Future Clinical Pharmacy Practitioners Should Be Board ...

1 Future Clinical Pharmacy Practitioners Should Be Board -Certified SpecialistsAmerican College of Clinical PharmacyJoseph J. Saseen, , FCCP, Sarah E. Grady, , Laura B. Hansen, , FCCP, Brian M. Hodges, , Steven J. Kovacs, , Larry D. Martinez, , John E. Murphy, , FASHP, FCCP, Robert L. Page, II, , FASCP, Marc G. Reichert, , Kathleen A. Stringer, , FCCP, and Charles T. Taylor, Words: Board -certified pharmacotherapy specialist, BCPS, boardcertification, Clinical Pharmacy , credentialing, Pharmacy practice, professionalprivileging, specialist.(Pharmacotherapy 2006;26(12):1816 1825)The vision of the American College of ClinicalPharmacy (ACCP) is that, in 20 30 years, mostclinical Pharmacy Practitioners will be Board -certified , 2 This White Paperdevelops a rationale for this position, describesspecialty Board certification in Pharmacy ,3andarticulates recommendations for attaining thevision.

2 The justification of the need for boardcertification as a part of Future quality assuranceand professional privileging processes, therationale for the argument that most futureclinical faculty and residency preceptors shouldbe Board certified, and the identification ofobstacles that hinder achieving this vision arealso Future of Pharmacy PracticeThe Joint Commission of Pharmacy Practitioners (JCPP) the members of which include theAcademy of Managed Care Pharmacy , theAmerican College of Apothecaries, the ACCP, theAmerican Pharmacists Association, the AmericanSociety of Consultant Pharmacists, the AmericanSociety of Health-System Pharmacists (ASHP),and the National Community PharmacistsAssociation developed a consensus position onthe Future of Pharmacy practice for document represents the opinion ofmultiple Pharmacy organizations with the sharedvision that pharmacists will be the health careprofessionals responsible for providing patientcare that ensures optimal medication therapyoutcomes.

3 The document describes the founda-tions of Pharmacy , how pharmacists will practice,and how Pharmacy will benefit society. The JCPP document encompasses all Pharmacy practicesettings. Of importance, this vision statementincludes the need for implementing effectivechange within community Pharmacy and healthsystem Pharmacy , 6It is clear from thisvision that most pharmacists of the Future areexpected to be Clinical Pharmacy practitionerswho provide advanced patient care services. ThisJCPP vision is consistent with ACCP s vision thatin 20 30 years most Clinical Pharmacy practi-tioners will be Board -certified of Clinical Pharmacy PractitionerIn 2005, ACCP defined Clinical Pharmacy asthe area of Pharmacy concerned with the scienceThis document was prepared by the 2005 2006 ACCPC ertification Affairs Committee: Joseph Saseen, ,FCCP, BCPS, Chair; Sarah Grady, , BCPS, BCPP;Laura Hansen, , FCCP, BCPS; Brian Hodges, , BCPS, BCPSP; Steven Kovacs, ; LarryMartinez, , BCPP; John Murphy, , FASHP,FCCP; Robert Page, , BCPS; Marc Reichert, , BCPS; John Smith, , BCPS; and CharlesTaylor, , BCPS.

4 Approved by the ACCP Board ofRegents on January 25, reprint requests to the American College ofClinical Pharmacy , 3101 Broadway, Suite 650, Kansas City,MO 64111; e-mail: or download CERTIFICATION FOR Clinical Pharmacy Practitioners ACCPand practice of rational medication use. 7 Withinthis definition, it is stated that the discipline ofclinical Pharmacy relies on caring, values,specialized knowledge, experience, andjudgment. Clinical pharmacists are individualswho practice within this discipline. For thepurposes of this article, the term clinicalpharmacy practitioner refers to clinicalpharmacists working within the health caresystem as experts in the therapeutic use of drugs,who are primary sources of scientifically validinformation and advice and who generate,disseminate, and apply new knowledge thatcontributes to improved health and quality in PharmacyConsiderable effort and activities surround thenumerous approaches to ensuring ordocumenting the knowledge and skills of healthcare professionals.

5 There is also debate in theprofession of Pharmacy regarding who Should berequired to receive specific ofthat debate reflects fundamental questions aboutwho determines which providers and therapieswill be accepted as safe, effective, appropriate,and reimbursable. 8In the Pharmacy profession,credentialing, privileging, specialty certification,and the provision of certificates are among theapproaches used to document skills andknowledge. Unfortunately, the requirements andmeaning of these vary a comprehensive article outlining thedefinitions and issues related to credentialing inpharmacy, three types of credentials available topharmacists are identified9: Credentials needed to prepare for practice( , academic degrees) Credentials needed to enter practice ( ,licensure) and to update professionalknowledge and skills ( , relicensure)under state law Credentials that pharmacists voluntarily earnto document their specialized or advancedknowledge and skills ( , postgraduatedegrees, certificates, certification)That article further explained the differencebetween credentialing, which is a process bywhich an organization or institution obtains,verifies, and assesses qualifications, and acredential, which is a title indicating documentedevidence of qualifications ( , doctor ofpharmacy [ ], registered pharmacist, andboard-certified pharmacotherapy specialist[BCPS]).

6 9 Several types of credentials are voluntarilysought by pharmacists to demonstrate specializedskills and knowledge. In a recent review of theissues surrounding credentialing and privileging,credentialing was defined as the process used byhealth care organizations to validate professionallicensure, Clinical experience, and preparationsfor specialty practice. 10 Moreover, the authorstated that credentialing is what is required forhealth care professionals to be hired in a healthsystem and awarded specific patient careprivileges. In that same review, privileging wasdefined as the process used by health careorganizations to grant to a specific practitionerthe authorization to provide specific patient careservices. 10 Credentials in the Pharmacy profession can beobtained through a variety of ways.

7 For example,they can be acquired through receipt of acertificate at the completion of a lengthy andtargeted disease state specific continuingeducation program, or through the rigorousexamination process required to become boardcertified by the Board of PharmaceuticalSpecialties (BPS).Certificate programs are distinct fromcertification and licensure, which have differentpurposes and meanings. Certificate programs( , smoking cessation, anticoagulation) are amechanism for pharmacists to receive Accreditation Council on PharmaceuticalEducation defines certificate programs inpharmacy as structured and systematicpostgraduate continuing education experiencesfor pharmacists that are generally smaller inmagnitude and shorter in time than degreeprograms, and that impart knowledge, skills,attitudes, and performance behaviors designed tomeet specific Pharmacy practice objectives.

8 11 Compared with other forms of continuingpharmaceutical education, certificate programs inpharmacy are designed to instill, expand, orenhance practice competencies through thesystematic acquisition of specified knowledge,skills, attitudes, and performance programs are educational activitiesundertaken by is the process by which anongovernmental agency, such as a professionalassociation, grants recognition, after assessment,to an individual who has met certainpredetermined qualifications specified by thatorganization. The formal recognition ofcertification is granted to an individual to1817 PHARMACOTHERAPY Volume 26, Number 12, 2006designate to the public that this person iscompetent to practice in the designated area with certification, licensure refers to therecognition of an individual and involvespredetermined qualifications, but the grantingagency is governmental, and licensure provides alegal basis for Certification in PharmacyThe history and evolution of specialists inpharmacy are much shorter than those inmedicine and other health care since the late 1960s and early 1970s havevarious Pharmacy visionaries and organizationsencouraged and proposed the development ofspecialty Practitioners to benefit patient care andthe profession.

9 In 1976, the American Pharma-ceutical Association established the BPS to grantspecialty certification to qualified , five specialty practice areas havebeen established; they are nuclear Pharmacy (since 1978), nutrition support Pharmacy (since1988), pharmacotherapy (since 1988), psychiatricpharmacy (since 1992), and oncology Pharmacy (since 1996).3 Each specialty has its ownmission, which is described elsewhere in , the specialties share the BPS coremission, namely, to improve health throughrecognition and promotion of specializedtraining, knowledge, and skills in December 2005, more than 5000 pharmacistswere BPS certified. Figure 1 depicts the growingnumber of pharmacists certified by specialty from1994 value of BPS certification is evident onmany levels.

10 Although the fundamental intent ofcertification has been to enhance patient care,current Board -certified pharmacists haveexperienced a number of other personal andprofessional benefits. Board -certified pharmacistsbelieve that certification increases their market-ability and acceptance by other health careprofessionals, improves feelings of self-worth,and differentiates them from general , 15 Some Board -certified pharmacistshave received financial rewards including salaryincreases, job promotion, bonus pay, and directcompensation for , 15In some states,BPS certification enables pharmacists to partici-pate in collaborative drug therapy Regarding Pharmacy Practice in20 30 YearsSignificant changes within the profession ofpharmacy will be needed to realize the visionthat, in 20 30 years.