See open letter to BPS Board below.
May 24, 2012
Susan Goodin, PharmD, BCOP
Chair, Board of Directors
Board of Pharmacy Specialties
Assistant Director for Clinical Science and Professor of Medicine, Medical Oncology
UMDNJ-Robert Wood Johnson Medical School
Dear Dr. Goodin:
I am writing you on behalf of the Practice Analysis Task Force for Pain and Palliative Care convened in April of 2011. While we are discouraged with the BPS Board of Directors’ decision to omit Pain and Palliative Care from the call for petitions issued this week, we respect the Board’s decision based on the information available at the time of review.
Given the Board of Pharmacy Specialties mission statement which includes “…improving patient care through the recognition and promotion of specialized training, knowledge, and skills…” we strongly disagree with the Board’s decision that Pain and Palliative Care does not, in fact, represent a unique and discreet model of practice for pharmacists in direct patient care settings. We believe that BPS’s decision, as our profession’s recognized credentialing body, to exclude this submitted specialty from the call for petitions sends a powerful and negative message to our colleagues in other professions about the values and priorities of pharmacists with respect to this growing public health problem. Pain alone surpasses cancer, cardiovascular disease, and diabetes in prevalence and impact on the US healthcare system. Add the growing problem of prescription analgesic misuse, diversion, and overdose-related deaths and the role of specialized pharmacotherapy practitioners becomes even more clear.
With respect to palliative care, the recent Joint Commission Advanced Certification for Palliative Care requires “…a formal, organized palliative care program led by an interdisciplinary team whose members are experts in palliative care.” While pharmacists are frequently members of these interdisciplinary teams, we are currently the only profession outlined as key members that do not have a profession-specific credentialing opportunity in this subspecialty.
We applaud the ambitious course BPS has taken with consideration of new areas of specialty for pharmacists and anticipate that other groups may come to this unfortunate crossroads following practice analysis and role delineation work. We believe that given the amount of time, effort, and resources that have been expended by both your administration, as well as our Task Force, a transparent reporting of the deliberations of the Board and shortcomings of the data leading to its decision will not only help our ongoing efforts for recognition, but additionally assist other groups which either seek specialty recognition and fail or prevent the investment of time and resources prior to undertaking such an endeavor. We submit that this reporting should include, but not be limited to, specific break points in terms of survey response rates, reported time spent on individual identified specialized tasks, and other data points considered from the validation survey that were used to base the call for petition decisions. Additionally, if PGY2 residency availability is a key driving force in the decision making process, we believe that a target number for this metric should also be provided and relative growth versus absolute number be considered. A clear statement on future viability and next steps for groups such as ours is also crucial should the profession of pharmacy continue to grow and develop. Unanswered questions specifically of concern are the longevity of the survey results and the possibility or process of Board reconsideration in future deliberations should key shortcomings identified change or be answered.
We realize that this decision was undoubtedly not easily reached and we appreciate the Board’s time and consideration, as well as the countless hours Mr. Ellis devoted to the process. We hope that as BPS continues to streamline its review process that these recommendations from our Task Force may be of assistance to future groups.
Chris M. Herndon
CC: ACCP, APhA, ASHP, APS, AAHPM, NHPCO
The following Practice Analysis Task Force for Pain and Palliative Care members have reviewed and endorsed this open letter:
Mary Lynn McPherson