Competition or Collaboration in Pharmacy--Are We Pharmacists First?

Specialization in pharmacy could lead to fractured community with a weakened voice.

Why do we have so many national pharmacy organizations? Could this be caused by pharmacists themselves? Pharmacy school graduates do not see themselves as pharmacists first, but rather apply an adjective before the word “pharmacist” when identifying themselves, so is that the reason? This idea was expressed in a recent e-mail I received:

“When I was at pharmacy school, I began to realize that pharmacists, unlike physicians (the world from which I came), often do not see themselves as pharmacists first as a collective like physicians do. We see ourselves first and foremost as a retail/community pharmacist, a hospital pharmacist, a residency-trained clinical pharmacist, etc. ASHP, ACCP, APhA, and other chain/retail organizations have divided the pharmacist’s voice. Do we really need all these organizations? Is it now impossible for us all to stand under the same umbrella?

“Despite what many would like to believe is not true, if you ask a pharmacist to identify his or her occupation, the anticipated response of ‘pharmacist’ would not be the majority response. A pharmacy practice specialist at a hospital, for example, would be insulted to be grouped with a retail pharmacist and would say they were a ‘clinical’ pharmacist (whatever that means). Even a general pharmacist working in a hospital would be more inclined to say ‘hospital’ pharmacist rather than just pharmacist.

“I didn’t join APhA this year because I joined ACCP, thinking that my skills as a pharmacist would be more respected. I find it most interesting that if you glance at the employment listings…you will rarely find ‘Seeking Pharmacist.’ Most of what you will see is ‘Clinical Pharmacist’ or ‘Clinical Pharmacist Specialist’ or ‘Board-Certified Pharmacist’ or ‘Retail Pharmacist’ or ‘Community Pharmacist.’ What have we done?

“I graduated…with highest honors and highest distinction and chose, despite having completed an all-honors pre-residency track program…to practice in the retail setting. Until a few months ago, I actually began to believe that what my ‘clinical pharmacist’ friends said about retail pharmacy practice was true. I was, in their opinion, non-clinical and just a dispenser of pills. You have to know that this attitude is becoming more prominent due to increased enrollment in residency programs. The result is this huge chasm between the retail community PharmD and the ‘clinical’ hospital-based PharmD. The RPh pharmacists, even with experience, find their options severely limited….

“I truly do hope that retail pharmacists and community pharmacists, who are the front line and the first phone call for most patients, will eventually be accorded the respect they deserve. If we fail to achieve this, then the cacophony of voices from the various pharmacy camps won’t help us garner the kind of support we will need on Capitol Hill in the coming years.”

Do you agree with this colleague’s opinion that pharmacists do not see themselves as pharmacists first? If pharmacists are more interested in protecting and/or advancing their special interests rather than advancing pharmacy as a profession, then we need all these national pharmacy organizations. But is that good for pharmacy?

Will pharmacy as a profession be better served if a pharmacy practice segment advances while the rest of the profession stagnates or declines? Would it not be better to work collaboratively within the profession to advance the whole profession rather than acting competitively to advance 1 particular area, often by putting down another aspect of the profession? Who wins when this happens? I do not think pharmacy as a profession wins, but it may help those forces outside the profession who want to advance at pharmacy’s expense.

To assure that the pharmacy profession remains strong and viable, what should we do? Let me suggest 3 things:
1. Begin to think of yourself as a pharmacist first rather than your practice role first.
2. Begin to interact with pharmacists from all areas of pharmacy practice. As you get to know them, you will find that all pharmacists have much in common. We can be proud of our profession as a whole, not just our own practice setting.
3. Support those pharmacy organizations that advance the profession before supporting the organization that advances your special interest.

It will be through collaboration, not competition, that pharmacy will become stronger.

Mr. Eckel is a professor at the Eshelman School of Pharmacy, University of North Carolina at Chapel Hill. He serves as executive director of the North Carolina Association of Pharmacists.