Pharmacists in the Laboratory Space: Friends or Foes?

As they have been in the past, pharmacists are ranked among the most trusted professionals, according to the results of an annual Gallup poll. These trusted healthcare professionals are easily accessible to most Americans, with nearly 60 000 community pharmacies in the US. Approximately 18% of these pharmacies have CLIA-waived status and can perform any of the approximately 120 CLIA-waived tests. In addition, many pharmacists are now helping patients make drug dosage decisions in specialized Coumadin and diabetes clinics, among others. With healthcare dollars and physician time stretching thin, the easy access to pharmacists is an attractive way for many patients to receive medical care. But what does this mean for the clinical laboratory community? Do pharmacists receive the proper training to perform and interpret laboratory tests, and how do we ensure the quality of testing? Here we talk to 4 experts, 2 pharmacists and 2 laboratorians, to discuss this rapidly changing space. Additionally, a list of suggested reading materials is provided in a Supplemental file that accompanies the online version of this article at http://www.clinchem.org/content/vol62/issue5. What kinds of testing are pharmacists now involved with? Are they all CLIA waived or do they also order non–CLIA-waived tests? Alex Adams: In a recent study, more than 10 800 pharmacies in the US were reported to hold a CLIA waiver. Thus, pharmacies are currently the fourth leading CLIA-waived facility in the country. Of these pharmacies, 99.85% held only a CLIA waiver, and thus very few pharmacies are currently providing non–CLIA-waived tests. Interestingly, the number of CLIA waivers varies by pharmacy format. More than 43% of supermarkets with pharmacies hold a CLIA waiver; by contrast, only 24% of traditional chain pharmacies, 5% of independent pharmacies, and 4% of mass merchant pharmacies hold a CLIA waiver. Recent publications have documented the growth of …