The pharmacist as physician extender in family medicine office practice

J Am Pharm Assoc (2003). Jan-Feb 2006;46(1):77-83. doi: 10.1331/154434506775268599.


Objective: To describe the role of the pharmacist as a salaried physician extender in a private practice diabetes management clinic.

Setting: Columbus, Ohio.

Practice description: Private suburban family medicine office practice.

Practice innovation: Clinical pharmacy physician-extender practice in a private medical office and direct compensation to pharmacist.

Interventions: Not applicable.

Main outcome measure: Financial reimbursement for providing pharmaceutical care; improvement in disease outcomes; pharmacist and student pharmacist satisfaction.

Results: Family medicine physicians hired a pharmacist to extend their diabetes care for complex metabolic syndrome patients and other patients with diabetes who had therapy management problems. The pharmacist, working with student pharmacists, develops treatment plans for drug therapy, nutrition, exercise, and foot care that are reviewed and approved by the managing physician and implemented by the pharmacist and other office staff. More than 260 patients have been referred and managed by the practice with favorable results. The pharmacist is reimbursed as an employee and the practice receives revenue for the pharmacist's practice.

Conclusion: Working in a private physician office practice provides a unique means of providing pharmaceutical care with reimbursement for the pharmacist.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Diabetes Mellitus, Type 2 / therapy*
  • Disease Management
  • Education, Pharmacy
  • Ethnic Groups
  • Family Practice*
  • Female
  • Humans
  • Male
  • Metabolic Syndrome / therapy*
  • Middle Aged
  • Pharmaceutical Services / economics
  • Pharmaceutical Services / organization & administration*
  • Pharmacists / statistics & numerical data*
  • Physicians' Offices / organization & administration
  • Reimbursement Mechanisms / economics