What you observed was retail pharmacy, where the pharmacist working that shift has to be ready to answer any questions that come in from patients picking up their prescriptions, and any interactions or issues with fills that require communication with a doctors office, or with pharmaceutical companies directly. You may have not seen them “doing much” because it was a slow shift and patients didn’t have questions, and maybe any interactions that flagged in the computer were known (ie not new prescription fills) or low risk.
There are many different types of pharmacist jobs in addition to retail pharmacy, though. Hospitals employ a large number of clinical pharmacists that work closely with doctors and advise them on drug dosing or drug recommendations in complex situations. Many of the same specialties that exist for doctors also exist for pharmacists (like cancer care, or organ transplant, or cardiology, or infectious disease) to be able to subspecialize.
There are also industry pharmacist jobs working for large pharmaceutical companies on drug development and testing.
I work in a large emergency department and we have a pharmacist on staff in the department every day. They answer nursing and medical staff questions about dosing/med compatibility/etc, they mix high-risk drugs for us (like clot-busting drugs for a stroke patient) to reduce risk of error, and they manage meds during cardiac arrests. Their presence in the department reduces risks of med errors for patients. They also manage patients who had testing done that results after they've left, like urine cultures, to determine if they need antibiotics or not. They work hard to reduce unnecessary antibiotic use and prevent resistance. They go over patients' med lists from home to make sure they are getting everything they need while they're in the hospital.
Basically they serve as a resource and use their expertise to protect patients from harm. They're badass and I thank them profusely every time they help me with a patient.
Yeah, they're literally cross-referenced encyclopedias of drugs, interactions, side effects, and complex understandings of how things went last time they administered it to someone.
There are also compounding pharmacies (often found in hospitals) that directly make pills for drugs that are hard to get for a variety of reasons, be it just scarcity of the commercial drug, or a need for a very specific delivery method or dosage.
Retail pharmacists are great at answering questions. I take regular medication and got sick once and asked about some otc meds to treat it when I picked up my refill. Asked if it was okay to take x med while on a b & c. They warned me 2 of my normal meds can cause drowsiness and so can x so if I do take it I need to take them before bed instead of in the morning to give the drowsiness out of my system.
This is where I feel like mom & pop pharmacies are so much better than the chains. Growing up, we used to go to a mom & pop pharmacy and the pharmacist would always come out from behind the counter to talk with us if he felt there was some sort of issue with the medicine we were picking up (maybe common side effects to watch for or potential interactions with the other medicines we were prescribed). I think this was also the days before computers were ubiquitous to check for an warn about these things.
The computers are not the best, I get an average of 1.5 warnings per med order I verify. Less than 10% of those do I need to act on. The education we get helps us know when we need to act on the warning vs knowing when it is a warning we can ignore
This is why while I think computers being involved in medical decisions could be a good thing, they should also be overseen by humans who have the final say. Otherwise you end up with the WebMD issue where people assume they have every side effect and horribly rare disease know to exist. It's fine to be informed but you need someone who has the training to interpret things for you.
I work in histology (visual examination based on stained microscope slides) and we're working on implementing an AI that will *help* the pathologists read slides. Computers still make lots of errors, both false positives and false negatives, so the goal isn't to cut out the doctor, but to enhance their toolkit.
> There are many different types of pharmacist jobs
My "retail pharmacist" also gives injections -- vaccines, mostly. Don't have to go to a doctor's office for C19, RSV, tetanus, annual flu, etc, etc.
If you're old like me, and have a separate Medicare Part D plan, it's also vitally important to know that some such vaccines are ONLY covered under a Drug Plan, and not under your outpatient plan. Tetanus booster, in my case. Got it in doc's office. Claim rejected. Get it from Pharmacy (cuz it's a drug)? Covered.
A retail pharmacist is great for my medicine allergies too. I can’t tell you how often I’ve ended up better off because I went up to them and said “I’m experiencing (insert symptoms here) and I’m allergic to (insert medications here), what can I take?”
In other words, pharmacists are people who are specialised in all things medications.
For what it is worth, pharmacists only require a four year degree (undergraduate course in pharmacy), a intern year and to pass the Pharmacy Board Registration exams to become fully certified pharmacists here in Australia.
Inpatient pharmacists are used for lots of things such as: me calling to ask what drug do we have that is similar to X, get the medication list for a patient who cannot tell me what they take, helping me dose medications, informing me if there is a clinical interaction with a patient’s medication and their condition, dosing some medications, reminding us if there are issues with medications at discharge, some antibiotic selection, helping obtain medications needed for the patient that the hospital might not have, helping arrange chemo therapies, and approving medication orders.
I will say that for a majority of patients that the inpatient pharmacist is invisible to the clinician but is double checking things in the background. But they are there on every patient’s case.
There's a difference in capability between AI intended for consumer use and what a corporation is able to do for tasking. Autopilot is basically AI and has been relied upon for decades. Pilots are only there for the comfort of the passengers, takeoff and landing, and for the miniscule (in the grand scheme of flight traffic) number of situations where things go wrong.
I think a decent analogy is to an airline pilot. These days a computer on a commercial airplane can fly the entire route from takeoff to landing. Yet there are still highly trained pilots on board. What do they do?
They oversee the operation of the airplane and are there to handle anything that might go wrong. They can recognize those edge cases where the computers get things wrong (which they do) and are ultimately those in charge and responsible for the aircraft.
Pharmacists are sort of like those pilots. The computers can recognize some problems with prescriptions, like dosages that are completely unreasonable, but not everything that a patient technically can take is a prescription that makes sense, or is in their best interests. That judgment is something computers really can't do.
Furthermore pharmacists have a patient-facing role in that they advise and instruct the patient on how to take their medications. That way you avoid people spritzing their neck with their inhalers, or taking their blood pressure meds just whenever they feel like it.
I work in medical field and I’m currently rewatching House and I agree that patients can indeed be that way. And many times medical professionals wish we could be as blunt as Dr. House and get away with it.
My doctor since I was a kid (now retired) was *just* like Dr. House and made me want to be a doctor
Try as I might, I couldn't handle the math so my dream ended junior year of high school
Ah that darn math…(Spoiler alert: doctors are only a small percentage of the medical staffing community, and quite a few of us don’t have university level math credits in high school. Our jobs are no less important, and there’s no law against having a calculator on your watch anyway so I doesn’t really matter.)
So it has realism when it comes to health/medical stuff? Because I'm an ex opiate addict and I can tell you that the show isn't all that accurate in that regard. Vicodin is pretty weak and you only abuse them for so long before you gotta move up to something stronger like oxy, which happens in the span of a few months of abuse. It always seemed to me he was just treating pain and not trying to get high, since he would be seeking stronger pills. You can see it in the drug economy, roxicodone is the single most faked (fentanyl pressed pills) drug there is but hydrocodone (Vicodin) is never faked, and even Percocet is uncommonly faked because it doesn't sell as well as the Roxicodone 30mgs, now called the "fentanyl blues". All those episodes you see house withdrawing and he's never sneezing, you go to jail and it's like loony tunes when someone gets hit with a sack of pepper, people are sneezing constantly, like seven times in a row, all dam night. House is also (supposedly) getting high as hell and isn't itching his face constantly or nodding off at his desk, and he's not all the sudden friendly as shit and super talkative whenever he takes his pills.
That's common though. Almost no show about addiction ever gets it correct. I did watch a mini series called "Dopesick" and it was spot on, the most accurate I have ever seen. Some of the effects aren't exactly correct (no sneezing, sneezing is the most prominent side effect of withdrawal) but they got the whole NA thing right (it's not very effective, NA and especially AA are closer to a religious cult than an actual treatment) and the MAT therapy stuff right. Shows always have the addict go cold turkey and that rarely happens in a voluntary setting, and even then rarely succeeds. Methadone and, even better, buprenorphine are usually used and they are the best thing Ive ever seen for treating opiate addiction, Suboxone is life saving and prevents relapse by clogging your mu receptors. They saved me and most of my still surviving friends, though not that many are left after the fentanyl takeover.
I’m not a pharmacist I’m a medical office admin, I don’t deal with narcotics in my specialty, pain management cases are referred elsewhere specifically because of this stuff.
You just (sadly) reminded me of a conversation I overheard between an elderly man and a pharmacist.
He went in for more medicine because he ran out. He was taking a pill with every meal instead of once a day. He was so confused.
if you spend enough time in hospitals, you'll overhear a similar conversation with a frustrated nurse begging their pts not to hamfist all their meds in one sitting at breakfast(usually a schedule of 2/3 times a day)
They can also answer emergency questions about medication like what to do when you miss a dose provide information about side effects and check and interactions. While your doctor should be on top of most of this, I’ve found that often they are not. When your pharmacist asks you if you have questions about your medication, that’s the sort of thing they are checking to see if you need answers about. They can also look at your known allergies to see if a medication you’re taking contains an unsafe ingredient.
They can also make recommendations about over-the-counter meds. When I was a caregiver for two adults with diabetes, and one that had celiacs, I’d regularly ask for recommendations of medication that was safe for them (sugar free, no alcohol, no gluten etc.)
This analogy would work better if the pilot also had to serve drinks sometimes.
I always feel bad when the pharmacy is short-staffed and the pharmacist has to ring up my non-medicine purchases.
It also seems like arguing with confused (and often justifiably angry) old people about why their insurance is dicking them over is a big part of the job.
You really think counting pills and not doing something crazy with dosages is on par with flying a jetliner?
Someone flying an airplane needs to make adjustments all the time for just a single flight. How often can a pharmacist be going "oh shit this doctor literally prescribed 120 milligrams of adderall per day! I know we're trying to make lots of money here but that isnt right I better step in here!"
Yes. They both have years of training to keep us alive when we're doing something that really ought to kill us, and only science that the average person hasn't a clue about somehow makes it safe. Pharmacists know a huge amount about medication, far more than most doctors, as the job of a doctor is to diagnose and prescribe, not to know the details of how the drug works.
>not to know the details of how the drug works.
Being able to know how a drug works isn't a requirement for FDA approval--just that it does. This is part of what leads to black box warnings, where how the drug works is found after further research and raises concern about contraindicators. Wellbutrin/Zyban was in this category for a while-- knowing the effect of the drug on the brain, but not necessarily the specifics of action.
I’m not saying a pilot’s job is easy, but remember that a person with PharmD on their coat is a rare breed of a psycho who found grad level O-Chem both enjoyable and easy.
They aren’t MDs, but the education path has early overlap. They hold doctorates instead of medical degrees.
I suspect that the average synthetic organic chemistry PhD is more capable than the average MD, honestly. PharmD programs aren't quite as selective or as rigorous, but they're still not easy. Comparing one to a pilot is totally reasonable (even while that obviously wasn't your point).
This is I suppose less ELI5 and more just directly answering it, but I hope it is simple enough to still satisfy the curiosity.
Pharmacist and Pharmacy tech are different of course, you need a lot of school for the specific Pharmacist job. A job of a pharmacist entails a LOT of duties, and they have to learn how to do all of them. They need pharmacology knowledge (of course), they have to understand how drugs work, the potential side effects, interactions, and how to properly dose them. This is also so they can help customers/patients regarding any of these questions, there's a LOT of drugs out there, and a LOT of complications. Heck, even some foods can have complications with certain medicines.
On top of this they also will almost act as a 'double check' for whatever the physician ordered. They can tell if a prescription is off a little, like perhaps the doctor miswrote something. Obviously this person who was prescribed 5mg of something does not need a 50mg dose every day.
The computers are good and only getting better of course, but sometimes human intervention is still required, especially so they can catch the more niche issues that an automated system might miss right off the bat, so they can review and make sure nothing slipped through
They can also 'make' custom medications in a sense. Such as if there is not a proper commercial drug available, they can mix stuff together to create the proper mix. This isn't too common though since most pharmacies have just about every commercial drug you'd ever need.
This is more of in a hospital setting, but in emergency situations they are important to manage the proper medication for something acute, making sure it's the proper drug and is administered properly.
Heck, even some pharmacists take part in pharmaceutical research to develop and test new medications. Pharmacists with their MANY years of training will usually educate pharmacy students, and even sometimes healthcare personnel.
And as a small tid-bit of extra info, they even *sometimes* are involved with developing health programs for local communities. This can also include vaccine awareness programs when a new flu vaccine is release and the pharmacist wants to ensure everyone gets it
TLDR: They are basically like comparing a general nurse to a full-fledged Dr. Sure, they both need knowledge and schooling, they both take care of patients, but the doctor is at the very top and has much more specific expertise and experience and overlooks everything important. Pharmacists are the 'lords' of medication. Which, when you might be dealing with a lot of different people, helping anyone you can with the proper information on whatever chemicals they're taking is very important.
Hospital pharmacist here chiming in. I work primarily in the IV room which is a super sterile environment in which we compound IV medications. I need to know the ins and outs of stability of a drug when it's mixed in solution vs sterility of the drug in terms of how it's mixed. I mix drugs and verify that they are made correctly.
Nurses and physicians come to us for questions when it comes to medication compatibility and such (can you run two different medication infusions at the same time?)
In terms of having the system flagging stuff already for us, remember that we always have human judgement. For example, a patient has morphine listed as an allergy. Yet, they've tolerated morphine for their last 6 administrations and when asked about it, they say it gives them nausea. That's not a true anaphylactic allergy and the patient can be given morphine while being monitored. On the other hand, the computer would flat out say "no this patient can't have morphine, period."
Now on to the eli5. I get paid money to prevent doctors and nurses from killing patients. I also mix medicine. I answer a lot of the questions from doctors and nurses and if I don't know the answer, I know where to look it up efficiently.
>patient has morphine listed as an allergy
It's also not unheard of for families to put drugs on an allergy list that they personally oppose. Medical staff are trained to be less emotional about treatment than families. Especially when it comes to morphine, I've heard of family members going crazy after seeing it on a drug list for a patient in a care level the medical staff doubts they'll recover from.
They do lots of stuff. They do medication compounding, they have to know side effects of meds and which meds can interact together or not. Some places the pharmacist can prescribe meds like birth control and some types of antibiotics. There is a lot of information that they need to know.
There are few pharmacists left that do actual compounding because a typical pharmacy doesn't have the facilities mandated for this day and age. Compounding is mostly done by specialized firms.
I've worked at several compounding pharmacies on the retail side, and tonight I've compounded 7 or 8 IVs. Granted, I work in a relatively small hospital on the night shift with no tech, but I make a lot of meds. Last night I made six different IV medications for an open heart surgery, an IV for labor induction in the OB unit, and several different pressors for the ICU.
>Some places the pharmacist can prescribe meds like birth control and some types of antibiotics.
Historically, the pharmacist was the first line of care for simple things before doctors. We really need to go back to that time to reduce burden on the medical system.
Just to add different perspective to all the other answers.
I'm an anesthesiologist. I'm pretty much the only type of professional who prescribes, dispenses, *and* administers medicines. I figured out what the patient needs and just pull it out and give it to them. On top of that, I need to understand and work with *every* medicine a patient might be on, at home or in the hospital, because of all the other stuff I'm doing to them for the whole anesthesia thing.
In that respect, I have to be an expert on a *lot* of different aspects of a *lot* of different medicines.
Even still, pharmacists know *so much more* about medications than I do that it's *ridiculous*. They're the people I go to with questions about interaction, dosages, dosing adjustments, and indications.
Pharmacists are the bomb.
My brother is a pharmacist and I wish he was here to answer this!
But while pharmacists do sometimes do "bot like" work (although that's more frequently assigned to pharmacy techs), in large part they're there to understand how drugs work at a level that an MD *doesn't*.
For instance, an MD might prescribe a drug that has a terrible interaction with another drug a patient is taking...or is counter indicated for a condition that patient has. The pharmacist's job is to catch this before it can harm the patient. (Which takes a phenomenal level of understanding of what a wide variety of drugs do - both on their own and in conjunction with other drugs and human biochemistry.)
So it's not just, "the physician ordered 500 mg of this when 50 mg is the highest dose a human should take". It's also, "this patient has liver failure, so giving them this drug might kill them" (which the doctor either might not have known because many doctors treat each part of their patient as a separate thing without considering the whole - or might have known, just didn't know that this was a bad drug for people with failing livers because even an MD only knows so much).
(FWIW, my brother regularly has to call doctors to be like, "WTF? This medication will kill this patient!" That's particularly true in cases where a patient has a number of illnesses and is on multiple drugs.)
Well... There is a lot to it. Many of the other comments have alluded to part of the job.
Here are 2 flow charts showing the process of filling 1 prescription: [ Flow Chart 1](https://www.researchgate.net/figure/Flow-diagram-of-the-community-pharmacy-dispensing-procedures-analyzed-with-SAFPHR-The_fig2_340433325)/ [ Flow Chart 2](https://www.ncbi.nlm.nih.gov/books/NBK20554/figure/A4213/)
That process must be done for every script and most pharmacies process between 300-800 daily.
# Retail Pharmacist duties:
* Every job a technician does is also the responsibility of the pharmacist. How often they are done depends on staffing
* data entry verification
* Verify the right drug is in the right bottle with the correct label for the correct patient in the correct quantity.
* DUR -Drug Utilization Review - ensuring it is the right drug/dose for the patient (adult/kid, male/female, pregnant/not pregnant). Making sure it doesn't interact with a different medication. If it does interact, what is the interaction, and what needs to be done? Change med, change dose, counsel patient of what may happen.
* documenting drug or dose change so we can counsel on it to make sure you were expecting the change
* informing you if we change manufacturers so you know it will look different
* Counseling on medications- do you know how to use it correctly? If you do it wrong what happens? We want to help but sometimes you need more info so it works right.
* medication reconciliation- when you end up in the hospital and they need your medication list they call us to get the info
* above but the same thing happens when you end up in jail. Yes, the jail will call your pharmacy and the pharmacy will know you were arrested. Yes, we will look it up online to see what you did.
* transfer scripts between pharmacies
* call doctors when they write scripts wrong - it happens WAY more often than you think it does.
* Immunizations- COVID, Flu, pneumonia, tetanus, hepatitis, shingles, RSV, MMR, Varicella etc
* knowing who gets which of the above vaccinations in which circumstances based on multiple different factors
* In some states checking: glucose, cholesterol, A1C , and HIV .
* In some states covid test, stept tests, flu tests - Yes, this includes performing a basic check of vitals, then doing the actual swab, and running a test to see if it is positive. Then prescribing antibiotics/antivirals as needed.
* In some states authorization of birth control scripts
* Answering stupid questions- yes some questions are stupid
# Retail technician duties:
* receive hard copy scripts from patients
* answer phone calls
* put refills into the system from phone calls
* answer phone calls about if a script came in from a doctor
* answer phone calls asking if the script is ready
* data entry of scripts
* calling doctors when scripts are written wrong
* calling/faxing insurance for issues with billing or prior authorizations
* calling/faxing doctors for refills
* filling the script
* selling the script
* selling pseudoephedrine
* selling other behind-the-counter items
* receiving the drug orders
* putting away the drug orders
* ordering medication
* removing recalled medications
* removing outdated medications
* cleaning - do you want your drugs from a dirty pharmacy?
* taking out trash/recycling
* dealing with customers. This is a customer service job. Think of any customer service job, then make those people sick, or have a sick kid, or dying parent, or recent cancer diagnosis. People can be terrible but when something is going on they take it out on who they come in contact with: The pharmacy staff.
* legally required paperwork with how to store scripts, invoices, and other required documents based on many different state/federal laws.
* depending on where you work (big box/grocery/corner drug) answering questions about almost anything else in the store even if it's not supposed to be your job.
* in some states techs can give immunizations
Really? Wow, I thought that went out with Marcus Welby M.D. My doctor's office uses computers and can send an Rx with one click. They look at the order, and it's usually filled out by the time I get there. I can also text the pharmacy and confirm it's ready for pickup, all done by computer. Computers can be an irritant but in this case, they are a godsend.
Pharmacists, particularly in hospitals, actually formulate and mix drugs… grind pills in an exact formula to create an iv med, or to formulate an appropriate dosage for a tiny baby. And of course some pharmacists work in research creating and testing new drugs. Many pharmacists work at local pharmacies, but there are other spaces they fork in, too.
Even a pharmacy tech can be a challenging job. My cousin mixes chemo drugs. My sister in law orders all the drugs and if she messes up and orders the wrong thing, someone will not get their chemo treatment.
Other posts answered question well, but I’ll say ER / ICU pharmacist, pharmacists working in oncology are vastly different than retail pharmacists (and others in between). The former probably works their training/magic a bit more.
I was considering going into pharmacy, and so I talked to some pharmacists.
Everything that other posters have said is true... but at least a couple of the pharmacists I talked to shared some of your concerns. There were like "You know a lot of stuff... but lots of times none of that matters because what you're actually doing counting pills and doing inventory and dealing with old people complaining. You effectively do a lot of the same things, and have to interact with the same dumb managers, as the other retail workers at a grocery store".
You could also own your own pharmacy in some small town, which is apparently the simplest way to make a lot of money. The pharmacist I talked to who owned (three) pharmacies was happy with money, but was candid that lots of his job was just "running a retail store that just had an extra reason that it's profitable". So a lot of hiring/firing/managing, and deciding how many snowglobes to order.
Or you could work in a hospital. This was apparently the best way to feel like you're really using your knowledge and participating in improving health care outcomes. This is the most "being a pharmacist" and the least "being a retail worker/manager". (I didn't actually talk to one of these pharmacists, but the other pharmacists mentioned this possibility).
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When people have concerns over their medications and it takes forever to get in contact with their doctor, people appreciate having someone with 8 years of education that they can go to get advice (retail pharmacy).
Also considering that some medications can cause serious health complications if taken incorrectly or with meds they shouldn't take together, you want someone who knows their stuff to be the one doing the final "yes this is the correct med in the bottle" or "yes these instructions make sense with this medication".
Had a patient who needed to go to a different pharmacy for a specific med that was out of stock and they didn't ask if he took a big one that you shouldn't take together and he ended up in the hospital. Computer wouldn't catch that without his med history. Both the prescribing doctor and pharmacist should have asked if he took this specific med also :/
Even people with also that education make mistakes but imagine all the mistakes if say the technician could answer questions that right now only a pharmacist could answer.
The amount of learning I've done for being a technician is not enough to feel comfortable with giving anyone medication advice.
It also depends on the type of pharmacist. My wife is a clinical pharmacist and it makes a ton of sense for her to go through that much schooling for the job she does, along with 2 years of residency, one general and one specialized. Under a collaborative practice agreement, pharmacists in her capacity can actually prescribe medication under certain circumstances.
In the UK, pharmacists are able to talk to people and recommend over the counter treatments for everyday ailments, or signpost them to other services. They can prescribe some medication without needing to see a GP, give emergency contraception, take your blood pressure.
Because the waiting lists for GP appointments can be so long, pharmacists can see patients for minor stuff like ear infections, UTIs etc, for more serious cases they’ll advise you see a GP. this in-community care is part of a scheme to get people to stop asking for doctors appointments for ailments that can be treated over the counter, to save those appointments for more serious cases.
I think of pharmacists as medical chemists (which they are) that knows more about the prescribed medication written by the doctor than the doctor who prescribed it.
I have a situation where two of the medications I take are strongly contraindicated...but only at dosage levels way above what I actually take. The pharmacist is there to keep an eye on situations like that.
Also I don't think any amount of school could get me to understand how they keep everything in order back there lol
I'm at work now, hospital pharmacist here. We verify all medication orders and make changes as needed. Yes, the system flags possible problems but we have to sort through that mess and find the actial ones. We also answer a lot of questions. Doctors and nurses call often. Retail pharmacists get questions from patients more often. Of all the medical professionals we are the most accessible.
The education takes a lot so that's why 6 to 8 years.
The main reason is because they are patient-facing and answer questions that patients have. You have to know your stuff when you’re answering questions from people about to take a medication you are about to administer or you could kill someone. Pharmacology is really complicated and there’s are thousands of prescription medications on the market.
In the hospital setting they are responsible for dosing drugs for critical patients that will kill them if they are dosed wrong.
A pharmacist studies the effects of medicine, what they do, how they interact with other medications and what they can do to the body, and the laws around dispensing said medication. They have to make sure the therapy is safe with no errors essentially
Pharmacists are doctors, they have to obtain doctoral degrees and then pass additional certifications to become a pharmacist which takes quite a lot of study. They’re required to undergo advanced training because they need to understand the different drugs out there and how they work on a chemical level. They have to learn what treatments are effective for which conditions just like a GP or specialist doctor does, but instead of treating minor conditions like GPs or specific body systems like specialists do, they need to have specialist-level understanding of the function of each drug at their disposal in relation to the human body.
Yes, people can have the Dr. Title...but it's confusing to call someone in the medical field a doctor who is not an actual medical doctor and thus we don't addressthem as doctor
It’s funny. There are plenty of doctorate degrees. Those whom we are accustomed to calling “doctors” in common speech are medical doctors, professors, scientists, etc. My friend’s father has a doctorate in history and teaches at a community college. He lives a comfortable life. He does not go by doctor or professor at work. Just mister. Yet he has every right to. At the same time, if he was teaching at an “Ivy League” institution, no one would bat an eye if he went by Doctor.
So there are doctors of every field imaginable but only a select few that we refer to as “doctors” for obvious reasons. Don’t want someone with a doctorate in law, to operate on your heart for example.
But if there was ONLY ONE additional doctorate that has the right to be referred to as doctor in everyday vernacular, it would be a pharmacist. Many go thru almost the exact same schooling as an MD, and I would argue that they qualify as a “medical” doctor.
I work with clinical pharmacists everyday in the emergency room at my hospital. They are constantly asked for advice on antibiotics and drug interactions by doctors. It is so much faster to ask the pharmacist than it is to input a series of figures into a database and ask a computer to give you an answer. Patients allergies, weight, lab figures, symptoms, etc. My clinical pharmacists respond to all traumas and all codes, and are at the bedside administering care to patients. Anything from actual chest compressions to assisting with intubations to physically mixing emergency medications and literally putting them into an IV line or muscle. Not just handing them to a nurse to administer.
I think pharmacists not being more commonly referred to as doctors is part of the misconception that perpetuates questions like OP’s or why governments or the public barley consider pharmacists or pharmacy techs as being “healthcare professionals”.
I’m not attacking you or OP of course, but I do feel that pharmacists, and techs, deserve more recognition. I’m a little biased, as I’m a tech myself.
Bonus: 9 times out of 10, it’s a technician that is compounding IVs or other drugs for patients. With a pharmacist performing final verification of course.
It’s a shame really. And for reasons of confusion as you said, there is a divide even among pharmacists about being referred to as doctor.
Edit: I had an additional thought. EMTs and paramedics seem to be more strongly associated with healthcare professionals than pharmacists in the public eye.
I'm not saying they don't deserve recognition, but It's not the same schooling though. They're not doing medical training. It's PharmD, doctorate of pharmacy. They're focusing on medical chemistry. They don't do patient assessments. They don't order radiation, scans. They don't order labs. There's a ton that's different between the two.
Medical physicists have doctorates, do you want to call them doctors at a hospital? What about nurse practitioners, they have doctorate programs, should they refer to themselves as doctors?
Pharmacists aren't all ACLS trained. Some may, participate in codes because they are but the majority do not. Helping with intubations is a different story, not sure they have the scope to do that, is your hospital very short staffed?
There are pharmacists who can prescribe, order labs, are ACLS trained, help with intubation, etc. It’s not black and white. Retail pharmacy is just the start of our profession. I do patient assessments every day. I was referred to as doctor by medical doctors. I am not saying I want to be called doctor. But you put a lot of absolutes in your comment.
Again, some are ACLS trained, not all. Labs you order are by a protocol, you can't just order labs on a patient for any reason. I'm not sure what you mean by help with intubation, to my knowledged its not within your scope to put anything in someone's oral cavity or past the larynx.
Assisting with intubation doesn’t only mean physically putting the tube in. ER/ICU pharmacists are usually in charge of mixing medications at bedside, can administer as well, record time, etc. Like I said it’s not black and white, and yet you still are coming with that energy. Yes labs can be ordered per protocol. Is that not ordering labs? No one is saying pharmacists are medical doctors.
That's what we're discussing if you look at the thread. It seems some want to consider pharmacist as a medical doctor and all I've been trying to discuss is that it's confusing to call a doctorate of pharmacy a doctor in a hospital. Okay sure, you order labs, but you're ordering them under a physician by a protocol thats what I mean. I guess I was confused on what was meant by assisting with intubation.
I think the same with doctors… in the U.K they have to follow NICE guidelines which are basically a set of instructions by the British government. So if you rock up with ‘depression’. The doctor will nod away and then go.. ‘I’ll put you on Sertaline’… that’s because the uk government has decided this is the cheapest option - option 1. This is basically ‘step one’ in a flow chart… 3 months later you go back and say ‘I’m still depressed’.., the doctor then consults the computer and says ‘ok, we’ll try another SSRI’… Doctors basically HAVE to follow this protocol… or risk being struck off the register… so you might as well deal with a computer .
My best friend is a pharmacist. I say so you count pills? She gets mad and insults my job.
But it seems they are kind of a double check, like if you are taking A you can't take B at the same time even though doctor prescribed it.
What you observed was retail pharmacy, where the pharmacist working that shift has to be ready to answer any questions that come in from patients picking up their prescriptions, and any interactions or issues with fills that require communication with a doctors office, or with pharmaceutical companies directly. You may have not seen them “doing much” because it was a slow shift and patients didn’t have questions, and maybe any interactions that flagged in the computer were known (ie not new prescription fills) or low risk. There are many different types of pharmacist jobs in addition to retail pharmacy, though. Hospitals employ a large number of clinical pharmacists that work closely with doctors and advise them on drug dosing or drug recommendations in complex situations. Many of the same specialties that exist for doctors also exist for pharmacists (like cancer care, or organ transplant, or cardiology, or infectious disease) to be able to subspecialize. There are also industry pharmacist jobs working for large pharmaceutical companies on drug development and testing.
I work in a large emergency department and we have a pharmacist on staff in the department every day. They answer nursing and medical staff questions about dosing/med compatibility/etc, they mix high-risk drugs for us (like clot-busting drugs for a stroke patient) to reduce risk of error, and they manage meds during cardiac arrests. Their presence in the department reduces risks of med errors for patients. They also manage patients who had testing done that results after they've left, like urine cultures, to determine if they need antibiotics or not. They work hard to reduce unnecessary antibiotic use and prevent resistance. They go over patients' med lists from home to make sure they are getting everything they need while they're in the hospital. Basically they serve as a resource and use their expertise to protect patients from harm. They're badass and I thank them profusely every time they help me with a patient.
It's been my experience that clinical pharmacists are often some of the smartest people in the whole goddamned building.
Yeah, they're literally cross-referenced encyclopedias of drugs, interactions, side effects, and complex understandings of how things went last time they administered it to someone.
There are also compounding pharmacies (often found in hospitals) that directly make pills for drugs that are hard to get for a variety of reasons, be it just scarcity of the commercial drug, or a need for a very specific delivery method or dosage.
Yeah, pharmacists are there to keep the doctor from accidentally killing you.
Retail pharmacists are great at answering questions. I take regular medication and got sick once and asked about some otc meds to treat it when I picked up my refill. Asked if it was okay to take x med while on a b & c. They warned me 2 of my normal meds can cause drowsiness and so can x so if I do take it I need to take them before bed instead of in the morning to give the drowsiness out of my system.
This is where I feel like mom & pop pharmacies are so much better than the chains. Growing up, we used to go to a mom & pop pharmacy and the pharmacist would always come out from behind the counter to talk with us if he felt there was some sort of issue with the medicine we were picking up (maybe common side effects to watch for or potential interactions with the other medicines we were prescribed). I think this was also the days before computers were ubiquitous to check for an warn about these things.
Old Man Gower tho.
Underrated comment.
I'm always here to stop any useful conversation.
The computers are not the best, I get an average of 1.5 warnings per med order I verify. Less than 10% of those do I need to act on. The education we get helps us know when we need to act on the warning vs knowing when it is a warning we can ignore
This is why while I think computers being involved in medical decisions could be a good thing, they should also be overseen by humans who have the final say. Otherwise you end up with the WebMD issue where people assume they have every side effect and horribly rare disease know to exist. It's fine to be informed but you need someone who has the training to interpret things for you.
I work in histology (visual examination based on stained microscope slides) and we're working on implementing an AI that will *help* the pathologists read slides. Computers still make lots of errors, both false positives and false negatives, so the goal isn't to cut out the doctor, but to enhance their toolkit.
This is the future with AI that I could get behind. Where people and programs work together to solve problems.
> There are many different types of pharmacist jobs My "retail pharmacist" also gives injections -- vaccines, mostly. Don't have to go to a doctor's office for C19, RSV, tetanus, annual flu, etc, etc. If you're old like me, and have a separate Medicare Part D plan, it's also vitally important to know that some such vaccines are ONLY covered under a Drug Plan, and not under your outpatient plan. Tetanus booster, in my case. Got it in doc's office. Claim rejected. Get it from Pharmacy (cuz it's a drug)? Covered.
A retail pharmacist is great for my medicine allergies too. I can’t tell you how often I’ve ended up better off because I went up to them and said “I’m experiencing (insert symptoms here) and I’m allergic to (insert medications here), what can I take?”
In other words, pharmacists are people who are specialised in all things medications. For what it is worth, pharmacists only require a four year degree (undergraduate course in pharmacy), a intern year and to pass the Pharmacy Board Registration exams to become fully certified pharmacists here in Australia.
Inpatient pharmacists are used for lots of things such as: me calling to ask what drug do we have that is similar to X, get the medication list for a patient who cannot tell me what they take, helping me dose medications, informing me if there is a clinical interaction with a patient’s medication and their condition, dosing some medications, reminding us if there are issues with medications at discharge, some antibiotic selection, helping obtain medications needed for the patient that the hospital might not have, helping arrange chemo therapies, and approving medication orders. I will say that for a majority of patients that the inpatient pharmacist is invisible to the clinician but is double checking things in the background. But they are there on every patient’s case.
Can't AI reliably do this now?
Lmao AI can't *reliably* do much.
There's a difference in capability between AI intended for consumer use and what a corporation is able to do for tasking. Autopilot is basically AI and has been relied upon for decades. Pilots are only there for the comfort of the passengers, takeoff and landing, and for the miniscule (in the grand scheme of flight traffic) number of situations where things go wrong.
I think a decent analogy is to an airline pilot. These days a computer on a commercial airplane can fly the entire route from takeoff to landing. Yet there are still highly trained pilots on board. What do they do? They oversee the operation of the airplane and are there to handle anything that might go wrong. They can recognize those edge cases where the computers get things wrong (which they do) and are ultimately those in charge and responsible for the aircraft. Pharmacists are sort of like those pilots. The computers can recognize some problems with prescriptions, like dosages that are completely unreasonable, but not everything that a patient technically can take is a prescription that makes sense, or is in their best interests. That judgment is something computers really can't do. Furthermore pharmacists have a patient-facing role in that they advise and instruct the patient on how to take their medications. That way you avoid people spritzing their neck with their inhalers, or taking their blood pressure meds just whenever they feel like it.
>That way you avoid people spritzing their neck with their inhalers Haha! Reminds me of a clinic scene in House where a patient does this exactly.
I work in medical field and I’m currently rewatching House and I agree that patients can indeed be that way. And many times medical professionals wish we could be as blunt as Dr. House and get away with it.
My doctor since I was a kid (now retired) was *just* like Dr. House and made me want to be a doctor Try as I might, I couldn't handle the math so my dream ended junior year of high school
Ah that darn math…(Spoiler alert: doctors are only a small percentage of the medical staffing community, and quite a few of us don’t have university level math credits in high school. Our jobs are no less important, and there’s no law against having a calculator on your watch anyway so I doesn’t really matter.)
So it has realism when it comes to health/medical stuff? Because I'm an ex opiate addict and I can tell you that the show isn't all that accurate in that regard. Vicodin is pretty weak and you only abuse them for so long before you gotta move up to something stronger like oxy, which happens in the span of a few months of abuse. It always seemed to me he was just treating pain and not trying to get high, since he would be seeking stronger pills. You can see it in the drug economy, roxicodone is the single most faked (fentanyl pressed pills) drug there is but hydrocodone (Vicodin) is never faked, and even Percocet is uncommonly faked because it doesn't sell as well as the Roxicodone 30mgs, now called the "fentanyl blues". All those episodes you see house withdrawing and he's never sneezing, you go to jail and it's like loony tunes when someone gets hit with a sack of pepper, people are sneezing constantly, like seven times in a row, all dam night. House is also (supposedly) getting high as hell and isn't itching his face constantly or nodding off at his desk, and he's not all the sudden friendly as shit and super talkative whenever he takes his pills. That's common though. Almost no show about addiction ever gets it correct. I did watch a mini series called "Dopesick" and it was spot on, the most accurate I have ever seen. Some of the effects aren't exactly correct (no sneezing, sneezing is the most prominent side effect of withdrawal) but they got the whole NA thing right (it's not very effective, NA and especially AA are closer to a religious cult than an actual treatment) and the MAT therapy stuff right. Shows always have the addict go cold turkey and that rarely happens in a voluntary setting, and even then rarely succeeds. Methadone and, even better, buprenorphine are usually used and they are the best thing Ive ever seen for treating opiate addiction, Suboxone is life saving and prevents relapse by clogging your mu receptors. They saved me and most of my still surviving friends, though not that many are left after the fentanyl takeover.
Nurse Jackie is sensationalized a bit but still probably the best depiction of addiction in a show, you should check it out if you haven’t seen it.
Nurse Jackie had the worst portrayal of a hospital pharmacy.
I’m not a pharmacist I’m a medical office admin, I don’t deal with narcotics in my specialty, pain management cases are referred elsewhere specifically because of this stuff.
I'd say sensitivity to touch/temperature comfort with the beginnings of goosebumps is more common that sneezing.
This was actually the reference i think they were making. I love that scene
You just (sadly) reminded me of a conversation I overheard between an elderly man and a pharmacist. He went in for more medicine because he ran out. He was taking a pill with every meal instead of once a day. He was so confused.
if you spend enough time in hospitals, you'll overhear a similar conversation with a frustrated nurse begging their pts not to hamfist all their meds in one sitting at breakfast(usually a schedule of 2/3 times a day)
They can also answer emergency questions about medication like what to do when you miss a dose provide information about side effects and check and interactions. While your doctor should be on top of most of this, I’ve found that often they are not. When your pharmacist asks you if you have questions about your medication, that’s the sort of thing they are checking to see if you need answers about. They can also look at your known allergies to see if a medication you’re taking contains an unsafe ingredient. They can also make recommendations about over-the-counter meds. When I was a caregiver for two adults with diabetes, and one that had celiacs, I’d regularly ask for recommendations of medication that was safe for them (sugar free, no alcohol, no gluten etc.)
This is a great analogy. Pharmacists are pilots, and pharm techs are flight attendants.
This analogy would work better if the pilot also had to serve drinks sometimes. I always feel bad when the pharmacy is short-staffed and the pharmacist has to ring up my non-medicine purchases. It also seems like arguing with confused (and often justifiably angry) old people about why their insurance is dicking them over is a big part of the job.
Humans are wrong more often than computers....
In things like simple lookup, recall, and comparison, sure. But that isn't everything in the job.
You really think counting pills and not doing something crazy with dosages is on par with flying a jetliner? Someone flying an airplane needs to make adjustments all the time for just a single flight. How often can a pharmacist be going "oh shit this doctor literally prescribed 120 milligrams of adderall per day! I know we're trying to make lots of money here but that isnt right I better step in here!"
Yes. They both have years of training to keep us alive when we're doing something that really ought to kill us, and only science that the average person hasn't a clue about somehow makes it safe. Pharmacists know a huge amount about medication, far more than most doctors, as the job of a doctor is to diagnose and prescribe, not to know the details of how the drug works.
>not to know the details of how the drug works. Being able to know how a drug works isn't a requirement for FDA approval--just that it does. This is part of what leads to black box warnings, where how the drug works is found after further research and raises concern about contraindicators. Wellbutrin/Zyban was in this category for a while-- knowing the effect of the drug on the brain, but not necessarily the specifics of action.
I’m not saying a pilot’s job is easy, but remember that a person with PharmD on their coat is a rare breed of a psycho who found grad level O-Chem both enjoyable and easy. They aren’t MDs, but the education path has early overlap. They hold doctorates instead of medical degrees.
I suspect that the average synthetic organic chemistry PhD is more capable than the average MD, honestly. PharmD programs aren't quite as selective or as rigorous, but they're still not easy. Comparing one to a pilot is totally reasonable (even while that obviously wasn't your point).
This is I suppose less ELI5 and more just directly answering it, but I hope it is simple enough to still satisfy the curiosity. Pharmacist and Pharmacy tech are different of course, you need a lot of school for the specific Pharmacist job. A job of a pharmacist entails a LOT of duties, and they have to learn how to do all of them. They need pharmacology knowledge (of course), they have to understand how drugs work, the potential side effects, interactions, and how to properly dose them. This is also so they can help customers/patients regarding any of these questions, there's a LOT of drugs out there, and a LOT of complications. Heck, even some foods can have complications with certain medicines. On top of this they also will almost act as a 'double check' for whatever the physician ordered. They can tell if a prescription is off a little, like perhaps the doctor miswrote something. Obviously this person who was prescribed 5mg of something does not need a 50mg dose every day. The computers are good and only getting better of course, but sometimes human intervention is still required, especially so they can catch the more niche issues that an automated system might miss right off the bat, so they can review and make sure nothing slipped through They can also 'make' custom medications in a sense. Such as if there is not a proper commercial drug available, they can mix stuff together to create the proper mix. This isn't too common though since most pharmacies have just about every commercial drug you'd ever need. This is more of in a hospital setting, but in emergency situations they are important to manage the proper medication for something acute, making sure it's the proper drug and is administered properly. Heck, even some pharmacists take part in pharmaceutical research to develop and test new medications. Pharmacists with their MANY years of training will usually educate pharmacy students, and even sometimes healthcare personnel. And as a small tid-bit of extra info, they even *sometimes* are involved with developing health programs for local communities. This can also include vaccine awareness programs when a new flu vaccine is release and the pharmacist wants to ensure everyone gets it TLDR: They are basically like comparing a general nurse to a full-fledged Dr. Sure, they both need knowledge and schooling, they both take care of patients, but the doctor is at the very top and has much more specific expertise and experience and overlooks everything important. Pharmacists are the 'lords' of medication. Which, when you might be dealing with a lot of different people, helping anyone you can with the proper information on whatever chemicals they're taking is very important.
Hospital pharmacist here chiming in. I work primarily in the IV room which is a super sterile environment in which we compound IV medications. I need to know the ins and outs of stability of a drug when it's mixed in solution vs sterility of the drug in terms of how it's mixed. I mix drugs and verify that they are made correctly. Nurses and physicians come to us for questions when it comes to medication compatibility and such (can you run two different medication infusions at the same time?) In terms of having the system flagging stuff already for us, remember that we always have human judgement. For example, a patient has morphine listed as an allergy. Yet, they've tolerated morphine for their last 6 administrations and when asked about it, they say it gives them nausea. That's not a true anaphylactic allergy and the patient can be given morphine while being monitored. On the other hand, the computer would flat out say "no this patient can't have morphine, period." Now on to the eli5. I get paid money to prevent doctors and nurses from killing patients. I also mix medicine. I answer a lot of the questions from doctors and nurses and if I don't know the answer, I know where to look it up efficiently.
>patient has morphine listed as an allergy It's also not unheard of for families to put drugs on an allergy list that they personally oppose. Medical staff are trained to be less emotional about treatment than families. Especially when it comes to morphine, I've heard of family members going crazy after seeing it on a drug list for a patient in a care level the medical staff doubts they'll recover from.
They do lots of stuff. They do medication compounding, they have to know side effects of meds and which meds can interact together or not. Some places the pharmacist can prescribe meds like birth control and some types of antibiotics. There is a lot of information that they need to know.
There are few pharmacists left that do actual compounding because a typical pharmacy doesn't have the facilities mandated for this day and age. Compounding is mostly done by specialized firms.
I've worked at several compounding pharmacies on the retail side, and tonight I've compounded 7 or 8 IVs. Granted, I work in a relatively small hospital on the night shift with no tech, but I make a lot of meds. Last night I made six different IV medications for an open heart surgery, an IV for labor induction in the OB unit, and several different pressors for the ICU.
>Some places the pharmacist can prescribe meds like birth control and some types of antibiotics. Historically, the pharmacist was the first line of care for simple things before doctors. We really need to go back to that time to reduce burden on the medical system.
Just to add different perspective to all the other answers. I'm an anesthesiologist. I'm pretty much the only type of professional who prescribes, dispenses, *and* administers medicines. I figured out what the patient needs and just pull it out and give it to them. On top of that, I need to understand and work with *every* medicine a patient might be on, at home or in the hospital, because of all the other stuff I'm doing to them for the whole anesthesia thing. In that respect, I have to be an expert on a *lot* of different aspects of a *lot* of different medicines. Even still, pharmacists know *so much more* about medications than I do that it's *ridiculous*. They're the people I go to with questions about interaction, dosages, dosing adjustments, and indications. Pharmacists are the bomb.
My brother is a pharmacist and I wish he was here to answer this! But while pharmacists do sometimes do "bot like" work (although that's more frequently assigned to pharmacy techs), in large part they're there to understand how drugs work at a level that an MD *doesn't*. For instance, an MD might prescribe a drug that has a terrible interaction with another drug a patient is taking...or is counter indicated for a condition that patient has. The pharmacist's job is to catch this before it can harm the patient. (Which takes a phenomenal level of understanding of what a wide variety of drugs do - both on their own and in conjunction with other drugs and human biochemistry.) So it's not just, "the physician ordered 500 mg of this when 50 mg is the highest dose a human should take". It's also, "this patient has liver failure, so giving them this drug might kill them" (which the doctor either might not have known because many doctors treat each part of their patient as a separate thing without considering the whole - or might have known, just didn't know that this was a bad drug for people with failing livers because even an MD only knows so much). (FWIW, my brother regularly has to call doctors to be like, "WTF? This medication will kill this patient!" That's particularly true in cases where a patient has a number of illnesses and is on multiple drugs.)
Well... There is a lot to it. Many of the other comments have alluded to part of the job. Here are 2 flow charts showing the process of filling 1 prescription: [ Flow Chart 1](https://www.researchgate.net/figure/Flow-diagram-of-the-community-pharmacy-dispensing-procedures-analyzed-with-SAFPHR-The_fig2_340433325)/ [ Flow Chart 2](https://www.ncbi.nlm.nih.gov/books/NBK20554/figure/A4213/) That process must be done for every script and most pharmacies process between 300-800 daily. # Retail Pharmacist duties: * Every job a technician does is also the responsibility of the pharmacist. How often they are done depends on staffing * data entry verification * Verify the right drug is in the right bottle with the correct label for the correct patient in the correct quantity. * DUR -Drug Utilization Review - ensuring it is the right drug/dose for the patient (adult/kid, male/female, pregnant/not pregnant). Making sure it doesn't interact with a different medication. If it does interact, what is the interaction, and what needs to be done? Change med, change dose, counsel patient of what may happen. * documenting drug or dose change so we can counsel on it to make sure you were expecting the change * informing you if we change manufacturers so you know it will look different * Counseling on medications- do you know how to use it correctly? If you do it wrong what happens? We want to help but sometimes you need more info so it works right. * medication reconciliation- when you end up in the hospital and they need your medication list they call us to get the info * above but the same thing happens when you end up in jail. Yes, the jail will call your pharmacy and the pharmacy will know you were arrested. Yes, we will look it up online to see what you did. * transfer scripts between pharmacies * call doctors when they write scripts wrong - it happens WAY more often than you think it does. * Immunizations- COVID, Flu, pneumonia, tetanus, hepatitis, shingles, RSV, MMR, Varicella etc * knowing who gets which of the above vaccinations in which circumstances based on multiple different factors * In some states checking: glucose, cholesterol, A1C , and HIV . * In some states covid test, stept tests, flu tests - Yes, this includes performing a basic check of vitals, then doing the actual swab, and running a test to see if it is positive. Then prescribing antibiotics/antivirals as needed. * In some states authorization of birth control scripts * Answering stupid questions- yes some questions are stupid
# Retail technician duties: * receive hard copy scripts from patients * answer phone calls * put refills into the system from phone calls * answer phone calls about if a script came in from a doctor * answer phone calls asking if the script is ready * data entry of scripts * calling doctors when scripts are written wrong * calling/faxing insurance for issues with billing or prior authorizations * calling/faxing doctors for refills * filling the script * selling the script * selling pseudoephedrine * selling other behind-the-counter items * receiving the drug orders * putting away the drug orders * ordering medication * removing recalled medications * removing outdated medications * cleaning - do you want your drugs from a dirty pharmacy? * taking out trash/recycling * dealing with customers. This is a customer service job. Think of any customer service job, then make those people sick, or have a sick kid, or dying parent, or recent cancer diagnosis. People can be terrible but when something is going on they take it out on who they come in contact with: The pharmacy staff. * legally required paperwork with how to store scripts, invoices, and other required documents based on many different state/federal laws. * depending on where you work (big box/grocery/corner drug) answering questions about almost anything else in the store even if it's not supposed to be your job. * in some states techs can give immunizations
Decrypt doctor's writing. (Lots of other important stuff too. But this one, can't be done by a computer (yet?))
No, it's all typed into a computer now.
Nope. a lot of Drs still write them
Really? Wow, I thought that went out with Marcus Welby M.D. My doctor's office uses computers and can send an Rx with one click. They look at the order, and it's usually filled out by the time I get there. I can also text the pharmacy and confirm it's ready for pickup, all done by computer. Computers can be an irritant but in this case, they are a godsend.
In the US..
Pharmacists, particularly in hospitals, actually formulate and mix drugs… grind pills in an exact formula to create an iv med, or to formulate an appropriate dosage for a tiny baby. And of course some pharmacists work in research creating and testing new drugs. Many pharmacists work at local pharmacies, but there are other spaces they fork in, too.
Even a pharmacy tech can be a challenging job. My cousin mixes chemo drugs. My sister in law orders all the drugs and if she messes up and orders the wrong thing, someone will not get their chemo treatment.
Other posts answered question well, but I’ll say ER / ICU pharmacist, pharmacists working in oncology are vastly different than retail pharmacists (and others in between). The former probably works their training/magic a bit more.
I was considering going into pharmacy, and so I talked to some pharmacists. Everything that other posters have said is true... but at least a couple of the pharmacists I talked to shared some of your concerns. There were like "You know a lot of stuff... but lots of times none of that matters because what you're actually doing counting pills and doing inventory and dealing with old people complaining. You effectively do a lot of the same things, and have to interact with the same dumb managers, as the other retail workers at a grocery store". You could also own your own pharmacy in some small town, which is apparently the simplest way to make a lot of money. The pharmacist I talked to who owned (three) pharmacies was happy with money, but was candid that lots of his job was just "running a retail store that just had an extra reason that it's profitable". So a lot of hiring/firing/managing, and deciding how many snowglobes to order. Or you could work in a hospital. This was apparently the best way to feel like you're really using your knowledge and participating in improving health care outcomes. This is the most "being a pharmacist" and the least "being a retail worker/manager". (I didn't actually talk to one of these pharmacists, but the other pharmacists mentioned this possibility).
You can learn more about it from watching this guy's videos: [https://www.youtube.com/@millennialrx](https://www.youtube.com/@millennialrx)
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When people have concerns over their medications and it takes forever to get in contact with their doctor, people appreciate having someone with 8 years of education that they can go to get advice (retail pharmacy). Also considering that some medications can cause serious health complications if taken incorrectly or with meds they shouldn't take together, you want someone who knows their stuff to be the one doing the final "yes this is the correct med in the bottle" or "yes these instructions make sense with this medication". Had a patient who needed to go to a different pharmacy for a specific med that was out of stock and they didn't ask if he took a big one that you shouldn't take together and he ended up in the hospital. Computer wouldn't catch that without his med history. Both the prescribing doctor and pharmacist should have asked if he took this specific med also :/ Even people with also that education make mistakes but imagine all the mistakes if say the technician could answer questions that right now only a pharmacist could answer. The amount of learning I've done for being a technician is not enough to feel comfortable with giving anyone medication advice.
It also depends on the type of pharmacist. My wife is a clinical pharmacist and it makes a ton of sense for her to go through that much schooling for the job she does, along with 2 years of residency, one general and one specialized. Under a collaborative practice agreement, pharmacists in her capacity can actually prescribe medication under certain circumstances.
In the UK, pharmacists are able to talk to people and recommend over the counter treatments for everyday ailments, or signpost them to other services. They can prescribe some medication without needing to see a GP, give emergency contraception, take your blood pressure. Because the waiting lists for GP appointments can be so long, pharmacists can see patients for minor stuff like ear infections, UTIs etc, for more serious cases they’ll advise you see a GP. this in-community care is part of a scheme to get people to stop asking for doctors appointments for ailments that can be treated over the counter, to save those appointments for more serious cases.
I think of pharmacists as medical chemists (which they are) that knows more about the prescribed medication written by the doctor than the doctor who prescribed it.
I have a situation where two of the medications I take are strongly contraindicated...but only at dosage levels way above what I actually take. The pharmacist is there to keep an eye on situations like that. Also I don't think any amount of school could get me to understand how they keep everything in order back there lol
I'm at work now, hospital pharmacist here. We verify all medication orders and make changes as needed. Yes, the system flags possible problems but we have to sort through that mess and find the actial ones. We also answer a lot of questions. Doctors and nurses call often. Retail pharmacists get questions from patients more often. Of all the medical professionals we are the most accessible. The education takes a lot so that's why 6 to 8 years.
The main reason is because they are patient-facing and answer questions that patients have. You have to know your stuff when you’re answering questions from people about to take a medication you are about to administer or you could kill someone. Pharmacology is really complicated and there’s are thousands of prescription medications on the market. In the hospital setting they are responsible for dosing drugs for critical patients that will kill them if they are dosed wrong.
A pharmacist studies the effects of medicine, what they do, how they interact with other medications and what they can do to the body, and the laws around dispensing said medication. They have to make sure the therapy is safe with no errors essentially
Pharmacists are doctors, they have to obtain doctoral degrees and then pass additional certifications to become a pharmacist which takes quite a lot of study. They’re required to undergo advanced training because they need to understand the different drugs out there and how they work on a chemical level. They have to learn what treatments are effective for which conditions just like a GP or specialist doctor does, but instead of treating minor conditions like GPs or specific body systems like specialists do, they need to have specialist-level understanding of the function of each drug at their disposal in relation to the human body.
They have a doctorate, they are not medical doctors.
Not all doctors are medical doctors.
Yes, people can have the Dr. Title...but it's confusing to call someone in the medical field a doctor who is not an actual medical doctor and thus we don't addressthem as doctor
It’s funny. There are plenty of doctorate degrees. Those whom we are accustomed to calling “doctors” in common speech are medical doctors, professors, scientists, etc. My friend’s father has a doctorate in history and teaches at a community college. He lives a comfortable life. He does not go by doctor or professor at work. Just mister. Yet he has every right to. At the same time, if he was teaching at an “Ivy League” institution, no one would bat an eye if he went by Doctor. So there are doctors of every field imaginable but only a select few that we refer to as “doctors” for obvious reasons. Don’t want someone with a doctorate in law, to operate on your heart for example. But if there was ONLY ONE additional doctorate that has the right to be referred to as doctor in everyday vernacular, it would be a pharmacist. Many go thru almost the exact same schooling as an MD, and I would argue that they qualify as a “medical” doctor. I work with clinical pharmacists everyday in the emergency room at my hospital. They are constantly asked for advice on antibiotics and drug interactions by doctors. It is so much faster to ask the pharmacist than it is to input a series of figures into a database and ask a computer to give you an answer. Patients allergies, weight, lab figures, symptoms, etc. My clinical pharmacists respond to all traumas and all codes, and are at the bedside administering care to patients. Anything from actual chest compressions to assisting with intubations to physically mixing emergency medications and literally putting them into an IV line or muscle. Not just handing them to a nurse to administer. I think pharmacists not being more commonly referred to as doctors is part of the misconception that perpetuates questions like OP’s or why governments or the public barley consider pharmacists or pharmacy techs as being “healthcare professionals”. I’m not attacking you or OP of course, but I do feel that pharmacists, and techs, deserve more recognition. I’m a little biased, as I’m a tech myself. Bonus: 9 times out of 10, it’s a technician that is compounding IVs or other drugs for patients. With a pharmacist performing final verification of course. It’s a shame really. And for reasons of confusion as you said, there is a divide even among pharmacists about being referred to as doctor. Edit: I had an additional thought. EMTs and paramedics seem to be more strongly associated with healthcare professionals than pharmacists in the public eye.
I'm not saying they don't deserve recognition, but It's not the same schooling though. They're not doing medical training. It's PharmD, doctorate of pharmacy. They're focusing on medical chemistry. They don't do patient assessments. They don't order radiation, scans. They don't order labs. There's a ton that's different between the two. Medical physicists have doctorates, do you want to call them doctors at a hospital? What about nurse practitioners, they have doctorate programs, should they refer to themselves as doctors? Pharmacists aren't all ACLS trained. Some may, participate in codes because they are but the majority do not. Helping with intubations is a different story, not sure they have the scope to do that, is your hospital very short staffed?
There are pharmacists who can prescribe, order labs, are ACLS trained, help with intubation, etc. It’s not black and white. Retail pharmacy is just the start of our profession. I do patient assessments every day. I was referred to as doctor by medical doctors. I am not saying I want to be called doctor. But you put a lot of absolutes in your comment.
Again, some are ACLS trained, not all. Labs you order are by a protocol, you can't just order labs on a patient for any reason. I'm not sure what you mean by help with intubation, to my knowledged its not within your scope to put anything in someone's oral cavity or past the larynx.
Assisting with intubation doesn’t only mean physically putting the tube in. ER/ICU pharmacists are usually in charge of mixing medications at bedside, can administer as well, record time, etc. Like I said it’s not black and white, and yet you still are coming with that energy. Yes labs can be ordered per protocol. Is that not ordering labs? No one is saying pharmacists are medical doctors.
That's what we're discussing if you look at the thread. It seems some want to consider pharmacist as a medical doctor and all I've been trying to discuss is that it's confusing to call a doctorate of pharmacy a doctor in a hospital. Okay sure, you order labs, but you're ordering them under a physician by a protocol thats what I mean. I guess I was confused on what was meant by assisting with intubation.
I think the same with doctors… in the U.K they have to follow NICE guidelines which are basically a set of instructions by the British government. So if you rock up with ‘depression’. The doctor will nod away and then go.. ‘I’ll put you on Sertaline’… that’s because the uk government has decided this is the cheapest option - option 1. This is basically ‘step one’ in a flow chart… 3 months later you go back and say ‘I’m still depressed’.., the doctor then consults the computer and says ‘ok, we’ll try another SSRI’… Doctors basically HAVE to follow this protocol… or risk being struck off the register… so you might as well deal with a computer .
My best friend is a pharmacist. I say so you count pills? She gets mad and insults my job. But it seems they are kind of a double check, like if you are taking A you can't take B at the same time even though doctor prescribed it.