Who has the final say in a CPA?

• A. The Physician
• B. The Pharmacist
• C. The Patient
• D. The Institution

Answer: (A)

In a collaborative practice agreement, the physician holds the ultimate authority over medical decisions. The pharmacist is empowered to manage and adjust drug therapy within the agreed-upon protocols, but any major treatment choices or changes to the plan still require the physician’s review and approval. The patient contributes preferences and informed consent, but the CPA centers on medical judgment and safety under physician supervision. Institutions can set policies, but they don’t override the physician’s clinical responsibility. This structure ensures that complex medical decisions remain under a physician’s oversight, while pharmacists optimize therapy within that framework.