When Reyna or Justin Ansley or one of their three children is sick and needs to be tested for strep throat or the flu, there’s a good chance they will go to their local pharmacy in Hemingford, Nebraska or Alliance. Dave Randolph, owner of two Dave’s Pharmacy locations, can do a quick test, give them medication when they need it, and get them on the road.

“I’m a rancher,” said Reyna Ansley, whose family lives about 15 miles outside Hemingford. “You don’t necessarily have time to drive to the doctor and sit in the waiting room. It’s really faster to go through Dave.”

The Ansley family has no health insurance and charges $50 to $60 at a pharmacy that uses Randolph for tests, which is cheaper than paying up to $200 for a visit to a local doctor, Ansley said. If the test comes back positive, the drug usually costs $20 to $30.

Randolph’s ability to provide treatment for influenza and strep throat is somewhat unusual. He can do so in Nebraska because he has an annual cooperative practice agreement with local doctors, which is subject to state approval.

The easy availability of pharmacists also helps propel them to a critical role during the pandemic, as they become the go-to resource for COVID-19 testing and vaccines. However, even before COVID swept the nation, many states were giving pharmacists a bigger role in consumer health.

More than a dozen states have expanded the work of pharmacists to include testing and treating people for conditions like strep throat, the flu and urinary tract infections, and HIV prevention, according to the National Coalition of National Pharmacy Societies. Some states allow pharmacists to prescribe oral contraceptives or drugs to help people quit smoking. Typically, pharmacists have prescribing rights under an agreement with a doctor, or a rule called a statewide agreement.

But a handful of states have gone further, allowing pharmacists to prescribe self-medication to treat a wide range of ailments, with rapid point-of-care testing if appropriate according to clinical guidelines.

“We are now seeing more and more states focus on direct prescribing rights rather than cooperative practice agreements,” said Allie Josh Shipman, National Policy Director of the National Coalition of National Pharmacy Societies. The alliance provides point-of-care testing and point-of-care training programs for pharmacists and pharmacy students.

The Biden administration, which has relied on pharmacies to help fight the COVID-19 pandemic by administering vaccines and testing, is now calling for a limited number of pharmacies to have retail clinics, hire doctors or other health care workers who have the authority to deliver medicines directly to people who have tested positive for the virus. people.This “Test to Treatment” Program The aim is to ensure that COVID patients get a quick course of antiviral medication, as it is most effective if used within five days of someone developing symptoms.

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Pharmacists say their expanded efforts on COVID have helped boost their visibility.

“One of the big things that’s happened with COVID is that consumers understand that pharmacies do provide these great, convenient services and support their health,” said B. Douglas Hoey, CEO of the National Association of Community Pharmacists, which represents independent pharmacists teacher’s interests.

But doctors don’t necessarily welcome this development. Physician groups have long opposed pharmacists, nurse practitioners, physician assistants and other non-physicians taking on certain types of patient care unless it is supervised or approved by a physician.

In November, the American Medical Association, which represents physicians, announced that since 2019, successfully opposed More than 100 legislative actions will expand non-physician practice, known as scope creep.The group also issue a statement Criticized the Biden administration’s plan to allow pharmacy clinics to prescribe COVID antiviral drugs, saying it poses a threat to patient safety and has the potential to negatively impact health. and AMA against failure Federal decision to let pharmacists give COVID vaccines to children under 18.

Meanwhile, the American College of Physicians, which represents physicians, declare it “Against independent pharmacist prescribing privileges and initiation of drug therapy outside of collective practice agreements, physician routine or supervision, or similar arrangements.”

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The AMA did not answer questions about independent pharmacist prescribing, and the ACP declined to comment on its policy.

But if physicians are not involved in prescribing decisions, are physicians rightly assuming that patient safety is at risk? Pharmacists say they want to provide care based on their training and skills, and they know their limits. They point out that timely prescribing of medication is critical for treating COVID and other infectious diseases.

They also noted that pharmacists are increasingly part of multidisciplinary clinical teams directing patient care in hospitals and healthcare systems.

“Pharmacists are the most trained professionals to deal with drug interactions,” says rita jew, a pharmacist, is president of the Institute for Safe Medication Practice, a nonprofit focused on preventing medication errors. “We monitor patients for efficacy and side effects. So from that perspective, it’s not a safety issue. Delaying treatment is an issue.”

Many pharmacists are eager to expand their menu of patient services, but payment remains an issue. Pharmacists are generally not considered service providers under Medicare and typically do not receive payment when they spend time evaluating, testing, or treating patients. Many private insurers have followed Medicare’s lead in paying.

For many people, pharmacies are both convenient and familiar. More than 90 percent of people in the United States live within 5 miles of a community pharmacy, and Medicare beneficiaries visit the pharmacy nearly twice as often as their primary care physician.

Dr. Jeffrey Singergeneral surgeon and senior fellow at the Liberal Cato Institute, recently wrote a blog post This suggests that physicians opposed to over-the-counter prescribing may be more concerned about competition than patient safety.