94. PHARMACIST AND EMPLOYMENT IN HEALTH SECTOR IN INDIA

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It was in 1974-75 when I had just joined service as Graduate Pharmacist in Govt Wenlock Hospital, Mangalore, under Government of Karnataka, when a some of the under graduate pharmacists and my counterparts in other hospitals discussed to propose to the Government to have a job chart prescribed. Till then I had no idea of a job chart or its need as Doctors, Nurses, Technicians had no such thing like a job chart. At the first instance, I wondered why at all it is needed.

My understanding was Pharmacist is a pharmacist irrespective of where he works. All jobs he does as a pharmacist in main store, Sub store, Dispensary and the then existing I V Fluids manufacturing unit are nothing but a job of a pharmacist. Why anyone should tell us what we should do? Latter with the passage of time slowly I realized the need for the job chart when I found that the hospital was using the the pharmacists mainly for services other than the pharmacy work like: Writing of OP ticket, In patient admission register, office clerical work like preparation of salary bills of the hospital staff etc. At last we succeeded in getting a Government Notification on the job chart of the pharmacist with the support of the Pharmacists Association the contents of which were latter found in the subsequently published WHO publication 'Role of Pharmacist in Healthcare'.

The situation in terms of work culture and positioning of pharmacist did not improve even after the official job chart was notified as the medical officers didn't change their attitude and mindset towards the pharmacist and majority of the pharmacists did not cultivate professional look and work culture. All these struggle with suffering had to be done only by the pharmacists on their own and none of the pharmacy institutions like Academe, Councils, national Associations like IPA, IHPA, IPGA came forward to support the cause. They were all buisy with their conferences and seminars that were and are beyond the reach of common pharmacists. Even the Pharma Regulatory sector of the Government remained mute but watchful enough to ensure the parity of their status and pay remains undisturbed.

None of the agencies mentioned above visited health sector institutions to mitigate the problem of the pharmacists. Regulatory officers were finishing their job by merely reporting that pharmacist was not found in the dispensary but silent on stores and sub-stores. Those letters had no impact as there was administrative or regulatory compulsion to comply. Even today the plight of the D Pharm and B Pharm pharmacists is very pathetic. They have no professional freedom let alone the much talked out 'Practicing' pharmacy. This is because Acts and Rules do not mandate the need of the pharmacists service in bulk management of drugs and hence such tasks are authoritatively being carried out by non-pharmacy personals like doctors clerical staff and administrators. Ofcourse Pharmacist is lending his knowledge and skill without professional authority.

Today I find a big hue and cry on placement of PharmD graduates.

Every national level Pharma agencies including the Pharma faculty members are actively canvassing and orchestrating to position the PharmD graduate in place. I don't grudge rather I appreciate. But, why this care and concern was not and is not shown to the under graduates and graduates? Why the care is not taken to ensure good professional glow and shine on the look and work culture of the pharmacy students? In what way the PharmDs look differently than the routine graduates and undergraduates?

I have seen PharmD students wearing shabby jeans, T shirts, chappals entering their class room and labs with unshaven beard, untrimmed nails - that means without any professional outlook and shine.

Can they command respect from the patients and co-professionals?

A common reply I got from the PharmDs whom I met was Sir, even our teachers also don't wear formal dress and they come to teach us in the same way as we are.

One teacher lamented that students don't heed the advice when asked to come in formal dress.

What a shocking situation? The question I foresee is will the medical officers who did not and do not allow the pharmacist to professionally manage the drugs in the hospital, accept the PharmD and allow them to handle their prescription clinically?

Can the M Pharm or PharmD function comfortably without professional support of the pharmacists down the line?

Now, lets look into admin scenario. Time and again I have been airing my observations and comments on the positioning of the pharmacists with different qualification.

Example: A 750 bedded hospital is having:

* 6 Junior Pharmacists (D Pharm),

* 4 Senior Pharmacists (D Pharm)

* 2 Graduate Pharmacist ( one B Pharm and another happens to be M Pharm)

* 1 Chief Pharmacist (B Pharm or M Pharm).

And now, the hospital appoints a PharmD graduate.

1. Who will head the Pharmacy department?

2. What would be the promotional ladder for the pharmacists including PharmD?

3. Can any program succeed without the support of the lower cadre staff and promotional incentive to them?.

4. Should the pharmacist continue to stagnate in the same entry cadre till his retirement in the way it has happened and is happening now?

If so:

a. Why any one should become a hospital pharmacist?

b. Why make anyone a hospital pharmacist to ruin his life?

A person with a general degree courses entering service at lowest step will retire as administrative officer.

But a pharmacist with D Pharm to PharmD stagnates! I am putting forth this analysis not to demotivate or discourage any one but to drive home the ground reality that needs to be addressed urgently on priority. A feasibility study and need analysis should be done before starting any major activity that too when it concerns the life of youngsters. The level and sectors to be addressed are: Academe, Regulatory, Acts and Rules, National Health Policy, Pharmacovigilance program, Health sector and drugs management, Bottomline: Lets wake up or ......

Please at least mention 'Like' or 'Unlike' after you read and before moving out.

About the Author

Ph. Bhagavan P S RPh's picture

I am Bhagavan ,Rtd. Dy Dir.(Pharmacy),Govt of Karnataka, India and currently serving as Registrar, KSPC, Bengaluru, India . I love to write on Hospital pharmacy series related topics out of my experience and observations. Check out my Pharmacist in the Hospital.

Comments

A.R.Khan's picture

Thanks for Your blog Sir.

But how they will be placed in Hopital's and promted in Hospitals is Hospital problem . I mean they have to have structure in according to their needs and organization policies etc..

When we got Indipandance , we have very few pharmacists working in Industry .. Slowly we evolved and got a lead role in pharmaceutical Industry in India and NOW even supporting global needs for medicines. Its a natural evolution in competitive world .. We proved it..

Same thing for Pharm D gradutes ..They need to go through natural evolution process and fittest will survive just like in Pharmaceutical Industry ...

This is a competetive world and don't thing we need government polocies and reservations etc to survive ..
Formal Education ( B-pharm or PharmD ) is just get you glimpses of everything you might face in future .. Any student professional growth or success depend how they adopt in real time and team player in the organization ..

If your goal is to make money like any businessman study M-Pharmacy and get in to the Pharmaceutical Industry.

If your goal is to SERVE people and making money for a living by HELPING then choose PharmD or infact any medical profession like Doctor...

IMHO

Ph. Bhagavan P S RPh's picture

Thank you Dr Khan. Good that we got into the dialogue after a long time. Hope you are doing well.

Well Dr Khan, if you go through my blog three issues will be evident like a failure in product management:

Use, Misuse and Abuse.

All the three are happening due to lack of familiarity, lack of product knowledge. Any employer first prefers familiar skill and takes a long time to accept new skill and knowledge.

It is only now after the necessary amendment to the Drugs Act the private hospitals are employing Registered pharmacists .Earlier they were taking shelter under Schedule K that exempts the doctor from appointing a pharmacists to dispense the drugs to his own patients.

In case of Government the enforcement is not that forceful. Either the post of the pharmacist remains vacant without being forcefully demanded or the services of appointed pharmacist is either misused or abused in the way I have explained in my blog.

The Government is a body made up of people including our own people. Some are in position with empowerment and authority. If we wash off our hands saying that it is Government's head ache to use the service forces when our people in authority and empowerment are not asserting the need and protect the professional rights who else would help the employed and unemployed pharmacists?

Do we find such an apathy in our co-professional's organizations? Immediately the IMC, INC and other bodies step in to set right. Government is a biggest employer of pharmacists considering its civil, community, defense, airforce, navy, ESI, railway sectors.

If strategically worked with a pragmatic proposal it is possible to set right the deficiencies, inconsistencies and contradictions in academe, regulatory, sectors and convince the beurocrats and policy makers to provide professional position and freedom to our pharmacists in all the departments in the hospital..

All categories of pharmacists should be treated alike and there should be good intra-professional coordination, understanding and support among all of them. No category should feel let-down. Particularly the higher category suffer badly if they do not have and gain the confidence and support of the lower category.

I have seen cold-war brewing between D Pharm and B/M pharm in the hospital that should be stopped immediately.

Again I repeat that I do not grudge the projection of PharmD. But my appeal is address all the issues of all categories of pharmacists in healthcare sector and the direct health oriented industry sector. Thank you again

Bhagavan P.S. B Pharm

Rtd. Dy Dir.(Pharmacy),Govt of Karnataka, India
A.R.Khan's picture

I understand that,,,but still sounds funny for professionals looking at secured jobs in government sector .. its a competitive world ..

But i\Changes needs to be done at system level for those jobs .. Even pharmaceutical industry is doing good because our law allowed us to reverse engineer drugs that are patented in some other countries ...

same thing here, the laws can make pharmacist position mandatory BUT professional growth and salaries depend on how they evolve ..time will tell

regarding dress code..they are all subjective and kids now are smart enough to dress according to situation ....they will adopt if their job demands .....

Prof. J. Vijaya Ratna's picture

Sir

I am observing a downtrend with respect to job opportunities for all pharmacy people. But that is so in our state for all sectors- including engineers and doctors. But I am thinking with all the investments going on, situation will improve soon. There is a clear difference between the B. Pharm person and the Pharm D person with respect to their hospital activities. Pharm D person is more clinical pharmacy oriented whereas B.Pharm person is more towards hospital pharmacy activities.

Regarding the way they dress, the young generation has a way with itself and we can't do much about it. We tell them to look professional and that is the end of it.

I understand your worry sir, but my feeling is that situation for pharmacy people with necessary skills will definitely improve.

Vijaya Ratna

Ph. Bhagavan P S RPh's picture

Today I bounced upon my own blog while browssing casually. I found I had left your comment un answered. My appologies madam.

Well, empowerment of pharmacist when employed is imminent to deliver professional service.

Employment without empowerment reduces him to a slave.

Bhagavan P.S. B Pharm

Rtd. Dy Dir.(Pharmacy),Govt of Karnataka, India

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