Elizabeth Briand
Across the country, patients are finding it increasingly difficult to access the services of a primary care physician (PCP)—a situation that likely will not improve anytime soon. In fact, the Association of American Medical Colleges projects that by 2034 there will be a nationwide shortage of between 17,800 and 48,000 PCPs.
Fortunately, pharmacists are being empowered to help mitigate this shortage by increasingly taking on prescribing duties, based on state scope of practice laws, that are traditionally held by PCPs.
Bridging the gap
A recent data brief published by Surescripts examined growth in e-prescribers on the Surescripts network and found that while primary care prescribers—defined as physicians, nurse practitioners, and physician assistants working in family practice, internal medicine, and pediatrics—increased by an average of just 0.6% a year between 2018 and 2022, prescribers outside of primary care increased by an average of 12.1%.
That increase was driven in large part by pharmacists. Between 2019 and 2022, there was a 47% increase in the number of e-prescriptions issued by pharmacists. Currently, the majority of those prescriptions were for patients with chronic conditions such as diabetes, high cholesterol, and hypertension.
“The stark difference in growth was very surprising,” said Shannon Reidt, director of medication research and analytics at Surescripts. “It shows that our PCPs are maxed out. They cannot prescribe anymore.”
In recent years, more and more states have changed laws to welcome more direct intervention by pharmacists on behalf of patients. “Over the past several years, states both have broadened their collaborative practice agreement laws and expanded independent prescribing laws for pharmacists,” said Allie Jo Shipman, PharmD, who served as senior director of policy and professional affairs at the National Alliance of State Pharmacy Associations. “This trend seems to be growing exponentially, so I do see pharmacists continuing to get more involved in prescribing.”
The increase in prescribing by pharmacists offers benefits for patients and physicians alike, providing expedited service for individuals in need of medication and relief from time-consuming duties for PCPs.
“Community pharmacists are the most accessible health care provider, especially in small towns and rural areas,” said Shipman. “Also, since pharmacists are medication experts, utilizing them to manage chronic conditions makes sense because it frees up time for other primary care providers.”
In addition, said Shipman, “more patients get access to care, and patients also get more dedicated time with a medication expert who can answer their questions and concerns.”
For anyone who has ever faced confusion over a new prescription or had questions on behalf of a loved one, that added time with an expert pharmacist can be a difference maker.
Looking ahead at a growing trend
This rise in prescribing reflects a growing trend that welcomes pharmacists as partners on the care team, with many even joining clinic staffs. A recent survey by Surescripts found that 89% of prescribers and 97% of pharmacists felt it was important for health care to move toward a more team-based approach to care.
“Everyone on a health care team has a role,” said Reidt. “And whether we’re talking about PCP shortages or not, the pharmacist should have a role. All of their training is about medications and how they can support patients to make sure those medications work for them.”
Once they are part of the care team, pharmacists demonstrate their collective ability to improve outcomes and reduce costs. These benefits, alongside changing policies and attitudes, are fueling this new era in care management.
Reidt believes that pharmacists will become even more involved as the physician shortages continue. “Long ago, you wouldn’t have thought to get your vaccines from pharmacists,” she said. Now, the pharmacy is the first stop for the annual flu shot. Soon, “you’ll go to a clinic and expect to see a pharmacist there. For transitions of care pathways, we’ll see more patients referred to pharmacists. It’s all happening now.” ■