The patient facing me across my pharmacy counter in Yonkers had already lost half his right leg to diabetes. What he was about to lose next was access to the medication that might help save the rest of it
His physician’s office was difficult to reach. His insurer required another prior authorization. The cost of his medications continued to rise. He found himself trapped in a healthcare system that seemed designed to create obstacles rather than remove them
As a pharmacist, I could explain his medications, identify more affordable alternatives and work with his physician to overcome some of the bureaucratic barriers he was facing. But I wasn’t allowed under current New York State law to provide the ongoing accessible healthcare he needed. It will take both Congress and New York State to change that
My patient’s story isn’t unique. It reflects a broader problem. As America grapples with physician shortages, rising healthcare costs and an epidemic of chronic disease, policymakers continue searching for ways to improve access to care. Yet one of the country’s most accessible healthcare professionals remains largely overlooked: the community pharmacist
Nearly 90% of Americans live within five miles of a pharmacy. Many patients see their pharmacist far more often than they see their physician. The Association of American Medical Colleges projects that the United States could face a shortage of up to 40,000 primary care physicians by 2036, even as an aging population requires more chronic-disease management
Our healthcare policies treat pharmacists primarily as dispensers of medication rather than as clinicians capable of improving patient outcomes. Pharmacists earn doctoral degrees, undergo extensive clinical training and practice in communities across the country, often with far greater accessibility than physicians. Despite this, reimbursement policies and regulatory barriers frequently limit their ability to provide clinical services that improve medication adherence, identify medication-related problems and help patients manage chronic illnesses.
Numerous studies have found that pharmacist-led medication management improves diabetes control, medication adherence and blood-pressure management. Better adherence and earlier intervention can help prevent costly complications that drive healthcare spending, including hospitalizations, emergency-room visits and disease progression. This isn’t about expanding pharmacists’ professional standing. It’s about expanding patients’ access to care
Pharmacists cannot replace physicians. Nor should they. But they can extend the reach of the healthcare system by helping patients manage chronic diseases, improve medication adherence and avoid preventable complications. Every hour a pharmacist spends helping a patient better manage diabetes, hypertension or heart disease is an hour that may prevent more expensive interventions later
Congress should expand Medicare reimbursement for pharmacist-provided clinical services, while states should allow pharmacists to help manage chronic diseases under physician supervision. These practical reforms would strengthen — not replace — the physician-patient relationship while making better use of an existing healthcare workforce. The question is not whether pharmacists have the training or the accessibility to play a larger role. They do. The question is whether our healthcare policies will allow them to do so.
I still think about the man at my pharmacy counter after losing part of his leg to diabetes. What he needed most was not another layer of bureaucracy. He needed a healthcare professional who was accessible, knowledgeable and able to spend time helping him manage his disease, from right behind the pharmacy counter
Zive is a pharmacy manager at Grace Pharmacy in Yonkers
