In a recent blog, I thanked our Government Affairs staff and those of other pharmacy organizations for sticking together to achieve success in the health care reform process. In addition, lots of others deserve thanks and recognition for their efforts during this important time in pharmacy history.

Heroes this past year include our members who served as volunteers and advocates on our Government Affairs Committee and Key Contact Network, or those who were active in our grassroots-lobbying initiatives. Every pharmacist in America owes a debt of gratitude to their colleagues who cared enough to contact their Members of Congress.

Let’s keep up the momentum and the unity! We still have a long way to go, but we’re off to a great start on redefining pharmacy’s future.

(The below e-mail message was sent to Allison Wiley, one of our dedicated Government Affairs staffers, by Julie Stading of Creighton University. Following that is a message I sent to Dr. Stading after Kristina Lunner, our VP of Government Affairs, told me about this great feedback.)

Allison,

I wanted to send a personal e-mail to encourage you to continue with your efforts. It was not until this current situation with health care reform that I realized that APhA is really the main pharmacy organization that is taking consistent action to push for pharmacy as a part of the health care reform. The other organizations that I belong to talk about it, but APhA is taking action… regularly. Again, thank you for all your efforts… it is noticed!

Julie

My response:

Hi Julie,

Thanks for your kind note to Allison Wiley regarding APhA’s advocacy. If you’ll indulge me, I’d like to share a story.

I first became involved with APhA as a student, although in those early, formative days of Student APhA, I really didn’t make the connection between our school’s chapter and anything “big picture.” After I graduated, like many of my peers I got immersed in life, building a family, and launching a practice. I wasn’t really involved in any organizations, until Frank McClendon invited me to a local association meeting and Harvey Barton, another Huntington, WV, pharmacist, started talking with us about our myriad opportunities. The three of us are still friends and business partners in a home infusion and specialty practice we own in Huntington. From the local association, I got involved in the state association, and in 1984, my first interface with APhA “national,” I was invited to make presentations on home infusion practice. In 1986, I was offered a job at APhA, which I accepted. Joe McGlothlin joined me as a partner in my Medicine Shoppe, and I moved my family to Washington for my first first day on the job with APhA 23 years ago on February 2, 1987.

What struck me about APhA back then was that they (now “we”) were for things, rather than against things. I first saw the organization through the eyes of Steve Crawford, a West Virginian, former APhA President, and practice innovator, and Tim Covington, a West Virginia University faculty member at the time and an innovator in community pharmacy residencies. From my vantage point, they and APhA in general always seemed to be looking forward, reaching for something better, working hard to learn from their leaders, and sharing those learnings with their members. As a young staffer back then, my initial impressions were validated, first by Jack Schlegel, the APhA CEO who hired me, and then during the ensuing 20 Gans years. I’ve been privileged to learn from these two, as well as from hundreds of others whom I’ve met over the years who share our passion for innovation and lifelong learning.

My tenure as exec is dedicated to making a difference and providing opportunities for pharmacists to contribute to excellent patient care by practicing as they’ve been trained. We do that, because that’s what we hear from our members that they want. We continue to be for things, whether in our work on Capitol Hill to advance our agenda, or with CMS or managed care, where we’re trying to maintain the MTM momentum.

In just 4 weeks, when 7,000 folks convene in Washington for our Annual Meeting, I’ll spend 18 hours each day talking with really energized and positive practitioners and students who are excited about our profession. That exercise should be exhausting, yet I’m always pumped and filled with new ideas at meetings’ end. I just wish more pharmacists took advantage of the opportunity.

I doubt you realize how important your encouragement is to staffers who work on pharmacy’s behalf. Thanks again for taking the time to do so.

Best regards,

Tom

Those words, spoken by President Barack Obama during his State of the Union address on January 27, were intended to spur Congress to continue its deliberations until health care reform is achieved. How Congress will respond will be the topic of speculation, conjecture, and debate for weeks. I have concerns about how we’ll pay for reform, but even more serious concerns about what will happen if we don’t.

My personal views on the “whether or not” are unimportant. What is important to you as a pharmacist in America is that we are working for you to ensure you have the opportunity to practice what you’ve been trained to do and to provide the services you’ve asked us to promote for you.

APhA will continue to pursue with Congress, CMS, AHRQ, FDA, and managed care organizations the principles we’ve so often articulated: consumer access to quality pharmacist-provided medication therapy management (MTM) services. We will continue that fight because it is the mission we set about achieving 20 years ago and the mission that the Joint Commission of Pharmacy Practitioners (made up of all pharmacist-member national associations) articulated for 2015.

I’m willing to accept criticism that APhA is too focused on this mission! And believe me we do receive criticism. We get it from folks who feel stuck in jobs that don’t allow them lunch breaks, let alone the time to conduct MTM. And we get it from pharmacists who don’t think immunization is the purview of pharmacists. We sometimes hear that our pursuits aren’t realistic to young practitioners who enter a practice that isn’t yet progressive enough to allow them to practice as they were trained. The criticism is healthy. If someone is feeling beaten up by the “system,” no one can say they are wrong.

Yet, what really energizes me are the conversations I have with practicing pharmacists who have incorporated MTM in their daily practice through use of technology that allows their review and entries into electronic medical record systems. I get energized when I talk with large pharmacist employers who have awakened to the power of their pharmacist workforce. These leaders are conducting training, providing additional certifications or education, and promoting services to employers and others.

If you are a pharmacist who hasn’t yet talked with someone in an empowered practice, there’s an opportunity to do so just around the corner. Please join us in Washington, DC, March 12–15 for APhA2010, the must-attend pharmacy conference of the year. If you are open to new ideas and want to get turned on by the possible, I promise you won’t be disappointed.

You have a choice: Grumble about how bad things are, or join us in creating a brighter future.  We need your support. Don’t walk away from reform!

This morning the Senate voted passage of HR 3590 to reform America’s health care system. Now the House and Senate must reconcile their considerable differences in an expedited process intended to get a reform bill on the President’s desk efore his State of the Union address in late January or early February. The blogs are buzzing with enough pros and cons to make your head spin.

Pharmacists will play a significant role in this reformed system, as both House and Senate versions include better access to pharmacist clinical services, intended to reduce the toll of inappropriate medication use, including nonadherence. We support these provisions whole heartedly and thank our supporters in the House and Senate for their good work.

In the bill passed on Dec. 24, there are provisions that:

• Expand patient access to pharmacist clinical services
• Ensure patient access to medications
• Ensure a viable pharmacy infrastructure
• Improve the Medicare Part D medication therapy management program

We’ve got a lot of work to do to ensure our patients’ interests are kept ahead of special interests and the process plays out.  Thanks for your support.

Our APhA family wishes you a blessed and healthy holiday season and a prosperous and Happy New Year!

“’The die is cast. It’s done,’ a jubilant (Chuck) Schumer said, adding jokingly that ‘Harry’s almost going to have a drink.’

“Reid, a devout Mormon, abstains from alcohol.”

—From the December 21 Roll Call article by David Drucker on Sunday’s Senate debate and the cloture vote taken at 1 AM on Monday

Senate Democrats cleared a major hurdle during the night on Sunday when the Democratic Conference, with its 58 Democrats and 2 independents, closed rank and voted to end debate on the health care reform (HCR) package put forward by Majority Leader Harry Reid (D–NV). Combined with two more procedural votes later this week, the way is seemingly paved for the Senate to approve a HCR bill on Christmas Eve.

That’s the big picture. What ultimately remains for pharmacy in the Senate proposal is not totally clear, nor is it certain that major differences between this bill and the House version can be resolved.

Our Government Affairs staff and lobbyists have been in frequent and at times frenetic discussions with Hill staff as relevant provisions are proposed and quickly debated. APhA is in discussions with stakeholders about proposals relevant to several important aspects of pharmacy practice. These would provide funding for closing adherance gaps, a concept akin to but not exactly like MTM; include compounding in the definition of manufacturing, potentially opening the door for FDA regulation of pharmacy compounding (something we oppose); and pay for tobacco cessation counseling in Medicaid. A proposal in an earlier freshmen’s amendment (referring to the first-term Senators who introduced it) to improve Medicare Part D MTM has also been included in Reid’s final package.

Knowing what to oppose or support has been a challenge when we have not always had access to bills that change rapidly or were released in incomplete form. In general, we have continued to focus on those provisions specifically identified as relevant to pharmacy.

I’d like to offer special recognition to our Government Affairs Committee—a group of involved APhA members (volunteers) who spend many hours working with our Government Affairs staff to review and interpret language in the context of our policies in order to help us frame our positions and approaches.