Read the thread from 5 years ago, get that we need people with expertise in medicine _at some point_ in the chain of care, but unclear why it all needs to be at the end.
Background: finding myself needing to visit the pharmacy quite frequently for prescriptions for family members (so no opportunity to visually inspect the patient), whenever the pharmacist goes over dosages and instructions, it’s nearly verbatim what’s printed and in the bag, and it’s always pills. Seems like you could have the pharmacists that check for bad interractions in some pharmacy Mission Control, and my small bottles of pills could be assembled from big bottles of pills by a machine.
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There’s a lot on the backend. The pharmacist’s interaction with you is only a part of the whole thing. Running a pharmacy is a lot of work (any regulated industry is a lot of work). Also the pharmacist has to deal with the prescribers and drug manufacturers. And that’s a lot of work, too.
What you’re talking about happens all the time. The VA has CMOPs (consolidated mail order pharmacies) that are giant warehouses full of conveyor belts and machines that put pills into bottles. Pharmacists are located there as a final check.
This hasn’t caught on everywhere but it’s probably the future
In the end, the Pharmacist is the last line of defense for a patient. It is their job to know what drugs do, what the pills look like and if dosage and interactions are going to be ok. People can go to multiple doctors and get many different prescriptions. If one doctor prescribed something that would have an issue with another drug they are taking, the pharmacist is the last person to stop it from having serious or fatal consequences.
Our local drug stores almost seem like they have a shortage of them and restrict the hours of service because of it. There are some jobs I wouldn’t want to trust blindly to a computer. Handing out drugs is one of them. If someone loaded a pill hopper wrong, think of the consequences to the patient.
The pharmacist does a number of things. They communicate with doctors offices to receive orders, they process those orders through insurance companies (at least in the USA), they physically dispense the pills into a bottle for the customer, evaluate potential adverse interactions that the doctor didn’t think of, interact with customers, and maintain an inventory of thousands of different drugs.
A number of those things could be theoretically eliminated (like if the USA moved to universal health care and dealing with insurance was no longer an issue). Other things are much harder to do, like physically counting out and dispensing pills, which would be hard to automate since there are so many different medicines of different forms (all shapes and sizes of pills, liquids, creams etc.). Artificial intelligence systems could potentially help prevent adverse drug interactions, but those systems don’t exist yet in an approved commercially available form.
>whenever the pharmacist goes over dosages and instructions, it’s nearly verbatim what’s printed and in the bag, and it’s always pills.
In addition to what others have said, pharmacists exist to make sure *every* patient receives the proper care and knows how to take their medication. Not everyone will be getting pills, and some patients will need further explanation than what is printed on their bottle for any number of reasons.
Some patients may have difficulty reading the bottle either due to poor eyesight or difficulty with the language. Patient consultation is a great place to catch that the language used on the bottle is not the patient’s native language and may need translation. Additionally, not every patient has the same level of education. Pharmacists are trained to write instructions out as simply and accurately as they can so they can be used by patients of all education levels, but there will still be opportunities for confusion. For example, compare “Take 1 tablet by mouth twice daily” with “Take 1 tablet by mouth two times per day” and “Take 1 tablet by mouth every 12 hours.” Those should all be equivalent, but patients may interpret them differently.
Some patients may have difficulty with measurements for liquid medications. I know that one teaspoonful is five milliliters, but not every patient knows that or how to measure it out. I once had a patient who misunderstood their instructions and was taking 1.5 teaspoonsful per dose instead of 1.5 milliliters per dose, five times as much. It was written correctly on the bottle, but they were far more accustomed to imperial measurements than metric.
(I worked as a pharmacy technician for about fifteen years.)
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