Number of deaths happening on roads is more than any epidemic. This is due to bad roads and the way the traffic is managed. There is no value for human life in India. On the same lines, in the health sector also, there is no consideration whatsoever, for patients’ health and safety. The drugs that are administered are highly potent and specific, with the potential for causing severe damage, if not used properly. All this critical information about thousands of drugs is beyond the capability of a doctor, who certainly needs an expert helping hand. This has to come from a professionally trained clinical pharmacist. This aspect has been very well recognized and appreciated as well as implemented in corporate hospitals, offering world class healthcare.

Hospitals opting for NABH accreditation have realized the importance of the department of clinical pharmacy/pharmacy practice and have been benefited in getting accreditation from NABH. Several medication errors happening in ICUs, and surgeries can be avoided by the involvement of clinical pharmacist. A thorough and informed knowledge of several drugs used in emergencies can help in saving precious lives. Doctors themselves have thankfully acknowledged the role of clinical pharmacist in top notch hospitals. Therefore, let us not attach undue importance to the comments of people who have no idea of what a clinical pharmacist’s role is.

Clinical pharmacist
Clinical pharmacist researchers generate, disseminate, and apply new knowledge that improves health and quality of life. They routinely provide medication therapy evaluations and recommendations to patients and health care professionals. They  are a primary source of scientifically valid information and advice regarding the safe, appropriate, and cost-effective use of medications. There are a wide range of clinical pharmacy activities performed globally, which include, but are not limited to, patient medication review, ward rounds, therapeutic drug monitoring, drug information, in-service education, medication counselling, medication histories, drug utilization evaluation, adverse drug reactions management and reporting, clinical research, and provide poison information services. A questionnaire circulated in 2001 to hospital pharmacies in Australia showed that 41% of pharmacists’ time was spent in clinical activities dedicated to the patient, drug information services, training and education; 39% of the time was dedicated to acquisition, manufacture, and dispensing of medications; and 16% of the time was allocated to managing drug and personnel resources. There is increasing evidence that pharmacists improve patient care and decrease health-related costs as such, have begun to economically justify their place within the clinical care of the patient. As well, the improvement in patient safety through reduction of ADRs has given pharmacists an important justification for involvement in direct patient care. Their ability to respond appropriately in acute medical situations, plus their expertise in dispensing the correct dosages of the proper medications, particularly to high-risk patients, has become even more valued. Fewer mistakes lead to cost savings in any setting. As  the healthcare system continues to evolve, doctors and pharmacists will work even more closely to provide the best patient care possible. A Pharm D degree often gives pharmacists the confidence they need to handle communication with other medical professionals with ease, knowing they are well-prepared to meet patient medication needs.
 
The statement from the SHPA (Society of Hospital Pharmacists of Australia) declares that all patients should receive clinical pharmacy services as part of routine care since clinical pharmacists have been shown to decrease the incidence of adverse drug events (ADEs).This is based on a study of the impact of pharmacists in eight Australian teaching hospitals that documented the clinical impact of pharmacist-initiated drug therapy. Twenty-five per cent of the interventions were determined to be of major significance (preventing or addressing very serious drug related problems). Thirty-eight per cent of the interventions were of moderate significance (prevented major temporary injury, enhanced the effectiveness of drug therapy, or produced minor decreases in patient morbidity or a < 20% chance of noticed effect), and 30.4% were of minor significance (small adjustments and optimizations of therapy). One per cent of the interventions documented were life-saving. A more recent article from Israel documented 160 medication errors over a 6-month period (11.2 errors/1000 prescriptions) and showed that pharmacists identified and rectified these errors. Of the documented errors, subsequent pharmacy interventions were accepted in 87.5% of cases. The introduction of a clinical pharmacist to an intensive care unit team in Pakistan demonstrated a high acceptance rate of interventions (91.6%) and has led to the creation of other clinical positions in varying practices in the hospital. As clinical practices increase, the numbers of pharmacists who participate in research also increases. A questionnaire sent to drug information centres in Italy revealed that 22.5% were involved in self-initiated research projects and 57.5% conducted research both independently and in partnership with other institutions. In the Canadian pharmacy services survey, participation in clinical drug trials increased from 50% of hospitals in 1991-92 to 80% in 1997-98. 57% of Australian hospitals reported provision of pharmacy services for clinical trial support, and 34.3% indicated there were research activities or opportunities. So looking at the scenario, countries like Australia, Canada, Denmark, Germany, India, Netherland, Pakistan, South Africa and UK benefit from clinical pharmacy services.

Community pharmacist
Community pharmacists, those who work in corporate or individually-owned pharmacies, do more than just fill prescriptions. They are increasingly providing direct patient counselling on prescription and OTC medications as well as overseeing pharmacy support staff and managing the business side of the pharmacy. Pharm D degree will enable community pharmacists to recommend more effective therapies when consulted by patients, doctors and other healthcare professionals. Pharm D is a good choice for any pharmacist striving to become a drug therapy expert for patients.

Pharmacy professionals employed by pharma companies are involved in research, marketing and the regulation and development of new/enhanced medications. With a Pharm D degree, they are able to expand their role to more of a ‘medical liaison’ who supervises and designs studies and acts as the lead investigator on medical projects.

The Pharm D qualified candidate is trained for five years and one year of posting in hospital to be competent to play the role with full responsibility and beneficial outcomes. These candidates undergoing training and graduating from reputed institutions are in demand and employed gainfully. Clinical pharmacist is an expert in the therapeutic use of medications, hence is used proactively to ensure and advance rational drug therapy, thereby averting many of the medication therapy misadventures which result from  inappropriate therapeutic decisions made at the point of prescribing.

In India, govt can hire Pharm D professionals for district hospitals, govt dispensaries and primary healthcare centres. The dearth of qualified doctors in rural areas can be offset by the Pharm D candidates. They can practice on their own and charge consultation fee as per Govt Gazatte notification (No.14-126/2007-PCI dated May 10, 2008). Utilizing the services of Pharm D candidates will be a step in the right direction to realize former Indian president Dr. APJ Abdul Kalam`s vision of Health For All By 2020.