So, you practice pharmacy. So what does that mean you do? More importantly, what does it mean you have the legal right to do? How does the Louisiana statute define the practice of pharmacy? May a person with only a Louisiana pharmacist license also administer the medication he has dispensed? May such a person draw blood to be used for a clinical laboratory study, maybe a lab study to determine the concentration of a drug he has dispensed?

The answers to some of these questions are clear, are easy, but some of the answers are difficult to fathom. And there are many, many more than just these questions, I know.

A starting point in this quest for answers must be the legislative definition of the "practice of pharmacy." The Louisiana statute (LSA-R.S. 37:1222) defines the practice of pharmacy as:

"The term 'practice of pharmacy' or 'practice of the profession of pharmacy' means and includes the compounding, filling, dispensing, exchanging, giving, offering for sale, or selling, drugs, medicines, or poisons, pursuant to prescriptions or orders of physicians, dentists, veterinarians, or other licensed practitioners, or any other act, service, operation or transaction incidental to or forming a part of any of the foregoing acts, requiring, involving or employing the science or art of any branch of the pharmaceutical profession, study or training."

Omitting the prefatory phrases, there are sixty-five operative words in the statute, sixty-five words devoted to defining the practice of pharmacy, and those words are divided into two distinct parts.

Filling Prescriptions

The first part of the definition contains twenty-seven words (from "compounding" through "practitioners") and is not difficult. Paraphrased, the first part of the definition says simply that the practice of pharmacy is the compounding or dispensing of medicines pursuant to a physician's order — "filling prescriptions" as we all say.

The second of the two part definition, however, is not all that easy. At least one way to re-phrase or paraphrase the second part of the definition is this:

"The 'practice of pharmacy' means and includes, in addition to filling prescriptions, any other act, service, operation or transaction that is either incidental to, or forms a part of, the act of filling prescriptions and that requires, involves or employs:

(a) The science or art of any branch of the pharmaceutical profession,

(b) The science or art of any branch of pharmaceutical study, or

(c) The science or art of any branch of pharmaceutical training."

While the sixty-five words are not without some uncertainty if approached as the single lengthy sentence they are, without a doubt there is enough there to give a reader more than just a vague understanding of what a pharmacy practice is. The second of the two distinct parts of the definition is made less difficult to pin down and understand by physically separating it from the first part and then paraphrasing it. Once done as shown above, at the least these two points seem to emerge about this definition of the practice of pharmacy:

1. "Filling prescriptions" certainly is not the only thing pharmacists may do; and
2. Pharmacists might not be limited to performing the "other acts" only when they are filling prescriptions.

It is these "other acts" part of the statutory definition of the practice of pharmacy that is the most intriguing. And, it is those other acts that offer the most potential, will open more new doors, for modern day pharmacists and the practice pharmacy.

Other Acts

If filling a prescription is viewed as the "distributive service" in the context of this definition, certainly the patient counseling of today's pharmacist is an "other ... service ... incidental to ..." filling a prescription and a cognitive service that is an act "... requiring ... the science or art of ... pharmaceutical ... study or training." Notice, too, that if a pharmacist wanted to offer for sale to the public only "cognitive services," this definition by our legislature certainly seems to permit him to do so. But, if he wanted to do so from a place he would call "Hawk's Family Pharmacy" that has a "pharmacy permit," would the answer be so easy. Would he (or, should he) be compelled to also be able and prepared to "fill prescriptions" at that "pharmacy"? Also, "care," as in pharmaceutical care, is surely an act falling within this Louisiana legislative definition.

There does not seem to be any express language in this statutory definition that says the other acts must be performed at the same place, or at the same time, a prescription is filled. What avenues does that open up. And, if one wanted to argue that a pharmacist is not authorized to perform these other acts unless in fact at that time a prescription is also being filled, again there just isn't any language to require such.

Then, there are still the words "operations," and "transactions," as part of these "other acts" to be explored and considered in the legislative definition. Notwithstanding, however, these different hypothetical practice settings, there surely is a limit to the "acts" encompassed by this legislation — no one could successfully argue there is no limit at all to what a person licensed to engage in the "practice of pharmacy" can do ? What is that limit, is that limit clear, how does one test that limit without running the risk of violating the law and having a license revoked, or suspended?

As pointed out in the beginning, some questions are easy to answer, but some are not. For example, by the statutory definition quoted at the beginning of this article, in Louisiana there probably are some acts a pharmacist must perform and some that a pharmacist need not perform if he chooses. But, law (a statute), just like medicine, is an art not a science. The words and phrases used in the second part of the definition are very "generic," are very "empirical." Yet, just what are all of the acts you can safely (legally) do must be answered with "it depends." It will depend on who is answering. It will depend on who is asking. It will depend on the setting — is it at a hearing before a health care practice regulatory agency, or a monthly meeting of a hospital P. & T. Committee?

Your Practice Setting

So, if you describe what you do as "practice pharmacy," would you answer more questions. Do you ever fill a prescription in your practice? Is "filling prescriptions" the only thing you do in your practice setting; or, is that only part of what you do? If only part, what else is there that you do? What are the acts or services you feel you need to perform to be able to deliver quality and cost effective health care? Would those services fit within limits of the definition in the Louisiana statute?

I have not intended the foregoing to have all the answers, and there will surely be some people who will not agree with some of the answers I have suggested. Nor do I even have all the questions. What I do intend, however, is to prod all of you/us to ask questions. And, if the answers do not fit your practice or the needs of your pharmaceutical care patients, then what * * * ??