Magazine article Drug Topics

Clinical vs. Dispensing Pharmacists

Magazine article Drug Topics

Clinical vs. Dispensing Pharmacists

Article excerpt

An odd thing happened to the pharmacy profession while all of the pharmacists watched. Someone forgot to ask working community/chain and hospital staff pharmacists what direction the profession should take. The "leaders" in pharmacy have directed the pharmacy profession toward clinical pharmacy. As a result, pharmacy students are attaining an excellent clinical pharmacy education. But the standards have been set by people who don't practice in a community pharmacy setting.

Would a majority of pharmacists concur with the "leaders" that community pharmacy practice does not need to be taught by the pharmacy schools? From all indications, AACP, ASHP; APhA and ACPE have written off the dispensing pharmacy practice. Why? I am told that it is difficult to qualify a community or chain pharmacy for a clinical rotation for the new Pharm.D. degree.

Twenty years ago, when the board of pharmacy asked new pharmacists how many of them wanted to own their own pharmacy, about 75% to 80% said they did. At that time, the length of rotations through community practice and institutional practice was about equal. Why has the curriculum of most pharmacy schools today switched to training clinical institutional pharmacists, when about 70% of the graduating pharmacists go into community pharmacy practice?

Community shortages

Because of the trend toward clinical practice, we have created a shortage of "trained" community pharmacists. The colleges have very few professors who can be community pharmacy role models. Most have spent very little time in a community pharmacy setting. I am told that students who indicate they are going into a community practice are made to feel inferior by their instructors and peers. Why? It is my understanding that a community pharmacy practice site, as we know it, would not be approved as a teaching site by ACPE. Why?

I ran across a speech given by Jack Voige, a past president of NABP He indicated that a few years ago, the dean of a leading medical school said that pharmacists were "either the most overeducated or underutilized members of the health-care profession." Voige added that several years ago the president of AACP, Varro Tyler of Purdue University, made the same observation. Tyler stated that this is the reason pharmacists often become frustrated. Voige's speech was presented in 1983. Some of us didn't listen and learn, because we later made the curriculum even more clinical in nature.

If the profession wants to go to only clinical services and not recognize community pharmacy services, I think the profession of pharmacy should make that statement. …

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