In earliest times, pharmacy was closely interwoven with medicine to the extent that one person usually carried out both functions. As both professions matured, the need for separate specialties became clear, although it remained equally clear they would need to retain close professional relationships for the greatest benefit to the patient. Although, typically the physician or another health professional may prescribe drugs and the nurse may administer drugs, the pharmacist is the member of the health care team whose expertise is related to the appropriate use of medications.
The primary role of a pharmacist is to assure that the medications used by the patient are the most appropriate: that they are indicated for the patient, they are effective and safe, and that the patient is able to take it. This is done by working in partnership with the patient and in collaboration with the patient’s other health care providers. Over the last few years the pharmacist’s scope of practice has continued to expand and, in addition to optimizing patients’ medications, many pharmacists can now administer influenza vaccination injections, prescribe medications to help patients stop smoking, and provide unique health services such as specialized monitoring of drug therapy for those with diabetes and those on anticoagulant medications such as warfarin.
Pharmacists practice in a wide variety of practice sites within the health care field. The majority of licensed pharmacists work in community pharmacies where they have responsibility for the medication and healthcare needs of individuals in their community who seek their services. There are also many other exciting areas of practice for pharmacists today. Licensed pharmacists may also work in hospitals, in clinics and other ambulatory care settings, or in research and teaching, in the pharmaceutical industry and government laboratories. Hospital pharmacists are primarily responsible for assuring the appropriate use of medicines by institutionalized patients, and also may be involved in the development of institutional guidelines for use of medicines. Research-focused pharmacists are generally involved in the development of new medicines and dosage forms, in the determination of how medicines alleviate disease, and in the assessment of the social and economic factors influencing the use of medicines. As professors/teachers they may be involved in the education of pharmacy students and pharmacy technicians. Industrial pharmacists might work in sales, drug information, regulatory affairs, production, quality control or research within the pharmaceutical industry. Government departments with public health concerns also employ pharmacists in analytical or toxicology laboratories, as inspectors, health supplies officers or in the armed forces. These areas are outlined more fully under the following headings:
Since its beginning, pharmacy has been practised in the community environment. Although other types of pharmacy practice have evolved from community pharmacy, a majority of pharmacy graduates still find their “place of practice” in a community setting.
The community pharmacist is an important member of the health care team and, as well, a part of the business community. As such, the requirements of community practice include both professional capability, and management and marketing skills, with an understanding of competitive enterprise.
The community pharmacist has a thorough knowledge of all medications including prescription drugs, non-prescription products such as cold remedies, vitamins, pain medications and herbal products, designed for self-medication. Being the most readily accessible health care professional and seen most often by the public, the community pharmacist needs to be able to meet patient needs by assuring the proper use of all drugs and related products. Today, many community pharmacists provide extensive health services, such as monitoring patients on medications for diabetes and providing annual influenza vaccinations.
Many community pharmacists also offer additional professional services such as surgical and home care supplies, self-diagnostic machines and kits and athletic supplies. Community pharmacists can practice, as well, in personal care or extended care homes and specialize in areas such as geriatric pharmacy. Clear and knowledgeable communication is important in each area of community pharmacy practice.
The professional capability of the community pharmacist is further enhanced by electronic documentation of patient records, which enables pharmacists to maintain patient specific information and the ability to assess the appropriateness of both over-the-counter and prescribed medications. Pharmacy technicians, who are regulated health professionals, assist the pharmacist in preparing the prescribed medications, enabling pharmacists to effectively fulfill their professional role as medication consultants.
The general responsibilities are very similar to those of a community pharmacist but the hospital pharmacy department is only one of several units serving the patient. The hospital pharmacist provides optimum care to the patient by: assessing and monitoring the patient’s drug therapy and by the provision of drug information to patients and to other health professionals. Pharmacists in hospitals are also involved in the selection and purchase of drugs to be used in the hospital, the method by which these drugs are distributed, and preparation of intravenous solutions.
The hospital pharmacist provides patient care at various locations throughout the hospital: on the ward or unit where the patient is, in an outpatient clinic where the patient visits, through patient education seminars, and as an active member of the patient’s interdisciplinary health care team.
Hospital pharmacists work collaboratively with physicians, nurses and other health care professionals to provide patient care. They may be involved in determining patients’ drug related needs while in the hospital, in educating patients about their medications before they are discharged, as well as monitoring drug therapy while in, and after leaving the hospital. Many hospital pharmacists work with the patient and their community pharmacist, to ensure that appropriate changes to medications are communicated to the community pharmacist, to enable patients to optimally use their medicines.
The Pharmaceutical industry in Canada is engaged in the research, development, production and marketing of modern drugs. The pharmacist working in industry may act as a liaison with government or may be involved in providing drug information and technical correspondence, or may be responsible for the preparation of educational materials to both the public and health care professionals, or take part in research. Some pharmacists in industry act as pharmaceutical sales representatives presenting drug information to physicians and pharmacists. It is possible for pharmacy graduates to find many positions in industry but specialty areas such as the research and development of new drugs may require postgraduate degrees.
Interesting careers in pharmacy are available in government agencies at the local, provincial and federal levels. The armed forces also provide positions for pharmacists in military hospitals both in Canada and overseas. Pharmacists are commissioned as officers and may hold a rank from second lieutenant to lieutenant colonel.
Both provincial and federal governments require pharmacists to monitor the distribution of schedule drugs (poisons, narcotics, etc.) and administer various drug plans and health care programs. Health Canada (Therapeutic Products Directorate), the Provincial Ministries of Drug Program Branches and Forensic laboratories employ pharmacists in a variety of capacities.
Education and Research
Careers in pharmaceutical education combine teaching with research and administrative activities. Most positions in education require a PharmD or a PhD degree; however, there are a few roles for BScPhm and Masters trained pharmacists. Many community and hospital pharmacists participate in the educational programs of the Faculty as clinical teaching assistants or provide classroom instruction in their specialty areas of practice. A particularly important role is their involvement with the training of pharmacy students during their experiential education rotations.
Additional Areas of Opportunity
Other areas open to pharmacists with particular interests or abilities include executive or administrative work in professional pharmaceutical organizations at the provincial and national level. There are also positions available within provincial licensing and regulatory bodies as inspectors and executives.
Some pharmacists work within healthcare organizations and others combine their pharmaceutical background with other professional endeavours such as law or business administration.
Pharmacists with good communication skills will find many opportunities to participate in professional relations and continuing education programs presented to groups ranging from school children to service clubs and health specific organizations, as well as to other health professionals.
Acknowledgement and appreciation is extended to the Canadian Foundation for Pharmacy from whom some of the above description was obtained.