Practice change. Expanded scope. Clinical services. It seems that as pharmacists across the country gain additional authority, many still struggle with progressing their practice. Getting the prescription out the door is still the primary priority, engaging patients in optimizing drug therapy, chronic disease management and preventative care come second, and often not at all.

Pharmacists are perhaps the only health care professional that upon completion of their training are prepared to practice a profession and end up using only a fraction of their education to do their job.

I’ve heard pharmacy leaders express that our amazing pharmacy students will save the profession. They are primed for “expanded scope” and will ensure pharmacists do not become an irrelevant profession as more and more patients move to having Alexa order their drugs for delivery and get their “patient counselling” from google.

Is that a realistic expectation for the profession? Pharmacy students are struggling. If a new grad is lucky enough to get a job in the depressed market that exists in many parts of the country, what they face is joining a less than desirable practice or one where they hope they can effect some change, but within a very short time slide into apathy.

Inevitably when I present at a conference, I have many students come up afterwards and ask me how they can avoid the peril of apathy after getting into practice. They’ve seen many pharmacy students before them go through the seemingly inevitable slide and they are afraid of what their own future holds.

The problem however is really with us. It is with veteran pharmacists and pharmacy teams who are comfortable doing things “the way they have always been done.” It is almost impossible for a new grad joining a dispensary to change this.

Every dispensary has a “culture”. The culture is the way we interact with each other, the way we talk to patients, our work flow, what we accept and don’t accept, what we complain about, what we value, how we treat each other and what is generally acceptable and for sure what is NOT acceptable in that dispensary. When a new member enters a dispensary, it is an unexpressed expectation that they will fit in and “conform” to the current culture, regardless of what that culture is. A new grad may be asked to “add” some clinical stuff in, as almost a separate entity to the regular work flow, but the essential nature of the culture is not to change.

If the prevailing culture in dispensaries is not a proactive engagement of patients, utilizing the full scope of pharmacists expertise in improving patients quality of life, but instead in utilizing pharmacists as a “checking machine”, new grads will slowly be assimilated into the same role.

If real change is to happen, it will have to come from us. We cannot afford to remain dispensers of drug products and information. Drugs and information are to be had much more conveniently and cheaper than in our pharmacies. Third party payers, government and patients themselves are figuring this out. But our expertise in determining, with the patient, the “best drug therapy” for them ie: solving drug related problems, is a skill no other profession has.  We need to embrace it, or risk losing it altogether.