Pharmacy has made progress on Capitol Hill, through federal agencies, and in states over the past decade. And our patients are beginning to see the benefits from the increased recognition of pharmacists’ services. Progress has been slow, in part because pharmacists went to the Hill divided, and we came back empty handed or feeling shortchanged. In recent years, we have worked hard to communicate among national and state organizations—we’ve been more united in our asks of Congress, and we have seen some success.

Will this success continue as we make our greatest ask of all? There are certainly many challenges. We face a growing federal deficit, a divided Congress, and a Congressional Budget Office that does not recognize prevention or avoidance of costs as beneficial. Influential Members of Congress tell us if our services are to be made available to consumers, the profession must be united in its ask. The costs of pharmacists’ patient care services will be “scored,” but savings, especially those long-term benefits, won’t be counted. Even though we know it’s not right, provider status will be scored as adding to the debt. That makes it a very hard sell in DC, but with our unity and the recognition that our patients desperately need our services, we can be successful.

Despite these challenges, pharmacy came together this winter to form the Patient Access to Pharmacists’ Care Coalition (PAPCC) and took action with the introduction of H.R. 4190. Passage of the bill will take some time, and is just the beginning of our provider status journey—but the bill is winnable, as it is shaped around the opportunities and issues with which today’s Congress and health systems are dealing.

The organizations joining the coalition recognized the benefits of unity, even though the bill may not give them everything their individual organization wanted. But while consensus was reached, unanimity was not. A few pharmacy organizations, including the American College of Clinical Pharmacy (ACCP), did not join PAPCC during the initial coalition invitation. As described by them in a recent piece they published, ACCP is instead pursuing a different federal strategy, which is available on their website. While the specific language of their draft bill has not been shared, ACCP has been advocating for a couple years for a specific service to be delivered by a limited group of “qualified clinical pharmacists.” After months and ample opportunity, they were unsuccessful in convincing the rest of pharmacy theirs was the best initial approach. And, faced with the decision to continue pursuit of their own strategy or support the consensus approach via H.R. 4190, they have chosen recently to pursue their own.

As the oldest pharmacy association in the United States, APhA understands why the dozen or so other national pharmacy organizations were created, one by one and often as spinoffs from APhA. Each association has unique perspectives, important goals, and principled, quality leaders. Each organization is challenged from time to time to decide whether to side with the majority of the profession or to take a different—perhaps unique—approach to address issues.

Today is one of those times. Provider status would mean different things to pharmacists practicing in different settings, states, and situations, and that means that each association has had to be very deliberative in deciding whether to join PAPCC. Most of the pharmacy organizations came to the same conclusion: the time has come for the profession to move forward on increasing patient access to and coverage of pharmacists’ patient care services, and pharmacist recognition, as the solution to obstacles we all face. Honestly, I was gratified as nearly two dozen pharmacy associations and corporations coalesced in a united effort to achieve access to services for our patients that they desperately need.

As a profession, we’re faced with the difficult questions of how best to pursue provider status—patient/consumer access and coverage for pharmacists’ quality patient care services. Settings and structure for the provision of that direct patient care are wide and varied, from community pharmacies to ambulatory care clinics and physician office practices to long-term care facilities and hospitals. Just as these settings are highly varied, so too are the interests of the many membership organizations in pharmacy.

APhA invests a great deal of energy in supporting the process of respectful dialogue and consensus building among these varied interests while keeping patient interests paramount. We take the role of convener very seriously, and we think our members support us in this role.

As PAPCC works toward provider status in the federal, state, and private arenas, our invitation stands for ACCP to join the effort and support H.R. 4190. If they cannot, we will understand, but we hope that ACCP leaders will not oppose it or confuse policy makers with competing requests. Emotive articles with words and phrases such as those seen in a recent ACCP communication are counterproductive.  It’s time for unity in pharmacy.