APhA: The view from 35,000 feet

Mike SchuhI just returned from my annual trip to the American Pharmacists Association (APhA) meeting, where I flew in the jumbo jet at high altitude overlooking the pharmacy landscape below. At home, I usually fly at low altitude in a small biplane as I perform dispensing duties in the outpatient pharmacy and counsel patients on medication therapy management (MTM) in the physician offices upstairs.

For most of my pharmacy career chained to the pharmacy counter, I have flown at 5,000 feet or much lower, usually between the crop rows, only “seeing” colleagues through the telephone or at the occasional CE or company meeting. I knew colleagues more by voice than by sight and because my weekends/evenings were precious and used for family time, I seldom socialized with them. Now, sometimes at the highest cruising altitude or mid-elevations at the state association level, I can see colleagues as real people instead of a voice on the phone. Interestingly, many of those carrying the heavy professional and political lifting for the rest of us are flying at all levels. They have at least one professional job and are active at not only a local level professionally but at a state and national level as well. These are busy folks.

I do get a feeling of movement. Not from the 500 mile per hour jet velocity or the bumps from the occasional air pockets. No, it’s something different and seems like tremors. Not a full-blown earthquake yet but tremors building slowly, steadily, and gaining momentum. It is the excitement and passion of pharmacy leadership pulling together as one force to implement pharmacist clinical services, including MTM, as an everyday, viable model of pharmacy practice.

A unified movement

A few years ago I thought clinical services for pharmacists may never be a mainstay of practice no matter what we did. Now there is hope and progress. Now there is a more unified movement at all levels toward common clinical practice with a broader range of financial ability to support these practices.

At the APhA meeting, I enjoyed sharing of ideas and visits with colleagues who I seldom get to see unless freed from my geographic practice silo. I picked up a few tips regarding practice, obtained some CE, and participated in the sausage-making of policy creation via delegate caucuses, House of Delegates, and business meetings that are vital to the structure under which we all practice. There were spirited debates with important points made on all sides.

The interactions with my colleagues reminded me that to move forward you have to step up and lead. Positive change doesn’t happen by itself. Someone has to analyze the situation, step forward, and speak up. There are those who will disagree with you, sometimes vehemently but that is OK because sometimes their point is thought-provoking enough you may want to change your position. Sometimes you can persuade others to understand and support your position. This is how significant, positive change happens. It is a meeting of the minds, sometimes making sausage, but always keeping the eye on the prize-better care for all of our patients and all of us performing at our highest level professionally as the second most educated but most underutilized healthcare professionals.

There are still divisions, self-serving agendas, and those who think small. However, they should be minor distractions when viewed from a strategic perspective. I think as a profession we are now realizing that there is a larger good to be achieved by all of us. When I encounter these bumps in the road, I remind myself of writings such as the Paradoxical Commandments by Dr. Kent M. Keith. These types of writings and the hard work of my colleagues from all areas of practice continue to inspire me as an individual and a professional.

I can see progress at 35,000 feet such as provider status, access to patient health information, more inclusion into the healthcare team, and recognition as the patient-care professionals we all are.

Michael Schuh is a clinical MTM pharmacist in Jacksonville, Fla. He can be reached by e-mail, mschuhrx1@gmail.com.