Evolution of the Pharmacist’s Role

Coming from a family of pharmacists, I always look forward to celebrating American Pharmacists Month each October. The theme this year is Caring for our Communities while commemorating America’s 250th anniversary. From administering vaccines to assessing for drug interactions, pharmacists provide a variety of patient-care services in different pharmacy practice settings throughout the community. Throughout history, pharmacists have played a vital role in improving patient health outcomes throughout the U.S. This is the perfect theme to highlight how the pharmacist’s role has evolved through the years.  

Pharmacist Beginnings

Several years ago, I attended a pharmacy conference in New Orleans. One of the highlights was visiting the New Orleans Pharmacy Museum. This historical museum contains pharmacy artifacts dating back to the 1800s. Before it was a museum, it served as the residence and apothecary shop for the first licensed pharmacist in the U.S., Louis J. Dufilho Jr. An apothecary would typically own a shop and prepare medications using botanicals, minerals, and herbs. This was also a time before the U.S. Food and Drug Administration regulated medications. If you are visiting New Orleans, the museum is definitely a must-see experience.  

The 1922 American Pharmaceutical Association (APhA) Code of Ethics emphasized that pharmacists should refrain from discussing medications with patients. Patients should only discuss medication details with their prescriber. Ultimately, this limited pharmacists’ involvement in patient care. In 2002, the American Pharmaceutical Association changed its name to the American Pharmacists Association (APhA) to reflect that members are pharmacists rather than pharmaceuticals. APhA is an organization that continues to advance and support pharmacists through advocacy, education, and leadership. 

Between the 1950s to the 1970s the pharmacy profession began to shift to patient care. Eugene White was a Virginia community pharmacist and trailblazer who developed his own patient-centered community pharmacy with counseling areas. Other community pharmacies began following White’s community pharmacy model. White was also a driving force in the 1969 revision to APhA’s Code of Ethics that discusses the pharmacist’s duty to their patients. However, the 1980s is when we really started to see major changes in pharmacist’s roles across the U.S.  

Pharmacy Education and Training Advancements

The first Doctor of Pharmacy (PharmD) program was established by the University of Southern California in 1950. Other pharmacy schools began to follow this trend toward the clinical degree. This was a transition from the B.S. Pharmacy degree. In 2005, the transition to the universal PharmD degree was completed. It’s important to remember that pharmacists who hold the BSPharm degree carry a tremendous amount of pharmacy experience and knowledge. Additionally, they are an asset to any pharmacy practice setting. The number of pharmacists completing residencies as part of postgraduate training began to increase between 2009 and 2018.    

In 2003, the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) passed. This created the Medicare Part D benefit for prescription drugs. It also required Medicare Part D sponsors to include medication therapy management (MTM) as part of the benefits. There are opportunities to perform MTM services through community pharmacy settings and certain companies offer positions that include MTM. These include performing comprehensive medication reviews (CMRs) along with targeted reviews to identify and resolve medication-related problems. Pharmacies are also reimbursed for performing MTM services.

Evolution of Pharmacist Vaccine Administration

Almost 90% of individuals live within five miles of a community pharmacy, which makes pharmacists the perfect clinicians for administering vaccines. While pharmacists’ involvement with vaccines dates back to the 1800s, they weren’t always able to administer immunizations. U.S. pharmacists in New York City were first involved with storing diphtheria antitoxin in 1895 to distribute to physicians treating diphtheria cases. Additionally, pharmacists in the 1890s and early 1900s supplied physicians with smallpox vaccines.  

In 1961, APhA was part of a national conference on polio control. This was the pivotal moment that led to pharmacists’ involvement in the mass distribution of the polio vaccine. In the 1980s pharmacists were part of widespread vaccine campaigns that included physician and patient education. Nurses began administering influenza vaccines in pharmacies.  

In 1994, the first program to train pharmacists as immunizers was established, and by 2009 pharmacists were able to administer the influenza vaccine in all 50 states. Now pharmacists can administer vaccines in all 50 states, the District of Columbia, and Puerto Rico. Which vaccines pharmacists can administer vary based on the state laws. Pharmacists also play a vital role in administering childhood vaccines, which also varies by state laws.     

Pharmacists were on the frontlines during the COVID-19 pandemic. They played a vital role administering vaccines and testing patients. They still perform these important services today, which have also expanded to test and treat services for a variety of conditions such as COVID, influenza, and strep. While pharmacists continue to wear many hats, public health continues to be one of the most important roles.    

Innovative Pharmacy Practice Settings

There are a variety of innovative practice settings that were not even available while I was in pharmacy school. Networking, attending pharmacy conferences, and staying active on social media are strategies to get involved in these unique career options. Check out examples of these career opportunities for pharmacists: 

• Regulatory affairs 
• Medical writing 
• Medical editor 
• Consultant pharmacist 
• Academia 
• Informatics 
• Medical communications 
• Medical science liaison  
• Prior authorization 
• Medical reviewer 
• Medication safety officer 
• Managed care pharmacist 
• Veterinary pharmacist 
• Nuclear pharmacist 
• Director of pharmacy 

The Evolution of My Pharmacy Path

My pharmacy career has continued to evolve over the past 20 years. I took the more nontraditional career path of completing a drug information residency and then serving as an Assistant Professor of Pharmacy Practice for several years. During my time in academia, I managed a university-based drug information center and taught Drug Information and Drug Literature Evaluation pharmacy school courses. I also obtained my consultant pharmacist license and completed an MTM certificate program to enhance my skills. Combining pharmacy with my passion for writing was a great fit for my current role as a medical writer. 

The Past and Future of Pharmacy

As we look back on the evolution of the pharmacist’s role, we can admire how far the profession has come on this journey. During American Pharmacists Month, we remember the trailblazers who helped move the profession forward. I’m looking forward to what the next 250 years brings to the pharmacy profession.   

Sources: 

American Pharmacists Month. https://www.pharmacistsmonth.com/  

New Orleans Pharmacy Museum. https://pharmacymuseum.org/  

Urick BY, Meggs EV. Towards a greater professional standing: Evolution of pharmacy practice and education, 1920-2020. Pharmacy. 2019; 7(3):98. doi: 10.3390/pharmacy7030098.  

Medical College of Virginia Foundation. https://www.mcvfoundation.org/news/stories/125-years-pharmacy  

Kennedy D, Sorofman BA, Staggs SH. APhA’s name change reflects evolution of the pharmacy profession. J Am Pharm Assoc. 2003; 43(2): 132-135. 

Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences.  https://mann.usc.edu/program/doctor-of-pharmacy-pharmd/   

Medicare Modernization Act. https://www.ssa.gov/privacy/pia/Medicare%20Modernization%20Act%20(MMA)%20FY07.htm  

Goode JR, Rothholz MC, Foster SL, Brody ER, Grabenstein JD. Pharmacy-based immunization delivery: A comprehensive history and current challenges. J Am Coll Clin Pharm. 2026; 9(6):e70219. doi: 10.1002/jac5.70219.  

Berenbrok LA, Tang S, Gabriel N, et al. Access to community pharmacies: A nationwide geographic information systems cross-sectional analysis. J Am Pharm Assoc. 2022; 62(6):1816-1822.e2. doi: 10.1016/j.japh.2022.07.003.