Pharmacists

Pharmacists are medical personnel who practice the science of  pharmacy. In their traditional role, pharmacists typically take a request for medicines from a prescribing health care provider in the form of a medical prescription, evaluate the appropriateness of the prescription, dispense the medication to the patient and counsel them on the proper use and adverse effects of that medication. In this role pharmacists act as a learned intermediary between physicians and patients and thus ensure the safe and effective use of medications. Pharmacists also participate in disease-state management, where they optimize and monitor drug therapy or interpret medical laboratory results – in collaboration with physicians and/or other health professionals. Advances into prescribing medication and in providing public health advices and services are occurring in Britain as well as the United States and Canada. Pharmacists have many areas of expertise and are a critical source of medical knowledge in clinics, hospitals, medical laboratory and community pharmacies throughout the world. Pharmacists also hold positions in the pharmaceutical industry as well as in pharmaceutical education and research and development institutions.

In much of the United Kingdom and the British Commonwealth pharmacists are customarily sometimes referred to as chemist (or dispensing chemists), a usage which can, especially without a context relating to the sale or supply of medicines, cause confusion with scientists in the field of chemistry. This term is a historical one, since some pharmacists passed an examination in Pharmaceutical Chemistry (PhC) set by the then Pharmaceutical Society of Great Britain in 1852 and these were known as "Pharmaceutical Chemists". This title is protected by the Medicines Act 1968 section 78.

The 1852 Pharmacy Act, June 30 established a Register of Pharmaceutical Chemists in Great Britain, restricted to those who had taken the Society’s exams. However, the Act did not restrict the practice of pharmacy to examined and registered people, nor provide a legal definition for the trade and practice of pharmacy. This was first done by the Pharmacy Act of 1868.

In the near future it is proposed by the Draft Pharmacy Order 2009 that the title "pharmacist" be restricted to those who register with a new Regulatory body the General Pharmaceutical Council due to be established to take this role over from the Royal Pharmaceutical Society of GB in 2010. This article does not make reference to Pharmacy Law in the correct context.

History
In ancient Japan, the men who fulfilled roles similar to those of modern pharmacists were respected. The place of pharmacists in society was settled in the Taihō Code (701) and re-stated in the Yōrō Code (718). Ranked positions in the pre-Heian Imperial court were established; and this organizational structure remained largely intact until the Meiji Restoration (1868). In this highly stable hierarchy, the pharmacists—and even pharmacist assistants—were assigned status superior to all others in health-related fields such as physicians and acupuncturists. In the Imperial household, the pharmacist was even ranked above the two personal physicians of the Emperor.

Nature of the work
Historically, the fundamental role of pharmacists is to distribute drugs that have been prescribed by a healthcare practitioner to patients. In more modern times pharmacists advise patients and health care providers on the selection, dosages, interactions, and side effects of medications. Pharmacists monitor the health and progress of patients to ensure the safe and effective use of medication. In some cases, pharmacists may practice compounding (mixing ingredients to form medications); however, most medicines are produced by pharmaceutical companies in a standard dosage and drug delivery form. In some jurisdictions, pharmacists have prescriptive authority to either independently prescribe under their own authority or in collaboration with a primary care physician through an agreed upon protocol.

Pharmacists are trained in pharmacology, pharmacognosy, chemistry, pharmaceutical chemistry, microbiology, pharmacy practice (including drug interactions, medicine monitoring, medication management), pharmaceutics, pharmacy law, physiology, anatomy, biochemistry, pharmacokinetics, drug delivery, pharmaceutical care, nephrology, hepatology, and compounding medications. Additional curriculum covers diagnosis with emphasis on laboratory tests, disease state management, therapeutics and prescribing (selecting the most appropriate medication for a given patient).

One of the most important roles that pharmacists are currently taking on is one of pharmaceutical care. Pharmaceutical care involves taking direct responsibility for patients and their disease states, medications, and the management of each in order to improve the outcome for each individual patient. Pharmaceutical care has many benefits that include but are not limited to:


 * Decreased medication errors
 * Increased patient compliance in medication regimen
 * Better chronic disease state management
 * Strong pharmacist-patient relationship
 * Decreased long-term costs of medical care

Pharmacists are often the first point-of-contact for patients with health inquiries. This means that pharmacists have large roles in the assessing medication management in patients, and in referring patients to physicians. These roles may include, but are not limited to:


 * clinical medication management
 * the assessment of patients with undiagnosed or diagnosed conditions and for decisions about the clinical medication management required.
 * specialized monitoring of disease states
 * reviewing medication regimens
 * monitoring of treatment regimens
 * delegating work
 * general health monitoring
 * compounding medicines
 * general health advice
 * providing specific education to patients about disease states and medications
 * oversight of dispensing medicines on prescription
 * provision of non-prescription medicines
 * counseling and advice on optimal use of medicines
 * advice and treatment of common ailments
 * referrals to other health professionals if necessary
 * dosing drugs in renal and hepatic failure
 * pharmacokinetic evaluation
 * education of physicians and other health care providers on medications and their proper use
 * limited prescribing of medications only in collaboration with other health care professionals
 * providing pharmaceutical information
 * promoting public health by administering immunizations

Qualifications and registration
The role of pharmacy education, pharmacist licensing and graduate continuing education vary from country to country and between regions/localities within countries. In most countries, prospective pharmacists study pharmacy at a pharmacy school or related institution. Upon graduation, they are licensed either nationally or by region to dispense medication of various types in the settings for which they have been trained.

In the United States, a pharmacist must complete 4 years of graduate level training at a pharmacy school, usually after receiving a bachelors degree. A bachelors degree is not required, however, as most pharmacy schools only require two years of undergraduate education and the completion of a list of prerequisites. There are currently 116 accredited pharmacy schools in the United States, ( late 2009 ) and 6 of these schools offer "accelerated" 3 year PharmD programs by attending school almost year round - with less breaks for summer and holidays. There also is one fully accredited "distance/online" 4 year PharmD program offered by Creighton University. Pharmacists receive a PharmD (Doctor of Pharmacy) upon graduation, and licensure after passing the NAPLEX and MPJE.

Earnings and Wage
US Based Wage for Pharmacists 
 * Department stores $99,050
 * Grocery stores $95,600
 * Pharmacies and drug stores $94,640
 * General medical and surgical hospitals $93,640

( United States Bureau of Labor Statistics - Occupational Outlook Handbook, 2010-11 Edition ) :

Median annual wages of wage and salary pharmacists in May 2008 were $106,410. The middle 50 percent earned between $92,670 and $121,310 a year. The lowest 10 percent earned less than $77,390, and the highest 10 percent earned more than $131,440 a year.

Practice specialization
Specialties include:


 * Academic pharmacist
 * Clinical pharmacist (consisting of many subspecialties such as critical care, nephrology, cardiology, pediatrics, geriatrics, etc.)
 * Community pharmacist
 * Compounding pharmacist
 * Consultant pharmacist
 * Drug information pharmacist
 * Home Health pharmacist
 * Hospital pharmacist
 * Industrial pharmacist
 * Informatics pharmacist
 * Locum Pharmacist
 * Military Pharmacist
 * Nuclear Pharmacist
 * Oncology Pharmacist
 * Regulatory-affairs pharmacist
 * Veterinary pharmacist
 * Pharmacist Clinical Pathologist

Australia
In Australia, accreditation exists only for certain specialties and is provided by professional bodies for the following:
 * Consultant Pharmacist (AACPA), by the Australian Association of Consultant Pharmacy (AACP)
 * Certified Geriatric Pharmacist (CGP), by the Commission for Certification in Geriatric Pharmacy in conjunction with the Society of Hospital Pharmacists of Australia

France

 * Biological pharmacist
 * Hospital pharmacist

Portugal
In Portugal a pharmacist can become certified in recognized professional specialty practice areas by passing an examination administered by the Order of Pharmacists. The Order of Pharmacists certifies pharmacists in five specialties:
 * Pharmaceutical Industry
 * Hospital pharmacy
 * Comunitary pharmacy
 * Clinical Analysis
 * Regulatory Affairs

Spain
In Spain a pharmacist can become certified in recognized professional specialty practice areas by passing an examination in addition to spent two to four years of residency period in accredited hospital services and/or academic departments. The Minister of Health certifies pharmacists in eight specialties:
 * Hospital pharmacy after four years residency period
 * Industrial Pharmacy after two years residency period
 * Pharmaceutical Analysis after two years residency period
 * Clinical Analysis after four years residency period
 * Nuclear Pharmacy after two years residency period
 * Other specialities include Clinical Microbiology, Biochemistry and Inmunology

United States
In the United States, a pharmacist can become certified in recognized specialty practice areas by passing an examination administered by one of several credentialing boards.


 * The Board of Pharmaceutical Specialties certifies pharmacists in five specialties:
 * Nuclear pharmacy
 * Nutrition support pharmacy
 * Oncology pharmacy
 * Pharmacotherapy, which has two subspecialties:
 * Cardiology
 * Infectious disease
 * Psychiatric pharmacy
 * The Commission for Certification in Geriatric Pharmacy certifies pharmacists in geriatrics specialty practice.
 * The American Board of Applied Toxicology certifies pharmacists and other medical professionals in applied toxicology.