Especially on the part of pharmacies, a closer cooperation in medicine has been demanded for some time. This has published the Federal Association of German Pharmacists Associations in the perspective paper “Pharmacy 2030”.
Closer cooperation between physicians, hospitals and pharmacists called for
Highly specialized professionals are in demand in the medical and pharmaceutical sectors. Particularly the changing patient structure, the increasing number of people in need of care, but also the enormous shortage of specialists are reasons that speak for closer cooperation. Doctors and hospitals are rather critical of this demand, because the reform could change the entire healthcare system. Furthermore, experts fear that the competencies of pharmacists could be exceeded. The news magazine Die Welt addresses the physicians’ point of view:
“[…] However, it is also clear that the boundaries to each other’s core competencies should not be softened.” (Andreas Gassen, Chairman of the Board of the National Association of Statutory Health Insurance Physicians).
Gassen adds that the doctors who treat patients are the most likely to know about sensible preventive measures, as only they have detailed knowledge of the patient’s state of health. In addition, the cooperation between physicians and pharmacists is already good and does not need to be changed. Pharmacies, however, hope that the reform will have a greater impact on the patient’s healing process. Another reason in favor of closer cooperation is to counteract the shortage of specialists. Closer cooperation could ease the burden on both sides in other areas.
Healthcare industry particularly affected by shortage of skilled workers
According to a study by Roland Berger Strategy Consultants Holding, the entire industry is affected by this situation. At this point, the hospitals are to be mentioned, because according to the study, this is where most of the personnel is lacking. According to the study, around 80 percent of hospitals are already victims of the shortage of skilled workers. The pharmaceutical industry is not exempt from this trend. Although the job offer is plentiful, there is nevertheless a nationwide shortage of trained people. This is already confirmed by a critical look at the advertised positions. For example, according to the job postings on stepstone.de, highly qualified quality and product managers are currently being sought in addition to pharmacists and pharmaceutical employees. In the pharmaceutical sector, there are particularly regional bottlenecks in Baden-Württemberg, where vacancies are 44 percent higher than the national average. Berlin and Hamburg are also affected by this trend. In research, the shortage of qualified personnel is also making itself felt, as large pharmaceutical companies are constantly looking for specialists. Michael Burkhart, head of healthcare and pharmaceuticals at management consultants PricewaterhouseCoopers AG Wirtschaftsprüfungsgesellschaft, warns of this development. “From 2020, the shortage of personnel will increase dramatically, among physicians as well as nonphysician specialists.” Studies by the German Federal Employment Agency confirm the search for qualified personnel. This problem could be countered by closer cooperation between the various sectors, because better cooperative preventive work on the part of doctors, hospitals and pharmacies, would reduce the number of urgent cases of illness. Relief for specialist staff would be the result.
Patient coordinators to ease the burden within hospitals
A constructive proposal from those responsible is so-called patient coordinators, who take on the tasks of both physicians and nurses within the hospitals. These coordinators regulate the entire processes from admission to discharge. This would ensure adequate care for patients and, by shifting the bureaucratic burden to the coordinators, would relieve the workload on specialist staff.
Pharmacists call for involvement in treatment
Involvement of asthmatics is already established in therapy. In principle, pharmacies are calling for closer cooperation between different medical fields. One example is the Commission for the Involvement of Pharmacists in Diabetic Care. A cooperation of the German Diabetes Society as well as the Federal Chamber of Pharmacists has called for a stronger involvement of pharmacists in the treatment of patients with diabetes. This initiative was particularly due to Prof. Hermann Ammon, MD.The aim was to increase the level of knowledge of pharmacists through certified training programs and evaluations, thus ensuring high-quality advice in the case of diabetes. Similar involvement is already established in the treatment of asthmatics. This is defined in the program for national care guidelines. These have been compiled by those responsible for all areas of medicine and are intended to support those affected as well as physicians and pharmacists in the correct treatment.
Another initiative – The “future concept for pharmaceutical care”
A model project has been established in Saxony and Thuringia to ensure further cooperation between physicians and pharmacies. Various health insurance companies are also involved in the project. A joint drug supply for chronically ill persons or patients who are to take more than five active substances is the goal. This is because the more medications are taken, the greater the risk of medication errors. The project aims to provide patients with the correct active ingredients and quantities. In this way, any communication problems between pharmacists and physicians can be resolved constructively, as software provides those involved with an up-to-date overview of current medication. The concept is based on three pillars:
- Active ingredient prescription
- Medication Catalog
- Medication Management
The advantages of this initiative are especially the avoidance of duplicate medications and a gain in time on the part of doctors. These then have more room to explain to the patient the intake and side effects. So far, a total of around 1,000 pharmacists and physicians have taken part in the project. The recommendations relate to eight diseases, including hypertension, osteoporosis, heart failure, depression and Alzheimer’s dementia. However, the start of the project has been rather slow. In Thuringia, for example, 150 doctors are participating in the initiative, which is only five percent of all doctors in the state. Nevertheless, the numbers have risen steadily over the past year. Experts therefore expect the trend to increase.
Federal Court of Justice accommodates cooperatives
Normally, the allocation of medications is subject to strict rules. Nevertheless, the Federal Court of Justice has increased the scope for cooperation between physicians and pharmacists. Specifically, the ruling involved a Freiburg pharmacist who, as a result of the ruling, is now a partner in a discharge management company. In this way, he receives drug prescriptions from the university hospital shortly before the patient is discharged. This approach increases successful further treatment after hospitalization. However, the prerequisite for this cooperation is that the patient’s situation improves and that the patient agrees. In practice, this ruling could have an impact on the closer cooperation between the individual areas called for at the beginning.
