Pharmacists' scope of practice grows despite physicians' objections

A growing number of states have moved to expand what pharmacists can do to include treating a range of conditions, such as strep and flu, for which there are rapid point-of-care tests, Kaiser Health News reported March 31. 

More than a dozen states have OK'd pharmacists to test and treat people for things like urinary tract infections, strep and flu, according to the National Alliance of State Pharmacy Associations. Pharmacists typically have this ability through annual collaborative practice agreements with local physicians that are subject to state approval. A smaller number of states have looked to further expand pharmacists' roles, allowing them to prescribe medications for a range of conditions outside of these agreements. 

"We're seeing more states looking at direct prescribing authority now as opposed to collaborative practice agreements," Allie Jo Shipman, PharmD, director of state policy at the National Alliance of State Pharmacy Associations, told KHN

Medical groups have long been opposed to nonphysician scope of practice expansions, citing risks to patient safety. The American Medical Association in November said it had successfully opposed more than 100 legislative actions that would have expanded nonphysicians' scope of practice. 

In a position statement last year, the American College of Physicians said it "opposes independent pharmacist prescriptive privileges and initiation of drug therapy outside of a collective practice agreement, physician standing order or supervision, or similar agreement." 

Advocates for expanding pharmacists' abilities say it improves access to care. 

"We want to come alongside physicians," Dr. Shipman said. "We want to be another healthcare provider. In the middle of the pandemic, we need help. The burden is too great to be carried by any one provider." 

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