title: Pharmacists need recognition as providers to enhance patient care.
abstract: OBJECTIVE
  To demonstrate that pharmacists are vital but currently underutilized direct care providers and that full provider status and inclusion into advanced multidisciplinary team models is needed.
  
  
  METHODS
  Literature was accessed through Ovid MEDLINE from 1990 to the present using the terms pharmacy care, pharmacist care, medication therapy management, and pharmaceutical care. Web-based searching and backward citation tracking was conducted for context and additional citations.
  
  
  RESULTS
  There is strong data showing that pharmacists in patient care roles contribute to intermediate and final health outcomes improvements and cost-effectiveness. The general perception of pharmacists from prominent people in the Federal Government, some medical societies, and from physicians and nurses who work with pharmacists most closely is overwhelmingly positive. However, the penetration of pharmacists into complementary patient care roles is minimized by an antiquated reimbursement structure that needs to change. There are critical future primary care provider shortages that will be exacerbated under health care reform, and pharmacists can be a part of the solution if the reimbursement environment was altered.
  
  
  CONCLUSIONS
  For all the data and support for expanded direct patient care pharmacist services, pharmacists are marginalized by an antiquated reimbursement structure. Pharmacists need to be granted Medicare provider status, and new models of primary care need to include pharmacists in patient care roles in order to more fully meet the needs of patients.
authors.affiliation: University of Connecticut School of Pharmacy, Storrs, CT, USA.
authors.forename: C Michael
authors.initials: CM
authors.lastname: White
mesh_terms: D003362:Cost-Benefit Analysis; D006801:Humans; D054539:Medication Therapy Management; D005791:Patient Care / Q000191:economics; D010593:Pharmaceutical Services / Q000191:economics; D010595:Pharmacists; D024382:Professional Role
keywords: health care; patient care; pharmacist