SCOTT CITY, Kan. — The busiest part of Main Street Pharmacy on a Tuesday morning isn’t the counter. It is a small room in the back with a blood pressure cuff, a scale and two chairs, where pharmacist Dana Kerrigan sees patients by appointment.
The nearest full-time primary care clinic is about an hour away. For many of her patients, Kerrigan is now the health professional they see most often.
Under a state law that took effect two years ago, pharmacists in Kansas who complete extra training can work under agreements with physicians to adjust doses of some long-term medicines, such as those for diabetes and high blood pressure, and order basic lab tests. Kerrigan works with a family doctor in Garden City who reviews her notes each week.
What changes, and what doesn’t
Kerrigan is careful about the limits. She does not diagnose new conditions. When a patient’s numbers look wrong or a symptom worries her, she sends them to a doctor, sometimes the same day.
«I’m not replacing anyone,» she said. «I’m the person who notices.»
The payment problem
The arrangement works partly on goodwill. Most insurers do not pay pharmacists for this kind of visit. Kerrigan charges $25 for a visit, and her pharmacy covers the rest. A bill in the state legislature would require Medicaid to pay for some pharmacist visits.
A state-funded evaluation of the program is due next year. Early numbers from the health department show that patients enrolled in it have had fewer missed refills. Whether their health outcomes improve is still unknown.