As a Pharmacist, how will I make a difference in the profession? Back in August of 1998, I matriculated into the Doctorate of Pharmacy Program at the University of North Carolina School of Pharmacy in Chapel Hill. At that time, my perception of the role of pharmacists centered about the traditional role of drug dispensing. However, after participating in the program, I have gained a better appreciation of the pharmacist's role, both present and future. Currently, the U.S. leads the world in terms of “health” care costs. Prescription misuse has resulted in staggering expenditures of over $76 billion and 119,000 deaths a year. Drug misadventure presents a problem in both pharmacy practice and health care. In order to make a difference in the pharmacy profession, I must recognize the pharmacy practice dilemma, address the dilemma through a personal professional mission statement, and finally proceed by acting on the mission statement. Today's dilemma in pharmacy practice can be characterized based on individuality, profession, and public perception as it relates to pharmaceutical care. As William Zellmer, once stated, “The nature of our discipline is the sum total of the inner drives – that is, the souls of individual practioners. If reshaping the profession is the goal,then the target for action must be the souls of individual practioners.” In this respect, Zellmer is challenging individual pharmacists to cultivate their soul or character in order to save our profession. Furthermore, in Opportunities and responsibilities in pharmaceutical care, Hepler and Strand state, “To critically reflect on pharmacy's future opportunities and responsibilities as a clinical profession, it is instructive to briefly examine the three major periods in twentieth century pharmacy: the traditional (apothecary), transitional (clinical pharmacy practice), and patient-care (pharmaceutical care) stages of development.” Currently, the pharmacy profession is in a state of limbo. Some pharmacists are cultivating the soul of pharmacy by adopting the philosophy of pharmaceutical care. On the other extreme are pharmacists satisfied with the status quo. Then there are those who fall somewhere in between. Finally, as one lobbyist reflected to a pharmacist, “Pharmacists are easy to lobby against.” When questioned why, the lobbyist responded, “The pharmacy profession as a whole can never come to a consensus.” Does this example represent the public perception that our profession remains splintered? In addition, the public cannot perceive the pharmacist as both tradesman and professional. Sequentially, the individual influences the profession, which in turn affects public perception. My mission statement is: As a proactive, open-minded pharmacist, I will promote pharmacy care through covenantal relationships between profession, community, and myself in an effort to advance both the profession and the welfare of society. In analyzing the mission statement, key words include proactive, open-mind, pharmacy care, and covenantal relationship. Proactive means taking responsibility for one's life and being accountable for one's actions. Having an open-mind means seeing beyond personal paradigms. A paradigm is an inherited or learned mode of thought that may be unconsciously utilized to filter information. Often times, our professionalization leads to a paradigm paralysis that prevents us from seeing alternative ways to address health care issues. Pharmacy care or pharmaceutical care can be defined as accepting responsibility for the patient's welfare by utilizing pharmaceutical services in an interdisciplinary manner that balances quality processes with economics. A covenantal relationship between pharmacist and community (patients) denotes professionalism, intimacy, and trust. A contractual relationship on the other hand is more or less a business arrangement lacking such intimacy and trust. Taken altogether in context with the mission statement the end goal represents an alignment of the pharmacy profession and public health needs. As aforementioned our profession is the sum of the inner drives - that is, the souls of individual practitioners. The implementation of my mission plan represents my individuality that contributes to the nature of our practice. In the hospital setting, I will be involved in pharmacist interventions, interdisciplinary care teams, and P&T Committees. Inherent with increasing number of prescriptions is the increased chance for drug misadventures. Documentation of pharmacist interventions promotes the importance of pharmaceutical care as well as the pharmacy profession. Participating in an interdisciplinary team will foster an appreciation of the pharmacist's role in disease state management by other health care professions. I will be able to retrieve, analyze and apply published literature towards evidence-based discussion involving the interdisciplinary team. In addition, as part of an interdisciplinary team, I will establish a more visible presence with the patients. Hence, the pharmacist gains recognition by both the patients and the other health care professions. As part of the P&T Committee, I will be able to promote pharmaceutical care and continuous quality improvements. Analogous to the relationship between pharmaceutical care and the concept of continuous quality improvement at the patient level, the mission statement likewise must undergo such a process at the individual level.

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What Pharmacy practice is of greatest interest to me and why? Developing a care plan for children with Diabetes is something that requires the collaboration of pharmacists, physicians, dieticians, and family members. Perhaps the most important person to be consulted about a plan to control Diabetes is the child who has been diagnosed. Clinical pharmacy practice with an emphasis on Type I Diabetes is of great interest to me. This essay will explore the reasons I am drawn to this type of practice and what I hope to accomplish. I don't remember a time when I didn't understand what Diabetes was. My mom has had Type I Diabetes for twenty-nine years. When I was younger I was intrigued by the rigorous demands the disease put on her life. Now, in my second year of pharmacy school, I am still awed by the regimen that people are required to follow to control Type I Diabetes. People with Diabetes, including my mom, have touched my life. After my freshman year in college, I was a counselor for the Diabetes Camp of West Virginia. It was wonderful to see kids who had never been away from home socializing with one another. One eight-year-old girl told me that she had no idea there were other kids that had Diabetes. The children were comforted by talking with one another, and realized that others shared in the obstacles they were facing. The camp also educated them about the management of their disease. My experience at camp taught me the importance of educational and social activities in the lives of children with Diabetes. It also helped me to realize that I could play an integral role in Diabetes education. As a pharmacist, I would like to work in a clinic for children with Type I Diabetes. Collaborating with physicians and dieticians, I would offer pharmaceutical care to newly diagnosed as well as previously diagnosed children with Diabetes. I would provide clinical services, such as adjustment of medications based on laboratory tests. I would provide education about the disease to the children and families. The clinic would address the psychosocial aspects of having the disease or of being a family member of someone with the disease. The discussion of psychosocial aspects might reduce interpersonal conflict within the home and increase patient compliance with a Diabetes care plan. The clinic would provide a central place for children with diabetes to get feedback about the management of their condition. It would also provide a medium for children and families of children with Diabetes to come together and share ideas. Though the population of children with Type I Diabetes is small, this type of clinical practice would benefit a population of people who have touched my life.