As the United States moves toward value-based payment models, it is becoming more important for pharmacists to claim their role on the patient-centered health team. One of the best ways to accomplish this is by collaborating with your local physicians.

There are an abundance of skills and services that a pharmacist can provide to a prescriber that will save time, increase a patient's quality of care and generate revenue. The initial step to accomplishing this is to meet with your target doctor and present your value proposition.

Unfortunately, there are many barriers to this simple-sounding concept.

One of the biggest barriers that will need to be overcome is earning the physician's trust. Ideally, the prescriber you are targeting is one who is close by, shares many of your same patients and is already aware of who you are.

Even then, if you are pursuing a model where you work out of the doctor's office, you will become a reflection of that practice and you will be putting the physician's name and reputation on everything you touch. This is a major responsibility. I would not expect to be doing pharmacogenetic consults on day one.

It is a far more feasible pathway to offer something simple like handling the prior authorizations that come in or checking insurance formularies. Once you establish your value, you can identify more opportunities within the practice that would benefit from your expertise.

The caveat to building trust is that you have to be competent and up to date. You need to make sound recommendations for the physician to want to keep you around and increase your workload.

Another obstacle you may encounter is that the physician may not understand what you as a pharmacist can accomplish. Unfortunately, we are still seen by many as individuals who just count by five and operate a drive-through window.

Pharmacy practice acts will vary from state to state, but you could counsel on smoking cessation, screen for needed immunizations or train patients to use the newest injectable or inhaler device on the market. These types of tasks are all vital to the care of the patient, but they cut into the limited number of minutes a prescriber has for each appointment.

By highlighting to the provider some of the minutiae that you can take off their plate, you can prove your value and open the door to further and more in-depth collaboration.

If you are new to the area or targeting an unfamiliar practitioner, you will deal with a gatekeeper. You likely have technicians in this role who shield you from sales calls or the overly chatty patient, and physicians have the same.

The easiest way to work with the gatekeeper when cold-calling is to ask, "What is the protocol for meeting with the doctor?" This shows respect for the physician's time and is an easy question that this individual probably gets multiple times a day from drug reps.

From there, just follow the given steps, which is oftentimes providing a lunch for the practice. If necessary, you may be able to negotiate a more budget-friendly alternative like a breakfast or a one-on-one lunch offsite with the doctor.

Pharmacy practice based out of a physician's office is a relatively new concept, but it is one that is full of untapped potential and nearly unlimited growth. As doctors feel the pressure of pay-for-performance healthcare, the time is now for pharmacists to step forward and provide value.

It can be a tough road at first, and doctors you approach will tell you no. But it is imperative that you press on and overcome adversity to find the right partnership.

What obstacles have you encountered, and how did you get around them?