Have you ever visited any state/government hospital? Have you ever met any pharmacist working in government hospital? Have you ever asked him, what job he does or what job is assigned to him as a pharmacist in state health care system? Is his job a professional?  Answer to all these questions will be frustrating and annoying for him. Basically because, jobs and nature of work a pharmacist doing in Indian government run hospitals is no more than a “drug handler, who is responsible for distributing medicines on the counter”. In brief, it is like this. Taking a stock from the headman in the morning, giving out to the patients as per the doctor’s chit, and returning back the balanced stock to the headman in the evening. So simple! What is professional in that? Your second question would be - Why it is so? Answer to this is very simple but disheartening and demoralizing. Firstly, only those pharmacists who don’t get job anywhere, they join in government. So, that is last choice. But why this is a last choice? Because there is no much professional work to do, no future prospects, no challenges for work, and on the top of these upsetting issues, pharmacist in Indian state run hospitals is not given equal treatment with medical professionals, not equal even with the other para-medicals like nursing, technicians etc.

I am working in public health care system since last more than three decades as a Head of Pharmaceutical Services in the state of Maharashtra. I had also exposure to Central government public health care system. Presently, I am at the fag end of my carrier in public health care service. Looking back from here, as far as my carrier growth is considered, what I see is utter disappointment. My fellow medical colleagues, who had started with me, are now either deans of medical colleges or medical superintendents or at least heads of the department. As against this, I got this single promotion to Class-I post, only after putting 30 years of my life. Here also, everyone is not that lucky to get this promotion, as this is the only single post available, only topmost post available to pharmacy profession in public health care system in State of Maharashtra. Ironically, this promotional post is available only under Ministry of Medical Education. The condition of pharmacy services under Ministry of Health is still more pathetic and pitiable. In the Ministry of Health of State of Maharashtra, there is not even Class-II promotional post available for pharmacy profession. Under directorate of Health Services, the pharmacist starts his/her carrier as Class-III post and retires also as a Class III pharmacist. The condition of pharmacy services in other states of India is more or less similar and also disheartening.

On this background of unacceptable carrier prospects of pharmacy profession in public health care system, one can very well anticipate that no pharmacist will like to enter in government hospital services. Secondly, looking at the present appalling and terrible condition of hospital pharmacy in India, I personally feel that though so many institutes are coming up and starting the hospital oriented pharmacy degrees like, Pharm D, it is going to be a nightmare for the budding pharmacists who are opting for this course, hoping that they will have better prospects in public health care system or for that matter even in private/corporate hospitals. I am not against this new course, but some solid, firm, and positive efforts are needed to be made, at national and state level to create more graceful and acceptable opportunities for pharmacy profession in the Indian hospitals.

Every year more and more new colleges are opening; new budding pharmacists are coming out of these colleges with beautiful dreams in mind. But, at the same time, opportunities for them are shrinking with great speed, especially for those who cannot do the post-graduation, because of financial constraints. Therefore, the time has come now in India, that all those who are policy makers like Pharmacy Council of India, Heads of Educational Institutes, should come together and think seriously to open up widely the public health care system for the pharmacy profession, which had long been kept neglected and disregarded by our policy makers.

In view of getting recognition to pharmacy profession and pharmacy services in state health services and in the society at large and in view of opening the PHCS for the better pharmacy services in coming future, I am of the opinion that “each Indian state should have a separate and independent directorate of pharmacy services”. Under this single umbrella of pharmacy directorate, then all pharmacy professional services can be brought together so that they will work together more efficiently and cohesively. Similar to the “the PCHC programme of US (Patient Centered Health Care) using pharmacist-delivered medication therapy management, a customized programme for Indian situation should be started at each state level.

I am herewith proposing that this issue be taken up as a special and common agenda for next decade by all the pharmacy organizations, namely, IPA, IHPA, APTI and PCI etc, work towards it vigorously in the interest of pharmacy profession and in the interest of budding pharmacists.

Establishment of separate directorate of pharmacy at each state
The infrastructure of such a directorate will open up not only new avenues to the upcoming pharmacist but also streamline the working of pharmacy profession in a particular state under one roof and one control. Presently no such directorate is in existence in any of the state of India.

Set up of PCHC using pharmacist-delivered medication therapy management in rural, urban areas
There is a medication therapy management (MTM) programme, official in the US recognized by the federal government in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Fairview Health Services, a large integrated health care system, implemented a standardized pharmaceutical care service system in 1998, naming it a pharmaceutical care-based MTM practice in 2006 in the US.

This PCHC model implements a comprehensive medication therapy management (MTM) programme with pharmacist training, individualized patient encounters and group education, provider outreach, integration of pharmacists into health information technology, and on-site support in community pharmacies in a medically under served region with a large burden of chronic disease and health disparities. The programme also expands on traditional MTM services through initiatives in health literacy/cultural competency and efforts to increase the provider network and improve access to care. It is observed that - The programme was a good success and associated with improved clinical outcomes and cost savings. Patient satisfaction with the programme was also high.

On the similar breadlines, a PCHC programme should be initiated in India by each state, under a separate directorship of pharmaceutical hospital services.