In past times, an independent, community based pharmacist delivering considerate, effective, professional care, would be very busy. Those days are gone and replaced more and more by large community pharmacy corporate conglomerates. This change has ushered more depersonalization of pharmacy, focused mostly on business efficiency and minimal delivery of care. In 1976 the American Pharmacists Association (APhA) established the Board of Pharmaceutical Specialties (BPS) to improve patient care.
Care is defined as the provision of what is necessary for the health, welfare, and protection of someone.
According to the BPS website, “Board Certification through BPS is the gold standard for determining which pharmacists are qualified to contribute at advanced practice levels.”1 A “gold standard” self-labeling raises many issues, and in the absence of validating evidence is a hollow promise. Moreover, just because a pharmacist is capable of practicing at an “advanced level” is no guarantee of improved patient care. Independent of generational gaps, every pharmacist needs to have competency, but is BPS certification the only way to judge ability to practice in a proficient caring manner? My answer is no.
Each pharmacist has the ability to elevate their value to the patient by the care we deliver that responds to our patient’s circumstances, capabilities, and preferences. The quality is more dependent on our ability to deliver care, rather than our ability to answer questions on a challenging examination. I believe that passing a difficult examination tests your ability to answer a series of expected knowledge answers, but does not test our effectiveness to be a quality caring practitioner. Evidenced-based knowledge is important, but will never supplement the ability of an effective practitioner to apply it to the care and understanding to each patient.
The BPS website states that 36,000 pharmacists worldwide hold BPS Certification in one or more of eleven different specialties.1 Currently, there are a total of 4,067,718 licensed or registered pharmacists in 74 countries and territories throughout the world.3 Of those, approximately 70% are actively practicing.3 So, after 42 years, only 1.3% are BPS Certified. Are there really only 1.3% of practitioners who contribute at advanced practice levels? Obviously, no! This is an opportune time to reflect upon and have a professional dialogue about the use of BPS Certification as the “gold standard” for improved patient care. I believe it is time to determine the usefulness of BPS Certification.
There are numerous questions that need to be considered…Has the profession adopted BPS Certification? Do any state statutes and regulations require BPS Certification.? I am not aware of any. Why not? My presumption is that other professions or the law recognize that BPS Certification does not determine a quality caring advanced practice professional.
Do other professions recognize BPS Certification? The answer is not really. Medicine has many certifications where there is great debate about the justification of these certification exams.4 Many pharmacists and physicians
are practicing at an advanced practice level without certification, and providing exceptional patient care. To presume otherwise, would mean that only 36,000 pharmacists are capable of improving patient care, and the remaining 4.03 million are unable to provide such care.
Where is BPS Certification being required? Principally in institutional pharmacy as a means to provide an economic or credentialing justification for their employees to practice. Many of these institutions pay for the employee’s certification, but only if the employee passes the first time.
Perhaps no single strategy for encouraging or assessing pharmacist performance over time is ideal. However, certification alone is not the answer as I have outlined above. Each individual pharmacist like our patients is unique. Aligning knowledge, skills, human behavior, patient needs, and professionalism requires a well thought out series of assessment tools, and a commitment to review the current status and then to act!
Copyright: Mark A. Munger, PharmD, FCCP, FACC, is a professor of pharmacotherapy and adjunct professor of internal medicine, at the University of Utah, where he also serves as the associate dean of Academic Affairs for the College of Pharmacy.
About BPS. https://www.bpsweb.org/about-bps/ Accessed 12/2018
What is Care? https://www.google.com/search?source=hp&ei=XakFXN_YMY-Oggf9yrz4Aw&q=definition+of+care&btnK=Google+Search&oq=definition+of+care&gs_l=psy-ab.3..0l10.4067778.4071022..4073526…4.0..0.167.1958.9j10……0….1..gws-wiz…..6..35i39j0i131.KZHpDXme23Y Accessed 12/2018