The Air Force and Navy likely will have to hire a few hundred more pharmacists over the next 18 months to meet tougher standards being imposed on the role of pharmacy technicians.

Even the Army, which for years has kept a higher ratio of pharmacists to pharmacy technicians than the other medical services, could be required to boost its number of pharmacists by an August 2006 deadline.

The Joint Commission on Accreditation of Healthcare Organizations formally notified the military surgeons general this month of a change in standards for accredited military hospital and clinics to meet regarding handling and dispensing of medications.

JCAHO no longer will exempt the military from a requirement that a pharmacist review all prescriptions and hospital medication orders before drugs are dispensed.

The exemption recognized that military pharmacy techs receive more comprehensive training than private sector counterparts, said Joseph L. Cappiello, the commission’s vice president for field operations. But standards on patient safety have evolved to where allowing technicians alone to fill prescriptions — by having military techs check other techs — no longer will be acceptable if hospitals and clinics are to stay accredited.

The change takes effect March 1 but the services have 18 months to hire the extra pharmacists they need or, in some cases, to buy telemedicine technology for pharmacists to supervise dispensing of drugs at remote sites.

Col. Phil Samples, pharmacy consultant to the Air Force surgeon general, said his service alone will need from 150 to 300 more pharmacists.

All but two Air Force pharmacies, both of them overseas, have at least one pharmacist on staff, Sample said, but not enough overall to provide direct supervision of every prescription filled. Prescriptions still get filled, for example, if the pharmacist goes to lunch. This more relaxed standard has allowed the Air Force to keep its ratio of technicians to pharmacist at four-to-one versus two-to-one found in most retail pharmacies and civilian hospitals.

Capt. Elizabeth Nolan, program manager for Navy pharmacies, said about 100 of its satellite pharmacies are technician-run, which means they soon will need direct supervision of pharmacists. Not impacted are ships at sea and remote operational outposts as in Iraq or South Korea.

The services want to avoid closing satellite pharmacies, a third option. But finding and paying hundreds of additional pharmacists won’t be easy. Demand far outpaces supply given expanding chains of retailers and supermarkets who want to dispense drugs, and the growing dependence of patients everywhere on medications to maintain health.

All Navy pharmacy operations are under review “because there are a lot of ways to skin this cat,” said Nolan. “Our focus is going to be on patient safety but maintaining the same level of service to beneficiaries.”

Col. Mike Heath, top pharmacy consultant for the Army, said he can’t say until a “gap analysis” is complete how many more pharmacists even his service might need. “I imagine we will have to hire more,” he said.

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