If one word could be used to sum up pharmacy in the 20th century, then it would be "supply". But as the century has progressed, the profession has moved further and further away from supply as its be-all-and-end-all. From the beginning of the century, when all prescribed items were assembled from scratch and home-made nostrums were the order of the day, through ethicals to patient packs, the physical input of the pharmacist has steadily lessened. Now the profession must have the courage to look into the 21st century.
There are many reasons why supply is, of itself, no longer an adequate role for the 21st-century pharmacist. Foremost among these is the rise of automation and information technology. If mail order and internet pharmacy can be made to work in the United States, then it can be made to work (in a technical sense, at least) in the United Kingdom. Today's modern wholesale warehouses are around 80 per cent automated and are capable of detecting the difference between an empty tote box and one containing a single patient pack of Zantac. Mail order is not a great leap forward from this.
Then there is the imminent demise of the pharmacist's friend, the FP10. The Government has already made this an endangered species through its stated desire to see doctors prescribing electronically by 2002. The paper prescription could be a museum piece within five years and pharmacy will have to fight hard to put over compelling reasons why electronic prescriptions should be delivered to pharmacies rather than some other "fulfilment centre". Work practices centred around pieces of paper will have to change.
Finally, it is far from clear that the new pharmacists of the 21st century, with their four-year masters degrees, actually want to "count, pour and stick", shunning patient contact. Current recruitment problems in community pharmacy simply serve to emphasise the direction of this trend. In hospitals, dispensing is becoming passé;, left to checking technicians while pharmacists get closer to patients on the wards.
There are many out there who will leap to the defence of the status quo claiming that dispensing is pharmacy's core role and that it must not be relinquished. "What will we do without it?" is their question.
As ever, there is no simple answer to this, but any new role will have to involve patient-focused medicines management or pharmaceutical care, paid for as a professional service. Without a change of mindset and practice model, pharmacy as it exists today, will go the way of all the other vanished occupations which linger only on the pages of history books.