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APhA to Debate Controversial Issues at Annual Meeting
House of Delegates
APhA to Debate Controversial Issues at Annual Meeting by Sara Martin
T
he freedom of patients to choose their own pharmacies, ensuring that pharmacy school curricula reflect contemporary pharmacy practice, and studying the effectiveness of needle exchange programs are some of the controversial issues the APhA House of Delegates will consider at the Association's Annual Meeting, March 10-14 in Washington, D.C. APhA's four policy committees educational, public, professional, and scientific affairs - met in September 1989 to discuss issues that will be presented to the 1990 House of Delegates - the largest and most representative democratic body in American pharmacy. The committees, made up of pharmacists from all segments of the profession, make recommendations that the House of Delegates votes to adopt, revise, reject, or refer back to a policy committee. For the complete policy committee reports, which include background information on all recommendations, see pp. 43-59 .
Freedom of Choice
O
ne recommendation that affects the pharmacist-patient relationship is freedom to choose a pharmacist. The public affairs policy committee is recommending that APhA affirm a patient's freedom to choose a provider of health care services. The recommendation also calls for APhA to express opposition to any government or private third party program that allows only a select group of health care providers to provide services to program participants. Over the past 10 years there has been tremendous growth in the number of third party prescription drug programs that limit a patient's choice of pharmacy. In most cases, these programs require patients to
purchase their prescription medications at select pharmacies, or in some cases, from mail order firms. The committee, opposing such agreements, believes that they deprive patients of access to the broad range of pharmacy services and prohibit fair competition among pharmacies. While such restrictive third party plans may save patients money and benefit those pharmacies that participate, the committee is concerned that the pressure of the increased volume of prescription orders could limit patient counseling.
The committees, made up of pharmacists from all segments of the profession, make recommendations to the House of Delegates.
Pharmacy Curricula
W
hat students learn in pharmacy school is critical to the future of the profession. Recognizing gaps between contemporary practice needs and the curriculum offerings of pharmacy schools, the educational affairs policy committee recommends that APhA work with pharmacy schools to address these differences. The committee recognizes that pharmacy students do not receive adequate education in areas such as geriatric pharmacy, nuclear pharmacy, pharmacy administration, and biotechnology. In other recommendations, the committee also believes APhA should: • Encourage schools and colleges of
American Pharmacy, Vol. NS30, No.1 January 1990/41
pharmacy to establish internships, externships, and clerkships in nontraditional areas such as nuclear/ radiologic, hospice, industry, and home health care pharmacy. APhA should encourage state boards of pharmacy to recognize such work as appropriate experience toward licensure, in addition to currently recognized programs toward candidacy for licensure. • Explore ways to increase interest in science and mathematics in primary and secondary schools by asking pharmacists and pharmacy students to participate in curriculum development and special programs.
Needle Exchange?
A
n issue that promises to be controversial is the recommendation of APhA's professional affairs policy committee to study the effectiveness of needle/syringe exchange programs that seek to prevent the spread of AIDS and other infectious diseases. For the past 50 years, drug abusers have been contracting and spreading infections by injecting themselves intravenously with contaminated needles and syringes. Current estimates are that IV drug users make up 33% of new AIDS cases, an increase from 27% in 1987. Other diseases transmitted by needles include syphilis, hepatitis B, tetanus, and even malaria. As a way to stop drug abusers from sharing needles and spreading these diseases, several U.S. cities have begun needle/syringe exchange programs. The three basic objectives of such programs are to: • Dispense sterile needles to current IV drug users to reduce the spread of infection. • Promote and accept returns of used needles to control how needles are discarded. 41
• Provide IV drug users with health education and counseling. The professional affairs policy committee recognizes that one concern about such programs is their potential to increase intravenous drug abuse. However, before the Association can formulate a policy either in support of or against the concept, the committee believes that objective research on needle exchange programs must be done. The committee also recommends that APhA support distribution of educational materials on the risks of sharing needles and syringes.
Effects of Federal Policy he array of health care issues T that face the country in the 1990s grows increasingly complex. Concerns about long-term care for the
Recognizing gaps between contemporary practice needs and the pharmacy curricula, the educational affairs policy committee recommends that APhA work with pharmacy schools to address these differences. elderly, the AIDS crisis, and the millions of Americans who have no health insurance are just some of the issues on the horizon. As health care concerns and costs continue to escalate, the government seeks to develop cost-effective health care programs. But before any changes in federal health policy are implemented, the federal government should conduct careful and objective evaluations of health policies, especially those relating to pharmaceutical services, according to the scientific affairs policy committee. The committee further recommends that APhA urge the federal government to establish funding for research to assess the impact of public policy on the health care system, particularly pharmaceutical services. Organized pharmacy should 42
have input on any research that addresses policy pertaining to pharmaceutical services, the committee asserts. Such research, says the committee, would help support pharmacy's cost-effective role as a provider of valuable health care services.
More Topics for Debate
O
ther policy committees' recommendations ranged from the legalization of drugs to the disposal of hazardous pharmaceutical wastes. The policy committee on public affairs recommends that: • APhA encourage the government and other third party payers to reimburse patients for Food and Drug Administration approved drugs when they are used for indications other than those specified in the product labeling. (Policies similar to this have been adopted by both the Health Insurance Association of America and Blue Cross/Blue Shield.) • APhA oppose legalization or decriminalization of the possession, sale, distribution, or use of drug substances for nonmedicinal uses. The policy committee on professional affairs recommends that: • APhA support the proper handling and disposal of hazardous pharmaceutical products and associated products. APhA should work with representatives from industry, government, and other health care organizations to develop guidelines for the proper disposal of hazardous products. APhA also supports the development of educational programs for health professionals and patients on hazardous waste disposal. • APhA oppose drug testing as part of any employment practice, including preemployment screening.
One Of AmericaS Best Run
Companies Gives 95% Of Its Money To Chanty. CARE was recently named the best rull, best managed charity in America. We aren't surprised. 95% of every dollar we receive goes to help impoverished people. Only 5% goes to run our organization. No other company could survive on margins like that. But a lot of starving people can.
1(~ll1t]~1 We're Helping People LearnTo live Witliout Us. 1-800-242-GIVE
American Pharmacy, Vol. NS30, No.1 January 1990/42
APhA to Debate Controversial Issues at Annual Meeting by Sara Martin
T
he freedom of patients to choose their own pharmacies, ensuring that pharmacy school curricula reflect contemporary pharmacy practice, and studying the effectiveness of needle exchange programs are some of the controversial issues the APhA House of Delegates will consider at the Association's Annual Meeting, March 10-14 in Washington, D.C. APhA's four policy committees educational, public, professional, and scientific affairs - met in September 1989 to discuss issues that will be presented to the 1990 House of Delegates - the largest and most representative democratic body in American pharmacy. The committees, made up of pharmacists from all segments of the profession, make recommendations that the House of Delegates votes to adopt, revise, reject, or refer back to a policy committee. For the complete policy committee reports, which include background information on all recommendations, see pp. 43-59 .
Freedom of Choice
O
ne recommendation that affects the pharmacist-patient relationship is freedom to choose a pharmacist. The public affairs policy committee is recommending that APhA affirm a patient's freedom to choose a provider of health care services. The recommendation also calls for APhA to express opposition to any government or private third party program that allows only a select group of health care providers to provide services to program participants. Over the past 10 years there has been tremendous growth in the number of third party prescription drug programs that limit a patient's choice of pharmacy. In most cases, these programs require patients to
purchase their prescription medications at select pharmacies, or in some cases, from mail order firms. The committee, opposing such agreements, believes that they deprive patients of access to the broad range of pharmacy services and prohibit fair competition among pharmacies. While such restrictive third party plans may save patients money and benefit those pharmacies that participate, the committee is concerned that the pressure of the increased volume of prescription orders could limit patient counseling.
The committees, made up of pharmacists from all segments of the profession, make recommendations to the House of Delegates.
Pharmacy Curricula
W
hat students learn in pharmacy school is critical to the future of the profession. Recognizing gaps between contemporary practice needs and the curriculum offerings of pharmacy schools, the educational affairs policy committee recommends that APhA work with pharmacy schools to address these differences. The committee recognizes that pharmacy students do not receive adequate education in areas such as geriatric pharmacy, nuclear pharmacy, pharmacy administration, and biotechnology. In other recommendations, the committee also believes APhA should: • Encourage schools and colleges of
American Pharmacy, Vol. NS30, No.1 January 1990/41
pharmacy to establish internships, externships, and clerkships in nontraditional areas such as nuclear/ radiologic, hospice, industry, and home health care pharmacy. APhA should encourage state boards of pharmacy to recognize such work as appropriate experience toward licensure, in addition to currently recognized programs toward candidacy for licensure. • Explore ways to increase interest in science and mathematics in primary and secondary schools by asking pharmacists and pharmacy students to participate in curriculum development and special programs.
Needle Exchange?
A
n issue that promises to be controversial is the recommendation of APhA's professional affairs policy committee to study the effectiveness of needle/syringe exchange programs that seek to prevent the spread of AIDS and other infectious diseases. For the past 50 years, drug abusers have been contracting and spreading infections by injecting themselves intravenously with contaminated needles and syringes. Current estimates are that IV drug users make up 33% of new AIDS cases, an increase from 27% in 1987. Other diseases transmitted by needles include syphilis, hepatitis B, tetanus, and even malaria. As a way to stop drug abusers from sharing needles and spreading these diseases, several U.S. cities have begun needle/syringe exchange programs. The three basic objectives of such programs are to: • Dispense sterile needles to current IV drug users to reduce the spread of infection. • Promote and accept returns of used needles to control how needles are discarded. 41
• Provide IV drug users with health education and counseling. The professional affairs policy committee recognizes that one concern about such programs is their potential to increase intravenous drug abuse. However, before the Association can formulate a policy either in support of or against the concept, the committee believes that objective research on needle exchange programs must be done. The committee also recommends that APhA support distribution of educational materials on the risks of sharing needles and syringes.
Effects of Federal Policy he array of health care issues T that face the country in the 1990s grows increasingly complex. Concerns about long-term care for the
Recognizing gaps between contemporary practice needs and the pharmacy curricula, the educational affairs policy committee recommends that APhA work with pharmacy schools to address these differences. elderly, the AIDS crisis, and the millions of Americans who have no health insurance are just some of the issues on the horizon. As health care concerns and costs continue to escalate, the government seeks to develop cost-effective health care programs. But before any changes in federal health policy are implemented, the federal government should conduct careful and objective evaluations of health policies, especially those relating to pharmaceutical services, according to the scientific affairs policy committee. The committee further recommends that APhA urge the federal government to establish funding for research to assess the impact of public policy on the health care system, particularly pharmaceutical services. Organized pharmacy should 42
have input on any research that addresses policy pertaining to pharmaceutical services, the committee asserts. Such research, says the committee, would help support pharmacy's cost-effective role as a provider of valuable health care services.
More Topics for Debate
O
ther policy committees' recommendations ranged from the legalization of drugs to the disposal of hazardous pharmaceutical wastes. The policy committee on public affairs recommends that: • APhA encourage the government and other third party payers to reimburse patients for Food and Drug Administration approved drugs when they are used for indications other than those specified in the product labeling. (Policies similar to this have been adopted by both the Health Insurance Association of America and Blue Cross/Blue Shield.) • APhA oppose legalization or decriminalization of the possession, sale, distribution, or use of drug substances for nonmedicinal uses. The policy committee on professional affairs recommends that: • APhA support the proper handling and disposal of hazardous pharmaceutical products and associated products. APhA should work with representatives from industry, government, and other health care organizations to develop guidelines for the proper disposal of hazardous products. APhA also supports the development of educational programs for health professionals and patients on hazardous waste disposal. • APhA oppose drug testing as part of any employment practice, including preemployment screening.
One Of AmericaS Best Run
Companies Gives 95% Of Its Money To Chanty. CARE was recently named the best rull, best managed charity in America. We aren't surprised. 95% of every dollar we receive goes to help impoverished people. Only 5% goes to run our organization. No other company could survive on margins like that. But a lot of starving people can.
1(~ll1t]~1 We're Helping People LearnTo live Witliout Us. 1-800-242-GIVE
American Pharmacy, Vol. NS30, No.1 January 1990/42