The Evolution of the Pharmacist

Published: October 13, 2023
Melody Berg
By Melody Berg, PharmD, MPH, BCPS

“Why does it take so long to count pills and pour them in a bottle?”, “Why do you have to go to school so long just to count pills?”, “Wait….pharmacists work in hospitals?”….These are all examples of common questions that arise when people think of pharmacists. The role of the pharmacist has been changing throughout the years to meet the needs of modern biomedicine, and these changes have continued to put the pharmacist in the position to be the medication expert.

The Changing Role of the Pharmacist in This Country
For thousands of years, pharmacists have existed to make use of medicinal products to treat a variety of ailments. Before the rise of pharmaceutical manufacturing in the United States, patients would be sent by their doctors to visit “the soda shop pharmacist.”  who would  mix up the appropriate medicine . As pharmaceutical companies first began producing medicines, the role of the pharmacist had to change from compounding to dispensing. Since dispensing was not as profitable as compounding has been, the soda shops began to expand to sell other goods, which led to modern-day pharmacies where front stores are devoted to sales of non-medicinal goods, like cosmetics, gifts, and stationary.  As pharmacists attempted to redefine their role to provide knowledge and expertise, they were met with resistance in the medical community. Despite this resistance, early pharmacist innovators persevered until the creation of the modern-day pharmacist role in the 1970s—the patient care-centered pharmacist who not only dispenses medications but also evaluates medication therapy for efficacy and safety and provides consult to patients on a variety of clinical areas.

Changes in Pharmacy Education
Early pharmacists primarily learned the trade from apprenticeship, but as the role of the pharmacist grew, educational requirements also changed. In addition to apprenticeships, pharmacist jobs began requiring a degree. The pharmacy degree started as a 2-3-year degree but eventually evolved into the 6-year degree it is now. In fact, up until about 10 years ago, pharmacy programs still offered a 5-year bachelor's degree, but today’s pharmacy schools only offer a 6-year doctorate degree. Some pharmacists obtain a bachelor’s degree in a different area of study before proceeding to a 4-year professional pharmacy program, so obtaining a pharmacy degree often takes 6-8 years. Some pharmacists choose to continue their training by completing dual degrees in business or public health or by completing post-graduate training in the form of a residency or fellowship, which can take an additional 2-3 years.

What Today’s Pharmacist Can Do for You
Pharmacists can work in a variety of settings! The most common practice areas include community pharmacies, hospitals, and clinics. In community pharmacies, pharmacists receive and review prescriptions for safety and appropriateness. They ensure the correct medicine for the condition, the right dose for the patient, and the safety of use with other medications, while considering the patient’s conditions, allergy history, and the most affordable option based on the patient’s insurance formulary. Pharmacists in this setting also counsel patients on appropriate use of medicine, advise patients on therapy options, and administer vaccines. In some states and situations, pharmacists can also prescribe medicines!

Pharmacists in hospitals and clinics may be responsible for prescription review and dispensing like community pharmacists, but they may also provide a more direct patient care role. Some pharmacists see patients in clinic to help them manage intensive medication regimens for disease states like HIV, heart disease, diabetes, blood clots, and others. Some pharmacists in hospitals round with doctors to help advise them on medicines available to best treat patients or to help ensure the safe and effective use of medicines in this setting.

The pharmacist role has changed so much and continues to change to meet the needs of society. Your pharmacist can help you and your doctors and nurses make sure your medicines are working for you and are safe for you. Pharmacist education and training have truly prepared them to be the medication expert!

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