Abstract
General practice (community) pharmacy as a healthcare profession is largely devoted to therapeutic treatment of individual patients whether in dispensing medically authorised prescriptions or by providing members of the public with over-the-counter advice and service for a variety of common ailments. Recently, community pharmacy has been identified as an untapped resource available to undertake important aspects of public health and in particular health promotion. In contrast to therapeutic treatment, public health primarily concerns the health of the entire population, rather than the health of individuals (Childress et al. in J Law Med Ethics 30:170–178, 2002). Thus, an important question for the profession is whether those moral and professional values that are appropriate to the therapeutic care of individual patients are relevant and adequate to support the additional public health role.
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Notes
All pharmacists are able to supply certain designated more potent medicines without prescription and within specified circumstances. Additionally, some pharmacists (pharmacist independent prescribers) are trained and are authorised to manage, prescribe for and more directly treat patients in certain specified therapeutic areas, e.g. hypertension. Regulations to allow independent prescribing by pharmacists came into effect in May 2006. Pharmacist independent prescribers can prescribe for any clinical condition but they must only prescribe within their professional and clinical competence. These changes mark a significant shift of emphasis from a purely methodological, product-focussed and somewhat impersonal relationship with patients to a more directly patient-centred practice of pharmaceutical care.
Both Wanless reports are downloadable from www.dh.gov.uk/publications.
Interview for BBC Woman’s Hour programme September 23rd 1987.
Yet it is interesting to note that UK pharmacists are now encouraged to not only: build stronger bonds with their customers by promoting a culture of greater health literacy for all—particularly those who live in areas of greater social deprivation or where significant health inequalities persist and (but also) take on a community leadership role, providing positive action that makes a significant contribution to tackling the root causes of health determinants, such as fuel poverty and benefits uptake and signposting to services or hosting other service providers in pharmacy premises. (Pharmacy in England. Building on strengths—delivering the future (2008 pp. 51–6).
This is not to suggest that causal inference offers anything approaching near certainty. For a valuable debate on some of the relevant considerations see Rothman ed. (1988).
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Acknowledgments
I would like to express my thanks to the anonymous referees whose comments helped to frame and clarify important aspects of this paper, and to Pekka Louhiala for his patient and helpful advice.
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Badcott, D. Professional values in community and public health pharmacy. Med Health Care and Philos 14, 187–194 (2011). https://doi.org/10.1007/s11019-010-9281-0
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DOI: https://doi.org/10.1007/s11019-010-9281-0