To dispense or not to dispense

dispensary robot

Readers weigh in with broad support over calls for pharmacy to be careful before devolving too much dispensing to pharmacy technicians or assistants

AJP readers have expressed a range of views in response to a recent academic editorial which advised caution on the current trend for pharmacists to expand their role in a range of clinical areas while leaving dispensing increasingly to pharmacy technicians.

In his editorial in the Journal of Pharmacy Practice and Research, Professor Chris Alderman said “it seems that enthusiasm for participation in the work of dispensing prescriptions is waning among contemporary practitioners”.

Professor Alderman warned that while there is “great enthusiasm for devolving the traditional tasks of the pharmacy profession to those who don’t hold pharmacy-related tertiary qualifications”, this push does need to be questioned.

Most respondents agreed with the comments, which were backed by another article in the journal by Danielle Stowasser, from Metro North Hospital and Health Service, Brisbane, who highlighted the need for pharmacist oversight in the dispensing process.

Regular AJP contributor, Victorian pharmacist Jarrod McMaugh said: “A lot of what this article says is very true, in that the role of dispensing is far more than the technical/physical role of dispensing. Problems will arise if this technical role is “devolved” (i don’t agree with that terminology), and the clinical role is lost in the process.

“Unfortunately, I think a significant number of pharmacists have already done this – they are performing a technical role only, and not applying their clinical knowledge.

“This is the thing – dispensing is a clinical role. Professor Alderman’s quoted line discusses the attractiveness of “clinical pharmacy” but it doesn’t mention that dispensing is a clinical role. I perform my clinical role a few hundred times a day, yet the term “clinical pharmacist” is regularly used to describe pharmacists who do something other than dispensing – it shouldn’t be used as a term of differentiation”.

Grant Oswald also agreed, commenting: “I have been saying this for ages now. Let’s make sure we do what we are supposed to do properly and better than anyone else before we try and do something else. Dispensing and counselling are core to our patient’s health. Please let’s not forget this!!”

Leading clinical pharmacist Debbie Rigby also highlighted the importance of review and oversight by pharmacists: “Dispensing is the core role of pharmacists and always should be. But dispensing is far more than the technical pick and stick. By devolving this part of dispensing, we endanger the perception of the other part ie. assessment of the safety and appropriateness of the prescription for the individual patient and their understanding of the chance of benefit and risk of harm. Wise words from Chris and Danielle”.

Another regular AJP contributor, Jim T: said that the situation would vary for each pharmacist depending upon their work location: “Pharmacists just don’t dispense. It depends very much on the situation he/she is in. One person show with no other staff, to pharmacist and front of shop staff, to pharmacist and disp. technician and front of shop staff, to pharmacist and disp. technician and front of shop staff and front of shop manager, to 2 or more pharmacists and all the extras to boot.

“Hence depending where you slot in will govern the type of work you do. I have worked in all the said scenarios as proprietor and salaried pharmacist over the 40 odd years of my pharmacist working life and have had to adapt to what was required in each work environment and what was required by the people above me. ONE size doesn’t fit all….not even close.”

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  1. H Shan

    “Dispensing is a clinical role” really? If you look at big and medium sized chain pharmacies, you might think otherwise. They want the poor pharmacist to dispense 200 scripts a day, counsel patients, do clinical interventions, sale S3, and do dispensary orders.

    If the authorities have brains, they should have imposed a cap on the average daily dispensing by a pharmacist.

    • Jarrod McMaugh

      Yes, it is a clinical role.

      With regards to the conditions…. perhaps if people stopped working in conditions that were not conducive to good clinical practice, then those conditions wouldn’t continue to be imposed?

      The reason that so many pharmacists work in poor conditions and for low wages, is because if one person refuses, someone else would step in.

      I think it’s disgusting that some proprietors expect people to work in these conditions, but if these proprietors have no disincentive to offer these conditions (ie no one will work for them), then they will continue.

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