Pharmacists work with a variety of support staff. Common examples include:
Pharmacy clerks (also called assistants) are unlicensed personnel who support front-end operations and customer service. They typically need only a high school diploma and on-the-job training. Their duties include:
- Customer Service: Greeting customers, answering phones, accepting prescriptions
- Data Entry: Inputting patient and insurance information into the pharmacy system
- Inventory Tasks: Stocking shelves, checking stock levels, receiving shipments
- Payment Processing: Handling customer payments and receipts
- Clerical Work: Filing records, organizing paperwork
📌 In some states, clerks may not be permitted to enter or access prescription data.
Pharmacy technicians are healthcare professionals who assist pharmacists with technical tasks. In some states, techs are only registered, not licensed. At minimum states require that technicians are registered (and usually licensed), while some employers may also require national certification. Their scope of practice typically includes:
- Prescription Processing: Receiving and processing medication orders, measuring and preparing dosages
- Labeling: Packaging and labeling medications with usage instructions
- Insurance Processing: Assisting with insurance claims and patient billing
- Compounding: Preparing sterile and non-sterile medications under pharmacist supervision
- Patient Records: Collecting and entering patient data into pharmacy systems
- Inventory Management: Monitoring stock, ordering medications, & notifying pharmacists of shortages
- Maintenance: Keeping the pharmacy in clean, neat, and in proper working order
🔗 Continued Notes on Pharmacy Technician Scope of Practice, Credentials, & Career
Interns are pharmacy students enrolled in a PharmD program and working under a pharmacist’s supervision. They typically hold an intern license. Responsibilities include:
- Patient Interaction: Taking medication histories and verifying prescriptions
- Medication Prep: Counting, packaging, and labeling prescriptions
- Administrative Support: Entering data, monitoring inventory, and maintaining records
Pharmacists are healthcare professionals licensed to dispense medications, counsel patients, and oversee pharmacy operations. They must hold a Doctor of Pharmacy (PharmD) degree and pass the NAPLEX and MPJE for licensure. Their duties include:
- Prescription Review: Ensuring accuracy, safety, and clarity in filled prescriptions
- Patient Education: Explaining medication use, side effects, and safety
- Drug Interaction Checks: Monitoring for potential medication conflicts
- Administering Vaccines: Providing immunizations (as allowed by state law)
- Health Screenings: Conducting blood pressure checks and other basic screenings
NPs and PAs are advanced practice providers who are licensed to diagnose, treat, and prescribe medications. Their authority varies by state, but they often function similarly to physicians in outpatient settings.
- Prescribing Authority: Can write prescriptions for both non-controlled and controlled substances (depending on state law and DEA registration)
- Collaborative Practice: Often work under a supervising or collaborating physician
- Vaccinations: Can administer and prescribe vaccines
- Pharmacy Role: Pharmacy personnel often verify NP/PA credentials and DEA numbers when filling prescriptions
Preventing medication errors is an important goal of every pharmacy and, therefore, pharmacy technicians play an important role in preventing medication errors.
Emily's Law refers to a piece of legislation that focused on improving the qualifications and training of pharmacy technicians after a medication error led to the death of a child, resulting from a malpractice lawsuit. The pharmacist did not catch this error and both were held liable.
🔗 Further Reading on Medication Safety Practices & Errors
Communication is an important part of teamwork in any pharmacy. It can take place in written, verbal, or nonverbal forms. As a technician, you may be communicating with patients, their representatives, as well as other healthcare professionals. The clarity, tone, and professionalism of your communication can directly affect patient safety and workflow efficiency.
🔗 Further Reading on Professional Communication Standards
Certain federal laws have established pharmacist responsibilities that directly affect pharmacy operations, particularly in how pharmacists interact with patients and manage drug therapy. These laws also shape how pharmacy technicians support those processes.
The Omnibus Budget Reconciliation Act (OBRA-90, 1990) was a major federal law affecting Medicaid prescription drug programs. It mandates that states receiving federal funds must require pharmacists to:
- 📄 Maintain Patient Medication Profiles: Pharmacies must maintain records (on-site for a minimum of 2 years) of a patient’s medication history to support counseling and DUR obligations.
- 📋 Conduct DURs: Evaluate prescriptions to identify adverse effects, therapeutic duplication, drug–disease contraindications, incorrect dosage or duration, and drug–drug interactions.
- 💬 Offer Counseling to Medicaid Patients: Pharmacists must “offer to counsel” Medicaid patients on:
- Proper use of the medication
- Potential side effects or adverse reactions
- Storage instructions
- What to do in case of a missed dose
- 📁 Document Counseling Offers: While OBRA-90 requires the offer, specific documentation requirements (such as signed refusals) vary by state.
⚠️ Some states have extended OBRA-90 requirements to all patients, not just Medicaid recipients.
A process to ensure the most accurate, complete list of all medications a patient is taking—name, dose, route, and frequency—by comparing current medical records with patient and provider sources.
Especially critical for:
- Emergency Department admissions
- Hospitalist-managed patients
- Patients with Congestive Heart Failure (CHF)
- Transfers from Skilled Nursing Facilities (SNFs)
The Medicare Modernization Act (MMA, 2003) established Part D of the program to provide prescription drug coverage and requires pharmacists to provide Medication Therapy Management (MTM) services to optimize therapeutic outcomes while minimizing adverse events. These include:
- Comprehensive medication reviews (CMRs): Reviewing all medications a patient is taking
- Identifying duplications or interactions
- Providing personalized medication action plans
- Optimizing therapeutic outcomes
- Monitoring side effects and adherence
- Coordinating care with prescribers
📌 MTM is usually targeted toward patients taking multiple chronic medications, especially those with multiple conditions or high drug costs.
Technicians assist by preparing medication histories, documentation, and assisting with insurance or billing tasks.
🛡️ HIPAA Requires all patient health information (PHI) obtained during Counseling, DSM, MTM services to be kept strictly confidential.
Pharmacists provide Disease State Management services to help patients with chronic conditions understand and manage their illnesses. Common conditions include:
- Diabetes
- Hypertension
- Asthma
- Hyperlipidemia
DSM programs often involve patient counseling, medication adherence support, lifestyle education, and clinical monitoring. Technicians support DSM by scheduling appointments, preparing documentation, and assisting with data collection.
⚖️ DSM is not mandated by federal law, but it is commonly implemented under MTM programs (via MMA, 2003) and state Medicaid or managed care plans.
Vaccines help your body build protection against infectious diseases by "teaching" your immune system to recognize and respond to viruses or bacteria. Herd Immunity is a phenomenon where a sufficient proportion of a population is immune to a disease, indirectly protecting those who are not immune; which is critical for the protection of public health.
To support public health through vaccine efforts, pharmacies offer immunization services.
🔗 Further Reading on Vaccines as well as Initiatives in Retail & Hospital Pharmacy.