Like many comprehensive proposals, this bill may need to be “tweaked” in years to come as we see the benefits roll out (which in some cases will happen several years from now). While your politics may differ from the current path on the broader aspects of the legislation, this effort was, at least by my account, unprecedented. It includes some major advances for pharmacy.

Intact in the final bill are pharmacy’s provisions. We helped to shape those elements, and all of pharmacy advocated their passage. Perhaps the MTM grant programs could have been larger, but what we have is a good move in the right direction.

We will have years of work ahead of us in the regulatory process to assure that our patients get the full benefit of our services. And pharmacists will have to step up and deliver. But the profession’s years of work to promote patient care services together with safe and accurate dispensing production may be paying off.

Congrats to our APhA Government Affairs team and our HCR Task Force, not only for their incredible hard work, but for their productivity, effectiveness, and excellent communications with our membership. Congrats too to all of the other pharmacy association government affairs teams. It has been and will continue to be a pleasure working with all of you.

House Democratic leaders expect the vote on HCR to occur between 6 p.m. and midnight this evening. Watch pharmacist.com for news and updates as the vote occurs.

I believe pharmacists in this country take supply-chain integrity for granted. I say this with the perspective of someone who spent almost 8 years doing supply-chain audits and chasing diverted drugs all over the world. My opinion doesn’t come just from my own experiences (which focused largely on the mainstream distribution system in the United States, where major improvements in security have occurred) but also from conversations and meetings with many industry security professionals who are faced with protecting their companies’ products. These folks are challenged every day in this country and around the world. 

These recent high-profile thefts should serve as a reminder to all pharmacists to pay attention to where you purchase your pharmaceuticals. Know your distributor and ask questions about their practices. Do not respond to faxes offering deals you know are too good to be true. These thieves will find someone to buy their take—make sure it isn’t one of your patients who ends up with these diverted drugs! If you are not careful, this could happen to you.

In addition, be sure to warn your patients about the dangers of buying drugs from the Internet. Most diverted drugs will find their way to consumers through this channel. The National Association of Boards of Pharmacy tries to warn Internet consumers they should use only known sites that are verified through NABP’s VIPPS program. But with all the noise consumers hear, it is a difficult message to convey. Be sure your patients hear it!

We have the content of our educational programs audited for content and quality. Our auditors told us this year’s body of work was the best they had ever seen. But there’s more in this embarrasment of riches we call our Annual Meeting.

We had politics, with a keynote presentation by Mark McClellan, former head at FDA and CMS. At the Political Leadership Breakfast, more than 550 pharmacists and student pharmacists gathered at 7 am to hear from senior staff of the Senate Finance Committee.

We also highlighted the achievements and contributions of dozens of award winners, topped off by a beautiful Remington Honor Medalist speech by Mary Ann Koda-Kimble of the University of California, San Francisco. I was especially moved by her inspirational words about the importance of mentorship and our ability to rise above adversity.

As a follow-up to last year’s presentation by Francis Collins, now NIH head, we also heard from geneticist Alan Guttmacher. He shared his thoughts with us about the present and future opportunities for pharmacists to be the professionals to help consumers understand the burgeoning information about pharmacogenomics and the impact our genetic makeup is having on drug therapy.

Our House of Delegates took a significant stand against the sale of tobacco in pharmacies and considered how we should view any community pharmacy accreditation process. As my predecessor John Gans likes to say, we had “red meat” in the House this year!

I also was moved by the orderly and exemplary transition of leadership that occurs each year. Former President Tim Tucker ended his 10-year run on the Board of Trustees, and Ed Hamilton completed his term as President. I can’t say enough about these two gentlemen and what their friendship and guidance have meant to me this year. Harold Godwin took the helm as President for 2010–11. His background and work with students and residents shows in his approach to leadership. He is truly a collaborator, and I look forward to a great year with him as my boss.

If you are reading this, you care about pharmacy. If you care about pharmacy, make plans now to attend next year’s meeting in Seattle. You have my personal guarantee that you won’t be disappointed. If you are on the fence, just talk to someone who comes regularly, like my friends Sami and Ilan from Israel who travel thousands of miles every year to attend our meetings and go home with their brains once again overflowing with ideas and opportunities.

Gotta go. It’s time to start planning next year’s meeting!

For me, the first on-site meetings began on Wednesday. By this morning, I was able to take an inch of paper out of my binder, which serves as my “bible” through the roughly 7 days of meetings.

Our Board of Trustees meeting is complete, and our work with state associations is well under way. It is so energizing to associate with so many motivated and innovative pharmacists. While we’re beating last year’s attendance numbers, I wish we could get every pharmacist in America to attend. We could cross-pollinate best practices so much faster if more pharmacists congregated, engaged, and networked in forums like this one.

For APhA2010, the train has left the station. All the planning is done, and now we execute! In what will seem like a blur, the meeting will be over. We will review everything that happened so that APhA2011 can be our best Annual Meeting ever!

If you are reading this, and you are not here in Washington, make your plans now to be in Seattle on March 25–28, 2011. And make sure you attend your state association meeting this year! The wealth of information and networking opportunities available at pharmacy meetings are a great way to recharge your professional batteries and stay current in your practice. I’ll see you at many state association meetings this year and APhA2011 next March!

PS You can follow all the action at APhA2010 on Twitter and Facebook. Follow our Twitter feed or find us on Facebook.

CMS terminated its contract with a prescription drug plan (PDP), Fox Insurance Company, which was providing Part D benefits to patients in 21 states. The action took effect immediately. All patients enrolled with Fox will temporarily receive their medications through LI Net/Humana, a program run by Medicare and administered by Humana. More details about this action are available in a news article posted last night on pharmacist.com.

Dr. Kelman stressed to me that all drugs will be reimbursed and that patients should not walk out of pharmacies empty handed. Implicit in that statement is that CMS will back the pharmacies if questions arose.

I encourage all pharmacists who encounter patients affected by this action to take a moment to explain to them that medicines are being covered and that patients have the option of choosing a new PDP between now and May 1. If beneficiaries do not choose a new PDP, one will be assigned for them by CMS, so it is important they proactively choose a plan that will best meet their needs.

Earlier this week, our staff conducted our final preconference planning meeting (“precon”) for the Annual Meeting coming up on March 12–15 here in Washington. Our staff is really pumped, and it was fun to listen to the banter as people from our various departments very professionally—but not too seriously—slugged through the incredible detail that makes one of these meetings a success.

We’re certainly buoyed by the response of our membership—we’ve already exceeded last year’s Annual Meeting registration numbers. Our staff is also excited about the quality of our speakers and the meeting content. Here’s a tip of the hat to a great staff!

I’m also very proud of our Board of Trustees. They volunteer hundreds of hours to provide leadership and perspective to us. Many of them have recruited dozens of student pharmacists and new practitioners to attend the political leadership breakfast on Monday morning. These events have the potential to make an indelible mark on impressionable pharmacists in the early stages of their careers. This mentorship is laudable, and not bad for supporting our advocacy agenda either!

So, while things are shaping up for our meeting, we’re still very unsure about what Congress will do with health care reform. Charlie Rangel (D–NY), under scrutiny for ethics violations, is stepping aside from his powerful leadership post on the House Ways and Means Committee. Lawmakers are debating the pros and cons of reconciliation as a legislative maneuver to pass a majority-supported HCR bill. President Obama is supporting that approach—even giving Congress a 2-week timeframe in which he’d like to see movement. Senate Republicans say we should start over, but that’s not going to happen.

Meanwhile, as far as we can tell, all of the MTM provisions we’ve fought so hard for this past year are still in the bills under consideration. Stay tuned. This ain’t over yet.

At our meeting, we struggled with many issues, including the state of ambiguity surrounding health care reform and the business model reforms needed if we want continued development of pharmacists’ services. While each organization has a focus on its own members’ needs, it is gratifying to see all of organized pharmacy unified around this primary vision for the future of pharmacy practice.

I don’t often talk to practicing pharmacists who know much about JCPP. That’s too bad. If you’d like more background on this important part of our profession, let us know.  We’ll give the topic some “ink”—or at least a few electrons!

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

Over the past few days, Washington has been hammered with 28+ inches of snow. And we’re expecting another 10-22 inches tonight. That will make the winter of 2010 the snowiest on record for the nation’s capital. The snow coming tonight is the product of two low fronts–one from the southwest and one from the northeast. The Metro has been shut down at times, the federal government is closed, and just about everything else has stopped as well.

The same descriptor–Imperfect Storm–could be applied to the Cornhusker Kickback, the Louisiana Purchase, and the election in Massachusetts, events that produced the current paralysis over health care reform. Today’s headlines suggest that President Obama’s interest in convening a health care summit later this month may go nowhere as Republicans jockey for compromise and Democrats hold their ground.

In terms of educating Members of Congress, we’ve made a lot of headway despite the storms over health care reform of the past year. As we go forward, we’ll do our best to maintain this momentum, despite this Imperfect Storm!

During our meeting, we were briefed by representatives from the Accreditation Council for Pharmacy Education (ACPE) on the state of the rapidly changing world of education. New schools, rising standards, IPPEs (introductory pharmacy practice experiences) and simulation, and the enhanced continuing professional education credit criterion were all topics of discussion. We also reviewed the evolving concept of Continuing Professional Development, or CPD. You’ll be hearing more about all of these topics in coming months and years.

We are fortunate to have ACPE working to ensure that our country’s pharmacists and future pharmacists maintain the highest educational standards. ACPE is an incredible organizations run by dedicated individuals. Sometimes their rules may seem inflexible or illogical. When that occurs, constructive public debate follows and the process gets better. Ultimately, our patients benefit. Here’s a tip of the hat to a group of dedicated folks at ACPE.

Our staff members at APhA are also working hard to assimilate new rules, criteria, and standards to ensure that we maintain the excellent pharmacists our educational efforts are expected to produce, as measured by the new standards of education and outcomes measurement. Come see what I mean at APhA2010, coming up in Washington from March 12 to 15. And don’t worry–the snow will be gone by then!

In a few days, I’ll be presenting at the American Association of Colleges of Pharmacy (AACP) Interim Meeting 2010. Those attending this meeting are the folks most intently focused on ongoing improvement in our education of pharmacists. It will be a privilege to visit with them and to learn about their innovations intended to better our profession and patient care. This group is especially creative, so I expect to receive information I can use on Capitol Hill to make our case for pharmacists’ services.