With over 200 pharmacies closing across Ohio in 2024, many rural communities are becoming “pharmacy deserts,” leaving residents without access to essential medications and care. At the forefront of this crisis is Emily Eddy, a pharmacy professor at Ohio Northern University and a newly appointed fellow with the National Rural Health Association. From her base in rural Hardin County, she is not only training the next generation of healthcare professionals but also advocating for a fundamental shift in how we value and sustain community pharmacies. We discussed her innovative student programs designed to meet local health needs, her vision for expanding the role of pharmacists in primary care, and the systemic changes required to ensure these vital health hubs can survive and thrive.
Your Rural and Underserserved Scholars program trains students to assess community needs and design health projects. Can you share an example of a specific student-led project, detailing the need they identified and the steps they took to create and measure their intervention?
We really empower our pharmacy and nursing students to become health detectives in their own communities. For instance, a student might notice through local data and conversations at a senior center that many older residents with diabetes are struggling with their medication schedules. That’s the need. From there, they design a project, perhaps a series of “brown bag” events where seniors bring in all their medications. The student then provides one-on-one counseling, creates simplified medication charts, and a few months later, they follow up to see if it worked. They measure effectiveness by tracking things like reported missed doses or even looking at anonymized blood sugar logs, giving them real-world research experience that proves their intervention made a tangible difference.
You envision an expanded role for pharmacists in primary care to help manage chronic conditions like diabetes. What are the practical, step-by-step changes a clinic would need to make to successfully integrate a pharmacist into their patient care team and daily workflow?
The potential here is immense, especially with the primary care shortages we’re facing. The first step for a clinic would be to physically carve out a space for the pharmacist to conduct private patient consultations. Next, they would need to integrate the pharmacist into the electronic health record system so they can document interventions and communicate seamlessly with the physicians. The most critical piece is developing a clear workflow: when a doctor diagnoses a patient with diabetes, there’s an automatic referral to the pharmacist for medication management. The pharmacist then takes the lead on patient education, follow-up calls, and adjusting therapies in collaboration with the doctor, freeing up physicians and providing patients with an expert dedicated to their medication success.
To combat the rural ‘brain drain,’ it’s vital to train students in environments similar to where they are needed. Besides recruiting from rural areas, what specific training methods or partnerships have proven most effective in convincing graduates to build their careers in underserved Ohio communities?
It’s absolutely crucial. You can’t train a student in a large, urban medical center and then expect them to feel prepared for the realities of a small-town practice. At Ohio Northern, we are fortunate to attract students who already have rural roots. To keep that talent local, we build strong partnerships with independent community pharmacies and rural health clinics for their clinical rotations. This immerses them in the day-to-day operations and lets them build relationships with patients and mentors. We ensure their training includes the unique challenges of rural healthcare, so when they graduate, the idea of practicing in a place that looks and feels like where they trained isn’t just a possibility, it’s a natural and appealing next step.
With over 200 Ohio pharmacies closing in 2024, many due to financial pressures, what would a better reimbursement model look like? How would valuing services like patient counseling, not just dispensing pills, concretely change the daily operations and sustainability of a small community pharmacy?
This issue hits close to home; our own small town of Ada lost its chain pharmacy, putting immense pressure on our one remaining community pharmacy. The current system is broken because it’s a volume game—a pharmacy only gets paid when a pill goes into a bottle. A better model would recognize pharmacists as the providers they are. This means creating a system where a pharmacist can bill for their time and expertise, just like a doctor. Imagine a pharmacist being able to schedule and get reimbursed for a 30-minute consultation to help a patient get their diabetes under control. It would fundamentally change their daily work from a frantic race to fill prescriptions to a sustainable practice focused on quality patient care, making the pharmacy a financially viable and indispensable health hub.
What is your forecast for the future of community pharmacies in rural Ohio over the next five years?
If we continue on the current path, my forecast is grim. We will see more closures, and the pharmacy deserts that plague our state will expand, leaving our most vulnerable residents isolated from care. However, I am also hopeful. There is a growing recognition of this crisis, and we have an incredible, untapped resource in our highly trained pharmacists who are ready and waiting for the opportunity to step in. If we can successfully advocate for sustainable payment models that value their clinical services, the forecast changes dramatically. In five years, rural pharmacies could be transformed into vital primary care access points, not just surviving, but thriving as they provide the essential, hands-on care that our communities so desperately need.
