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The field of Pharmacy can generally be divided into three main disciplines:
- Pharmaceutical chemistry (often Medicinal chemistry)
- Pharmacy practice
The boundaries between these disciplines and indeed with other sciences, such as biochemistry, are not always clear-cut; and often collaborative teams from various disciplines research together.
Pharmacology is sometimes considered a fourth discipline of pharmacy. Although pharmacology is essential to the study of pharmacy, it is not specific to pharmacy. Therefore it is usually considered to be a field of the broader sciences.
Pharmacists are highly-trained and skilled healthcare professionals who perform various roles to ensure optimal health outcomes for their patients. Pharmacists are also often small-business owners, owning the pharmacy in which they practise. This unique dichotomy is often the subject of debate within the profession—in part due to the perception of pharmacists as "common shopkeepers" by many in the community.
Separation of prescribing from dispensing
In most jurisdictions (such as the United States), pharmacists are regulated separately from physicians. That is, the legislation stipulates that the practice of prescribing must be separate from the practice of dispensing. These jurisdictions also usually specify that only pharmacists may supply scheduled pharmaceuticals to the public, and that pharmacists cannot form business partnerships with physicians or give them "kickback" payments.
In the minority of jurisdictions (such as China), doctors are allowed to dispense drugs themselves and the practice of pharmacy is integrated with that of the physician.
The reason for the majority rule is the high risk of a conflict of interest. Otherwise, the physician has a financial self-interest in "diagnosing" as many conditions as possible, and in exaggerating their seriousness, because he can then sell more medications to the patient. Such self-interest directly conflicts with the patient's interest in not being ripped off.
Although conflicts of interest also exist with regard to medical procedures and surgeries, they are usually seen as less of a problem. The physician can only perform so many before a patient becomes suspicious.
A pharmacy (commonly the chemist; or drugstore in the U.S.; or Apothecary, historically) is the place where most pharmacists practise the profession of pharmacy. It is community pharmacy where the dichotomy of the profession exists—health professionals who are also retailers.
Community pharmacies usually consist of a retail storefront, with a dispensary where medications are stored and dispensed. The dispensary is subject to pharmacy legislation; with requirements for storage conditions, compulsory texts, equipment, etc., specified in legislation. Where it was once the case that pharmacists stayed within the dispensary compounded/dispensed medications; there has been an increasing trend towards the use of trained dispensary technicians while the pharmacist spends more time communicating with patients.
There is a requirement that all pharmacies must have a pharmacist on-duty at all times it is open. In many jurisdictions it is also a requirement that the owner of a pharmacy must be a registered pharmacist. This latter requirement has been revoked in many jurisdictions, such that many retailers (including grocery stores and mass merchandisers) now include a pharmacy as department of their store.
In much the same way that hospital pharmacists have different roles to community pharmacists, hospital pharmacies have different roles to community pharmacies. Some pharmacists in hospital pharmacies may have more complex clinical medication management issues whereas pharmacists in community pharmacies often have more complex business and customer relations issues.
Unlike community pharmacies, which are usually independently owned, hospital pharmacies are usually a department of the hospital where it is located. Hospital pharmacies usually stock a larger range of medications, including more specialised medications, than would be feasible in the community. Traditionally, hospital pharmacies have also prepared various injectable preparations such as saline, total parenteral nutrition (TPN), and other drug infusions; but there has been a trend to outsource these functions to specialised pharmaceutical companies.
History and traditions