What your pharmacist does

A lot of people don't really know exactly what a pharmacist does, and I think everyone in my profession feels my frustration when I tell them 'No, we do not (just) count your pills!' If that's all we did, why don't they just hire chimps instead??

Under the Pharmacy Act, a pharmacist's scope of practice "is the custody, compounding and dispensing of drugs, the provision of non-prescription drugs, health care aids and devices and the provision of information related to drug use." Simply put, a pharmacist needs to there at your Shoppers/Pharmaplus/Pharmasave/etc in order for it to be open! You will notice that in Dominions, Loblaws, etc, they will have a "Lock & Leave" pharmacy where the drugs are sealed off so that the public can't access it when the pharmacy is closed (usually after 9 pm).

What pharmacists learn in school
I think different faculties may teach the courses in a different order, but the courses itself are generally the same. Human Anatomy and Histology, Micriobiology of Infectious Diseases, Statistics (so that we can analyze the evidence about the efficacy of drugs), Basic Human Physiology, Medicinal Chemistry, Biochemistry and Molecular Biology, Pharmaceutics, Pharmacology, Pharmacokinetics (how the drug is absorbed, distributed, metabolized, excreted through the body, Toxicology, Pharmaceutical Care (aka Therapeutics - where we learn important information about the drugs we give you), etc are just a few of the MANY courses that we learn during our 4 years in school.

While most students take five 1.0 credit courses during an academic school year, we as pharmacy students take up to 8 or 9 courses/semester that vary from 0.25, 0.5 and 1.0 credits. Tuition is MUCH more expensive (double that of regular arts&sci students) and we graduate with a BSc.Phm (Bachelors of Science in Pharmacy).

What pharmacists (would ideally) do at work
Unfortunately, doctors are not perfect and they make mistakes too! Luckily, we are there to catch them (most, if not all of the time). We also make sure that the drug you're getting is the appropriate one for the right condition. When you come in with a script, we will know the many uses for that drug, as well as appropriate dosing. This is why sometimes we confirm what you're taking it for and what the doctor has already told you. Ideally, we would follow up with you to see if there are any undesirable side effects due to the medication and if the medication is working (eg. has blood sugar, or blood pressure gone down).

If you get a new prescription, we are SUPPOSED to counsel you on its use! If it's a repeat prescription (you've had it before), we're usually ask if you have any questions regarding the medication. When you come in with a question about colds/allergies/rashes/burns/lice/pinworms/scabies/multivitamins/herbals etc, we can answer your questions and make a recommendation about which product would be best for you.

Here is a common example of a pharmacist intervention:
Mrs. X comes in with a prescription for one of her maintenance medications. Usually, she gets HCTZ (water pill) 12.5 mg daily. HCTZ is available as 25 mg strength. Instead of writing, ss (1/2) tab daily, doctor Y has written it as 1 tablet daily. I confirm with Mrs. X to see if she is aware that her dose has increased. She is unaware that there were changes to her medication regime. I call doctor Y and confirm that she is to stay on 1/2 tablet daily.

Pharmacy technician DNE Pharmacist
It always amuses me when patients/clients come up to the counter and start talking about their cold/allergies/rash to the first person they see at the dispensary. After the patient goes on for 2 minutes, the technician usually says "Hold on, I'll get you the pharmacist," and then the patient has to repeat their case to me. Most people do not realize that there is usually ONE pharmacist and one or more pharmacy assistants/technicians, and that legally, only the pharmacist can legally provide recommendations on over-the-counter medications. Usually, person wearing WHITE labcoat = PHARMACIST.

The technician(s) can make or break the pharmacist. I can't tell you how important they are. They can either make the workflow go very smoothly, or slow the pharmacy down tenfold. They can enter in prescriptions, deal with billing issues, count/prepare the medications, answer the phone that rings incessantly, as well as answer certain patient questions (eg regarding billing, location of products). I really really really appreciate my technicians!

Ontario set up a program last year called MedsCheck, which I think highlights the importance of a pharmacist and what they can do for patients! It allows patients who are taking 3 or more chronic medications to set up an appointment with his/her pharmacist and go over their medications thoroughly. During a MedsCheck appointment, patients can ask any questions regarding the use/storage of their medications, and it provides pharmacists with the opportunity to identify and resolve any drug therapy problems. Best of all, it's free for patients (all they need to bring is their health card) and is paid for by the Ontario government! The patient leaves the pharmacy with a complete list of all the medications they are taking (prescription, OTC, herbals), and sometimes the doctor is usually notified of a MedsCheck being performed.

Wow, that was a lot of typing in one day! I hope you enjoyed this special edition of "What your pharmacist does". I like comments (positive more so than negative). Thanks for making it this far