Access to physician care is already strained in the United States and, unfortunately, it’s only going to get worse. A recent report from the American Association of Medical Colleges estimated that by 2030, the United States will face a shortage of up to 120,000 physicians. Rhode Island is not immune to this problem.
As both primary care providers and health care specialists become increasingly hard to come by, states must provide innovative solutions that give patients seeking health care services the opportunity to see a trained health care provider.
There is one bright light on the horizon: When it comes to birth control access, several states have enacted sensible scope-of-practice reforms that allow pharmacists to prescribe hormonal contraception to patients directly, rather than forcing women to visit a physician to obtain a prescription. Rhode Island is poised to become one of them, as Rep. Vella-Wilkinson, D-Warwick, recently introduced a bill to adopt the pharmacy-access model.
Right now, 52 percent of pregnancies in Rhode Island are unintended, which is higher than the national average of 48 percent. Unintended pregnancies, whether mistimed or completely unwanted, impose high costs on both the mother and the public. For example, the 2010 health care costs for unintended pregnancies in Rhode Island were partially funded by taxpayers to the tune of $72 million. Rhode Islanders directly shouldered $27.5 million of this amount. These costs can largely be alleviated with greater access to birth-control providers, which is what the pharmacy-access model allows.
The antiquated physician-access model presents barriers to women in need of prescriptions. Typically, a doctor’s appointment for birth control costs anywhere between $35 and $250. This is before factoring in incidental costs such as transportation and loss of income due to time taken off work. Replacing this model with a pharmacy-access model can lower the overall cost for women who want a birth control prescription, making them more likely to seek one.
Opponents of pharmacy access are often concerned with the safety of allowing pharmacists to prescribe birth control. Yet a typical doctor’s appointment to obtain birth control consists of only a questionnaire for the patient and a blood pressure test. As medication and health experts, pharmacists are perfectly capable of providing these services to patients. It has also been shown that women are already very good at self-identifying any potential contraindications for a birth control prescription, including high blood pressure, meaning that women are capable of obtaining birth control without direct doctor oversight. In fact, many leading medical associations, such as the American College of Obstetricians and Gynecologists and the American Medical Association, advocate taking birth control access a step further by making it available entirely over-the-counter.
Removing the barrier of a doctor’s visit to obtain a prescription for birth control is catching on in politically diverse states, and for good reason. Implementing the pharmacy-access model would increase the number of providers available to consult with patients, could significantly lower the public health-care burden on state and federal budgets, and would allow pharmacists to practice well within their medication expertise.
Right now, 10 states and the District of Columbia already allow pharmacists to prescribe birth control. Yet in the Northeast, only New Hampshire has passed a pharmacy-access bill. By passing pharmacy access, Rhode Island could help lead the way on adopting innovative health care solutions in the region.