Managed Care and Your Pharmacist


Healthcare decisions can be complicated. But who ultimately makes the final decision? Is it you and your doctor? Or is it the insurance company?

In a perfect world, the answer is simple: you decide on your medical treatment in consultation with your physician. Doctors, nurses, physician’s assistants, and all the other health professionals involved do their job and provide you with the best possible care. They gather all of the available information that they can to help you choose the best treatment option for you. But the final decision is always up to the patient.

In the US, insurance companies have unnecessarily injected themselves into the decision-making process. For example, insurers often control which medical procedures are approved, which medications are covered, and even the length of your hospital stay. They call it “managed care.” Unfortunately, it’s primarily about managing the profits for the insurance company. There are better ways to manage care, though.

Your pharmacist is an essential part of the healthcare system that is often overlooked. More than just pill counters, pharmacists should be an important part of your healthcare team. In Europe, they are considered the point person for the system and can make dispensing decisions, since many of the drugs that require prescriptions in the US are available over-the-counter there. Pharmacists help identify what a patient needs and whether a doctor’s visit is required.

American pharmacists are well-educated, highly qualified, tested and licensed medical professionals. We should better take advantage of the skills that they have to offer. It would be quite easy to review their credentials and then begin to utilize pharmacists to the fullest extent. This would improve efficiency, lower healthcare costs, and help the US to “manage care” even better.

Physicians frequently get their information on medications from pharmaceutical company sales reps. It’s easy to see how that might be a bad idea. I think we would be much better off with our pharmacists contributing their knowledge to the process. After all, drugs are literally their area of expertise. Physicians and pharmacists working closely together would lead to better patient outcomes. Why don’t we let our pharmacists help manage healthcare right from the start?



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