MentorVIEW
 A shorter distance between two points 

Bill Smith's illustrious career has included major contributions to the Pharmacy profession, both in management and clinical practice. As a Harvey A.K.Whitney Lecture Award recipient, Smith has earned Health-system Pharmacy's highest honor. In our 2002 MentorVIEW with Bill, he observed that Pharmacy was still "struggling to try to identify what its core purpose or mission is. We continue to be dominated by the dispensing function ...," he said. Five years later, Smith still feels that Pharmacists need a more clear picture of their role(s) in healthcare. Here, we resumed our visit.

PN: What problems are you seeing 
in Pharmacy, today?
Bill: First, there are many positives in Pharmacy that I see. As for negatives, the list may be short ... but is significant. We're still fighting the 3rd party payer system. But the bigger issue is we as yet haven't defined clearly -- to ourselves, healthcare, or patients -- what we are all about. There are still too many people being damaged by medication errors.

PN: What promising signs do you see?
Bill: I'm encouraged by the development of measures that illustrate Pharmacy's performance, like what is coming out of AHRQ (Agency for Healthcare Research and Quality; website is www.ahrq.gov). This is a real plus. We've been recognized that we have a clinical role to play.  I also feel that the opportunities with Medicare Part D are exciting (www.medicare-partd.com). Though I'm not sure where this funding will come from. There is much acceptance for Pharmacists in clinical practice. Particularly in chains. We've simply got to think differently as a profession, and get active in promoting our roles in clinical practice.

PN: You mentioned AHRQ. Are you satisfied with "best practice" benchmarks for Pharmacy quality and performance?
Bill: My main problem with benchmarking is this: there is no science behind it. Most hospitals are doing comparative data using statistics from all hospitals. This is very arbitrary. It's just numbers. Pharmacy is more impacted by its facilities than any other healthcare area. If there is a poor internal location for a Pharmacy, it will affect that Pharmacy horribly. The profession has never come to grips with this; and yet everybody wants their orders filled now. That's a tremendous strain on a Pharmacy Department.

PN: Is there a need to change Pharmacy practice, somehow, to better underscore the value Pharmacists bring to healthcare?
Bill: I hear this often, and I ask this question in reply. Why is there a need to change? Our challenge is unchanging: to resolve patients' drug-related issues. We have to keep shifting the focus on the cost of our services, and our impact on the overall quality of care a patient receives. John P. Kotter at the Harvard Business School has done terrific research on change (dor.hbs.edu), which could help us in this conversation.

PN: You've been a Pharmacist for over 40 years. You're a professor at VCU. What is your take on the next generation of Pharmacists?
Bill: They are extremely talented, as Ron Cameron (www.temp-pharmacist.com; Ron Cameron) recently said in his MentorVIEW. They can make a difference in patient care. I also suspect too many new Pharmacists see $$ signs. There is a great need in Community Pharmacy to offer clinical therapy for patients, and to meet the needs of other people. I can't answer if the Pharm.D. is attracting a better student ... but they are very good.

PN: What final thoughts do you have for our young Pharmacist, and other Pharmacist and Technician readers?
Bill: Recognize that you have a responsibility to take care of patients. Not everybody can do great things, but people can do little things in a great way every day. If they do this ... they'll be fine.

MentorVIEW Archives

Other Features:
It's Been Said
PharmacyNOW Bookstore
Then & Now

Pocono

Health