FP Report -- June 1999
Pharmacists should not expand scope except under supervision
A pharmacist should not administer immunizations or alter doses of prescribed drugs except in an integrated practice supervised by a physician. That's the point of a policy adopted by the AAFP Board of Directors in March. The statement is AAFP's answer to pharmacists' efforts to expand their scope of practice in many states.
"With mail-order drug companies, patients bypass pharmacists, and pharmacists want to make sure their profession survives," said family physician and pharmacist Leah Raye Mabry, M.D., R.Ph., of Pleasanton, Texas. "And many health plans have reduced the time physicians spend with patients, so physicians look more to the team concept."
The Texas Medical Association and Texas Pharmaceutical Association hammered out an agreement last year for changing the Texas Pharmacy Practice Act, and the legislature made the change. If a physician and a pharmacist work out a protocol, the pharmacist may now immunize a patient who is at least 12 years old. Then the pharmacist informs the physician.
Mabry, who worked as a pharmacist for 15 years and is immediate past president of the Texas AFP, helped forge the Texas agreement. "We came to the table and developed a proposal in order to avoid a fight on the floor of the legislature," she said.
They decided what didactic material the pharmacists would need, and the Centers for Disease Control and Prevention offered courses on immunizations.
Idaho, Louisiana, Nebraska, Ohio, Tennessee, Wyoming, Virginia and Guam are among jurisdictions that permit pharmacists to develop collaborative practice agreements with prescribers.
"Some pharmacists want to manage disease states, such as hypertension, diabetes and asthma, but continuous, comprehensive care by a physician is best," said Mabry. "A patient is a whole, not just a disease state."
FP Report is published by the AAFP News Department. Copyright © 1999 by American Academy of Family Physicians.
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