D. Pharm or Pharm D: A Professional Chirality?

S. K. Kulkarni

Perspective and Preparedness

Douglas Hepler and Linda Strand of the University of Minnesota, USA described the concept of Pharmaceutical care (PC) in 1990. They defined the term PC as the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve the patients quality of life. Further, PC implied that the practitioner (Pharmacist) takes responsibility for patient's drug related needs and holds him/herself accountable for meeting these needs. In other words pharmacist assumes the responsibility for providing a service of real value and for which he would be paid for. This role is much bigger and responsible than simply dispensing a drug.

The definition of pharmaceutical care essentially addressed two issues, namely the patient (as the focus) and the responsibility of the pharmacist for providing real service (practice and the value of it).

In order to meet this responsibility, the profession of pharmacy in the USA debated on the issue of “dispensing” to “dispensing and patient care”. The patient care required the pharmacist to know and also have expertise on drug related morbidity and mortality, selection of drug therapy, its optimization and cost effectiveness.

It took almost 10 years for the American Association of the Colleges of Pharmacy (AACP) to effectively advocate and mandate the concept and to bring in the changes in the profession's mission and direction. These included changes in regulations, reimbursement, pharmaceutical education, practice, patient education and expectations, relationships with physicians, responsibility of professional associations, physical structures of pharmacies and attitudes of the pharmacist.

The AACP has not only re-defined its goals and mission to advance the quality of pharmacy education and the leadership role of the pharmacist but also mandated Doctor of Pharmacy (Pharm D.) degree (a six year program) as the first professional degree. This new professional degree has now completely replaced the traditional B.S. degree in Pharmacy in the United States of America. 


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