Pharmacy dispensing and patient counseling

Oluwole WilliamsThe public rightly views a pharmacist as a walking encyclopedia of drugs. The pharmacist is expected to know about manufacturing, costs, adverse effects, therapeutic indications, mode of administration, alternative medicine, Beer’s Criteria, third-party formulary and non-formulary, dispensing and compounding laws, and laws covering medical insurance and non-medical insurance.

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For a pharmacist, there will never be an excuse for a public display of ignorance on any subject related to medications and their uses. Pharmacy practice today is akin to running a gauntlet. Such simple tasks as inability to identify a pill sample at a Christmas dinner may draw the ire of your friends and family; even in private they may question your competence.

Identity crisis?

For the life and future of the pharmacy profession, there are some roles and responsibilities in practice that must never be taken away. Dispensing of medications and direct preparation of medicinal compounds are excellent examples of the critical roles played by pharmacists.

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It is good to know the difference between desonumab and adalimumab in terms of therapeutic indications, adverse reactions, and monitoring parameters of use, but it is not enough without the practical experience of dispensing them and the direct encounter with the patient who requires counseling on their use.

What is a pharmacist like who has never handled a prescription product or who does not know what one looks like? It is necessary to reiterate and even belabor this point, lest we forget whom we are and what our profession is.

Direct dispensing of drug products should never be taken away from pharmacy practice; otherwise the profession will lose a connection to its very essence and origin.

A unique role

It is a matter of concern that employment for pharmacists is declining while jobs for technicians are on the increase.

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Do not miss the point here. The pharmacist’s role is unique. Dispensing will never detract from the importance of a pharmacist as an expert on drug information, which is why the boards of pharmacy mandate the necessity of internship hours and practicing preceptors for pharmacy students.

 It also explains why laboratory training and practical classes are critical in the education of pharmacists. What pharmacist, for instance, even in a rural hospital, would not know how to compound tincture of iodine, dusting powder, Schragger’s Paste, and milk of magnesia, given the basic tools and ingredients?

Possession of a Doctor of Pharmacy degree does not necessarily imply that dispensing functions are now beneath the holder. And a pharmacy class instructor who herself is not in practice is similar to a farm advisor who has never ploughed or set foot on a farm or touched a seed before.

More than the internet

To eliminate dispensing functions from the equipping and practice of pharmacists trivializes our profession, and a pharmacist who despises dispensing or regards it as “technician’s job” has lost touch with the significance of the profession.

Do you ask someone who has never flown an airplane to represent a pilot at a meeting of aviation experts? Similarly, a pharmacist who is not a practitioner in the true sense of that word is ill equipped to represent pharmacists or to speak on their behalf.

 Providing drug information services with the aid of computer software will not engender the true professional satisfaction that a pharmacist needs, especially in circumstances from which dispensing functions and direct patient contact are absent.

In today’s world, access to knowledge and information through telecommunications is cheap and efficient. But to crouch for eight hours daily behind a computer screen and dish out information over the internet will never equip you with the professional skill acquired by healthcare practitioners who meet and interact with patients on a one-on-one basis, and who practically handle their prescription needs face-to-face.

Oluwole Williamspractices pharmacy in the Philadelpha, Penn., area. Contact him at pharmwillie@yahoo.co.uk.