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The Growing Role of Pharmacists in the Practice of the Future

By Dr. Betty Rabinowitz, MD FACP

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In 2016, the U.S. spent $3.34 trillion, or 17.9 percent of the gross domestic product (GDP), on healthcare, of which $329 billion was spent on prescription medications.  Forty-four percent of all Americans take at least one prescription medication, and 17 percent take three or more medications. Five of six people aged 65 and older take at least one medication, and almost half of those aged 65 years and older take three medications or more. 

Considering the significant percent of Americans taking medications, many as part of complex regimens, it is not surprising that  the estimated annual cost of drug-related morbidity and mortality resulting from nonoptimized medication therapy is $528.4 billion, which is equivalent to 16 percent of total U.S. health care expenditures in 2016.   

Nearly 90% of Americans live within two miles of a pharmacy, likely making pharmacists the most accessible healthcare provider in the American healthcare system.Patients visit a pharmacy an average 35 times per year compared to just four visits to see medical providers. Indeed, community-based pharmacists are playing increasingly central patient care roles which extend beyond the traditional role of dispensing prescriptions and medication education and counseling, which pharmacists have always very successfully played.  

By 2015, 280,000 pharmacists in 50 states were licensed to provide vaccinations and in 2017 the CDC estimates indicated that 28.3 percent of adults were vaccinated at a pharmacy or store, up from 24.3 percent in the 2016 season.  In Canada, a pharmacist-led educational intervention compared with usual care resulted in greater discontinuation of prescriptions for inappropriate medication after six months. Legislation passed in 2015 provided for medication therapy management (MTM) services to Medicare beneficiaries with specific single chronic conditions, including diabetes, cardiovascular disease, COPD, and high cholesterol. These conditions have been shown to respond especially well to MTM which improves medication adherence, leading to better outcomes and reduced overall costs. In many states, pharmacists have the authority to recommend and prescribe routine medications such as smoking cessation agents and oral contraceptives, as well as interpret common diagnostic tests such as influenza and strep throat tests. Utilizing collaborative care agreements with physicians and practices, pharmacists in the setting of advanced practice models such as patient-centered medical homes are able to perform patient assessment activities, ordering and interpreting laboratory tests, developing therapeutic plans, and ultimately utilizing prescriptive authorities to initiate, adjust, or discontinue drug treatment. In the initial phases of the COVID-19 pandemic in April 2020, the U.S. Department of Health and  Human Services (HHS) authorized licensed pharmacists to order and administer COVID-19 tests to their patients. HHS did so, stating that the accessibility and distribution of retail and independent community-based pharmacies make pharmacists the first point of contact with a healthcare professional for many Americans.  

In the last few weeks, Walgreens and VillageMD announced that Walgreens will be the first national pharmacy chain to offer full-service doctor offices co-located in its stores. This expanded partnership will open 500 to 700 “Village Medical at Walgreens” physician-led primary care clinics in more than 30 U.S. markets in the next five years, with the intent to build hundreds more thereafter. The clinics will uniquely integrate the pharmacist as a critical member of VillageMD’s multi-disciplinary team. This is clearly a significant milestone in the evolution of the role of the pharmacist as a full-fledged member of the primary care team.  Patient access and quality of care only stand to gain from this evolution.


Dr. Betty Rabinowitz, MD FACP

Chief Medical Officer

Dr. Betty Rabinowitz was appointed as our chief medical officer on April 19, 2018. She brings to this position more than 25 years of extensive clinical experience and expansive knowledge of population health and value-based practice transformation. In her role, Betty is tasked with helping NextGen Healthcare promote and improve our solutions in support of our clients’ provider performance, clinical outcomes, patient satisfaction, and financial efficiency…

Dr. Betty Rabinowitz was appointed as our chief medical officer on April 19, 2018. She brings to this position more than 25 years of extensive clinical experience and expansive knowledge of population health and value-based practice transformation. In her role, Betty is tasked with helping NextGen Healthcare promote and improve our solutions in support of our clients’ provider performance, clinical outcomes, patient satisfaction, and financial efficiency.

Betty joined the NextGen Healthcare family in August 2017 as one of the founders and the former chief executive officer of EagleDream Health, the cloud-based analytics and population health management solutions we now know as NextGen® Population Health, which drives meaningful insights across clinical, financial, and administrative data to optimize ambulatory practice performance.

Born in Johannesburg, South Africa, Dr. Rabinowitz graduated from Ben-Gurion University Medical School in Israel, where she also completed a residency in Internal Medicine. She came to the United States in 1990 for a fellowship in Medicine and Psychiatry at the University of Rochester School of Medicine, where she became a professor of clinical medicine. In addition, Dr. Rabinowitz served as the medical director of the University of Rochester’s Center for Primary Care, overseeing clinical operations and population health management for the university’s large employed primary care network. In 2020, she was named on the list of the Top 25 Woman in Healthcare Software by the Healthcare Technology Report.

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