Integrating primary care and specialty pharmacy practice to improve ambulatory patient care services

This article describes the evolution of clinical pharmacy services in an outpatient setting over a 20-year period. An historical overview of the initiation of services, the state of current practices, and the development of a new clinical service--the medication management service (MMS)--to provide care for general medical patients is presented. Four case studies of recent patients managed by the MMS are given to illustrate the interrelationship between this service and the pharmacist-managed specialty clinics.