About My Job: The Pharmacist

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by Conor Friedersdorf

A male reader writes:

I'm a full time pharmacist in a smallish community hospital.  What people think about my job, and the media misinterprets, is that I spend all day counting pills.  Look at any news story about a pharmaceutical product, or a pharmacy, or a drug recall, and there is a stock loop of footage of someone counting tablets.  The media never shows a pharmacist counseling a patient, conferring with a physician, giving an immunization or any of the hundreds of other things that we do to keep our patients healthy.

And a female writer concurs:

I am a pharmacy student, and will graduate in 2012.  I am part of the increasingly small proportion of pharmacy students who entered pharmacy school without a B.S. or B.A., as many pharmacy schools are beginning to require said degrees.  Whenever I tell people that it will take me 7 years total to become a pharmacist and that it is a doctorate degree, their immediate response is generally, "Why do you need to go to school for that long?  All you have to do is take pills from a big bottle and put them into a little bottle."  Unfortunately, much of the general public has this view of pharmacists, and fail to take advantage of all the services they have to offer.  Every day pharmacists catch mistakes and make clarifications on prescriptions that patients bring in.  They also do everything in their power to make sure that you're paying the lowest price possible at that location.  (For the most part, pharmacists do not determine the prices of medications, and at big box stores they often even operate in the negative, so no, you're not contributing to the pharmacist's yacht; you're contributing to the drug company's deficit for developing the drug.)  Yes, the computer system flags for drug interactions and duplicate therapies, but it takes clinical expertise and education to determine whether or not the interaction is significant enough to warrant a phone call to the doctor and have the prescription changed. 

In the hospital setting, pharmacists are being called upon to complete medication reconciliation upon admission.  That is, they draw from many sources, ranging from a bag of bottles brought in by a family member to a medication list complied some time in the past, and they help determine what medications patients should continue to receive while in the hospital.  In a similar fashion, pharmacists also perform discharge planning and counseling to help the patient understand any new medications that may have been added or discontinued as part of the hospital stay.  (The healthcare reform that just passed allotted a lot of money for those two items, as they prevent expensive hospital re-admissions.)  Some pharmacists who build solid relationships with doctors even obtain prescribing rights in their area of expertise.  For example, in a diabetes clinic the doctor is responsible for making the diagnosis, but might hand the pharmacist the responsibility of developing a personalized treatment plan and choosing all of the patient's medications.  This practice is not yet very common, but it shows the direction in which advocates of the profession hope to head.
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