Chair and Associate Professor of Pharmaceutical Sciences, Ryan A. Schneider, Pharm.D., Ph.D., has added another title to his name: President of the Ohio Pharmacists Association (OPA). On April 21, 2018, he was elevated from his role as president-elect to begin his one-year role as president and will remain on the board the following year as immediate past president. A member since his college days, Schneider has first-hand experience how membership in a professional organization increases your impact within your career, your network and in the practice of pharmacy.
Q: How did you first become involved with the OPA?
A: I had the opportunity to be a student trustee on the OPA board of trustees when I was a pharmacy student. Through this experience, I obtained my first taste of what it was like to participate in dialogue with statewide thought leaders in pharmacy. I witnessed leaders in the profession that were engaged in advocating for the profession including lobbying efforts to influence legislation that impacted pharmacy. In my final year of pharmacy school, I did a one-month externship at OPA and I really developed a strong connection with the executive director and had the opportunity to lobby against a bill with him at the Ohio Statehouse. It was a great opportunity. Through this I further developed a passion for pharmacy advocacy and a passion for getting involved and trying to make a difference in that area of the profession.
Q: What motivated you to become involved in a professional organization?
A: I saw the value and the importance of professional organizations and I certainly wanted to give my time to help advocate for the future of pharmacy in the State of Ohio as well as nationally. I saw an opportunity to represent the voice of pharmacists around the state, especially from a community pharmacy perspective since that is my background. OPA is an umbrella organization that represents pharmacists from all facets of practice in the state, though community pharmacy is highly represented.
Being a pharmacist isn’t just about standing behind a counter, it’s about getting out and participating fully in your career as a pharmacist. If you want to do more with your career and if you want the practice of pharmacy to be progressive and continue to evolve, then you need to be involved. The practice of pharmacy is legislated by each state, so state legislators have the ability to expand rights and responsibilities, but also have the ability to take away the rights and responsibilities of pharmacists. Professional organizations have the responsibility and the ability to get people behind legislation to expand the scope of practice of pharmacists and we also have to lobby against bills that could potentially set back the profession.
Q: What are some challenges facing professional organizations today?
A: Historically, pharmacy has had very poor membership in professional organizations. If you look at physicians and dentists, almost all of them are part of their respective professional organization. There are approximately 12,000 pharmacists in the state of Ohio and only around 2,000 of them are OPA members. Even less of a percentage of pharmacists nationwide are members of national pharmacy organizations. If we as leaders in pharmacy organizations can create connections with pharmacists and help them see the importance of membership and engagement, over time we can hopefully grow membership and involvement. When you can say, “We represent half the pharmacists in the state,” that adds power behind your lobbying efforts.
Q: What goals would you like to achieve during your tenure as President?
A: One of the goals of pharmacy over the last several years has been to get provider status. This would allow pharmacists to continue to grow as a profession, to expand our scope of practice and do things that we are truly trained to do which will ultimately improve the care we provide to patients. Pharmacists have traditionally been paid for the products that we dispense and not for our cognitive services. However, not all pharmacists work behind a pharmacy counter. We have pharmacists inclinic and hospital settings that meet with patients and utilize their knowledge as drug experts to enhance patient care. These pharmacists may meet with patients to optimize drug therapy, counsel on proper drug administration or ensure that patients understand the reasons why new medications being prescribed are being used. Since pharmacists are not considered providers, they are unable to bill most insurance companies for these services. Pharmacists simply want the opportunity to be reimbursed for their cognitive services in a similar manner to several other mid-level practitioners. In doing so, pharmacists could help to optimize medication therapy for patients. According to a recent study, non-optimized drug therapy costs the U.S. healthcare system approximately $530 billion each year. Recognizing pharmacists as providers will create opportunities for pharmacists to decrease this amount while improving overall care for patients. OPA continues support legislation at the state and federal level to recognize pharmacists as providers.
Another goal of mine is to expose some of the mismanagement of funds in our healthcare system. Pharmacy is being squeezed by middlemen. We have had 167 independent pharmacies in the state close over the past two years due to very low reimbursement rates by pharmacy benefits managers (PBMs). In some cases, PBMs are reimbursing pharmacies less than what it costs the pharmacy to purchase the drugs they dispense to patients. In certain Medicaid plans, for example, the PBMs are actually reimbursing pharmacies $80 to $100 less than what it costs for the pharmacy to acquire the medication from a wholesaler. That’s a huge impact on the bottom line and it is unsustainable! We really have to stop the bleeding of low reimbursement rates and closure of independent pharmacies and look at what is happening to the practice of pharmacy in retail chains. Some pharmacies have avoided closing, but many have seen cuts in staffing, which ultimately increases the risk for medication errors. Pharmacies already function on slim profit margins for dispensing drugs and typically rely on sales from other areas in the store to turn a profit. Small independent pharmacies are at a disadvantage compared to pharmacies that are within large supermarkets or chain stores, but all have felt the impact. The result has been an alarming rate of independent pharmacies who have closed their doors and retail chains downsizing and downgrading staffing and benefits. This is a threat to healthcare and access to medication in communities throughout the state of Ohio. We need the cooperation and transparency of PBMs to fix some of these problems. Legislation has recently been introduced in Ohio to help with some of these issues and OPA continues to lobby for increased PBM transparency and adequate reimbursement rates for drug products.
Q: What ideas from OPA would you like to bring back to your classroom?
A: My goal would be to get students engaged in advocacy early on in their careers. The sooner they realize they have a voice and they can get involved in legislative affairs that impact their profession, the sooner they will learn that they can pick up a phone and call their state and federal legislators. This is an important part of a representative republic every citizen should know about and I would like to encourage students to participate in the process. During my interactions with students, I try to get them to understand the importance of being in an organization. It doesn’t have to be OPA, but I encourage students to become involved with at least one pharmacy organization. There are several out there that are working toward the common good of promoting the profession and practice of pharmacy.
I hope to leverage my role as a faculty member to engage the students in membership and advocacy efforts early in their careers. Hopefully, students feel encouraged to join OPA or another pharmacy organization when they graduate to really enhance what OPA and other pharmacy organizations are able to do: to serve, advocate, and lobby for the profession. I’m working with OPA’s lobbyist and the executive director of OPA to schedule visits with our students over the next year. We’re also looking to do policy nights where we rent out a room near several of the colleges of pharmacy in the state and talk about pharmacy-related legislative policy with the students. Through these efforts, I hope to further expose pharmacy students to the value of advocacy and engagement within their profession and help them realize that they can make a difference if they get involved.
Q: Why is the role of the pharmacist important to the community?
A: Pharmacists are one of the most accessible health care providers because when patients need their prescription medications, they go to a community pharmacy. Patients don’t need an appointment to visit their local pharmacist, whereas they may have a long wait to see their primary care provider. Also, in rural areas, often times there are more community pharmacists than primary care providers, so pharmacists can truly increase access to healthcare.
While it’s important for the profession to expand the scope of practice with our cognitive skills, it’s also important to remember the role we play in the dispensing aspect of pharmacy. We need to maintain our current role as drug experts and ensure that drugs are safely dispensed to the public. It is important that pharmacists do not separate themselves too far from the drug products that are being dispensed. If pharmacists allow that role to be given to someone else in the healthcare field, we would be doing a disservice to patients and the profession of pharmacy. Pharmacists can still be involved in the dispensing process and yet expand their scope of practice. We should always do what we can to provide the best care and make it a patient-centered process. We need to provide patients the right drug product at the right time, but also provide them comprehensive care related to their drug therapy, and I think we can do both.