I would say as a indian Pharmacist, there is no role for pharmacist in india other than selling the drugs to patients as per the prescription. So sad but, true.

The question, and consequently, the answer are dependent upon one's view (i.e., practical and philosophical perspective) regarding "clinical pharmacy practice". Using definitional statements from the AACP and my own published views, I would begin by stating that pharmacists should be the primary expert in regard to ALL issues involving drug development, clinical research, and practice. That said, it is VERY important to note that the role of the clinical pharmacist has been, and continues to be, one of cooperation, support, and work with other members of an interdisciplinary health care team. Thus, in clinical conditions (e.g., diabetes mellitus, hypertension), which are primarily treated with pharmacotherapy, the pharmacist could (and should) take the lead (MOST are already well equipped academically to do so now -- in many, if not most, countries). In some contexts of practice, other health care providers (e.g., nurses, physician assistants) could easily perform the "diagnosis" OR pharmacists themselves can also easily perform the diagnoses by utilizing available technology to determine blood pressure and blood glucose levels (including use of referrals of the patient to a medical laboratory to serially determine A1C levels). AFTER the diagnosis is made, the pharmacist can play a tremendous role in selecting optimal pharmacotherapy and helping to improve patient compliance. China is an "international" example of a country in which clinical pharmacists are beginning to play a significantly bigger role in health care . . .

Dear Pagliaro,

Well said! Of course, they started to play a key role in china..

As a qualified pharmacist from India, i would appreciate it.

In practical, People will be happy to reach the primary health care professional(A pharmacist)..with less stress(in getting appointments) if the same concept reaches the other developing countries like India too..

But, it may take decades..or so!!

I think this question should be taken as a human resource for health question. As around 80 countries in the world have severe shortage of health work force, i think in those countries pharmacists with a little training in medicine should be allowed to practice medicine.

Dear Rahad,

I, too, would like to see ALL health care professionals utilized to their optimum potential in order to help reduce associated pain and suffering. HOWEVER, the scale must be carefully and considerately balanced between "provision of health care services" and "protection from additional, or unnecessary, harm" to the patient. That is a challenge, not only for individual health care providers, but also for health care educators, health care professional regulatory agencies, and government officials . . .

Thanks for your inputs colleagues. Very refreshing perspectives coming through. Please keep them coming. The future and continuing relevance of pharmacy and its professional focus areas are our responsibility as current pharmacists, and such discussions as this will ensure that the profession does not gradually fade away into irrelevance going forward.

Very good and relevant question. In India we are having very limited role in health care probably just dispensing the medicines. The real potential of pharmacist comes out only in industry, where they are involved in research. while in health care sector pharmacist's potential is largely unused. Most part of knowledge imparted by pharmacy curriculum remains unused, which can be best employed in primary health centers with little training. An additional focus should be given on diagnosis (differential diagnosis) of disease and exercises on selection of drug therapy.

Candidates with M. Pharm. (Pharmacology) can work very well in clinical set up, if this is practiced quality of health care services can be greatly improved.

hopefully waiting to see Pharmacy rise in India.

Unfortunately pharmacy in Barbados is just about at the same level as it is in India where our primary role is dispensing. In the community pharmacies, we do the usual counseling and OTC recommendations but our role as clinicians is very limited especially in secondary care. This is a sad reality for us when we think of the significant contribution a pharmacist can make in the management of a patient's therapy and how we can impact patient outcome. The first step for us will be educating the public and sensitising the rest of the healthcare team about our level of training, the scope if what we are trained to do, and the importance of our role as clinicians. We are yet to take that first step.

I’m a fellow South African, working as a research pharmacist on clinical trials in the HIV/TB field. I never knew the concept of a research pharmacist existed back when I was on campus! I agree that the undergrad curriculum needs re-structuring to encompass more clinical pharmacy practice, which I am now being exposed to via my post grad endeavours - I’m currently doing my Masters in Pharmacy online through a local university. I also believe that Continuing Professional Development (CPD) will go a long way in getting current practicing pharmacists to “evolve” into clinical practitioners. Some food for thought attached.

I agree with Bhavna that CPD has a role in re-orienting traditional pharmacy practice to fill in the gaps in primary healthcare as identified in the PSSA article. I’ll also venture that most pharmacy curricula adequately address some of the gaps identified in primary healthcare. The challenge though emanates mainly from the current community pharmacy business model. In current practice settings income is generated primarily from selling medicines because of the reluctance of third-party funders to recognize the value-add of so-called “pharmaceutical care” over and above the dispensing of medicines. I suppose it’s the classic chicken or egg tale: ‘Justify your value beyond dispensing and we might pay’ versus ‘Pay before we move beyond just dispensing’. In the mean time there are lost opportunities all around, of health expenditure savings and of extending our professional scope. Let’s also not forget the powerful vested interests of the medical profession to maintain the status quo so as to protect their turf. That’s another challenge to negotiate!