What is a clinical pharmacist?

Just what exactly is the definition of a clinical pharmacist? this term seems to be something like the term professional. A lot of people use the term but never define it. When questioned you usually get an answer something like this, “I know one when I see one”

So let me give you something to think about. Here is the definition of clinical pharmacy has found on Wikipedia.

“Clinical pharmacy is the branch of Pharmacy where pharmacists provide patient care that optimizes the use of medication and promotes health, wellness, and disease prevention.[1] Clinical pharmacists care for patients in all health care settings but the clinical pharmacy movement initially began inside hospitals and clinics. Clinical pharmacists often collaborate with physicians and other healthcare professionals.”

Set aside for a moment the idea that I just used Wikipedia as a reference. I’m not writing an academic paper I’m just making the point. And frankly more people read Wikipedia then read any of the academic textbooks I could reference.

But notice that in this definition the practice of community pharmacy is not excluded. In fact, I could make that case that as a community pharmacist with a patient base of 4000 patients I am optimizing the use of medication, promoting health, wellness and disease prevention and collaborating with physicians and other healthcare professionals. I believe that although I am not providing critical care like an inpatient pharmacist might I am providing care that is critical to the well-being of the patient. I may not be performing vancomycin dosing or deciding which cardiac stimulant to inject. But I can recognize an adverse reaction and head off a major disaster, because I know the patient well enough to know that they don’t look right.

Let me give you an example. Mrs. O’Neill, a regular customer came into my store to pick up her prescriptions. Normally she was pretty upbeat and had a pale Celtic complexion. On this particular day her face was beet red and she seemed agitated and in pain. When I asked her about it she mentioned that she’d had this roaring headache for two days. I sat her down in our consultation room, took her blood pressure and she was at 240/180. I immediately got her over to the local emergency room. They stabilized her and discovered that she had had an adverse reaction to Vioxx that she received in the mail. two years later Vioxx was removed from the market. But she’s alive today because I bothered to care about her. To me that’s the essence of clinical pharmacy.

There seems to be a bias in academia against community practice as a legitimate use of the Pharm.D. degree. Several students have told me they’re afraid to tell some of the clinical faculty that they have an interest in owning their own store. As I have gotten to know the clinical professionals that teach at Wingate University School of Pharmacy, I have learned that most of them are residency or fellowship trained and have chosen to specialize in a particular inpatient or ambulatory care practice setting.

They don’t necessarily dislike community practice it’s just not what they know or what they do on a regular basis. Like all of us they try to do their jobs well and try to get better at their particular practice setting. And when they’re advising students about future opportunities they can only really speak from their own experience. Since what they know is not community practice they talk about what they do know. The sheer weight in the number of clinical courses and acute-care rotations means that students will receive more input from clinical faculty than from community care pharmacists.

I am hoping that many of my faculty colleagues will read this blog and begin to understand what community pharmacy is all about. Chain drug pharmacy is a different animal than independent pharmacy ownership. I personally believe that all the truly incredible innovations are occurring in independent pharmacy practices.

If you would like to participate in a survey we are conducting on exposure to practice settings in the academic environment please follow this link: Current SURVEY