[wahern]

> i think such a system makes pharmacists de facto community doctors, but without the time, training, or patient medical data to function correctly.

A U.S. Pharma.D is a professional doctorate degree. They don't just study organic chemistry, but also little things like treatment indications and counter-indications, patient management, etc.

Having access to the patient's medical history is a solvable problem. Some pharmacists already have access to and make use of such information.

Regarding patient time, there are more pharmacists in the U.S. than primary care physicians--roughly 290,000 versus 250,000. (See https://www.statista.com/statistics/185723/number-of-pharmac... and https://www.ahrq.gov/research/findings/factsheets/primary/pc...)

The problem today is that we waste our physicians' expertise on trivial stuff. It's an inefficient allocation of resources. Pharmacists have traditionally always been on the front-lines. The past half century in the U.S. has been anomalous in how underutilized are our pharmacists. Fortunately their training is still quite rigorous. They regularly catch physician errors, including a significant portion not related to drug interactions. (See https://www.sciencedirect.com/science/article/pii/S131901641...)

As long as the lines of communication are kept open, what's the issue? An M.D. or O.D. doesn't make one omnipotent. And U.S. pharmacists are better trained than the pharmacists in many other countries who enjoy greater independence and authority. The sky isn't falling in those places, AFAICT.

[Engineering-MD]

I was not belittling the pharmacist’s qualification, they often helped advise me and fit a specific role in the health care system. They are however trained for a different role (at least in the uk where I am based). General practioners are trained to deal with long term conditions. These conditions often require patients to be managed over a long period of time, and seem several times, hopefully by the same clinician. They also see them for the majority of their other illnesses. General practitioners allow a patient to develop a long term relationship with a doctor, and allow the doctor to become an expert in the patient.

I agree with you that a pharmacist is capable of dealing with many of these issues, but (at least in the uk) they are not primarily set up to deal with long term health conditions, and don’t develop that expertise in a single patient. If they become like GPs (which they feasibly could), it would work. But why do that when there is already a doctor who specialises in that? Maybe my arguments work less well in America, but my knowledge of that healthcare system is limited.

Ultimately though it seems we agree medications need some form of specialist oversight, rather than being freely available.