I dont know if anyone is as sick of hearing physicians being portrayed as a Dr Frankestein-obsessed-with-God-like-abilities stereotype as I am.
I have always pondered this argument myself (a med student) with other pharm students and have never found a satisfying answer. No doubt, you guys are great in drugs, pharmacokinetics, etc, etc. but what warrants a pharmacist's job in the clinical aspect of treatments? While pharmacists are obviously invaluable in terms of research, why pay someone 6 figures when a computer can do the same job? Wouldn't that save tons of money our health care system desperately needs? Do we need as many pharmacists as we have?
I heard the analogy of WebMD to diagnosis is computers to pharmacy, but that absolutely makes no sense. The problem with WebMD, is that it is unable to discern the signs and make sense of symptoms into a proper diagnosis. When it comes to drug and dosing, its either they work together or they dont. Its either the person's lab show that they their liver can handle the drugs, or they dont. And in most cases (I hope) doctors have already evaluated that.
Another argument for eliminating pharmacists clinically is that it may get lazy doctors to shape up and make sure their doses are correct.
The same argument could be made for Physicians .... why pay someone 6 figures to prescribe antibiotics and other random medications that were detailed that week and dork around with a stethoscope and reflex hammer ... or make an incision to drain an abscess that any tech with a little training after high school could probably do even better. I don't agree with this perspective any more than I agree with your perspective about pharmacists. I view it as a lack of being aware of what is going on ... but there is a certain amount of merit to the argument.
More to the underlying issue ... in a way, I agree with you. Let's eliminate the requirement of going to school (and residency) and let anyone who can demonstrate the skills and references from licensed people the right to take a test and earn a medical, pharmacist, RN or whatever license. Schools and training programs would have an incentive to be as efficient and effective in providing knowledge because their only value is the actual knowledge they provide ... no more wasted time and wasted rotations. They would still be liable and need insurance. Their employer would also be liable, and thus provide more reasons for people to make sure only qualified personnel are being provided to the public. Require health insurance to pay a certain amount for a procedure based on geography and maybe quantity but that's it for any "provider" who meets the legal requirements and conditions of the insurance (covered procedure, etc.). Similarly for hospitals ... anyone could open one as long as they can demonstrate meeting legal requirements and passing inspections. No more protected markets for hospitals.
This would reduce pay and turn medical care into a free market and many people (particularly Libertarians) dream about this. However, we aren't going to see this fantasy played out anytime soon. People get into a profession or market and protect it; they don't want easy access for competitors. There is a barrier to becoming a pharmacist (only so many spots in pharmacy school) and since there are so few licensed, they pay goes up. They get great pay right out of school because there are so few of them licensed. Similarly for physicians. You can't just become a neurosurgeon in a year at a community college if you can pass the board exams and demonstrate the skills because your dad showed you how for 5 years or whatever ... there are many barriers that must be overcome (for good reason). If there were was 50% unemployment 100s licensed physicians competing for every position, we would see physician pay plummet (similarly for pharmacists).
Thus, the argument you make for pharmacists could also be applied to physicians ... make it easier for people to get licensed as long as they can demonstrate the necessary skills to pass a board exam and perhaps have licensed people serve as references for appropriate experience and training. The job of president of the USA has no school or internship requirements. As long as you can show that you are the right person for the job and get the majority of voters (the market) to agree, you get the job. That might explain some of the complaints that people have about U.S. presidents, but I'm not sure requiring going to "president school" and getting licensed to serve as a president (or for that matter a senator, etc.) would improve quality very much. Here we are talking about a job that involves the ability to start nuclear war and destroy mankind. It's hard to argue that physicians (or pharmacists) have more responsibility. By opening things up, it would let the market sort out the value. Again, this is a fantasy that won't happen for many reasons (many of them good, some very inefficient).
These inefficiencies in the market make the services more expensive, but they also help protect us from unethical pharmacists who would just sell their inventory (which would have a street value of bizillions) and disappearing into the night with enough money to retire. Similarly, having an inefficient medical training system discourages certain people from the medical profession ... certain people who would take advantage of patients by ordering unnecessary procedures to enrich themselves. These safeguards aren't perfect, but they, along with various board exams, interview processes, peer-monitoring, etc. are the best we have for now. To some extent we have see things played out in the financial markets (mortgage crisis, previously the S&L crisis, etc.) when the balance between regulation and free market is not optimal.
We do wear a white lab coat though but that has been our tradition (pharmacy is a very old profession dating back from Egypt and even more).
for pharmacists. Retail AND clinical.
