The pharmacist is in

November 04, 2007

Good news from the campaign to expand access to health care: The federal government is exploring making greater use of pharmacists.

As reported last week by The Sun's Stephanie Desmon, the Food and Drug Administration is considering whether pharmacists should be allowed to dispense certain medicines without a prescription for patients who have common or chronic ailments, such as allergies or high cholesterol. The goal is to take advantage of the pharmacist's expertise in the chemistry and interaction of drugs in a way that supplements but doesn't supplant the primary care physician.

At a time when millions of Americans don't have access to primary care - including thousands of Marylanders with chronic diseases such as diabetes - expanding the role of community pharmacists is just common sense.

Maryland officials should make their own contribution to the cause by allowing pharmacists to administer all adult vaccinations instead of limiting them to flu shots, as they are today. These skilled health professionals, who are on duty sometimes around the clock at the drugstore down the street, could be a valuable source of vaccinations for shingles and pneumonia for the elderly.

Physicians traditionally resist any potential incursion on their turf, whether it's nighttime urgent-care clinics or mini-clinics in shopping malls. Indeed, Martin P. Wasserman, executive director of MedChi, Maryland's doctor lobby, said he fears the FDA proposal would advance a trend of non-physicians treating patients on their own that poses safety concerns.

But it doesn't have to. Pharmacists should simply be part of a health care team on which the primary care doctor serves as the anchor. They should have to meet certain licensing and regulation standards - which those trained at the University of Maryland already do - and serve mostly as an auxiliary, quick access source of advice and counseling.

The business model of medical care is constantly changing to adapt to circumstances; it may be that the time has come for re-emergence of the friendly neighborhood "druggist" - modern pharmacists hate that term - who knew everybody's business and everybody's ailments and could often provide a first line of defense.

All that skill and training should not be allowed to go to waste.

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