George Bernard Shaw once said that “Progress is impossible without change, and those who cannot change their minds cannot change anything.” The way healthcare and medicine are being delivered is changing rapidly, and pharmacist today need to be thinking about these changes and their impact on our profession and careers.
An example of such change was seen recently in Massachusetts as 800,000 MassHealth (the state Medicaid program) members were automatically enrolled in new plans to align with the networks chosen by their primary care doctor. Matt Klitus, the CFO and chief strategy officer for MassHealth said “It’s an enormous change…to get us to the point where there’s accountability for the total cost of care.” Pharmacists across the state have had to scramble to help patients find their new coverage information.
But this change is just one small example of many shifts that are occurring, most of which are all concerned about cutting costs and increasing market share.
Another example of the change going on is the recent news of Walmart’s potential deal with major insurer Humana, a deal which has many hospital nervous. According to a Wall Street Journal article the idea of such a merger is causing “deepening anxiety in the hospital sector.” Randy Oostra, the president and CEO of a non-profit hospital system, said this combination of Walmart and Humana “should be a concern to everyone in healthcare.”
Hospital pharmacists may feel the pressure created by these market changes. Eroding margins are leading to layoffs in some areas of the country already. It won’t be long before health systems may not be able to afford the level of pharmacist staffing they have kept up until now.
And, of course, everyone is talking about what Amazon is doing in the pharmacy business space. Could pharmacists in the near future be employed by Amazon to dispense and ship prescriptions directly to patient homes, like other mail-order pharmacies do already? Could they even leverage their size and technology to accomplish a same-day delivery service for certain medications? These questions remain unanswered, but the fact is that (as Bob Dylan would say), the times they are a-changin’.
I was interested to read recently about both Walgreens and CVS partnering with Blue Cross and ride-service Lyft to offer transportation to their stores to get prescriptions, as well as rides to medical appointments. The program is just in “pilot” mode at the moment, and it is hard to say if it will fly. It is hard to see how giving patients a ride is more cost effective than a pharmacy-based deliver service, but this just shows how organizations are endlessly trying new things.
For pharmacists there has never been a better time to expand your skills, keep an eye on these market changes, and prepare for the types of new opportunities that might occur. Our focus needs to go beyond simply providing excellent clinical care, although nothing can substitute for the importance of this. But we need to be thinking about where we will fit in as health systems change, consolidate, try to control drug spend and provide more affordable models of care. This is the future of healthcare. This is the future of pharmacy.
If we are committed to progress, then, as Bernard Shaw said, we must be committed to change. One of the hardest things to change is our own way of thinking about our profession and our careers. But we need to embrace the change, adapt our skills, and be prepared to contribute to the versions of our healthcare delivery system that are coming. Don’t just wait for change to happen. As Mahatma Gandhi put it well “be the change that you wish to see in the world.”