The Pharmacy profession is at a pivotal time in the development and movement for pharmacist provider status.  This essential recognition not only sets the stage for reimbursement for clinical services by pharmacists but also defines the actual roles or responsibilities for Advanced Practice Pharmacists. Nationally, the current movement in Congress to amend the Social Security Act (HR 592 and SB 314) to add pharmacists to the recognized list of health care providers is critical to the profession.

Locally, many individual states have, likewise, recognized the value of pharmacists providing expanded patient care services particularly in the ambulatory care practice setting.  As a consequence, these states have created their own pathway to recognizing and creating the Advanced Practice Pharmacist practitioner.

States like North Carolina, New Mexico, California, Oregon, Washington, and Minnesota have in their own way enabled an increase in the scope of practice for pharmacists.   However, in accomplishing this, each State Board has struggled with determining the qualifications or credential for these newly created practitioners.  New Mexico, for example, has required increased education in physical assessment and a requirement for physician preceptor case reviews for a selected number of pharmacist managed medication therapy patients.  California, on the other hand, has required other qualifications such as Board Certification, Residency Training, or advanced pharmacy practice experience with a preceptor as some of their qualifications.  In other states, several hospital systems have used the medical staff credentialing or privileging process to address this practice qualification issue.

As the profession welcomes this movement and accepts the responsibility for an elevated scope of practice, there needs to be a more uniform recognized credential or credentials to qualify the practitioner for advanced pharmacy practice.  The profession cannot afford,  both from a time or cost standpoint,  to have fifty individual states determine or identify the credentials necessary as qualifications for an advanced practice.   I firmly believe that Board of Pharmacy Specialties (BPS) Board Certification should be recognized as the Premier Credential at this time as the profession moves forward in achieving provider status and/or creating advanced practice pharmacists.  BPS Board Certification should not necessarily be the exclusive qualification pathway but at this point in time BPS Board Certification is the major nationally recognized pharmacist credential demonstrating expertise in medication therapy management in health system and ambulatory care practice (Pharmacotherapy, Ambulatory Care) as well as a number of specialized medication therapy areas (Nuclear Pharmacy, Nutrition Support, Oncology, Psychiatry, Critical Care, Pediatrics and added qualifications in Cardiology and Infectious Diseases).  Board certification is determined by practice experience and by national psychometrically validated exams created by expert pharmacist specialists.

In conclusion, the rapid movement towards creating Advanced Practice Pharmacists is essential for the profession and the health care team. The Affordable Care Act (ACA), which expanded our health care coverage to US citizens, has prompted greater health care provider accountability and a greater emphasis on both collaborative practice and interprofessional practice for the health system and ambulatory care patient.  The Advanced Practice Pharmacist movement meets this intent as well as improves the quality and safety of medication therapy.   During this significant role transformation in pharmacy, BPS Board Certification should be considered by all to be the Premier credential for this practice advancement.

 

Harold N. Godwin, RPh, MS, FASHP, FAPhA

Godwin is Professor of Pharmacy Practice at the University of Kansas School of Pharmacy in Kansas City, Kansas and serves as Associate Dean of Pharmacy for Clinical and Medical Center Affairs.  He currently serves as a member of the Board of Directors for the Board of Pharmacy Specialties (BPS).  He has served as President of the American Pharmacists Association (APhA), President of the American Society of Health-System Pharmacists (ASHP), and President of the American Council on Pharmaceutical Education (now the Accreditation Council for Pharmacy Education) (ACPE)