2013 Rho Chi Lecture: writing the headlines of tomorrow.

Headlines are a reflection of society, what people value or find interesting. They indicate sensational events as well as trends that affect important aspects of peoples' lives. While headlines originated in the print mass media, they remain important in our wired and digital world. When headlines are about pharmacy, they provide a mirror to how we are perceived by society. Whether headlines are good or bad, they influence the course of our profession. Recently the negative headlines about pharmacy unfortunately outnumbered the positive, mostly referring to the New England Compounding Center tragedy, and that is something the profession will need to work through to reestablish credibility and trust that was lost. We have seen many positive headlines that reflect how pharmacy is changing and moving to a patient-centered rather than product-centered profession. On August 14, 2010, a headline on the front page of the New York Times (1) read "Pharmacists do more than count pills." The story begins: "Eloise Gelinas depends on a personal health coach. At Barney's Pharmacy, her local drugstore in Augusta, Ga., the pharmacist outlines all her medications, teaching her what times of day to take the drugs that will help control her diabetes." This is a lengthy story about Barney's Pharmacy and the pharmacists who work there. They provide a wide range of wellness and clinical services in addition to traditional prescription services. Such a story in a prominent news source is a significant positive impact. In the December 15, 2012, edition of the New York Times, (3) on the editorial page, the headline read "When the doctor is not needed" and it goes on to describe the potential for pharmacists (and other health professionals) to fill the big gap in primary care. It talks about how pharmacists are underutilized given their education, training, and closeness to the community. Last week, on National Public Radio a nationally broadcast story was headlined "Why The Hospital Wants the Pharmacist to Be Your Coach." It talked about how hospitals are partnering with community pharmacies to help keep patients out of the hospital by managing their medications. What will the headlines be 20 years from now? That will be in an era determined by your generation, not mine. I can imagine the good headlines: "Pharmacists clinical services become a standard in health care" or "Retirees demand medication therapy management by pharmacists" or "Pharmacists play major role in designing drug treatment regimens using genomics." And even the possible negative headlines, such as "Importation and automation lead to demise of the pharmacy profession." I am and remain very optimistic about our future as pharmacists and the roles that we will play in health care. Medications are much more commonly used, particularly for chronic diseases, and make up a greater portion of the national health care expense compared with 10 years ago. Medications are increasing as a portion of the national health care budget, the number of prescriptions will significantly increase, as will expenditures on prescription drugs. When I think about the huge changes that the profession has gone through from the time I graduated in the late 1970s until now, I am confident that we will continue to progress as a profession. There is so much that we know now about our profession that was not evident a decade ago. Years ago we talked about how much we needed the evidence for the effectiveness of pharmacists in health care. The evidence is in and has been published in well-respected journals. Studies by Cab Bond showed that clinical pharmacists working in hospitals are associated with lower mortality rates. (4) Pharmacists effectively manage patients with diabetes, as demonstrated in the Asheville Project, (5) and manage hypertension (6) and many other diseases and conditions. Pharmacists activities result in a significant savings in health care costs (approximately $5 for each dollar spent on clinical pharmacy services). …