Members can opt in to any of these SIGs for networking opportunities and work on potential projects. Several other SIGs are in various stages of development.

To date, Leal has gathered more than 15,000 signatures from physicians, patients, pharmacists, and a senator from Kentucky. Her grassroots effort was profiled on January 15 in the Arizona Daily Star newspaper.

Leal works in a community health center that is a recognized medical home and has been having challenges integrating into the medical home model because the lack of provider status causes payment challenges in her work setting.

APhA has been in frequent contact with Leal to get updates from her, and we facilitated a conference call she had with a CMS representative. We have been supportive of her efforts to raise awareness about pharmacists and lack of provider status by promoting them in our electronic communication vehicles.

We’ll continue to update you as this initiative progresses.

In an exciting development for the pharmacy profession, U.S. Surgeon General Regina Benjamin, MD, MBA, released a letter publicly supporting the report. It is notable that a high-ranking government official would get behind a report that advocates pharmacists as health care providers.

The USPHS report is already generating a buzz within the profession, and APhA will be using the report in our advocacy and practice development work. The report and the letter from the Surgeon General are available on pharmacist.com.

The report, “Improving Patient and Health System Outcomes through Advanced Pharmacy Practice: A Report to the Surgeon General 2011,” was coauthored by several USPHS pharmacists and led by U.S. Assistant Surgeon General Scott Giberson.

APhA Board of Trustees member and student pharmacist Sara McElroy is currently on rotation with RADM Giberson and was instrumental in developing communication strategies for the report and interfacing with APhA so that we were ready with a public statement and news article as soon as the report was made public.

We all know about the fight-or-flight response from pharmacology class. When threatened, though, the turtle exhibits a third response—retreating into its shell and waiting for the world to get better on its own. The ostrich, head in sand, provides another passive option for dealing with problems.

As pharmacists move into the pivotal election year of 2012, we have much to feel threatened by. Whether health care reform survives the Supreme Court and the presidential election, the inexorable wheels of change will continue turning in our professional world. As they do, we have a number of responses we can take, some more effective than others.

We can disengage from the conversation surrounding changes in health care, retreat to our caves, and hope the storms will pass, or just go through our daily motions as if nothing is happening. But what will those options achieve? As one of the mice in Who Moved My Cheese said, “I guess we resist changing because we’re afraid of change.” That’s true, but do we want to be sitting around in a few years talking about Old Cheese, or feasting on the New Cheese we’ve found?

APhA members are laser focused on finding and, when needed, fighting for the New Cheese. We see opportunity in change. We work together well, and we are capable of leading from where we stand. I’m proud of members like Sandra Leal, a Tuscon, AZ, pharmacist we featured in last month’s mini-profile in Today’s Pharmacists in Action section. She singlehandedly launched a change.org petition asking for the federal government to recognize the knowledge and capabilities of the nation’s third-largest profession by making pharmacists eligible to bill for clinical services provided to Medicare patients. Just 5 weeks later, she had nearly 13,000 signatories to her petition, including pharmacists, physicians, other health professionals, and patients. That’s the kind of response to change that characterizes APhA members. That’s leading from where you stand.

Leal’s zeal for change won’t take root without strong advocacy from organized pharmacy. We need your strength and your numbers to succeed as your advocates! The largest association of pharmacists in the world, APhA has grown well above 60,000 and our average member’s age is younger. We need your support now—that of people who care about pharmacy and want to make a difference in years to come. When we talk to Congress about provider status, we need stories and we need numbers. It will be a fight, but it’s a fight we can win if pharmacists across America are willing to support the effort. Whatever other New Year’s resolutions you’re working on this year, please add this one to your list: I will support my profession by joining and getting involved in APhA, my state association, and another pharmacy group that supports my practice setting.

In turn, and along with the incredible APhA staff team, we promise that we will make the most of APhA members’ time, money, and energy as we fight for a better world for pharmacists.

As we look back on the past year and anticipate the next, I “zoom in” to recalling the many conversations, e-mails, and letters this past year from individuals in all walks of pharmacy who have expressed the full range of emotions about our profession. As we “zoom out” to look at the macro view, we see huge challenges in the economy and old business model for pharmacy, while also witnessing major positive changes in the attitudes of policymakers and those in our colleague professions. And we see pharmacy systems and business changes that bode well for pharmacists and the patients we serve, if we can step up when the opportunities arise. Payers will increasingly turn to pharmacists to help them meet quality goals, and pharmacy employers are really gearing up with new technology, services, training, store configurations, and systems to make the conversion from buy low, sell high to the provision of enhanced patient care.

Yes, we’ve got a long way to go, and that’s where the frustration arises, at all levels. But in this season of thanks, hope, and new beginnings, I look forward to learning from you as we continue our path of advocacy and innovation. We will continue to highlight exemplary practices in our publications and meetings, and we’ll be driving for changes that empower you to provide the kind of care Americans deserve. We must succeed! Our patients are waiting.

On behalf of the staff and volunteer leadership at APhA, I hope you and your families enjoy a healthy, happy and prosperous New Year!

I shared with the group that, while the number of pharmacists in the US is only about one-quarter that of physicians and about one-tenth that of nurses, most Americans are in a pharmacy several times a month and have ready access to us. While we are in an uncomfortable place between building service offerings (medication therapy management) and finding payment for those services, we have a medication use crisis and there are very few incentives to fix that crisis, despite pharmacists being readily accessible and well trained. Also, we typically make a significant number of referrals to our medical colleagues in the course of our practice.

I further shared that I’ve been encouraging pharmacists to “walk across the street” and talk with physician colleagues about their approach to accountable care organizations and medical homes or medical neighborhoods. We should consider organizing joint listening sessions to learn more, and then to discuss in an interdisciplinary way the best approaches to integrated care delivery. It will only change if it changes at the practice level. I also shared that we have a growing workforce, well trained to integrate with physicians in medication management, but that we need help and cooperation among our physician colleagues to build the business models.

We MUST agree on principles for collaborative practice if we are going to avoid the typical turf wars that occur in state houses around the country when one discipline or another wants to change a practice act. And we must create incentives for all. I shared that incentives are not just about driving selfish action, but are primarily about a system describing through incentives the behaviors and outcomes desired.

I shared, too, how the lack of provider status was not only hurting our profession, but also the medical profession and health care in general. If we pursue it, we will face a major war absent up-front agreement in principle, but all have much to gain, as many of the services we provide will likely be done through physician practices and will lead to gains in improved patient care.

We had a chance to discuss each of these points, and I felt there was agreement that all of these topics were worth continued dialogue. I did not hear any disagreement. While there’s no cause for celebration just yet, I think it’s fair to say that pharmacy is at the table.

Thought you’d like to know.

According to our pharmacist.com news article, Leal believes people should sign the petition because now—while health care reform is being implemented—is a “critical time to assert ourselves as pharmacists.” So far, the impact of the petition has been to educate people that pharmacists do not actually have provider status. She hopes to reach 10,000 signatures, a realistic goal considering that more than 7,000 pharmacists, physicians, patients, and legislators have signed the petition since it started on November 15.

Leal told pharmacist.com that she will keep the petition open until she receives enough signatures to make a difference. Sign on in support!

At this time of thanksgiving, I’m grateful for these comments and have great respect for the perspectives of my colleagues. It wasn’t that long ago that I was there. At different times in my career, I have been an employee, a manager, and an owner. As an employee, I too sometimes felt I didn’t have the help and support I needed. Even in management and ownership, life as a pharmacist can be challenging, and at times overwhelming.

Despite our challenges, I hope we can all see that we have the talent, insight, and innovative spirit to create a better world. My sole purpose in sharing my observations was to stimulate others to think about their own opportunities. Change is never easy, and we all know how hard it is, for example, to add immunization services on top of everything else we do as pharmacists during our 12-hour shifts. MTM programs take time to develop and even more time once implemented. But we know—somewhere deep inside—that while we continue to dispense safely and accurately, our pharmacy services must grow. “Buy low, sell high” is broken. Margins will never get better on either brands or generics. Chains, independents, and specialty pharmacy owners need to find other ways to pay for the services we know patients need. While we fervently pursue recognition and value (read “compensation”) for our services, we must embrace technology and certified paraprofessionals to give pharmacists the time needed to develop new services and new skills for the pharmacy workplace of the future, if we are to have a relevant role there.

As I wrote in Chain Drug Review earlier this year, we in pharmacy are in an uncomfortable place. Times are challenging, and we’re not yet where we need to be. We have the opportunity to be the disruptive positive force in health care. We have the skills and ability to address the medication-use crisis in this country. I hope we can continue to talk about our profession’s internal challenges while simultaneously pursuing change in the system to allow us to practice the way we’ve been trained. We have a bright future as a profession. The question is not whether change is real or inevitable—it’s how are we going to manage that change.

I recognize these challenges and those faced by those who commented about my blog. I hope we can all focus our passions on positive change. We need all pharmacists as members of APhA, and I wish everyone could attend one of our meetings to see people being the change they want for our profession.

It’s not easy, and APhA will be there to help with this transition. The tide is rising and people are noticing. If we can keep our boats intact as we navigate these rough waters, we will all find ourselves in a much more comfortable place than many imagined.

Happy Thanksgiving, everyone!

APhA is seeking pharmacist members who wish to be considered for the elective offices of APhA President-elect for 2013–14 and two Board of Trustees positions for 2013–16. The 2013–14 President-elect will serve as President of the Association for 2014–15 and as Immediate Past President in 2015–16. The two Trustees will serve for 2013–16.

Individuals submitting their name for consideration must provide the following by December 15, 2011 (items may be submitted electronically to blawson@aphanet.org unless indicated otherwise):

1. Completed and signed Nomination Form: 2013–16 APhA Board of Trustees Candidate Application
2. A current résumé or curriculum vitae
3. A headshot photo suitable for publication (minimum of 300 dpi)
4. Confirmation that you have submitted your Disclosure and Confidentiality Statement to APhA’s Legal Counsel. The form is confidential and is submitted separately from the nomination packet. Please complete and submit form online (which goes to APhA’s Legal Counsel)

For more information about elected leadership positions available within APhA-APPM, APhA-APRS, and on the APhA Board of Trustees, please visit www.pharmacist.com/elections.

Questions? Contact Brian Lawson at (202) 429-7548 or blawson@aphanet.org.