"Pharmacy then and now" revisited

April 12, 2011

Over the past 40 years, human knowledge has expanded exponentially. Individual awareness, however, may not have kept up. A pharmacist whose POV has changed half a dozen times during his career shares his thoughts.

When I read Jim Plagakis’ column “Pharmacy then and now” [December 2010], many issues regarding the practice of pharmacy crossed my mind, some of which we seem to wrestle with over and over.

I agree with Jim. Certainly things have changed. There was a time when there was no such thing as a computer. Today I have an iPhone, iPad, iMac, and a PC, and the number of sources of medical information available today is mindboggling.

Knowledge is expanding so fast, it is absolutely impossible to keep up. In 1969, the Physicians’ Desk Reference was wafer thin; today you would get a hernia trying to carry it. Once again, thank heaven for technology.

The education of our young pharmacists is also different. In 2000 we transitioned to a PharmD entry-level degree. The (6-year) PharmD degree has given recent graduates a nice title. However, it is my experience that the educational-intensity level accompanying the additional year does not justify the title. Those I have worked with who have earned a 2-year postgraduate degree and a residency demonstrate a much better grasp of pharmacy than our 6-year brethren, and I believe their title of PharmD is legitimate.

In my last practice I interviewed many incoming pharmacists. Their knowledge of medication safety was very poor. I have always had a special interest in medication errors and I review for ISMP Ambulatory/Community edition, so this was particularly unsettling for me. My young colleagues were not aware of medication-error issues and the new recommendations. When asked, “What would you do if you received a prescription for fentanyl patches, 100mcg, for a 72-year-old-man who is opiate-naïve,” we got blank stares. It amazes me that some of our young colleagues do not continue to read and study.

A few years ago I took 3 courses toward the nontraditional PharmD degree. I discovered, during a course in searching and evaluating the literature, that my professor had never heard of "Pharmacist’s Letter" [https://pharmacistsletter.therapeuticresearch.com/] and thought Drug Topics and similar journals were of little relevance. I explained what I gleaned from these publications and, with a little investigation, what I learned and how they helped me keep up. It is as though today’s PharmD professors seem to think that unless the research is 24 pages long with 2-3 pages of references, it is not relevant.

Stan Illichhas practiced in chain-store pharmacies, owned a drugstore, served as an army pharmacy officer and a civil service employee, and been vice president/COO of a community health center. He is currently practicing in Mississippi. You can contact Stan at stanillich@comcast.net.