Dawn News

The Medicine men and women

Medicines are incredibly important to us. We need them to maintain or restore health, prevent disease, injury and damage to our body or mind. Medicines cure illness, boost immunities, and provide extra nutrients and vitamins that the body can't produce or consume in a daily diet. Pharmacists are the men and women of health professionals who have the most detailed knowledge of medicines and how they work. This blog is dedicated to what they do or don’t.

Fundamental as medicines are for human wellbeing, the men and women responsible to deliver good drugs and information about them to doctors, nurses, as well as patients, remain conspicuous by absence from the health care scene in my country and most developing world.

Pharmacists are arguably the most important missing link in the provision of quality medicines and their safe use today. They have the potential to fill the gap created due to the acute shortage of doctors and nursing personnel in primary health care.

Pharmacists are the first port of call for people to get advice on health in general, as well as specific clinical conditions. The pharmacist is trusted by other members of the community to offer professional advice. A common example is a patient coming into the pharmacy with a weepy eye, wanting advice. It’s the pharmacist’s job to identify that problem and refer them onto other health professionals, such as an optometrist.

Pharmacists are responsible for the quality of medicines supplied to patients, ensuring that the medicines prescribed to patients are suitable. They advise patients about medicines, including how to take them, what reactions may occur and answering to other various patients' queries.

Pharmacists also supervise the medicines supply chain and ensure that the pharmacy premises and systems are fit for the purpose, advise other healthcare professionals about safe and effective medicine use, secure supply of medicine response to patients' symptoms and advise on medicines for sale in pharmacies providing services to patients, such as smoking cessation, blood pressure measurement and cholesterol management. They supervise the production and preparation of medicines and assessments of quality of medicines before they are supplied to patients from pharmaceutical manufacturers.

The pharmacy profession has come a long way from being almost non-existent before 1970 to an important provider of pharmaceutical care. The pharmaceutical industry today is in the forefront of Pakistan’s science-based industries, with wide ranging capabilities in the complex field of drug manufacturing and technology.

The spectrum of the pharmacy profession in Pakistan today covers a myriad of opportunities R&D, manufacturing, retail, clinical care, education and regulation. The current availability of pharmacists in terms of pharmacist to population ratio does not compare favorably with that in a developed country. However, the demand of pharmacists is further growing with the growth of the industry within the country and outsourcing from abroad.

Indeed the pharmacy profession in the country is in a state of transition as health care delivery has been completely transformed in recent years. The challenge for the profession today lies in becoming a fully recognised and integrated participant in primary health care as a source of relevant drug information and drug therapy recommendation. The need of the hour is that the extraordinary good work being performed by pharmacists should reach the common man, and that every segment of society should realise, experience and recognise the beneficial implications of such efforts for the well being of society.

It has been argued many times that every retail medicine shops should be managed by a graduate pharmacist. While I support this fully, there is the need to pay attention to the unique and diverse needs of industrial and healthcare aspects of pharmacy profession. This can be done by separating graduate level education by having specialised as PharmD – Industrial and PharmD - Healthcare. The curriculum should be re-oriented to fulfill practice requirements in both industrial, as well as healthcare settings.

The Pakistan Pharmacy Council should institute a comprehensive study to map out the existing pharmacy manpower in the country. This data will help in understanding the existing manpower and plan future human resource development. The Council should undertake a drive to update the practice status of registered pharmacists.

There is a need for establishing a benchmarks for availability of pharmacists in different areas of practice, for example, community pharmacists vis-a-vis population, hospital pharmacists as per number of beds etc. This will help in forecasting the future demand. There is also a need for benchmarking performance parameters for services and competency of pharmacists. These benchmarks should be publicised so as make people aware regarding their expectations from pharmacists. This should be supported by a system of monitoring and audit.

I am quite hopeful that the Pakistani pharmacist will measure up to the challenges and ready themselves to shoulder bigger responsibilities with competence and a sense of sincerity and dedication.


Ayyaz Kiani is a public health specialist. He heads Devnet – a network of development consultants. Based in Islamabad, he has travelled around the world and continues to do so to meet fellow travelers. He can be contacted at ayyaz_kiani@hotmail.com


The views expressed by this blogger and in the following reader comments do not necessarily reflect the views and policies of the Dawn Media Group.

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Comments (7) Closed

Mansoor Haq
Aug 27, 2012 04:27pm
I am a physician here in Canada and have practised in USA as well as Pakistan. Pharmacist play a very important role here in North America and we the physicians often consult them for best patient management. Having worked in Pakistan as well, I would recommend that qualified Pharmacists should be given officially permission to treat minor common ailments. They should also refuse to dispense prescriptions prescribed by quacks or otherwise bear responsibility for that. This will thus have an impact on curbing quackery.
Aug 27, 2012 08:31am
I am working in Oman in Primary Health Care. In Pakistan I was working in a government hospital. When I came here, I learnt what role pharmacist plays in health system. Back there, in the THQ Hospital, the pharmacist sat behind big office desk and his duty was to authorize the dispense register brought by a peon and to cit chat with doctors or keep account of their break-time meals. Here, I learnt that pharmacists play very important role; their main duty is to sit in pharmacy & properly dispense medicine to the patient.
Aug 27, 2012 11:10am
Dear Sir, with all due respect i think you have one-handedly blamed only the pharmacists for being unsure about their future choice of career (that is either in healthcare or an industry) and also not being ablee to cater the needs of our ailing society. I am a pharmacist too, and I have seen how demeaningly we are treated not only by the doctors, the employers but even the patients. As much as we would love to become a part of the healthcare society equally with the doctors and the nurses, we would also like a little respect from our society ( I am talking about this part of the World only).
Aug 27, 2012 10:50am
I completely agree with Mr. Kiani. Such articles are needed to be published regularly not only emphasizing the need of health care professionals in our country but also to understand the role of every key personal in this health care system. Where pharmacists, doctors,nurses and other specialist of medicine impart their role to the well being of the sufferers. I hope in near future we see a Healthy Growing Pakistan and Healthy Pakistanis, physically and mentally.
Khalid Bukhari
Aug 29, 2012 07:35pm
Very good article and very timely as Pharmcy in Pakistan is changing shape,for drug focused to Patient focused.Pharmacist should prepare them self for delivery as well being advisor, PHC advisor and prove that he can can be instrumental in full filing dream of Heath for all and a healthier nation.
kerry pay mann
Aug 28, 2012 04:33am
I am 61 year old single woman in San Francisco area and my father received his pharmacy degree in three years just before WWII and met my mother working as the pharmacist in Billings, Montana. After WWII he went to work for Eli Lilly headquarters V.P of traning sales force. In the 50's-70's you had to have a pharmacy degree to be a salesman for Eli Lilly so that you could talk and educate doctors about the drugs that would best suit their patients. Now you do not need any pharmacy or drug training to be a salesman for the drug companies to speak to doctors in America and I have watched and experienced how ignorant doctors have become in America as to the drugs they prescribe to their patients. My pharmacist informed me about a drug a doctor wanted me to take after I informed him as to drugs currently taking conflicted seriously. I would trust a pharmacist in America far more than a doctor today. I have had to educate my doctors I have seen and all that I have seen CANNOT EVEN WRITE CORRECT MEDICAL RECORDS WHEN SPEAKING WITH A PATIENT. After receiving a copy of my records from over a decade of "supposed medical care" not a single doctor could even write correctly my main symptoms I was describing and complaining about. I was appalled at the complete incompetence and massive errors in all my medical records. I had to diagnose and ask for tests that I had to investigate on my own from the internet and reading medical journals because they were all so incompetent. Doctors in America do not care if you get better because they only get paid if you remain sick so they return over and over again until you are so sick you are now in the hospital. THIS IS WHY I ONLY SEE DOCTORS THAT ARE NOT BORN IN AMERICA. The doctors in America now have gone into the specialties and we now have an extremely serious and dangerous problem of not enough GP's to see patients as our healthcare system starts to change over to the new healthcare law that will start in 2014. The specialties in medicine make more money and this is mostly the reason they become doctors in America so they can make a lot of money. It isn't the way it was before 1970. Doctors do not even know how to ask the right questions and how to listen to their patients as to what they tell their doctors. I was shocked at the incorrect information my doctors put into my medical records and now am informing any doctor I will be voice recording my office medical calls to maintain CORRECT records because of all the past mistakes I have seen in my medical records. If peope actually remember their history it was the druggist that was the doctor in the town or village and frankly I would trust their advice more than a doctor in America. Pharmacy degrees are extremely hard to study and get today. Pharmacists need to educate the public to the difficult training they have to have today because of all the drugs that are available and particularly with all the side effects that doctors do not tell their patients. I grew up on the stories my father would tell me about the mistakes that doctors would make in the hospitals that were covered up and not told to patients or their families in America. When my father had his fist heart attack he refused to go to the hospital because he knew about how dangerous hospitals are because of the constant mistakes happening that are covered up. He got out of the hospital as quickly as he could. Doctors do not even consult your medical chart from one month to the next and mistakes happen over and over. If Americans really knew how bad it was and it is a " total myth" that the U.S. has the best healthcare. We are about #17 and we spend twice as much as other countries in Europe because doctors are paid if you get sick not if you get well. Kerry Pay Mann
Aug 29, 2012 05:52am
Well said