If You Don't Like the Players, Change the Game

Eye roll on sports analogies ??, I know - but since I'm from Indiana where basketball rules, I'll go ahead and use one here. However, this post isn't going to be about basketball ??. It's going to be about pharmacy??.

Four other articles/posts are all providing fodder for the same point of this post:

1. This weekend, I posted an article on GoodRx, which drew thousands of eyeballs...and ire from some of my colleagues in pharmacy. A lot of pharmacists don't appreciate GoodRx. They think the solution of having transparent pricing online (with coupons and deals with PBMs in the background) only makes the pricing game in pharmacy 'problem' worse.
2. The Wall Street Journal last week had a different article on why America should just chuck pharmacy and basically have physicians do prescription dispensing as well. Several pharmacy organizations and pharmacists had scathing comments about this idea too. But I didn't hear a ton of solutions...at least not yet. (And in full disclosure, there's a letter to the editor rebuttal from this post that I honestly haven't read just yet.)
3. The BLS recently published pharmacy salaries for 2019, and in a post here, I argued that we need to think differently about APPE rotations, in that 'other' areas of pharmacy practice are increasing, so why not allow more opportunities for students to get out of the box on different types of APPE rotations beyond (too many and too narrowly focused?) required clinical rotations.
4. I attended an APhA CPE this week, and one of the questions was on whether or not attendees had advocated for the profession on provider status. The results are here. Nearly 40% of attendees didn't or haven't advocated for the profession with lawmakers on provider status...I don't know if that is because they didn't know how?

My point in posting all of these articles really was this:

...that we as a profession in pharmacy need to get over resistance to change.

That means:

• If we don't allow more flexibility in APPE rotation types, we're stunting growth of pharmacy into new areas of practice.
• If we continue a race to the bottom on lowest prescription price in pharmacy, the entire profession---AND our patients, will all lose in the end.
• If we don't prove our value to patients, other health professions, including physicians,
• ...as well as lawmakers, we get what we deserve in loss of a truly great profession.

Currently, my day job and I help self-funded employers choose the best pharmacy benefits they can get their hands on--which means understanding how pharmacy benefit managers (PBMs) work, and making recommendations on them. I see every day how pricing is not transparent in our world, and how it only hurts patients. It's frustrating for all of us!

But - I also see some PBMs providing really innovative, revolutionary services for patients too. I'm certainly not going to defend them as a group, nor lie and say that cost isn't a (huge) factor for self-funded employers (imagine for a moment if it was your checkbook being used). But, cost is not the only consideration when they are being evaluated.

Let me write that again, because it's important: COST IS NOT THE ONLY CONSIDERATION.

Friends in pharmacy, WHY do we make it so hard for patients and other HCPs to work with us?

If you're mad, frustrated, and as perplexed with our profession....here's some advice (enter the sports analogy):

If you don't like the players, change the game.

Meaning:

• Maybe it's time to let students in pharmacy choose their own adventure on more APPE rotations?
• Maybe it's time to differentiate on other factors beyond price for pharmacy and our patients - like: delivery? Telepharmacy? Mobile pharmacies? Apple-store-like MTM? Talking to a humans where the humans are speaking (like chat, text, phone without a huge phone tree)? Anticipating needs? Creating other services that maybe don't even yet exist that patients can ONLY get from YOUR pharmacy?
• Maybe it's time to work inside the doctors' offices along with them instead of against them? Check out the term "concierge pharmacy" to see what I mean here...
• Maybe it's time to have some conversations with our state and federal representatives in government if we haven't about our value?
• Maybe it's time to have less, rather than more legislation surrounding pharmacy? (See Idaho as an example.)
• Maybe it's time to share your thoughts on how to improve the profession.

I fully admit: I certainly don't have all the answers. And I'm as frustrated as many of my colleagues in pharmacy practice. I get it.

But I do know this: we have to change if we're going to survive and thrive as a profession. Name calling, pointing fingers, and arguing who's on the 'wrong side' just aren't going to cut it anymore. The best solution is to get out of the argument altogether and focus on evolving. It's time to level up and differentiate...or we as a profession are doomed.

As terrible as the COVID-19 pandemic is for our country, a silver lining is that it has opened the door to changing the game for us on how pharmacists can provide value to our patients and healthcare. We've got to take the ball and run with it. Now. And create a new game.

Change. The. Game.

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Erin L. Albert is a pharmacist and works for clients of Apex Benefits. Opinions above, however, are hers alone, and not necessarily those of Apex Benefits.