Part 2. Developing new standards: The American Association of Colleges of Pharmacy, 1925-1950

American Journal of Pharmaceutical Education, Fall 1999

By 1925, American pharmacy had lost whatever innocence it may have claimed in earlier decades. The Food and Drugs Act (1906) had controlled drug adulteration and misbranding, but had placed new restrictions upon pharmacists who preferred manufacturing their own preparations; the Harrison Narcotic Act (1914) controlled the most dangerous drugs pharmacists handled and imposed onerous record-keeping regulations; and the Volstead Act (1919) had transformed many hitherto respectable pharmacists into lawbreakers: the number of drugstores nearly doubled in some eastern cities as pharmacists were besieged with prescriptions for liquor. The fierce competition which accompanied the postwar economic boom encouraged the burgeoning chain drugstore industry and spawned the "drugless drugstore." Neighborhood pharmacists subsidized their professional function by selling other drugrelated items and a wide range of so-called "lines"-cosmetics, tobacco, sodas, sundries, as well as other unrelated commodities, in an essentially mercantile setting. Services were expanded to include both free delivery for minor purchases and family charge accounts. Shaken by the Great Depression, pharmacists provided curbside fountain service, sold postage stamps at cost, wallpaper, and even electrical appliances, maintaining mind-numbing 16-hour work days, seven days a week, to scrape out a marginal existence. Most succeeded, protected from ruinous price competition after 1931 by so-called "fair trade" legislation; hospital pharmacists manufactured simple galenicals in bulk and stocked "drug rooms" from which physicians and nurses could obtain the drugs their patients needed. By the early 1940s, the focus of the pharmacist's professional function in all settings continued to shift from the temporaneous compounding of simple drug products to the increasingly efficient, cost-effective dispensing of dosage forms prepared by large, specialized pharmaceutical manufacturers. In the community setting, the concepts of self-service and mass merchandising redefined first chain and then independent pharmacy practice, just as they had redefined the grocery and department stores of the 1930s. In teaching hospitals and other institutions, a growing number of dedicated pharmacists defined the first differentiated practice of pharmacy outside the retail setting, one which began to focus upon serving individual patient needs though a system of optimal drug distribution.99

America's pharmaceutical educators were as perplexed as the profession's practitioners by the sweeping societal changes swirling about them. Alarmed by the increasing commercialization of pharmacy practice, educators turned their attention to upgrading the vocation of pharmacy to a true profession in the only way they knew: enhancing their educational standards to the baccalaureate level through increasingly heavy doses of basic and applied pharmaceutical sciences and adding the liberal arts courses the universities required. By the late 1930s, pharmacists were already dispensing the newer, more effective chemotherapeutic agents rather than the palliative compounded products they had been preparing extemporaneously. Why not capitalize on this trend? Pharmacists would gain professional status by becoming experts on drugs and drug products. Most practical concems, they believed, should be relegated to the time-honored practice of practitioner tutelage. Moreover, it was unseemly to teach mercantile skills in a university setting; an introductory course in economic theory and accounting should suffice. The harsh economic realities ushered in by the Great Depression quickly shattered these beliefs as pharmacy educators scrambled to develop business-related courses for their students and continuing education programs for their alumni. Pharmacy education absorbed another blow to its professional pride at the outbreak of World War 11 when pharmacy students were once again refused deferments and graduates were denied commissioned status. When enrollments plummeted, America's schools and colleges of pharmacy adopted year-around, 32-month accelerated programs designed to offset anticipated pharmacy manpower shortages as pharmacists across the country were snapped up in the draft. Exhausted from their accelerated wartime schedules, understaffed, and overwhelmed by veterans seeking careers in pharmacy through the "GI Bill," postwar pharmacy educators still found time to explore curricular issues. The development of antibiotics, hormones, and other so-called "wonder drugs," coupled with rapid advances in the pharmaceutical sciences, indicated to many pharmacy educators the need to reconsider the Pharm.D. degree. The six-year doctoral programs they envisioned, however, were not designed to produce a clinical practitioner to complement the physician; rather, they focused on broadening the prepharmacy program of general education to prepare students for the rigorous demands of a highly scientific professional curriculum.