Everywhere community pharmacy operators turn these days there seems to be a new challenge.

Over the weekend, chain drug stores and other prescription drug providers began to feel the fallout from the reduction in average wholesale prices mandated by the settlement of a class-action lawsuit. Later this week, they will have to comply with new federal regulations or risk disrupting patient care for users of durable medical equipment, a group that includes people with diabetes.

Battles in the states over Medicaid reimbursement levels continue to flare up. And the ongoing fight over health care reform legislation is full of both promise and peril for the industry.

Those subjects receive their fair share of attention in the extended excerpts from a discussion sponsored by Chain Drug Review involving representatives of major pharmacy retailers and key suppliers.

In light of the problems that confront the pharmacy profession, one might expect that a downbeat mood would have pervaded the meeting, which was held last month in conjunction with the National Association of Chain Drug Stores Pharmacy & Technology Conference in Boston. The opposite was true. While fully cognizant of the current difficulties, the executives collectively articulated a vision of a profession on the brink of finally realizing its potential for improving patient outcomes and limiting overall health care expenditures.

Reasons for optimism are at least as compelling as causes for concern. Many of the goals included in health care reform legislation — improving access, affordability and efficiency among them — are in close alignment with retail pharmacy’s strengths. With a store, on average, within five miles of where most Americans live or work, the industry has unparalleled reach. The task at hand is to maximize the impact of the professionals who staff those outlets by enabling pharmacists to spend the lion’s share of their time counseling patients and interacting with other health care providers, thus ensuring that the right medications are used as directed to bring about the intended results.

Medication therapy management (MTM) is designed to do just that. As programs cited by participants in the Chain Drug Review roundtable show, MTM is good for patients and helps limit the total cost of treatment. It also has the virtue of shifting the focus for pharmacy reimbursement from products provided to services rendered, a change long sought by members of the profession.

The move toward MTM gained important momentum when it was included in the legislation that established a prescription drug benefit under the Medicare program, and it could get a further boost from health care reform. Whatever the fate of current proposals to change the system, pharmacists are all but certain to take on greater responsibilities going forward.

Close cooperation between physicians and pharmacists, which traditionally had been limited, is becoming the norm, according to the roundtable participants.

During the course of their training, future pharmacists and physicians now have greater interaction than in the past. They develop a team-oriented approach to patient care in which the latter rely on the former’s unequaled understanding of pharmacological agents, their effect on the body and possible adverse drug interactions. That relationship is slowly establishing itself in the real world, as new pharmacists, who hold doctorate degrees, and physicians enter the workplace.

That trend, together with community pharmacy’s increasing sophistication and efficiency in terms of processing scripts and the expansion of the industry’s scope to include such things as in-store clinics and immunization programs, should guarantee that pharmacy’s best days lie ahead.