Careers in Pharmacy
The need and demand for pharmacists is high, nationally as well as in American Indian and Alaska Native communities. The demand for well-educated pharmacy professionals has grown dramatically in recent years. This is due, in part, to the rapid growth of the health care and pharmaceutical industries and to the increase in the aging population. Also, as the number and complexity of medications and related products has grown, physicians and other health professionals are calling on pharmacists to help make decisions regarding drug therapy. In addition, physicians are inviting pharmacists to educate them and their patients about pharmaceutical products.
The need for pharmacists is projected to continue to rise. In 2006 the first wave of baby boomers turned 60. This aging of the population will drive up medication use because adults age 60 and older on average use three times as many medications as adults younger than 60. Pharmacists are also likely to have more responsibilities in primary and preventive services, home health care, and long-term care. In addition, pharmacists will continue to be the health care provider most accessible to all patients, especially the uninsured for whom the pharmacist might be the only provider.
Despite this growing need for pharmacists, a shortfall of as many as 157,000 pharmacists is predicted by 2020. Even if the number of pharmacy graduates increases, the shortage is expected to continue. In her profile Christi Rondeau, Turtle Mountain Tribe of Chippewa Indians, PharmD, chief pharmacist at Belcourt Indian Hospital, talks about the impact of the shortage of pharmacists in Indian communities.
Indigenous pharmacists, whose cultural sensitivity makes them valued members of the health team, are particularly in demand. Yet, of the approximately 145,000 pharmacists nationwide, less than 300 are American Indian or Native Alaskan.
Pharmacy students can expect to receive multiple job offers before graduation. There is also great potential for advancement. Being a pharmacist is also personally rewarding. As robots are taking over some of the mechanical aspects of filling prescriptions, pharmacists spend more of their time interacting with patients. Because of the care and the service pharmacists provide, the general public consistently ranks them as one of the most highly trusted health professionals.
A large number of pharmacists serve as retail pharmacists. These pharmacists include the professionals who work in drug stores and the pharmacy sections of supermarkets and department store chains. Their tasks include ensuring drug purity and strength, filling prescriptions, and sometimes making special products, such as creams or special mixtures. Some have managerial responsibilities.
“Retail pharmacists, to some extent, are a check on the doctor,” says Charles Russell Middaugh, Arapahoe, Iroquois, PhD, Higuchi Distinguished Professor of Pharmaceutical Chemistry at the University of Kansas. “They make sure that the drug the doctor prescribed is appropriate and won’t interfere with other drugs the patient might already be taking. They also make sure that there isn’t anything in the patient’s background that would indicate he or she shouldn’t be taking a particular drug. Often doctors don’t have time to fully talk with the patient about the drugs they have prescribed, so pharmacists educate patients about the drugs they are to take, including potential side-effects. They also try to answer patients’ questions.”
“Clinical pharmacy is another large side of the profession,” says Middaugh. “Generally clinical pharmacists work in hospitals where they are part of the modern healthcare team that includes doctors and nurses.” Clinical pharmacists also work in clinics, HMOs, long-term care facilities, home health centers, and other health care settings. Some clinical pharmacists are involved in developing medication distribution and control systems. According to Middaugh, clinical pharmacy is growing rapidly.
Some clinical pharmacists run clinics for patients who have problems, such as hypertension, which need regular monitoring. Jeff Maxon, PharmD, describes a pharmacy-run clinic at Parker Indian Health Service Hospital in Arizona.
“Some of the responsibilities that physicians had in the past are being turned over to clinical pharmacists,” notes Middaugh. “Pharmacists provide the drug regimen in collaboration with the physician, and they monitor what happens when the patient takes certain drugs. Because of these high level responsibilities, the standard degree is no longer a bachelor’s degree in science. Instead a doctoral level degree (the PharmD) is required.”
“A minority of students choose to go into research,” asserts Middaugh, who himself works in this field. “However, these are the people that drive everything.” Typically, researchers work in industry or in university settings.
Middaugh identifies several areas within research:
Pharmaceutics involves transforming a substance into a safe, effective medication. For example the substance can be made into a pill or the researcher might need to figure out another way to get the medication to where it is needed in the body.
Medicinal chemistry is devoted to discovering drugs. Researchers in this field try to create the raw substances that then go to the people doing the pharmaceutical chemistry of pharmaceutics.
Pharmacokinetics is concerned with what happens to drugs, how they are metabolized when they enter the body.
Pharmacogenetics is a new area. “You look at individuals in terms of their genetic makeup and decide what will work best for them," says Middaugh. "We are starting to learn that some drugs will work for one person but not for another.”
Other Work Settings
More than 3,000 full-time pharmacy faculty members, such as Dr. Middaugh, work in the nation’s colleges and schools of pharmacy. Some pharmacy faculty members also teach medical and nursing students as well as other health professionals. Still others work for the Food and Drug Administration, the Drug Enforcement Administration, the Veterans Administration, the Public Health Service, the Armed Forces, the National Institute of Health, and many other government agencies.
The Tribes and the Indian Health Service are always in need of capable pharmacists. Pharmacists working for IHS have access to the patient's entire health record so they are in a good position to assess the appropriateness of various drug therapies. In many locations pharmacists can use their prescriptive authority to evaluate and manage the care of certain patients.
This article was originally published in the Autumn 2004 issue of Winds of Change. (The cover artist is Clarrisa Hudson, Tlingit.)