What Do Pharmacists Actually Do?

featured image, pharmacy, pills

This post is a response to a recent blunder that angered pharmacists worldwide, by a certain journalist and broadcaster called Sam Delaney on ITV’s “This Morning”. Some things were said about the pharmacy profession, and the feathers of many pharmacists across the world were ruffled – mine included. Now, I like to think that I’m not someone who will lie down and roll over when I’m in a position to stand up against ignorance for something I believe in. So, since I’m a pharmacy student and hope to have a future in the healthcare profession, this is little ol’ me giving the internet an insight into what pharmacists are actually capable of.

In short, this is why you may have seen lots of angry pharmacists on social media ranting about Mr. Delaney recently. I particularly like the #whatwedoinpharmacy hashtag, in case you want to check it out.

Here’s a summary of the situation that pissed off all the pharmacists:

Sam Delaney, a journalist and broadcaster, was invited as a guest speaker for a discussion segment on ITV’s This Morning. This live TV segment was titled ‘Should chemists tell their customers they are fat?’, focusing on the role of community pharmacists in promoting health and wellbeing, and as the title suggests – weight loss advice.

 

When asked about this, he said that “patients could end up ‘being called ‘fat’ by a chemist who I think society generally — rightly or wrongly — don’t have much respect for anyway because we think that they’re pretend doctors”. 

 

He then carried on to say, “I’d say, listen, you are a chemist, all you do is, you go and collect the box of pills that I have been given a prescription for, from behind your shelf. Which is what they do, don’t they?”

Ah, the ignorance is alive and well. Now, I don’t know about you, but I don’t watch This Morning. It generally doesn’t add much to my mornings, and I would rather get my news updates from other sources. But that’s just me. If anything, Delaney has helped me confirm that I’ve made the right decision.

Pretend doctors?

pharmacist photo
Image by Alexas_Fotos from Pixabay

Here’s the thing – pharmacists and doctors do NOT do the same job. We are neither superior to doctors, nor inferior to them. We simply do different jobs. Doctors are trained to diagnose and treat conditions. Pharmacists manage the medicines needed to treat those conditions.

You might be wondering what this “managing” actually involves. Here are a few examples.

  • Making sure you’re getting the right dose for YOU.
diazepam monograph bnf
Diazepam drug monograph from the British National Formulary

This isn’t as simple as plucking a number out of the reference literature – if it were, we could probably get a computer to do the job. We take into account lots of other things – all your other conditions and how they might affect the way your body deals with your medicines. We consider the drugs you’re taking for these other conditions and whether we need to adjust the dose of the new medicine so that it provides benefit AND doesn’t interfere with the other drugs working. We take into account your body and how well it’s functioning – kidneys, liver, your blood results. All this affects how well your drugs work.

  • Making sure you get the right medicine in the first place.
nice pathway on hypertension prescribing
Treatment steps for hypertension by the National Institute for Health and Care Excellence

Sometimes, a certain medication may not be right for you. You may have certain factors that mean you won’t tolerate it as well, and your genetic makeup is considered too. You may be on other drugs that may interact and cause trouble with the new medicine. If one drug isn’t suitable for you, we tell the doctor that they may need to prescribe you something else, and why. We suggest an alternative treatment at the right dose and formulation, using sound scientific reasoning.

  • Making sure you take your medicines.
photo of capsules
Image by gaetano28 from Pixabay

Medicines adherence is a big problem in healthcare. The NHS throws away a significant sum in terms of the medicines that get supplied, but never get taken. It might sound silly, but drugs don’t work if you don’t take them. There are lots of reasons patients don’t take their medicines as they should. Sometimes, all it takes is education, hence pharmacists being a key part of the follow-up process after a doctor has prescribed a medicine. A pharmacist makes sure you are able to and know how to take your medicine, and helps you source an alternative regime if you have trouble.

Just an example – a schizophrenia patient may not be able to keep up with daily tablets and is wondering why his condition isn’t getting better. A pharmacist may suggest getting a long-acting depot injection that lasts him several weeks. This solves his problem of having to remember to take the tablets – all he has to do is set a date in his calendar to attend a clinic where he can get his injection administered by a healthcare professional, and that lasts him for a while.

You may notice that a lot of these involve working WITH a doctor, rather than trying to do what doctors do. I think my tweet below sums up my reaction to the whole “pretend doctor” thing:

tweet by janelle_thenellybean

Pharmacists count pills.

photo of tablets and capsules
Image by Remaztered Studio from Pixabay

Well, we can count pills. In the sense that we can do maths, and we can count things. Here’s the thing, why would universities set up a four-year degree that has to be accredited by the General Pharmaceutical Council, and also require a year of pre-registration training with a qualifying exam at the end – to teach us how to count pills? A five year old could probably count them for you. Besides, all that taxpayers’ money spent on student loans for Pharmacy degrees would be much better spent elsewhere – nobody needs 4 years of tuition fees to learn how to count pills and get them off a shelf.

We learn a lot more in our training than how to count pills. Here are just a few examples.

What do pharmacists study?
  • Pharmacokinetics – how a drug is absorbed, distributed, metabolised and eliminated from the body. Ie. what the body does to a drug. How does this affect drug dosing and how the patient will react to the drug? What will their side effects be like?
  • The organ systems – how the drugs match up to the different conditions associated with each system.
  • Drug formulation strategies – would a drug be best formulated as a tablet/solution/cream? Why?
  • Ethics – how would you handle complex patient dilemmas? How do you stand up for what you believe is best for a patient when other healthcare professionals oppose your stance?
  • The challenges that pharmaceutical companies face when manufacturing a drug – what should we consider when scaling up production? What happens if we overlook these factors?
  • Pharmacy law – how do legislations affect everyday clinical decision making?
  • Research – how does research inform evidence-based practice?

It may not come as much of a surprise that there are also a lot of career fields that a Pharmacy graduate can dabble in. Here are just a few.

What can pharmacists do?
  • Community/retail pharmacist – working in a high street or supermarket pharmacy.
  • Hospital pharmacist – working within a team of healthcare professionals to optimise patient care. Additional training can be undertaken to gain a prescribing qualification.
  • Medical science liaison – they serve as a bridge between clinicians and a pharmaceutical company, providing scientific expertise to both parties, analysing clinical trends and keeping ahead of emerging research.
  • Regulatory affairs – ensuring the safety of new medicines being approved for a certain market, considering the country’s drug laws, the drug development side of things and data from clinical trials.
  • Science/medical writer – pharmacists are armed with plenty of specialist drug knowledge, and they are able to present complex information in an accessible and attractive format to their audience.
  • Care Quality Commission – the CQC is an independent regulator that inspects and audits healthcare and social care services in England. A pharmacist’s background would be invaluable here.
  • Quality Assurance – working in a pharmaceutical company to ensure that a medicine is manufactured to the highest regulatory standards to ensure patient safety, using processes that have been validated and optimised.

Now, Sam Delaney may never see this. But I wanted to do my bit to tell people what pharmacists can really do besides stick a label on a box. Truthfully, I wasn’t aware of most of what I’ve written in this post until I started my degree in Pharmacy. I had no idea that there were so many career options for a Pharmacy graduate and how diverse they can be. That just goes to show that education and knowledge is everything, and it’s about time the world got to know what a pharmacist really has in their arsenal of skills. It’s about time we celebrated what a pharmacist is really capable of.

This is me waving my Pharmacy flag. Until next time.

– J

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Disclaimer: All opinions are my own, this post is not sponsored. Image sources are cited accordingly. 

7 Comments on “What Do Pharmacists Actually Do?”

  1. I’ve always wondered. And, yes as a younger person, I thought pharmacists were much like retail workers. Not in a disrespectful way as if I went out of my way to judge them as lesser medical beings. I just thought that was what the position entailed. In my adulthood – the more I needed medication lol – I learned that they were much more. But not this much more! This is quite fascinating. Thank you for speaking out.

    I’ll be browsing around your posts, but just in case you haven’t covered it yet – I would like to hear your thoughts on what a person coming in for a prescription should share, discuss, or ask their pharmacists.

    Often here, I’m not even asked if I have questions. Very rarely. Most often, they just direct me to check off that I have no questions as I swipe my card. It’s pretty annoying, but then again, I don’t know what to ask so they aren’t wrong. So, that’s why I want to hear your thoughts on that.

    1. Thank you for such an interesting comment! I’ll certainly be writing a post on what you can ask a pharmacist – it’s ironic that we are trained to give people the opportunity to ask questions, but somehow expect everyone to know what to ask! Thank you for the idea, it’s a really insightful one. Glad you enjoyed the post!

  2. Love that a non-professional can go on TV and make such bold statements without knowledge to back it up. This post was great to read because I’ve never known 100% what a pharmacist role entails.
    I do know that it’s very technical and just from the years of training alone, not as simple as handing over some medicine – as Sam seems to think. I don’t like how society puts different careers together and measures them against which one is tougher. It’s like the thing with doctors and nurses, why can’t we just accept different people are needed within the health care sector, and all play an important role.

    1. Ah I’m sure the doctors and nurses thing is a whole other can of worms. All we need is a little more education and a little less ignorant tarnishing! Glad you enjoyed this one x

  3. That’s terrible how ignorant Sam Delaney was & on live TV too!
    In the past year I’ve been needing medications from the pharmacy & just from my limited experience I know pharmacists are more than just handing over the medication you’ve been prescribed.
    It was nice reading about what a pharmacist actually does & the different career fields they can go into!

Comments and stories welcome!