The Evolution of the Pharmacist: One Profession, Many Roles in Modern Healthcare

How Pharmacy and Medication Management Are Transforming Patient Care

Pharmacist roles have evolved dramatically from ancient apothecaries to today’s clinical specialists who manage complex medication therapy and chronic disease management. Modern pharmacists serve as essential healthcare partners, providing medication management, preventive care, and technology-driven pharmaceutical services. 

At Clarest Health and its divisions, Remedi and ProCare, nearly 400 clinical pharmacists embody this professional evolution. Our pharmacists serve as medication therapy experts, chronic disease management specialists, and collaborative healthcare partners. To better understand how pharmacist roles have evolved, we explored the history of pharmacy and spoke with our own clinical experts about how their work transforms patient care and impacts pharmacy innovation.

The historical evolution of pharmacist roles: from compounding to clinical medication management

The history of pharmacist roles traces back to ancient Mesopotamia, Egypt, and China, where healers documented medicinal plants and prepared remedies. The profession formalized during the Middle Ages when apothecaries emerged as distinct practitioners separate from physicians. The first licensed pharmacy in the United States was opened by Louis J. Dufilho Jr. in New Orleans in 1823, marking the beginning of American pharmaceutical practice.

The 20th century transformed pharmacist responsibilities from compounding-focused work to clinical medication management. The introduction of industrially manufactured medications shifted pharmacist roles from preparation to distribution and consultation. By the 1990s, pharmaceutical care emerged as a practice model emphasizing patient outcomes over product delivery.

Today’s clinical pharmacists are medication therapy experts with extensive training in long-term care medication management and chronic disease management. Many Clarest Health pharmacists chose the profession for both professional and personal reasons. Jeremy Stehle PharmD, RPh and Clinical Hub Pharmacist Supervisor in Phoenix, AZ explains, “My personal path to pharmacy included a curiosity to learn more and a passion for people. My mom was diagnosed with lupus 20 years ago, and the medication she took was saving her life. I was intrigued.  This was the hook into pharmacy, but the most rewarding part (and what draws me to the profession) is the impact the pharmacist has on patients and family members that we interact with daily.”

Modern pharmacist roles: beyond traditional dispensing

With over 335,000 pharmacists currently employed in the United States and projected 5% growth through 2034, according to the Bureau of Labor Statistics, pharmacist roles continue to expand. More significantly, the scope of pharmaceutical practice has transformed dramatically.

“Technology is not changing just what tools we use. It is changing the expectation of what a pharmacist brings to the table: from medication expert to clinical partner and patient safety advocate,” explains Hiral Patel, PharmD, RPh, Staff Pharmacist at Clarest’s Clinical Hub. 

More than 75% of U.S. hospitals now assign pharmacists to provide direct patient care, according to the American Society of Health-System Pharmacists. This represents a significant evolution in pharmacist responsibilities from traditional dispensing roles to active participation in clinical decision-making and medication management.

Preventive healthcare: the hidden impact of clinical pharmacists

While patients typically associate pharmacist roles with prescription fulfillment, their preventive healthcare work often happens behind the scenes. “While patients might not ‘see’ our work directly, pharmacists are often the silent force preventing the next fall, the next hospitalization, or the next cognitive decline,” notes Patel.

This preventive care work is especially critical in long-term care pharmacy settings. Consultant Pharmacist, Rachel Echols, PharmD, elaborates: “In long-term care pharmacy and geriatrics, pharmacists aren’t often seen. Consultant pharmacists are always working behind the scenes, making sure doses, monitoring, and interactions are managed appropriately, and preventing issues before they arise.”

The impact of these pharmacist roles is measurable. All 50 states now authorize pharmacists to administer vaccines, and during the 2022-2023 bivalent COVID-19 vaccination campaign, pharmacies administered 67.7% of all doses, according to the CDC. Research published in the Journal of the American Pharmacists Association demonstrates that pharmacist involvement increases immunization rates by 14%.

“Pharmacists have administered more COVID vaccinations than any other healthcare professional,” observes Mike Zandri, RPh, VP of Integration, ProCare, a Division of Clarest Health. “For patients, it is easier and faster to get their ‘flu shot’ from their local pharmacist.”

Andy Zhang, PharmD, Staff Pharmacist, Clinical Hub, describes the breadth of preventive pharmaceutical care services: “Pharmacists, especially retail pharmacists who are at the forefront of customer service, are usually the first health provider patients come across when their health needs are not met. The ease of access to speak with pharmacists often means we provide services that patients might not realize such as Patient Education, Basic Health Screening, Vaccine Administration, Lifestyle Counseling and Medication Therapy Management.”

Multiple pharmacist responsibilities in daily clinical practice

Modern pharmacist roles encompass numerous functions that extend far beyond medication dispensing. Patel describes these multifaceted pharmacist responsibilities: “Beyond dispensing, my team and I serve in several critical roles: Interdisciplinary Consultant, Clinical Advisor and Reviewer, Advocate, and Educator.”

This comprehensive approach to pharmaceutical care yields measurable results. Studies published in the Annals of Pharmacotherapy show that pharmacist-led chronic disease management programs demonstrate A1C reductions of 2.1%, blood pressure reductions of 29.7 mmHg, and substantial improvements in anxiety and depression scores.

“Pharmacy is one of the first places both patients and health care providers turn when situations or outcomes are not as expected,” explains Dana Davis, RPH, Lead Pharmacist at Remedi in Cleveland, OH. “Anything from navigating regulation compliance to protocols for prescribing success to consolidation of medication administration.”

The data reinforces expanded clinical pharmacist roles. According to the American Society of Health-System Pharmacists’ National Survey of Pharmacy Practice in Hospital Settings, 63.2% of hospitals in 2024 reported pharmacists routinely managing anticoagulant dosing, up from 42.6% in 2016, representing a 50% increase in clinical responsibility.

Chronic disease management: expanding pharmacist roles in patient care

According to the CDC, chronic conditions affect six in ten American adults and account for 90% of annual healthcare expenditures. Clinical pharmacists have emerged as critical partners in managing conditions such as heart failure, COPD, chronic kidney disease, and liver disease. 

“Pharmacists are ideally positioned to provide patient-tailored recommendations to guide disease management,” explains Davis. “We are able to advocate for the best clinical outcome for a resident with a concise treatment plan in most efficient and economical manner.”

Patel emphasizes the continuity that pharmacist roles provide in long-term care pharmacy: “Where providers may rotate and nursing turnover is common, pharmacists provide a stable, continuous clinical presence that’s crucial for managing long-term conditions safely and effectively.”

Nearly 72% of hospitals with outpatient clinics now deploy pharmacists in chronic disease management roles such as diabetes and hypertension management, according to the American Society of Health-System Pharmacists. These clinical pharmacists have authority to monitor labs, adjust medications, and authorize refills, helping address physician shortages while improving patient access to medication management.

Stehle reflects on the evolution of pharmacist roles: “Pharmacists have long played an underappreciated role in chronic disease management. The pharmacist’s role enhances the healthcare team. The more services provided for patients by pharmacists increases the accessibility of healthcare services that may otherwise be unattainable. On the healthcare team, our extensive knowledge and expertise position pharmacists to provide instrumental recommendations to promote medication safety and improved outcomes for patients.”

Medication adherence: a critical pharmacist role in healthcare outcomes

Medication adherence represents one of healthcare’s most persistent challenges, making it a crucial focus area for pharmacist roles. Approximately 40% of patients fail to adhere to medication management to treat chronic diseases, contributing to an estimated 100,000 preventable deaths and $528.4 billion in annual costs, according to research published in Annals of Internal Medicine.

Clinical pharmacists are uniquely positioned to address medication adherence challenges. Studies show that patients who were adherent to antihypertensive medications were 30% to 45% more likely to achieve blood pressure control. Pharmacist-led medication adherence programs have demonstrated 5-8% improvements across multiple disease states, according to the Journal of Managed Care & Specialty Pharmacy.

“Meaningful resolution of medication adherence challenges always requires the willingness to investigate root causes and tailored, perhaps out of the box, solutions,” notes Davis.

Zhang elaborates on the foundational principles of pharmaceutical care: “One of the founding pharmacists of ProCare once told me ‘The most difficult challenge with pharmacy in term of patient care is to deliver the RIGHT medication to the RIGHT patient at the RIGHT time.’ These Three Rights have been my guiding principle throughout my pharmacy career.”

At Clarest, pharmacist roles focus on medication adherence through advanced pharmacy technology. “We are utilizing some of the most advanced pharmacy technologies (both hardware and software) to help drive medication adherence to further improve patients’ health outcome,” Zhang explains. “We are certainly setting the standard in pharmaceutical industry to address medication adherence challenges.”

Pharmacy technology innovation: transforming clinical pharmacist roles

As artificial intelligence and automation reshape healthcare delivery, pharmacy technology is transforming pharmacist roles. Rather than replacing clinical pharmacists, these innovations enhance medication management capabilities and free pharmacists to focus on direct patient care.

“Automation and Artificial Intelligence (AI) have been revolutionary,” says Joanne Stakias, RPh, Remedi Staff Pharmacist in Baltimore, MD. “Automation has greatly improved efficiency and error reduction. AI has provided the ability to personalize treatment plans and help to predict potential acute and chronic health conditions and concerns.”

The benefit is more time for clinical pharmacist roles. “AI will relieve the pharmacists of time-consuming tasks which will allow us to focus more on the clinical involvement with patients,” Stakias continues. “This will ultimately help patients manage chronic illnesses.”

Amy Shum, BS, Clinical Hub Staff Pharmacist, elaborates on how pharmacy technology changes pharmacist responsibilities: “Traditionally, pharmacists were focused on dispensing medication. Automation of dispensing process has been improved with technology which gives pharmacists more time to dedicate to clinical services, such as medication therapy management, chronic disease monitoring, and patient counseling.”

Zhang adds: “With the ever-widening adaptation of Artificial Intelligence in Health Care, pharmacists are able to free up more time from the routine role of verification and dispensing medications. This allows pharmacists to dedicate more valuable time to make clinical intervention that is more appropriate for the patients’ therapy.”

Patel explains how pharmacy innovation expands pharmacist roles: “AI-Powered Clinical Prioritization uses resident specific data to identify those at highest risk for adverse drug events, fall, or hospitalizations, enabling earlier, targeted interventions. Unified Health Data Systems integrate labs, vitals, med history, and care notes into one interface, improving decision-making during medication reviews and care transitions.”

Comprehensive clinical pharmacist services 

Clarest’s clinical pharmacists provide extensive pharmaceutical care services beyond dispensing. Their pharmacist roles encompass medication therapy management, drug utilization review, consultant pharmacy services, and transitions of care coordination.

Julie Herron, PharmD, Consultant Pharmacist, emphasizes the comprehensive approach to pharmacist responsibilities: “We just don’t ‘check for interactions’; we check the entire medication regimen to PREVENT problems. I’m not just reviewing medications; I’m part of the interdisciplinary team collaborating with the nursing home and with our Pharmacy team at Clarest.”

Zarin Dobrzelewski, RPh, Consultant Pharmacist, describes the diverse pharmacist responsibilities at Clarest: “Cost containment, ensuring right dose based on resident, conferring with providers regarding drug therapy, problem solving, keeping homes in compliance with regulations.”

A focus on deprescribing represents another area where Clarest Health pharmacists excel. Consultant Pharmacist Shelli Loy, PharmD, explains: “We don’t just want to push medication on our patients. In fact, it’s the exact opposite. We love preventing chronic disease and helping our patients live full and healthy lives without medications if possible. We look for ways to ‘de-prescribe’ whenever possible.”

Erin Donatelli, PharmD, BCGP, FASCP, VP of Clinical and Consulting Services, shares her perspective on clinical pharmacist roles: “I think pharmacists, at times, are the unsung heroes of healthcare, and we do not get a lot of focus. Yet we are still considered the top trusted healthcare professionals. Coming into the healthcare industry, pharmacists have the advantage of multiple years of medication learning and disease management. Our goal is not to ‘add’ medications, but to optimize what an individual is taking that is specific to their conditions and goals.”

Collaborative pharmacy practice: building strong healthcare teams

Effective pharmaceutical care emerges from strong team dynamics and collaborative pharmacy practice. Clarest Health prioritizes building cohesive teams that support expanded pharmacist roles and delivering optimal medication management.

“Pharmacists must build and maintain a strong, respectful, collaborative working relationship with their pharmacy technicians,” emphasizes Stakias. “When you create a positive environment that provides trust and clear communication, you cultivate a responsibly acting team that is focused on positive quality care for all of our patients.” 

Echoes Davis, “Open communication is key. Everyone benefits when everyone is on the same page.”

Zhang further explains interdisciplinary collaboration: “As Long-Term-Care Pharmacists, we are often tasked with the main responsibility of verification and dispensing medications to patients during our day-to-day routine; but in order for patients to get the most benefits out of medication therapy, we have to incorporate pharmacists’ clinical expertise and professional experiences along with nursing staff’s involvement to truly achieve successful therapeutic outcomes. I often reach out to nurses to inquire about how I as a pharmacist can make the nurses’ life easier so they can devote more time and energy to help patients heal and improve their health.”

Nate Richey, PharmD, Consultant Pharmacist, reinforces this collaborative approach to pharmacist responsibilities: “Pharmacists also work well with other healthcare providers. Transitions of care are very important, and coordination is required to provide the best patient care possible.”

Working with your pharmacist as a healthcare partner

Clarest Health pharmacists want patients and families to understand the full scope of pharmacist roles and how to engage with clinical pharmacists as healthcare partners.

“Pharmacists are your trusted partner in your lifelong journey to live a healthy and happy life,” says Zhang. “We are honored to be part of this journey with you along the way. Do not hesitate to reach out to us for any health-related need, especially medication related questions and concerns. We are all in this together.”

Patel offers this perspective on expanded pharmacist roles: “Don’t think of your pharmacist as just someone who fills prescriptions. Think of us as a second set of eyes and a constant presence on your care team. We are more than medication managers; we are safety advocates, educators, and part of the entire care team. In LTC, where patients may not always be able to speak for themselves, we help ensure that every medication truly supports their health and quality of life.” 

Vincent Severn, PharmD, RPh, Consultant Pharmacist, emphasizes the accessibility of pharmacist roles: “Take advantage of the unique skills, training, and perspective that pharmacists bring to the healthcare team. Pharmacists are often readily accessible, available, and open to discussing medication therapy. Pharmacists add tremendous value to managing medication therapy when considering concomitant disease states and the entire medication regimen.”

Finally, Zandri reminds us why trust in pharmacist roles matters: “Most years, pharmacists are voted to be the most trustworthy professional.”

The future of pharmacist roles and pharmaceutical care

Despite facing increased workloads, with 73% of pharmacists rating their workload as “high” or “excessively high” according to the Journal of the American Pharmacists Association, 87.3% of pharmacists report they are proud to be a pharmacist. This pride reflects pharmacist roles that recognize their expanding impact on patient outcomes and public health.

Donatelli offers the following advice for the next generation entering pharmacist roles: “Ask why, even when you’re new. Don’t be afraid to ask questions of why certain workflows, procedures, and recommendations are done. If you do not ask, people will think you already know. Also, don’t just memorize everything; learn to think clinically. Not every patient will fit the mold of what you memorized.”

Patel reflects on the evolution of pharmacist responsibilities: “I see this evolution not as optional, but necessary, for both improving patients’ outcomes and reducing the burden on the broader healthcare system. We are already medication experts, but now our role is expanding to include ongoing disease monitoring, therapeutic optimization, and outcome-driven interventions.”

Donatelli looks forward to more exciting innovations in pharmacy technology: “I am most excited to see different and more ease-of-use delivery options of medications come out recently. For example, nasal epinephrine vs an injection with an EpiPen, and the nasal rescue medications for seizures, vs the rescue injections. It is more patient focused and also keeps dignity and comfort in mind.”

Conclusion: one profession, many essential roles

This National Pharmacy Week, we honor the profession’s evolution from apothecaries of the past to the clinical specialists shaping health care today. Pharmacist responsibilities embody multiple critical functions: immunization provider, chronic disease management specialist, medication adherence champion, pharmacy technology integrator, patient educator, healthcare advocate, and trusted pharmaceutical care partner.

At Clarest, we are proud of our clinical pharmacists who serve as the “silent force” behind better patient outcomes. From preventing adverse drug events through medication therapy management to collaborating with interdisciplinary teams on chronic disease management, our pharmacists demonstrate daily that pharmaceutical care extends far beyond the counter. The result: better medication adherence, fewer hospitalizations, and improved quality of life for the patients and partners who depend on us.

About Clarest Health

Clarest Health works with long-term care facilities, healthcare providers, health plans, and patients at home to make medication a source of healing, not confusion. We deliver personalized medication management solutions at scale. Healthcare is personal for the individuals we serve. It’s personal for us. 

References

• Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Pharmacists
• American Society of Health-System Pharmacists, National Survey of Pharmacy Practice in Hospital Settings, 2024
• Centers for Disease Control and Prevention (CDC), COVID-19 Vaccination Data, 2023
• Journal of the American Pharmacists Association, Pharmacist Involvement in Immunization Programs
• Annals of Pharmacotherapy, Pharmacist-Led Chronic Disease Management Programs
• CDC, Chronic Disease Prevention and Health Promotion
• Annals of Internal Medicine, Medication Adherence and Healthcare Costs
• Journal of Managed Care & Specialty Pharmacy, Pharmacist-Led Adherence Programs
• Journal of the American Pharmacists Association, Pharmacist Workload and Job Satisfaction Survey