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Harvey A. K. Whitney Lecture. Shifting pharmacy's paradigm.

Changes occurring in the pharmacy profession and their effects on the paradigm for pharmacy practice are discussed. The paradigm of pharmacy, the pattern or model of pharmacy's structure, services, daily activities, and organization, is shifting, and if pharmacists do not shift with it, they will be left behind. Advances in technological capabilities often result in automation and centralization of services. Improvements in drug therapy have caused shifts in the performance of clinical functions. Philosophical changes about the way health care should be delivered have produced the concepts of pharmaceutical care, patient-focused care, and continuous quality improvement of care. Teams of caregivers whose primary concern is the patient have replaced caregiving based on technology, discipline, or employee needs. Pharmacists have focused on the patient as their primary customer instead of the nurse or practitioner, and they anticipate the patient's needs in a structured and documented fashion. The principles of continuous quality improvement have been applied to every aspect of providing pharmaceutical care. If pharmacists are to adjust to the shift in the pharmacy paradigm, they must recognize their strength as a group, make proper recommendations about pharmaceutical use, move horizontally to grow as professionals, consider themselves clinicians, be active in the making of pharmaceutical care decisions, and believe in themselves.