Who Is in Charge of Pharmacy Technicians?

The expansion of the pharmacy technician's role could allow pharmacists to practice at the top of their license.

One subject that gets many pharmacists emotional is the role that pharmacy technicians should play in pharmacy. My personal view is that the pharmacy technician’s role should be expanded to allow pharmacists to practice at the top of their license.

When I made that suggestion to student pharmacists they would agree initially. But when I offered a specific suggestion of what activity that might include, such as “independently” refilling prescriptions, I got a lot of push back. Patient safety was always the excuse used to justify their position. But in my mind, I thought the reason was more about job security. The same negative reaction was seen when I suggested this type of change to pharmacists themselves.

I thought this was only a concern among community pharmacists, but it is not. When my state pharmacy board, at the request of hospital pharmacy directors and after some demonstration projects that showed that it works, wanted to implement new regulations that would allow certified pharmacy technicians who had graduated from a pharmacy technician training program to perform “tech check tech” functions of filled unit dose carts, some hospital pharmacists got upset. Even though there was literature that demonstrated the safety of this activity and even though the checked carts were not going directly to a patient, some pharmacists were against it. Hospital pharmacists resisted because they saw that their job as a dispensing pharmacist might be eliminated.

Community pharmacists seemed to be against the use of pharmacy technicians in this way because they thought it might end up being expanded into their practice arena. When I proposed that these same technicians could safely perform a “tech check tech” role with refill prescriptions, I found myself with few friends. Even some of my academic colleagues thought I had lost my marbles.

Now that more pharmacy leaders are trying to create opportunities for pharmacists to practice at the top of their license, we may need to free pharmacists from being tied to the pill counting tray. Giving more responsibility to pharmacy technicians may be necessary. Who should make this decision? So I ask, “Who is in charge of pharmacy technicians?”

I would like to see pharmacists be in a position to make this decision, but I think too many pharmacists would approach such a decision in a self-serving manner. I believe that the push for expanding the role of pharmacy technicians will come from pharmacy leaders, but probably more from employers of pharmacists who want cost-effective but safe ways to allow pharmacists to practice at the top of their license. If several large pharmacy chains wanted this to happen, they could have much influence.

The other group that might be influential in helping to get this done is the Pharmacy Technician Certification Board (PTCB). It has announced pending program changes before implementing program changes beginning in 2014. The only change that may be controversial is the completion of an ASHP-accredited pharmacy technician education training program before being able to take the PTCB Examination. Although I agree with this recommendation, my own suggestion is that it should be implemented in 2017 instead of 2020 as proposed. I can imagine that many of my readers will disagree with me. With this requirement in place, I believe that pharmacy technicians will want and will expect a broader role as well as a higher salary. For employers to be able to pay more, they will expect more, thus I am suggesting that employers may play a role in helping to advance a broader role for pharmacy technicians.

If this proposal is implemented, it will follow the same model we use for pharmacists—a formal accredited educational program followed by a validated examination to ensure that pharmacists, have the ability to practice pharmacy. It has worked for pharmacists and I believe it will work well for pharmacy technicians too. What do you think?

To my knowledge, the other pharmacy technician certification program (ExCPT) has not announced plans to require completion of a formal education program to be able to take this examination. Hopefully before this type of change occurs there will only be 1 path to follow to become a certified pharmacy technician.

Mr. Eckel is a professor emeritus at the Eshelman School of Pharmacy, University of North Carolina at Chapel Hill. He is interim executive director of the North Carolina Association of Pharmacists