Chapter 1. The "Management" in Medication Therapy Management

Dr. Desselle is Dean and professor at the California Northstate University, College of Pharmacy. He received a B.S. degree in pharmacy and a Ph.D. in pharmacy administration from the University of Louisiana at Monroe. He has practice experience in both community and hospital pharmacy settings. He teaches courses in American health care systems, health care economics, social and behavioral aspects of pharmacy practice, and research methods. His research interests include performance appraisal systems in pharmacy, quality of work life among pharmacy technicians, direct-to-consumer prescription drug advertising, Web-based pharmacy services, and pharmacy benefit design. Dr. Desselle won the Duquesne University School of Pharmacy's President's Award for Teaching and President's Award for Scholarship and was recognized for his contributions to pharmacy by being named a Fellow of the American Pharmacists Association in 2006.

After completing this chapter, readers should be able to

1. Identify changes in the roles of pharmacists since the early 1900s.

2. Describe how pharmacy practitioners and educators viewed the need for management skills as the roles of pharmacists evolved.

3. Identify principal domains of pharmacy care. Describe how management skills and functions fit within the context of providing medication therapy management services.

4. Identify myths surrounding the practice of pharmacy and health care as a business.

5. Evaluate the need for a management perspective to better serve patients and improve outcomes to drug therapy.

6. List the managerial sciences and describe their use as tools to assist pharmacists in practice.

Mary Quint has just completed the first 2 years of a doctor of pharmacy curriculum. Despite many long hours of hard work and a few anxious moments preparing for examinations, she has been pleased with her educational experience. She perceives that as she continues progressing through the curriculum, the upcoming courses will be more integrated and directly applicable to pharmacy practice. She is especially excited about taking courses in pharmacology and therapeutics so that she can “really learn about how to be a pharmacist.” As she glances down at her schedule and sees that she is enrolled in a required course in pharmacy management, her enthusiasm becomes somewhat tempered. She immediately consults with fellow students on what they have heard about the course, and they tell her that the course is about “finance, accounting, personnel management, and marketing.” Despite some positive comments provided by students having already completed the course, she is concerned. “What do I have to take this course for? I did not come to pharmacy school for this. I'm very good at science. If I liked this kind of stuff, I would have majored in business. How is this going to help me to become a better pharmacist?” she asks herself.

After some thought she comes to realize that, at worst, taking this course will not be the end of the world, and even better, it simply might be a moderate intrusion in her Monday–Wednesday–Friday routine. She begins to focus on other issues, such as her ...