Home Medicine articles Pharmacy
Pharmacy is the profession of compounding and
dispensing medication. More recently, the term has come to include
other services related to patient care including clinical practice,
medication review, and drug information. Some of these new roles
are now mandated by law in various legislatures. Pharmacists,
therefore, are drug therapy experts and the primary health professionals
who optimize medication management to produce positive health-outcomes.
The symbols most commonly associated with pharmacy
are the mortar and pestle and the ? (recipere) character. Pharmacy
organisations often employ other elements such as the Bowl of
Hygeia, conical measures, and caduceuses in their logos. Other
symbols are common in different countries such as the green
Greek cross in France, and the Gaper in The Netherlands.
The field of Pharmacy can generally be divided
into three main disciplines:
Pharmaceutical chemistry (often Medicinal
The boundaries between these disciplines and
indeed with other sciences, such as biochemistry, are not always
clear-cut; and often collaborative teams from various disciplines
Pharmacology is sometimes considered a fourth
discipline of pharmacy. Although pharmacology is essential to
the study of pharmacy, it is not specific to pharmacy. Therefore
it is usually considered to be a field of the broader sciences.
Main article: Pharmacist
Pharmacists are highly-trained and skilled
healthcare professionals who perform various roles to ensure
optimal health outcomes for their patients. Pharmacists are
also often small-business owners, owning the pharmacy in which
they practice. This unique dichotomy is often the subject of
debate within the profession-in part due to the perception of
pharmacists as "common shopkeepers" by many in the
Separation of prescribing from dispensing
In most jurisdictions (such as the United
States), pharmacists are regulated separately from physicians.
That is, the legislation stipulates that the practice of prescribing
must be separate from the practice of dispensing. These jurisdictions
also usually specify that only pharmacists may supply scheduled
pharmaceuticals to the public, and that pharmacists cannot form
business partnerships with physicians or give them "kickback"
In the minority of jurisdictions (such as China),
doctors are allowed to dispense drugs themselves and the practice
of pharmacy is integrated with that of the physician.
The reason for the majority rule is the high
risk of a conflict of interest. Otherwise, the physician has
a financial self-interest in "diagnosing" as many
conditions as possible, and in exaggerating their seriousness,
because he can then sell more medications to the patient. Such
self-interest directly conflicts with the patient's interest
in obtaining cost-effective medication.
A pharmacy (commonly the chemist; or drugstore
in the U.S.; or Apothecary, historically) is the place where
most pharmacists practise the profession of pharmacy. It is
community pharmacy where the dichotomy of the profession exists-health
professionals who are also retailers.
Community pharmacies usually consist of a retail
storefront, with a dispensary where medications are stored and
dispensed. The dispensary is subject to pharmacy legislation;
with requirements for storage conditions, compulsory texts,
equipment, etc., specified in legislation. Where it was once
the case that pharmacists stayed within the dispensary compounded/dispensed
medications; there has been an increasing trend towards the
use of trained dispensary technicians while the pharmacist spends
more time communicating with patients.
There is a requirement that all pharmacies
must have a pharmacist on-duty at all times it is open. In many
jurisdictions it is also a requirement that the owner of a pharmacy
must be a registered pharmacist. This latter requirement has
been revoked in many jurisdictions, such that many retailers
(including grocery stores and mass merchandisers) now include
a pharmacy as department of their store.
In much the same way that hospital pharmacists
have different roles to community pharmacists, hospital pharmacies
have different roles to community pharmacies. Some pharmacists
in hospital pharmacies may have more complex clinical medication
management issues whereas pharmacists in community pharmacies
often have more complex business and customer relations issues.
Unlike community pharmacies, which are usually
independently owned, hospital pharmacies are can usually be
found within the premises of the hospital. Hospital pharmacies
usually stock a larger range of medications, including more
specialized medications, than would be feasible in the community
setting. Traditionally, hospital pharmacies have also prepared
various injectable preparations such as saline, total parenteral
nutrition (TPN), and other drug infusions; but there has been
a trend to outsource these functions to specialised pharmaceutical