Patient counsellor, shopkeeper, dispenser or clinician?

A review has found many pharmacists viewed themselves as dispensers and worried about being seen as “glorified shopkeepers” – but they want to move away from these identities

Most pharmacists perceive their professional identity in context of the dispensing role, but they want to see it move towards a more clinical direction, according to a new study.

The Canadian scoping review, published in the International Journal of Pharmacy Practice, investigated the identities that pharmacists embody in their practice settings.

A total of 23 papers analysed, of which 17 studies were qualitative, five were quantitative, and one was a systematic review – spanning multiple countries including Canada, the UK and the US.

Studies sampled pharmacists from community, hospital and primary care settings.

Five major identity themes were identified: clinician, dispenser, business person, patient counsellor and physician supporter.

The dispenser identity was the most widespread, but it was viewed by many pharmacists as undesirable.

This identity was associated with technical skills, a need for accuracy and precision, and was associated with important safety checks.

There was a feeling expressed by some of the pharmacists that dispensing was a mundane task and that they were over-qualified to perform this role on a regular basis.

It was deemed an important component for ensuring safety but there was a strong desire for pharmacists to move away from this role as their primary function.

By contrast, the clinician identity also had a strong presence and was viewed as an identity that pharmacists aspired to embody and move towards.

Pharmacists who perceived themselves to be clinicians viewed themselves as integral members of the healthcare team, whose role was to ‘improve individual patients’ health.’

However there was some perception that hospital pharmacists were more clinician oriented than community pharmacists.

The business person identity was “quite prevalent” but not viewed as desirable by most, the review found.

This identity was associated with the retail and shop-keeping aspects of the profession, but there was significant concern by pharmacists that being located in a retail environment impacted their ability to act, and be recognised as clinicians by other health professionals and by society at large.

“Some just think you’re a glorified shopkeeper. You’ve got stuff on the shelf,” said one participant.

“We’re just perhaps seen as businessmen, rather than clinicians.”

Pharmacists also expressed challenges with differentiating a person as a customer or a patient.

Overall this identity was dominant in community pharmacy practice and was not something that hospital or GP pharmacists discussed in relation to their practice.

Meanwhile there was a “strong connection and pride associated with” the identity of patient counsellor, said the researchers.

“Pharmacists believed they were in an ideal position to educate their patients on medications, particularly since they viewed themselves to be medication experts,” they said.

“Key responsibilities of pharmacists included counselling patients on proper medication use and encouraging compliance.”

Most pharmacists embodied a patient counsellor identity to some extent, with factors contributing to this including high level of comfort in educating patients on medications, beliefs that this is a key role for pharmacists, and support from other healthcare providers that this is a key role for pharmacists.

See the full review in the International Journal of Pharmacy Practice

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1 Comment

  1. (Mary) Kay Dunkley

    IMHO defining pharmacists as undertaking clinical work or not is not dependent on the location that a pharmacist works in. Rather it is the attitude of the pharmacist and how they use their skills. Apart from administrative roles the majority of pharmacist work relates to patients and can be clinical. Checking DAAs becomes clinical if the pharmacist reviews the doses and combination of medications being used and the timing of doses and is willing to raise any concerns with the prescriber. In a hospital setting a pharmacist can be non-clinical if they do not actively interact with patients and prescribers. We need to move away from limiting the clinical role of pharmacists to certain workplace settings.

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