Maybe in your lifetime ...

... We should all be doctors

Some will say that is exactly what we should be trying to accomplish. Our leaders in all areas of pharmacy seem to be absolutely and totally focused in this direction. This is a laudable goal; however, pursuing it to the exclusion of all other solutions will certainly have unintended consequences.

I personally advocate that some pharmacists become specialists and function totally as providers, much as do physician assistants and/or nurse practitioners. This is a critical step in the evolution of pharmacy practice. But if we all become providers, what will become of the dispensing function?

Believe it or not, there is a clinical element to dispensing. Who will catch the errors made by providers, the comorbidities not considered, the drug interactions overlooked, the issues generated by the patient using multiple providers and multiple pharmacies? Who will consult with the provider who has written the prescription?

And what about the patient? Who will work with the patient on all aspects of the drug therapy? Will it be technicians? Or will those of us who do not have direct patient contact be relegated to technician status?

Will pharmacies need pharmacists? Chains and grocery stores would find this question very attractive.

Reality gap

Most pharmacists are still referred to by the intentionally negative title of "dispensing pharmacists." This situation exists because pharmacists have always operated from a position that is weak.

Our practices are owned by others who do not share our professional goals. We have gone from being a group of professionals operating in a business atmosphere to drudges toiling in a never-ending, pressure-filled sweat shop. While we have patient-centered care foremost in our minds, in most cases the patient never gets to speak with the pharmacist. The laws that were put in place to ensure patient consultation with a pharmacist are useless. The result is demeaning and professionally nonexistent, and leaves many of us with an empty, helpless feeling.