Professional implications of the expansion of pharmacy-based medical clinics

Objective: To describe challenges and opportunities to the profession of pharmacy associated with the emergence of pharmacy-based medical clinics. Summary: Pharmacy-based medical clinics have emerged as a convenient, lowcost treatment option for many patients. These clinics, which are staffed by physicians' assistants or nurse practitioners, often are located directly within community pharmacies and offer rapid diagnosis and treatment for a limited number of health problems. With plans for significant expansion of these clinics, the profession of pharmacy faces a number of challenges. Allocating space in community pharmacies for medical clinics could place pharmacists at a disadvantage to other providers as they pursue ancillary health care activities. However, these clinics also represent an opportunity for pharmacists to position themselves as legitimized health care providers who are reimbursed for the consultative services they perform. Because most conditions diagnosed at pharmacy-based medical clinics have well-established treatment protocols, pharmacists would be well positioned to provide these services under collaborative practice agreements. This could ultimately provide the resources and payment structure necessary for pharmacists to provide other types of patient care services, including medication therapy management (MTM). Conclusion : As pharmacy-based clinics continue to proliferate, pharmacists should carefully consider surrendering space in community pharmacies to other health care practitioners. These clinics present pharmacists with an opportunity to provide many of the additional health care services for which we have so vigorously argued. Failure to respond to the acute care needs of patients today may present pharmacists with a significant barrier as they continue to expand into direct patient care activities.