What is provider status and payment parity for pharmacists?


The Texas Senate just passed two bills: HB 3441 and HB 1757 to ensure payment parity and provider status for pharmacists. I’m confused when I try to read up on the bills and was wondering if my favorite social media (I think reddit counts) could help me out

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Traditionally, doctors were in 100% charge of taking care of patients. They provided care to patients so they were called providers. Nurses, physician assistants, pharmacists, and pretty much everyone else just helped them do their jobs.

Today, there is a big shortage of doctors, especially in primary care (general price as opposed to specialty care like cardiology or neurosurgery.) As this has happened, those other jobs started taking on more responsibility. Now they want to be recognized not just as a helper for the doctor, but as people who can provide their own independant care to patients. That’s what provider status means. Payment parity means that they want to get paid for providing that care.

This gets at another weird idea. Medicine is a profession, and doctors protect that profession by lobbying the government. Doctors say that only doctors have the skills and training to take care of patients independently. It takes more time and school to become a doctor than pretty much any other job in the world. They lobby the government so that only they can provide care. They say that patients will be hurt if less qualified professions provide inferior quality care.

Weighed against that is the fact that other professions like pharmacys also have lobbyists. They want to expand their scope of practice, which is the jobs they are allowed to do. Provider work pays a lot better than pharmacy work and takes more skill. Pharmacists say that they are all very skilled and well trained in their own right so they can do the job. Plus, there is a shortage of doctors so if they don’t take on more responsibilities, patients will suffer.

Ultimately, healthcare is a very important thing for humans. People are willing to spend a lot more money on healthcare than they are on other things. As such, there is a lot of money in healthcare. Doctors want to keep other professions from honing in on their turf because it means losing money and power. Fewer providers means each provider gets paid more. Pharmacists want a wider scope of practice because it means they get paid more too. Both sides lobby the government to support them. Less cynically, both doctors and pharmacists want what’s best for patients.

Depending on your perspective, you can land on either side of the argument as an impartial observer. States where there is a greater doctor shortage tend to give more privileges and money to pharmacists. States that have enough doctors already tend not to. Hospital systems like the upfront cost savings of hiring pharmacists to do work traditionally done by doctors, but are wary of long term cost increases that might come with a change in the quality of care.

The overall answer is that it’s best if everyone works at the top of their scope of practice. It’s wasteful if the highly paid CEO of McDonald’s is making french fries. He should be in the boardroom making billion dollar decisions. But it’s also bad if the manager of a local McDonald’s is making boardroom decisions he’s not qualified to make because it could cost the company a ton of money and many jobs. If pharmacists are skilled enough to be providers, then it’s a good thing if they are recognized as such. It frees up doctors to take on more specialized higher scope of practice roles themselves. If pharmacists are exceeding their scope of practice, then patients might get hurt though.

At the risk of editorializing, my guess is that it’s a good thing for pharmacists to move up in their scope of practice. The same applies to many other fields. But this whole thing is a weird money driven enterprise rife with heavy lobbying on all sides. As long as it’s about providing the best quality care for patients first with cost cutting as a secondary concern, it’s a good thing. But if it’s just about professions fighting to make more money, it’s not good.