Tuesday, February 18, 2014

How far can clinical pharmacists go?

I have been working as a clinical pharmacist for 3 years plus. The daily job of a clinical pharmacist including following doctor's ward round, answering drug related enquiries,  examining medication charts, elicit patient's medication history, counsel patients who need to be started on new devices or new drugs and dispensing the discharge medications to the ward patients. We also work in an ambulatory clinic such as warfarin medication adherence clinic (MTAC), diabetic clinic, chronic kidney disease clinic, methadone clinic, respiratory clinic and etc.

It has been a while since I feel that working as a ward pharmacist is "looking good but going nowhere". Reading articles from David Gibson at http://www.pjonline.com/clinical-pharmacist/2014_feb/piece_of_the_jigsaw makes me wonder how far can a clinical pharmacist go in the future and whether the profession as clinical pharmacists will disappear in the near future.

In view of we are trained as pharmacists, we deal with medications and not diagnosing patients. Although in recent years, there are guides and books coming out in the US to teach pharmacist in physical examination of patients, what has been provided in the university or workplace is still not adequate to replace an actual diagnosis. Our recommendation rely very much on the doctor's diagnosis. The management plan can be not working not that our recommendation is inappropriate, but it is just because the diagnosis is wrong.

An experience doctor who know how to diagnose usually will know how to manage the patients and how to monitor the result after the management was perform on the patient. Maybe what we do was just fine-tuning on dosing, and selection of certain drugs, but  In view of the increasing in numbers of specialists with so many different types of sub-specialty, consultants, are the clinical pharmacist actually redundant??? Where are the clinical pharmacists heading to? What are we trying to achieve? Is it necessary that we go through the training by doctors to understand the patients more? If we really go through doctor's training, then why don't we change our title to doctor???

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