In Reply to ‘‘Why We Banned Use of Laptops and ‘Scribe Notes’ in Our Classroom’’

To the Editor. Motivated by concerns over the increasing numbers of pharmacy school graduates, Dr. Daniel Brown’s letter to the Journal and the American Pharmacists Association (APhA)/American Society of HealthSystem Pharmacists (ASHP) discussion paper all but say directly that a halt should be put to the opening of new pharmacy schools. If the only career options for pharmacy school graduates were retail and hospital pharmacy practice, then maybe (only maybe) too many graduates are being produced. But maybe not given the pressures building from an aging US population, an improving economy, and oncoming health care reform. Nevertheless, pharmacy school graduates could have many more options with some adaptations made to their education and training, but, regrettably, these other options are not taken into account by those who are worried about the number of graduates produced today. Thus, arguments about the need for more pharmacy schools based on the number of graduates required by retail and hospital pharmacy practice sites obscure the more important issue around whether new schools of pharmacy are needed to make all the possibilities afforded by a foundation in pharmacy real for students. Health care has evolved over the last couple of decades in ways that extend the value of a pharmacy education well beyond traditional practice sites. The market withdrawals of many prescription drugs have created a need for people who understand pharmacotherapy along with epidemiology, research methods and analysis, bioinformatics, and regulatory science. Payer organizations and benefit administrators need people who understand drug therapy along with benefit allocation policy, public administration, and economics to help them construct rational benefit designs and responsible clinical programming. Patients need comprehensive and comprehendible communications so they can use their drugs and their benefit plans effectively, which has driven a need for pharmacists who can create clear patient communications. Health care businesses have become correspondingly more complex and thus pharmacists with business or law backgrounds are in more demand now than ever. And even within the traditional practice settings, the advancements in automation, clinical decision support systems, and administrative transaction processes generate options for pharmacists who have expertise in industrial engineering and information technology. These are but a few of the growing opportunities for people with a foundation in pharmacy augmented by other skills. Alas, hiring managers looking for people with a pharmacy foundation combined with other particular capabilities are frustrated that few such people exist. Conversely, people with a pharmacy foundation who want additional skill sets find they have to seek them elsewhere than from integrated programming within pharmacy schools. Therefore, pharmacy schools should be working to produce graduates with the knowledge and credentials that make them effective contributors to health care across a wider range of industries than the traditional practice sites. The added education and training that pharmacy will need to provide students to qualify them for these expanded opportunities are not trivial. Pharmacy schools will need to integrate innovative and workable dual degree and certification programs into their curricula, and they will need to add experiential sites that correspond to their expanded educational programming. Pharmacy schools cannot do this alone. Accrediting organizations, state regulatory agencies, and professional organizations will be essential partners if pharmacy is to make the changes required to expand the opportunity range of its members and students. Such an undertaking will be hard and will require some imagination, but pharmacy has done it before—most recently to make the doctor of pharmacy degree universal. Pharmacy can do it again—pharmacy must do it again. The alternative, reducing the flow of graduates, is suicidal to the profession and a breach of the profession’s covenant with the people it serves.