Steve Anderson, president and chief executive officer of the National Association of Chain Drug Stores, has once again come to the aid of retail pharmacy, some of whose interactions with patients during the COVID-19 emergency have been called into question by the American Medical Association.
The AMA’s house of delegates last month adopted a resolution that contests the use of patient information collected by pharmacy operators while scheduling COVID immunizations. One of a series of new policy positions, the resolution goes on to oppose the sharing or sale of such data for marketing or advertising.
“A pandemic is not the time for large chains to find creative ways to expand their customer base,” said Dr. Bobby Mukkamala, AMA board chairman. “Medicine should be united in building vaccine confidence to reduce the health effects of COVID-19 — and not be raising privacy concerns.”
Anderson was quick to respond by putting the focus where it belongs — on the health and well-being of patients: “Programs that foster the pharmacy-patient relationship and pharmacy-patient communications certainly should not be mischaracterized and denigrated. Pharmacies follow the same HIPAA privacy rules as doctors, and a suggestion to the contrary is unproductive. Pharmacists and physicians collaborate extremely well during public health emergencies and in the face of daily health and wellness needs faced by patients. That should be the focus.”
In announcing its policy positions, the AMA acknowledged the pivotal role pharmacies have played in making COVID immunizations easily accessible to any American who wants one. (According to the Centers for Disease Control and Prevention, pharmacies have delivered 85 million vaccine doses — more than 25% of doses administered under the Federal Retail Pharmacy Program.) The AMA goes on, however, to assert that “some large retail pharmacy chains see this as an opportunity to recruit patients to their retail health clinics for routine visits” — yet another example of the parochial thinking that remains one of the major stumbling blocks to making health care in this country more accessible, affordable and effective.
The importance of retail pharmacies to the communities they serve has never been more apparent than during the course of the COVID pandemic. Deemed essential businesses, they kept their doors open throughout the crisis, continuing to offer health care services, along with household essentials, when other entities, including many medical offices, were shuttered. In the process they, as Anderson points out, not only improved health equity (CDC data shows that more than 40% of the COVID vaccine doses delivered by pharmacies have gone to members of minority groups or residents in socially vulnerable areas), but once again demonstrated their ability to meet many of the basic health care needs of their customers.
In addition to being a primary source of immunizations for a variety of conditions, including seasonal flu and shingles as well as COVID, retail pharmacy operators are leveraging the accessibility, knowledge and expertise of the professionals who staff their stores to support the well-being of patients. The era when pharmacy practice could be characterized as simply dispensing prescription medications is long gone; today’s practitioners are trusted health care advisors, who, when state regulations permit, also offer such services as point-of-care testing.
If some physicians see the expanding scope of pharmacy practice as an encroachment, the bigger concern, as reflected in the AMA’s statement, is retail health clinics. Such formats as the CVS HealthHUB, Village Medical at Walgreens, Walmart Health and The Little Clinic at Kroger offer 80% or more of the services traditionally accessed at a doctor’s office, and do so more conveniently and affordably.
One can only conclude that the AMA is engaged in rear guard action to protect what it sees as its territory, while clothing it in rhetoric about patient privacy. That, despite the fact that retail pharmacies have made it clear they are not attempting to supplant physicians — indeed some of the in-store clinics are staffed by them — but rather integrate their work into a broader framework.
It’s time to root out the tendency to think in silos that has long plagued health care in this country and is currently being exhibited by the AMA. All stakeholders should commit themselves to identifying the best way to deliver quality care at the lowest possible cost. Putting patients at the center of decision making and adapting the system to their needs, rather than clinging to past practices, is surely the optimal path to building a better, more efficient, economically sound system.
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