Approaching the millennium: The report the AACP Janus Commission

The Janus Commission was established by 1995-96 AACP President Mary-Anne Koda-Kimble to scan the health care environment and to identify, analyze, and predict those changes within the environment likely to profoundly influence pharmacy practice, pharmaceutical education, and research; and to alert the academy to both threats and opportunities that such environmental changes present. Throughout its deliberations, the Commission was drawn repeatedly to the pervasive influence of a changing, more intensively integrated and managed health care system on both pharmaceutical education and pharmacy practice. This fundamental change in health care has been the primary influence in the Commission's thinking and recommendations. The Commission believes that a revised model for pharmaceutical education is needed to meet the challenges presented by the changing health care system. In particular, schools and colleges of pharmacy must become true "activists" in health care policy, services delivery, and research in order to effectively achieve their missions in professional education. Employing the analogy of the pharmaceutical industry, the Commission suggests the following fundamental areas of emphasis for schools and colleges: • the need for enhanced research and development activities related to the provision of, compensation for, and outcomes of pharmaceutical care; • sustained curricular reform efforts that assure successful "manufacturing" of competent and caring pharmaceutical care providers; • aggressive "marketing" programs, working in collaboration with the profession of pharmacy, that promote the delivery of pharmaceutical care and foster enhanced practice/education partnerships; and • enhanced interaction with the "product" of professional education programs, the pharmacist, to assure that graduates can and will continue to provide effective clinical, humanistic, and economic outcomes in the course of their professional careers. Finally drawing upon the previous works of the Pew Health Professions Commission and the AACP Commission to Implement Change in Pharmaceutical Education, the Janus Commission believes that fundamental actions must be taken immediately within the academy to assure the future success of our professional programs and graduates within the evolving health care system. Among these are: • completion of the evolution of the "values system" of pharmaceutical education toward producing graduates who are patient-centered providers of pharmaceutical care; • active involvement by administrators and faculty of colleges and schools of pharmacy in health care system decision-making, policy determinations, and research activities; and • creation by colleges and schools of action-oriented business plans that result in effective partnerships with practice organizations and health care delivery systems. The Commission encourages a thorough and critical reading of its report and looks forward to a very healthy, lively, and productive dialogue within the academy over the next several months.