Successes and challenges of Clinical Pharmacist Practitioners in North Carolina

Objectives: To determine the successes and challenges of practicing Clinical Pharmacist Practitioners (CPPs), and the reasons why others have discontinued practice entirely.

Methods: A listing of current and inactive CPPs was obtained from the North Carolina Boards of Medicine and Pharmacy, which served as the study participants.  A survey was sent electronically to 84 active and 32 inactive CPPs to determine qualifications, experience, practice characteristics, and demographic information.

Results: Survey responses were collected from 54 active and 22 inactive CPPs.  Regarding perceived successes of the active practitioners, 48% (N=26) enjoyed an expanded scope of practice, and 41% (N=22) experienced improved patient care outcomes.  Other successes included creating a model of practice for learners, improved efficiency of health care services, and increased career opportunities.  Of their challenges, 56% (N=30) stated billing for services, with 37% (N=20) noting reimbursement through third parties. Other challenges were acceptance by other health care providers, work overload, and documentation/paperwork.  With inactive CPPs, 55% (N=12) indicated they discontinued their licensure because their current position did not require it.  Fourteen percent (N=3) noted discontinuance because of insurmountable challenges that made it difficult to continue working as a CPP.  Of their successes, 68% (N=15) experienced improved patient care outcomes, and 50% (N=11) said their licensure created a practice model for learners.  Other successes were expanded scope of practice, increased career opportunities, and improved efficiency of health care services.  Billing and reimbursement were the top challenges experienced by inactive CPPs, followed by acceptance by other health care providers, documentation/paperwork, and work overload.

Conclusion: Although CPPs enjoy an expanded scope of practice with improved patient care outcomes and the creation of a model of practice for learners, the ability to bill for services and reimbursement by third party insurers are the most prevalent challenges.