Pharmacy is the third largest health profession in the United States. In 1997, there were approximately 170,000 licensed pharmacists in the United States.Of these, some 43,000 worked in community pharmacies, with the others employed in all areas of health care and medical research. Pharmacists are employedin hospitals, nursing homes, home health care companies, managed care organizations, clinics, and physicians' offices. Other pharmacists work for federalagencies such as the Food and Drug Administration and the National Institutes of Health. Still others are faculty members at colleges and universities.
In the past, pharmacists were thought of as dispensers of medication, where their traditional role would be to count or pour medications. However, the role of the profession has evolved to include pharmaceutical care: the responsible provision of drug therapy to achieve specific outcomes that improve a patient's quality of life, and disease state management, and the systematic review of a disease process, the available treatment options, and the outcomes ordrug interactions that those treatments may be expected to produce.
Pharmacists earn either a five-year bachelor of science (B.S.) degree, or a six-year doctor of pharmacy (PharmD.) degree, although some pharmacists earn master's or doctor of philosophy degrees in related fields. Before entering practice, pharmacy graduates must pass a national licensure examination and meet additional requirements in the states in which they intend to practice. Theaging of the American population, and the on-going development of new medications coupled with the increasing complexity of drug therapies only bode wellfor the pharmaceutical profession in the twenty-first century.
There are many professional organizations that serve the needs of members ofthe pharmaceutical profession. These include the American Pharmaceutical Association (with offices in all 50 states and over 18,000 members), the NationalPharmaceutical Association, the National Community Pharmacists Association,the American Association for Health System Pharmacists, and the American College of Apothecaries.
For the medical consumer, the most common source for obtaining prescription medicines is the local or community pharmacy. Medical consumers who belong toHealth Maintenance Organizations (HMOs) may be required to use a pharmacy onsite (at the location of the HMO) or the HMO may have contracted with certainpharmacies to take their business. Another avenue that some individuals andsome insurance companies have chosen is mail-order pharmacy. With this arrangement, a prescription is normally sent to the mail-order pharmacy or phoned in by the physician. As it may take a week or more for the prescription to arrive at the home of the patient, mail order is best used for maintenance (long-term medications used to treat such chronic problems as high blood pressureand diabetes).
Since 1993, all pharmacists who practice in states receiving Medicaid funds have been required to provide counseling services on all matters pertaining tospecial directions for taking medications and to precautions about medication side effects, interactions, proper storage, techniques for self-monitoring,and other essential guidance. Once a community pharmacy has been chosen, itusually is in the medical consumer's best interest to stay with that pharmacyand not shop around for another pharmacy, especially if the selected pharmacy maintains patient drug histories. If the pharmacy maintains an accurate drug history on the patient, the pharmacist can more easily check for drug interactions that may be potentially harmful to the patient, or decrease the efficacy of medications prescribed by different physicians.