Careers in Pharmacy
Opportunities
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. 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.
Retail Pharmacy
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
“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.”
Research
“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.)