Setting the Scene
Community pharmacy practice is continuously evolving, and for us to know where the profession is going, it is important to know where we have been. Throughout history, as long as there was disease, illness, or injury to treat, roles like that of the community pharmacist have existed in forms such as medicine men, shamans, and healers.1 The concept of the distinct pharmacist role arose in medieval Islamic culture. By the mid-13th century, German emperor Frederick II issued his edict for the profession of pharmacy that established pharmacy as an independent branch of governmentally supervised health service. This was created by separating the pharmaceutical profession from the medical profession, requiring official supervision of pharmaceutical practice, and an obligation by oath to prepare drugs reliably in a uniform, suitable quality.2
In colonial America and the early Republic, apothecary shop practice began to evolve and by the 18th through the mid-19th centuries, pharmacists were manufacturing ingredients and preparations in their shops.1,3 Between the 1820s and the 1940s, pharmacists served as compounders of prescriptions, and the classic American drugstore arose. From the 1930s to the mid-1960s, more effective drugs were developed and trends of prescribing individual drugs rather than compounded medications increased, which further resulted in the era of the “count and pour” dispenser and development of the chain drug industry.1,3 Through the mid-1960s to 1990, the profession of pharmacy began to diversify as the role of hospital pharmacy and clinical pharmacy emerged.1,3 With the passage of the Omnibus Budget Reconciliation Act of 1990, pharmacists were brought into the pharmaceutical care era, as federal law now set a practice standard and a set of responsibilities for pharmacists. Finally, with the passage of the Medicare Modernization Act of 2003, the concept of medication therapy management (MTM) was born. As this cognitive service was now independent of medication products, this led us to the era of MTM and provider status.1,3
While this history was extremely brief and certainly not all-inclusive, this gives us a glimpse into the prospective future role of the community pharmacist, which may not always include dispensing medications. The vision of the American Pharmacists Association (APHA) adopted by their Board of Trustees adopted in 2017 was “The American Pharmacists Association inspires, innovates, and creates opportunities for members and pharmacists worldwide to optimize medication use and health for all…”4 In 2015, the Joint Commission of Pharmacy Practitioners (JCPP), a group of national pharmacy organizations that was established in 1977, issued their “Vision of Pharmacy Practice” that pharmacists will provide services within community-based practices, institutions, clinics, patients’ homes, or other settings, ...