RxEconsult: What is Medication Therapy Management (MTM) and how did it begin?
Dr. Schuh: In my mind, it is utilizing pharmacist cognitive skills and training to perform medical services vital to the health and welfare of the patient. Without a history lesson, it began with the Medicare Part D Act of 2003 and started for our department at Mayo shortly thereafter.
RxEconsult: Several years ago pharmaceutical care was the buzz phrase. What is the difference between pharmaceutical care and MTM?
Dr. Schuh: I see it as a more refined and advanced version of the same thing. MTM is broader and has the ability to cut the umbilical cord of product.
RxEconsult: What is the impact or significance of MTM to the pharmacy profession and patients?
Dr. Schuh: We have a major opportunity that may come along maybe once in a professional lifetime to really change the profession while playing a major role in improving the medical outcomes of our patients. I am a true believer in this.
RxEconsult: How far along are we in the MTM journey and what are some of the major hurdles that need to be addressed before MTM is widely adopted?
Dr. Schuh: Though MTM has been around for awhile, it is still in its infancy. The primary hurdle is pharmacist mindset. Pharmacists have been product and employee minded for most of the history of the profession. We must become more business and patient service minded. Some would say it is reimbursement for MTM. Though important, it is not a deal breaker like most naysayers in the profession believe, and there are many of them. If one produces what patients want, they will pay for it. Too many use payment as an excuse for inaction. If we always wait for others to act for us, we will be waiting a long time. I’ve already been waiting 30 years. I like to use our dentist colleagues as a practice analogy. Many do not have great dental insurance but will pay for whitening, braces, and other vanity services. We just have to create value in the patient’s mind that our services are worth paying for while simultaneously working on 3rd party payers to get equitable payment for services rendered.
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