Dramatic need for cooperation and advocacy within the academy and beyond.

There is no question of the need for advocacy within pharmacy and the health professions. Collective voices need to be heard, and those for whom pharmacists provide care and services need others to advocate for them simply because they have no voice in many discussions. Currently in pharmacy and the wider health professions, there are many points of contention and debate. This is not a new phenomenon; it has existed for decades. In 2010, the American Pharmacists Association and the American Society of Health-System Pharmacists (1) collaborated on a discussion paper that suggests that the rapid expansion of pharmacy schools' satellite campuses and the increasing class sizes enrolled in pharmacy colleges and schools needs to be thoughtfully reconsidered. Voices within the academy have also called for careful consideration of expansion plans for programs. These arguments are juxtaposed with suggestions that there are too many health care institutions or affiliated clinics in North America, some of which are an easy stroll across the street from one another. Some believe there are too many pharmacy organizations as well, all of which were under one umbrella before being split up decades ago. The point of this editorial is not to take sides in the debate over supply of health professionals and services or to criticize any entity, but rather to lament the lack of cohesion among all affinity groups in advocating for one special interest above all else: the graduates of pharmacy education programs. Regardless of vested interests, all pharmacy educators should hold the practice options available to graduates and future graduates in the highest importance of all that we represent, advocate for, or suggest allegiance to. Other Professions Filling the Expanding Need for Physician Extender Services Nurse practitioners (NP) and physician assistants (PA) have worked hard to take advantage of the tenets behind much of the Patient Protection and Affordable Care Act passed in 2010. Despite political posturing, many provisions of this health reform legislation have been implemented and experts believe that many of the preventive health services components put in play by this legislation will not be reversed in the future regardless of the fate of the overall Act. In mid-December 2011, the components dealing with payment and service provision for preventive obesity counseling and services imbedded in the legislation began to be operationalized for enrollees of Medicare. Physician extenders will provide many of these and other types of future needed services. Our previous research (2,3) found that consumers are willing to use physician extenders (eg, NPs) when seeking care for acute conditions requiring medical care services. Many if not all of these retail clinic-based physician extenders are located within pharmacies. There are numerous opportunities for professional collaboration between pharmacists and other physician extenders (NPs and PAs). The health professions striving to avail the opportunities presented by disruptive innovations such as retail clinic and the increasing demand for primary health care services do not need to do so at the expense of each other. There are tremendous opportunities for outreach and collaborative efforts, many in place already, that need expansion for the benefit of all--most importantly the patients served. These professions (NPs, PAs) have achieved tremendous success by working within and across their specific professional associations, practitioner groups, and health professional schools, and with colleagues to advocate for the benefits of PA- and NP-provided health care services. This has not been achieved without tremendous organizational and collaborative synergy uniting segments within these professions that may not always agree with all aspects of what disparate affinity groups might advocate for. These processes have been documented extensively in the literature, and most certainly provide blueprints for the pharmacy profession's future advocacy and cooperation with physician extender groups and physicians. …