excellent” in an interview with Pharmacy Practice News. He added that “pharmacists are very valuable members of the team.”

Pieters, who is a radiation oncologist at the University of Massachusetts Medical Center and president-elect of the Massachusetts Medical Society, went on to state that, as a physician who is board-certified in hospice and palliative medicine, he finds pharmacists to be “fantastic resources.”

With a strong commitment to getting to the right issues in the right ways, pharmacists and physicians can both be part of the solution to our nation’s epidemic of prescription drug abuse in a way that encourages the interprofessional collaboration that best serves our patients.