This column is part of a series of firsthand physician accounts that detail how AMA Health System Member Program organizations are moving medicine to support patient health and the medical profession.
It can be challenging in a large neurology practice that treats patients with complex conditions to find ways to improve both care and practice workflows. Our practice has found a way: integrating a clinical pharmacist.
Since we integrated a clinical pharmacist into our practice in 2021, we have seen a meaningful shift in how we treat patients and manage and integrate how our practice runs.
In four short years, a clinical pharmacist embedded in our practice has served as an invaluable partner to both physicians and patients. He has taken on responsibilities such as collaborative drug therapy management with other clinical staff, and seeing patients experiencing polypharmacy, side effects or those with medical histories involving multiple complex or chronic conditions.
To offer patients meticulous attention, our clinical pharmacist can order labs and check for drug interactions, allowing us to see where we might adjust medications. His work—including the ability to conduct telehealth appointments—serves as a bridge to ensure communication and coordination among all physicians in our practice.
This additional accessibility to our practice is no small accomplishment, especially when patients face physical limitations in attending appointments, such as those with epilepsy, who may not be able to drive.
Streamlining prior authorizations
Clinical pharmacists also play a lead role in navigating the process of prior authorizations, which has become an industry-wide challenge fraught with bureaucratic hurdles.
For example, the specialized knowledge that clinical pharmacists employ can free up both physicians and nonclinical office staff who may not have the expertise for tackling pushback from insurance companies and expediting medication access. This can be particularly crucial for migraine treatments such as Calcitonin Gene-Related Peptide inhibitors, which face complicated and stringent insurance scrutiny.
The AMA is fighting to fix prior authorization by challenging insurance companies to eliminate care delays, patient harms and practice hassles.
Providing patient education
In-house clinical pharmacists also play a pivotal role in patient follow-up and education. They check on patients to see if they’re adhering to treatment regimens and make themselves available to answer medication-related questions.
These follow-up appointments both assess and facilitate compliance and empower patients with knowledge and support. Checking in can help our practice prevent serious issues such as medication overuse, misuse, drug interactions and, in the case of migraine patients, debilitating rebound headaches.
The standard of care in physician well-being recognition
Institutions in this article have been honored by the Joy in Medicine™ Health System Recognition Program.
Reducing administrative burdens
When we embed clinical pharmacists to help manage the patient volume, they can take on tasks that would otherwise stretch the availability of neurologists. This shift allows physicians to use our time to focus and take our time getting to know and diagnosing our patients. Our collaborative model also enhances patient satisfaction, allowing patients to have follow-up visits and appointments in a timely manner, rather than waiting several months for specialist appointments.
Clinical pharmacists also offer vital support in identifying patients who may benefit from participating in clinical trials. This can open new avenues for research and treatment possibilities, connecting patients with treatments that are on the forefront of scientific advancements.
As the leader in physician well-being, the AMA is reducing physician burnout by removing administrative burdens and providing real-world solutions to help doctors rediscover the Joy in Medicine™.
Benefiting small practices too
Large health systems like Northwell Health have the resources and infrastructure to employ clinical pharmacists directly. However, even smaller practices may be able to bridge the gap when they can’t employ full-time, in-house clinical pharmacy services.
Specialty pharmacies, for example, offer support services to patients and physicians by focusing on dispensing and managing complex, high-cost medications used to treat chronic or rare conditions. They can be a tremendous help to medical practices by providing specialized expertise in overseeing these medications, streamlining their access for patients, potentially reducing costs, and ultimately, improving outcomes.
Embedding a clinical pharmacist into our neurology practice has brought practice staff and patients very practical benefits. This change bolsters the quality of our patients’ care while improving how our practice operates. We are effectively alleviating administrative burdens while enhancing patient care. As we continue to seek innovative solutions to deliver high-quality care amid increasing patient demand and complex medical landscapes, integrating clinical pharmacists represents a meaningful step forward.
Dr. Rosen is a neurologist and vice chair of neurology at Northwell Health, which is part of the AMA Health System Member Program. He also heads the Northwell Health Headache Center and is an associate professor at the Zucker School of Medicine at Hofstra/Northwell.
