The terms ‘pharmacy’ and ‘dispensing’ go hand-in-hand. Prescribers diagnose disease and approve treatment. We fill the treatment orders and dispense the therapy, along with any important educational points, to patients and their families. This has been our role for generations. We are known as some of the most trusted and most accessible health professionals in the world.

I admit to being a proud dispenser, but my priorities are beginning to shift. Medication has always held a fascination for me: the clever brand names (remember Desyrel? I still have ‘DEpressive SYmptom RELief’ bouncing in my skull somewhere), the odd shapes of certain tablets and the splashy marketing campaigns. Sometimes missing however, was the proper transfer of information to others. My counseling skills took time to develop, and early on I felt robotic and scripted when interacting with patients.

As a student, I recall basic functions such as writing up manual credits to Blue Cross or the now defunct Maritime Medical. We made funky compounds with Anthralin powder that stained everything a heinous shade of yellow ochre that would make Bob Ross proud. We were the gatekeepers of all things pharmaceutical and sometimes a cursory counseling session was all that a patient received. Sure, in classes and labs we were coached on communication styles and higher standards but the reality was a bit disheartening; dispensing was the main focus and any clinical intervention seemed like an exciting ‘Eureka’ moment for the team to share instead of the norm.

Doing pharmacy relief immediately after graduation had it’s advantages and disadvantages. Although leaving work at work when a shift was over was nice, ensuring patient follow-up and continuity of care was extremely inconsistent from one site to the next. Every interaction was a point-in-time and documentation was rather erratic from one pharmacist to the next. We were however excellent at monitoring days supply of benzos and narcs. I may not have had the relevant history or familiarity with the tools to best determine your pain control but I could certainly attest that those sixty OxyContin 40mg were triple-counted by three different people.

My, how times have changed…

So, there is less of a focus on pack sizes and pricing (still important, but more of a management focus as opposed to pharmacist); better prescription software has lessened the need to manually update every drug file or pricing strategy. Now it’s more empowering to take a deeper look at interactions and latest research guidelines. The volume of calls to the third-party plan to correct date of birth issues are tasks that now may be delegated. We are becoming more intimately involved with special authorization criteria and therapeutic substitutions. Cognitively, we have more opportunity to apply ourselves; with prescribing rights, we can now identify certain DRPs and be able to solve them for a patient. Things like INR and renal adjustments may now feature a pharmacist’s name on the order as we get other health professionals to recognize our new-found decision-making abilities. In fact, just the other day, I was able to halve a sulfamethoxazole dose for an elderly resident with a compromised creatinine-clearance.

The paradigm shift started long before my degree, but the visionaries who foresaw such radical changes had their work cut out for them. The baby-boomers were heading into retirement, and the aging population needed more medications to combat heart disease, diabetes and high cholesterol. In lockstep with that, they were also going to need more clinical care, and more than what general practitioners would be able to handle, especially in rural areas. I look forward to plugging some gaps through medication reconciliation, minor ailment prescribing, and lab requisitions.

To sum up: I am proud of my dispensing hat, I am proud of my expanded clinical duties now, and trust that I will enjoy however the role evolves from here. I guess I’m just proud to be a pharmacist.

Disclaimer: The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of any agency, employer or affiliation.