Pharmacists Stand Ready to Relieve Pressure on South Carolina’s Healthcare System

In South Carolina, where patients often drive far and wait weeks to see a doctor, the answer to faster, cheaper care may be standing behind the pharmacy counter.  

The United Health Foundation found that, in 2023, 31.8% of people in South Carolina live in rural areas, which is higher than the national average of 20.4%. Those rural South Carolinians face unique barriers when it comes to healthcare; a study completed in 2018 by the Pew Research Center found that rural Americans live 10.5 miles from a hospital while urban residents travel only 4.4 miles on average. But distance isn’t the only problem – healthcare practitioner supply is another. Within both urban and rural areas, patients suffer from long wait times, waiting on average 20 days to receive an appointment with a physician, even though the ideal standard wait time is  14 days.  

A comprehensive solution to the healthcare shortage does not just mean adding more doctors; it involves tapping into the qualified healthcare professionals who already serve patients every day.  

Enter South Carolina’s pharmacists. 

S.378 (filed by Senator Tom Davis, R-Beaufort) would allow pharmacists, who already may administer tests for common illnesses (think flu, strep, and COVID tests), to actually prescribe the medications needed for treatment of those sicknesses. Though the concept is more complicated than the popular phrase may indicate, the practice is essentially “test and treat.” 

Why Should Pharmacists Be Considered?  

Patients who live in low-income areas and lack access to physicians or urgent care facilities will often go to emergency departments rather than regularly visiting primary care for checkups, even though emergency rooms are far more expensive. The National Association of Community Health Centers estimates that one in three emergency room visits could be addressed in facilities outside of hospitals, resulting in annual savings exceeding $18 billion. Compared to rural residents that must travel 10.5 miles to emergency departments, 89% of Americans live within 5 miles of a pharmacy. 

This is where South Carolina’s 5,000 pharmacists can step in to help both rural and urban communities in South Carolina receive quality treatment for minor illnesses at a fraction of the waiting time. Pharmacies offer same-day appointments and weekend hours, providing patients who cannot visit physicians during the workweek with greater and more flexible access to care. Primary care physicians generally do not operate on weekends, which limits patients only to appointments during the week or long wait times at urgent care facilities. It is also important to consider that pharmacies are less expensive for one-off services like “test and treat” than primary care physicians, emergency rooms, and urgent care facilities. 

Legislative Efforts to Expand Healthcare Access in South Carolina 

Recognizing these challenges, South Carolina legislators have introduced measures to expand healthcare access beyond traditional doctor visits. S.378 attempts to better define the scope of practice for pharmacists. If this bill is enacted, then, by law, pharmacists would be authorized to prescribe select drugs. S.378 proposes three distinct changes:  

1. Defining a Pharmacist’s Scope of Practice: A pharmacist must determine if an action falls within their scope of care through determining if it does not violate state or federal laws, aligns with their education, and meets the accepted standard of care expected from a similarly qualified professional.  
2. New Prescribing Powers for Pharmacists: The definition of “practice of pharmacy” would be expanded to include prescribing drugs, as long as they: 
   • do not require a new diagnosis (pharmacists can begin, continue, or adjust a prescription after a diagnosis has been made by a qualified healthcare professional); 
   • are minor and generally self-limiting (conditions that are not complicated and will improve quickly after the appropriate care, such as a sinus infection); 
   • have a test that is used to guide diagnosis or clinical decision-making (a laboratory test must be completed before medications may be prescribed) and are waived under the federal Clinical Laboratory Improvement Amendments of 1988 (this amendment ensured that patients receive fast and accurate results); or 
   • in the professional judgment of the pharmacist, are patient emergencies (pharmacists may authorize medication, such as an EPIPEN, when a patient’s condition is urgent and any delay in treatment could result in declining health) 
3. Expanding the Definition of Unprofessional Conduct: The actions that are considered unprofessional by pharmacists are broadened to include acts that do not meet the level of care expected from other qualified professionals in comparable settings. This is a safeguard for patients seeing pharmacists under their expanded scope of practice. 

Are Pharmacists Prepared to Prescribe Drugs to Patients?  

Though the training of pharmacists differs from physicians, pharmacists have extensive knowledge of pharmacology. In addition to receiving a bachelor’s degree, pharmacists must possess a Doctor of Pharmacy. Pharmacists are already allowed to test for less complex illnesses, such as COVID or the flu, but if a test comes back positive, they are unable to prescribe patients with medication based on the results. Patients must go to an additional appointment with a physician to receive a prescription. This unnecessary step wastes a patient’s valuable time and money, and it would be far easier for a patient to be prescribed within the same appointment.   

Some critics of this proposal are concerned that pharmacists do not have the correct education to diagnose and prescribe medications to patients. However, the bill before the legislature would not allow pharmacists to test for illnesses beyond what they have already been allowed. Additionally, this bill would provide pharmacists with very limited prescribing ability, specifically “minor” and “self-limiting” drugs. A pharmacist’s training in administering tests and knowledge of medications equips them with the expertise needed to help patients treat common illnesses, particularly the ones for which they directly test. 

A National Trend 

Allowing pharmacists to prescribe medications for patients has become a reality in many states. According to the National Community Pharmacists Association (NCPA), in 34 states, pharmacists are able to prescribe drugs without approval from a physician. Among these states, in 2024, Tennessee passed Public Chapter 824, which allows pharmacists to prescribe the following:  

• Antivirals for influenza and COVID-19 (with a positive Clinical Laboratory Improvement Amendments-waived test)  
• All immunizations for adults (18+) and select immunizations for minors (ages 3–17)  
• HIV post-exposure prophylaxis (PEP), including lab ordering (a treatment for individuals who were recently exposed to HIV) 
• Epinephrine auto-injectors (also known as EPIPEN) 
• Naloxone (reverses opioid overdose) 
• Progesterone-only hormonal contraceptives  
• Topical fluoride products (when the fluoride in water is below Health and Human Services guidelines)  
• Tuberculin purified protein derivative (Tb) products (detects the bacterium Mycobacterium tuberculosis, which causes tuberculosis) 

In addition to this, as of October 1, 2025, pharmacists in North Carolina are allowed to prescribe medications for influenza only after performing a Clinical Laboratory Improvement Amendments-waived test. Other states with strong legislation regarding pharmacist prescription authority include Idaho, Colorado, and Montana. 

Conclusion  

In most rural areas and in many urban areas, South Carolinians face prolonged wait times and long drives to physicians to receive medications for minor ailments. However, a ready solution to the healthcare crisis may already exist in the heart of local communities.

South Carolina has the opportunity to join the majority of states, including our neighbors North Carolina and Tennessee, that have empowered pharmacists with the practice authority to use their extensive training to essentially “test and treat” common, minor illnesses. Allowing pharmacists to prescribe in very limited circumstances is a practical, cost-effective step toward closing a part of South Carolina’s healthcare gap and ensuring that quality care for certain conditions is only a few miles away for every resident.