To answer that question, it would be best to focus on the different types of models that could potentially be out there. If we're talking about a hospital-only setting, then the physician-pharmacist relationship would be much different from what it would be in an at-home setting for patients. It would be a much different type of relationship.
Pharmacists don't want to be involved in that determination of eligibility or competency, but certainly if a directive was given that involved the pharmacist's procurement of the medication, the directive would have to be clear in satisfying the eligibility and competency of the patient. That directive could not be misunderstood or misinterpreted, so that the pharmacist would be fully aware that the criteria or guidelines had been fully satisfied before an actual procurement or dispensing of medications could take place.
That would involve a lot of collaboration between the pharmacist and the physician, or maybe more than one physician, or maybe the medical team that would give the directive. In today's environment, pharmacists and physicians are collaborating on a whole range of therapeutics and options and treatment modalities for patients. Physician-pharmacist collaboration is not a new experience for our profession.