Over the past decade or two, the profession of pharmacy has undergone a sort of identity crisis. As an adjunct healthcare professional, where do we fit in the grand scheme of medicine?

The easiest answer to that question is basic retail and hospital pharmacy. We dispense drugs. A doctor writes a prescription, or (in a hospital) orders a drug, the pharmacy makes sure it's a valid prescription and that the doctor didn't make any obvious errors, and the patient gets the drug.

A broader definition, though, and one that lets us fulfill a larger role, is that a pharmacist is a drug expert. In the community, the pharmacist is the most readily accessible healthcare professional. They get questions from patients, family members, and occasionally doctors, and if they're lucky and don't work for a high-volume store, they talk to as many patients as possible about their prescriptions. In drug companies and insurance companies, the pharmacist is the drug information specialist, and answers questions and makes formularies and such. In the hospital, this has given rise to the idea of the clinical pharmacist, who is able to play a much more active role in a patient's care.

A clinical pharmacist (which is what I want to do) is the hospital's expert on drugs. They round with doctors and follow patients, make recommendations, do the dosing on things like gentamicin and vancomycin (which have to be calculated), deal with anticoagulation, catch any drug-related medication errors, and whatever other drug-related things they can fit into their day. Some have become nutrition specialists and handle all the TPN orders; some go into academia and do research and teaching. The job really is whatever you want it to be.

And essentially, they are a consult service for other healthcare professionals. A nurse might ask if two IV medications can be mixed together without precipitating; a doctor might ask for help calculating a dose. A student might ask about pharmacology or pharmacokinetics, and a patient might ask about side effects.

It's a new and ever-changing field, but it's getting bigger, especially as younger doctors graduate and have some idea of the kind of resource a pharmacist can be. And as new pharmacists (like me!) graduate and work to make pharmacy a bit more progressive in the next decade.