Pharmacists are health professionals responsible for the dispensation of prescription and nonprescription medications. They act as consultants to health practitioners and the general public concerning possible adverse drug reactions and interactions, and may also give advice relating to home medical supplies and durable health care equipment. The role of the pharmacist has evolved into that of consultant and medicinal expert, because of the expanded duties of pharmacy technicians and the increasing time restrictions placed on health maintenance organization physicians. There are more than 230,000 pharmacists practicing in the United States.
Pharmacist Career History
The word pharmacist itself can be traced to the early Greeks. During the time of Aristotle, those who compounded drugs were called pharmakons. The word has changed little from its original form and still means approximately the same thing: one who compounds drugs, medicines, or poisons.
Pharmacy as a profession grew slowly in the United States. It is said that one of our earliest pharmacists was Governor John Winthrop of the Massachusetts Bay Colony. He learned to compound drugs because there were no other sources in the colony for obtaining medicines. The first school established to teach pharmacy in this country was the Philadelphia College of Pharmacy, founded in 1821. It is still in operation today.
In 1906, the Federal Pure Food and Drug Act was passed. The Food and Drug Administration (FDA), created in 1931, must approve any pharmaceutical before it can be sold in the United States. The work of the pharmacist has become increasingly important because of the complexity and potential side effects of the thousands of medications now on the market.
Pharmacist Job Description
Pharmacists need a thorough knowledge of drug products. Most importantly, they need to understand how drugs work for people who are sick, how the drugs interact with a person’s body as well as illness, and how different drugs may interact with each other. In addition to dispensing drugs according to orders from physicians, dentists, and other health care practitioners, pharmacists advise these professionals on the appropriate selection and use of medications. They monitor how long patients have been taking a medication and provide information to patients and doctors when a generic brand of a drug is available. Pharmacist Shreen Beshures, who has been involved in the pharmacy business since high school, explains that part of her work includes “printing recommendations to the doctors for a reduction in the number of medications or a more cost-effective medication.” In addition to advising doctors and other health professionals, pharmacists talk with patients or customers about medications, explaining what the medications are supposed to do and how to use them properly. Pharmacists working in retail locations, such as a neighborhood drugstore, may also find that customers come to them with questions about symptoms. They may recommend nonprescription products such as headache remedies, vitamins, and cough syrups. All pharmacists keep records of drugs and medications dispensed to each person in order to identify duplicate drugs or combinations of drugs that can cause adverse reactions or side effects.
In conjunction with these duties, pharmacists are required to maintain their licenses through continuing education, though education requirements vary by location. Some states may require this education in the form of correspondence (written responses to educational material), or conferences and seminars. Some states may also require continuing education in particular disease topics and treatment.
Pharmacists’ duties vary somewhat depending on where they are employed. About 61 percent of pharmacists work for community retail pharmacies, such as a local drugstore pharmacy, a chain drugstore pharmacy, or a grocery store pharmacy. These pharmacists fill prescription orders, contact doctors and other health care professional by phone when clarification about a prescription is needed, and have frequent interaction with the public. In addition to pharmaceutical duties, they sell merchandise unrelated to health, hire and supervise other workers, and oversee the general operation of the pharmacy.
Pharmacists who work at hospitals or clinics prepare sterile solutions or special mixtures, dispense medications on-site, and complete administrative duties. They work closely with the medical staff, suggesting what medications to use, explaining their effects, and sometimes demonstrating how to give medications. They also keep precise records of what type and amount of medications each patient is on, keep track of supplies in the pharmacy, and buy new supplies as necessary. They may also interact with patients, meeting with them before their discharge to discuss what medications they will use at home. At a large hospital or clinic employing a number of pharmacists, a supervising pharmacist may also be responsible for arranging schedules and overseeing the work of others.
Many pharmacists are employed by large pharmaceutical manufacturers. They may work in one of several capacities. Some engage in research to help develop new drugs or to improve or find new uses for old ones. Others supervise the preparation of ingredients that go into the tablets, capsules, ointments, solutions, or other dosage forms produced by the manufacturer. Others test or standardize the raw or refined chemicals that eventually will go into the finished drug. Some may assist with advertising the company’s products, to make sure that nothing untruthful or misleading is said about a product in professional literature. Some pharmacists may prepare literature on new products for pharmaceutical or technical journals. Others write material for package inserts.
Pharmacists employed by government agencies may work in a number of different kinds of positions. They may be inspectors who monitor drug manufacturing firms, hospitals, wholesalers, or community pharmacies. They may work in research with agencies such as the FDA, testing the effectiveness of new drugs, or they may work with agencies involved with narcotics and other controlled substances.
Other opportunities for pharmacists include teaching at schools of pharmacy, working in the armed forces, and working for Health Maintenance Organizations (HMOs) or insurance companies. Some pharmacists write or edit reports for journals, draft technical papers, and staff professional associations. An increasing number of pharmacists—senior care pharmacists—are employed by nursing homes and other long-term care facilities to provide and monitor drug therapy for the elderly. Some pharmacists complete additional education to become patent attorneys or experts in pharmaceutical law.
All pharmacists must be diligent in maintaining clean and ordered work areas. They must be exceedingly precise in their calculations and possess a high degree of concentration in order to reduce the risk of error as they compound and assemble prescriptions. Additionally, pharmacists must be proficient with a variety of technical devices and computer systems. However, more and more drug products are shipped in finished form by the pharmaceutical manufacturer. The actual compounding of prescription medications, therefore, is taking a smaller amount of time.
Pharmacist Career Requirements
If you are thinking of becoming a pharmacist, you should take college preparatory courses in high school and concentrate in the areas of mathematics and science. It is especially important that you take biology, chemistry, and physics to prepare for this work. Additionally, you should take English, speech, and a foreign language, because good communications skills will be important as you progress through college, job interviews, and eventual employment as a pharmacist. If working as a community pharmacist sounds interesting to you, consider taking business and accounting courses to prepare yourself for working in and running a drugstore.
To become a pharmacist, you will need to earn the degree Doctor of Pharmacy (Pharm.D.) from a school accredited by the Accreditation Council on Pharmaceutical Education. The Pharm.D. has replaced the bachelor of pharmacy degree (B.Pharm.), which is no longer awarded. The doctorate degree generally takes six years to complete. The first year or two of study does not take place in a school of pharmacy but rather in a general college setting. You will take pre-pharmacy classes such as chemistry, organic chemistry, biology, physics, calculus, statistics, English, and social sciences. After you have completed this work you will need to gain admission to a school of pharmacy. You may apply to a school of pharmacy that is part of the university where you completed your pre-pharmacy work, or you may apply to a school of pharmacy that is not part of your undergraduate school. In addition to completing pre-pharmacy courses, some schools of pharmacy require applicants to take the Pharmacy College Admissions Test (P-CAT).
In pharmacy school, you will take courses such as the principles of pharmacology, biochemistry, pharmacy law and ethics, and pharmaceutical care. In addition, your education should include an internship, sometimes known as a clerkship, in which you work under the supervision of a professional pharmacist. When deciding on a school to attend, you should consult the Accreditation Council for Pharmacy Education’s annual Directory of Accredited Professional Programs of Colleges and Schools of Pharmacy for accredited programs. It is available on the council’s Web site http://www.acpe-accredit.org/deans/schools.asp.
Certification or Licensing
Pharmacists who specialize in a specific health care discipline can obtain voluntary certification. Currently the Board of Pharmaceutical Specialties recognizes and offers certification in five areas: nuclear pharmacy (involving the use of radioactive drugs), nutrition support pharmacy (involving care of patients with special needs in receiving nutrition), oncology pharmacy (involving care of patients with cancer), pharmacotherapy (involving the safe, economic, and proper use of drug therapies), and psychiatric pharmacy (involving the care of those with psychiatric-related illnesses). Pharmacists who specialize in geriatric health care may receive the certified geriatric pharmacist designation from the Commission for Certification in Geriatric Pharmacy (http://www.ccgp.org/).
Practicing pharmacists are required to be licensed in all 50 states, the District of Columbia, and all U.S. territories. Applicants for licensure must have graduated from an accredited pharmacy program, completed an internship under a licensed pharmacist, and passed their state’s board examination.
You will need good people skills to deal with patients, other pharmacy workers, and other health care professionals. A good bedside manner (a kind, comforting approach), like that required of doctors, will help you in a hospital or nursing home setting, particularly as pharmacists’ responsibilities expand to include counseling and advising. You should also be very organized, and have an eye for detail—doctors, nurses, and patients will all be relying on you to keep accurate drug records.
Exploring Pharmacist Career
To explore this job, talk to a local pharmacist about his or her work. Volunteer at a hospital or clinic in your area to get hands-on experience working in a medical environment. You can also try to get a paid part-time or summer job at a nutrition and vitamin store where you’ll have the opportunity to learn about dietary supplements, vitamins, and herbal remedies.
While in high school, Shreen Beshures got a part-time job as a pharmacy technician in a neighborhood drugstore. She advises those considering this career to “get a part-time job in a drugstore or…at a pharmacy in a hospital to see if it’s really what you want to do.” Of course, if you get a job at a pharmacy, do not expect to be in the back mixing medications with a mortar and pestle. Nevertheless, you can benefit by working in a position such as stock clerk, salesclerk, or delivery person. Any one of these jobs will give you the chance to observe firsthand the kind of work that pharmacists do, see how they interact with customers, and gain experience working with customers yourself. After you have demonstrated responsibility and interest, you may even have the opportunity to assist in the pharmacy—entering data in customer computer records, taking inventory on equipment, bottles, and vials, and preparing labels.
Depending on where you live, it may also be possible for you to get an internship through the National Association of Chain Drug Stores Foundation’s chain community pharmacy internship program. For more information, visit http://www.nacdsfoundation.org/.
Approximately 61 percent of pharmacists work in community pharmacies—there are approximately 35,500 pharmacies operated by chain drugstores, supermarkets, and mass merchants, and there are another 19,000 independent pharmacies. Approximately 24 percent of pharmacists work in hospitals. Pharmacists can also find work at mail order pharmacies, pharmaceutical companies, and agencies of the federal government. Some pharmacists are self-employed and fill-in as “temps” at a number of different community pharmacies. There are approximately 230,000 pharmacists working in the United States.
“I had always wanted to go to medical school,” Shreen Beshures says, “but wasn’t sure. I took pre-med classes in college, which were also pre-pharmacy, and decided to transfer to a pharmacy school in New York.” Once you are ready to graduate from pharmacy school, the career placement office of your college or university should be one source of information about job openings. Internships also provide the opportunity to make professional contacts, and you may hear about an open position through these contacts. A number of placement services involved in the health care field work with pharmacists, placing them in the jobs they want. Newspaper advertisements and associations, such as the American Society of Health-System Pharmacists, can also provide information on job openings. Once you have become licensed, you may apply directly to a community, hospital, or clinic pharmacy that interests you. Though the level of work is the same for beginning pharmacists as it is for experienced pharmacists, you may have to work long hours, evenings, and weekends until you’ve gained some seniority with the pharmacy.
Community pharmacists may enjoy advancement to supervisory positions. The hospital pharmacist may advance to the position of chief pharmacist or director of pharmacy services after accumulating several years of experience.
Pharmacists who are employed by drug manufacturing firms may anticipate increases in both salary and responsibility as they gain experience and increase their value to their firms.
Pharmacists who acquire advanced degrees and education may become pharmacologists, who study the effects of drugs on the body.
The earnings of salaried pharmacists are largely determined by the location, size, and type of employer as well as by the duties and responsibilities of the individual pharmacist. Pharmacists who own or manage pharmacies often earn considerably more than other pharmacists. According to the U.S. Department of Labor (USDL), pharmacists earned a median yearly income of $89,820 in 2005. The lowest paid 10 percent earned less than $64,350 per year, while the highest paid 10 percent made more than $113,310 during that same time. The USDL also reports that pharmacists earned the following mean salaries in 2005 by type of employer: health and personal care stores, $85,380; general medical and surgical hospitals, $84,560; grocery stores, $85,680; department stores; $86,720; and other general merchandise stores, $84,170.
Pharmacists, in addition to salary, enjoy fringe benefits such as paid vacation, medical and dental insurance, overtime, and sometimes bonuses and profit sharing, depending on the size and type of employer. Because of the high demand for pharmacists who will work odd hours in community drugstores, temp pharmacists can often negotiate for benefits, as well.
A pharmacy is usually a pleasant place to work. Pharmacies should be well lighted, well ventilated, and kept in a clean and orderly fashion. Many chain-owned pharmacies now provide 18- or 24-hour operations.
Hospital pharmacies are efficient, orderly, and busy with a variety of important activities. The physicians, nurses, technicians, and other medical personnel with whom the pharmacist works are usually intelligent and concerned people. These pharmacies are also usually in operation 18 or 24 hours a day.
The two most unfavorable conditions of the pharmacist’s practice are long hours and the necessity to stay on one’s feet. It is not unusual to be on duty at least 48 hours a week. Most state laws covering the practice of pharmacy require that there be a pharmacist on duty at all times when the pharmacy is open. Most pharmacies employ at least two pharmacists because it is customary to remain open at least 12 hours a day. Many pharmacies are also open at least part of the time on Sundays. Despite the requirements of the job, most pharmacists appreciate being involved in health care. “I’m an integral part of the health care system,” Shreen Beshures says, “preventing medication errors and aiding nurses and physicians with medications.”
Pharmacists who operate their own pharmacies have financial responsibilities. Many pharmacies do better than one to two million dollars in gross sales each year in business. They must hire employees, maintain an adequate inventory, and keep records. They must make rent or mortgage payments and pay insurance premiums and taxes. The growing influence of third-party prescription programs has forced pharmacists to spend considerable amounts of time processing claims, maintaining government records, and explaining benefit plans to customers. Many community pharmacy owners complain of restrictions placed on them by government agencies, insurance companies, and HMOs that they claim hinders their ability to compete with chain competitors.
Pharmacist Career Outlook
The U.S. Department of Labor (USDL) predicts employment growth for pharmacists to be faster than the average through 2014. Reasons for this increase include the growing middle-aged and senior population (generally the largest consumers of medications), technical and scientific advances that will make more drugs available and affordable, and even the advertising of medications that informs consumers of the variety of medicines available, resulting in their asking for these drugs.
Employment at hospital pharmacies should increase about as fast as the average because many hospitals are forced to reduce patient stay times. However, opportunities will open up in nursing homes, assisted-living facilities, and home care settings. Managed care organizations should also provide opportunities for pharmacists. These organizations use the pharmacist’s skills to monitor trends in and costs of medication therapies.
The role of the pharmacist is expected to expand. Pharmacists will be more involved in counseling their patients and in advising physicians on the drugs to prescribe. Pharmacists will make house calls and see patients in doctor’s offices. They will also be studying more complex medications and sorting out drug information on the Internet.
The USDL predicts that pharmacists will have good opportunities in managed care settings as they will be increasingly relied on to study trends and patterns in the use of medications and analyze the benefits and costs of various drug treatments. Drug companies will also need pharmacists to work in research and development and sales and marketing.
For More Information:
- Accreditation Council on Pharmaceutical Education
- American Association of Colleges of Pharmacy
- American Pharmacists Association (APhA)
- American Society of Health-System Pharmacists