The History of the American Pharmacy: Background information when reading The Love Elixir of Augusta Stern

The History of the American Pharmacy

This article relates to The Love Elixir of Augusta Stern

In Lynda Cohen Loigman's novel The Love Elixir of Augusta Stern, the title character works in her father's pharmacy and aspires to become a pharmacist herself.

Both the pharmacy and the role of the pharmacist have changed dramatically in the United States over the centuries. Pharmacies were referred to as apothecaries back in the day, while those who ran them were known as apothecaries, druggists, or chemists. There was no standard for medical care, and most remedies were based on herbs and other compounds found in nature. Chemists were responsible for creating, prescribing, and administering all sorts of liquids, powders, creams, and lotions, often with no more proof of their concoctions' efficacy than hearsay and a gut feeling that a certain combination would work. Knowledge was passed on through an apprenticeship, whereby a fledgling chemist spent years studying with an established one to learn the trade.

The haphazard nature of the business began to change early in the 19th century. In 1820 a group of physicians concerned about the poor quality of medicine banded together to form the United States Pharmacopeia (USP). The group published the first national guidelines for medicines and medical preparations. Even today, the USP is one of the most widely respected standards organizations in the world. In addition, the first pharmacy school in the country, the Philadelphia College of Pharmacy, opened in 1821. Its graduates began referring to themselves as "pharmaceutists," which evolved into the term we use for these professionals today.

It's certain there were women chemists in the early days of the trade, although most have been lost to history. Elizabeth Gooking Greenleaf is widely thought to have opened the first apothecary in the Colonies, in Boston in 1727 (and she bore 12 children to boot). Another well-known female pharmacist was Elizabeth Marshall, who inherited her grandfather's Philadelphia practice in 1804. Women in the field were undoubtedly rare, though, and it wasn't until 1863 that Mary Jacobi became the first woman to obtain a pharmacy degree.

The first colleges offered a two-year Graduate in Pharmacy degree (Ph.G.), which could become a Ph.C. — Pharmaceutical Chemist — with an additional year of study. In the 1940s, the four-year Bachelor of Science in Pharmacy (B.S.Pharm.) became more common. It wasn't until 1997 that the Doctor of Pharmacy (Pharm.D.), requiring six years of study, became the only accredited pharmacy degree.

Until 1951 pharmacists were almost the equivalent of doctors and could prescribe and dispense any non-narcotic medication. The Durham-Humphrey Amendment to the Food, Drug, and Cosmetic Act separated drugs into those that could be safely dispensed without a prescription (i.e., over-the-counter) and those that couldn't (prescription only). The amendment also specified that doctors alone could prescribe certain medications; pharmacists could only fulfill the doctor's scrip. By the 1980s, momentum was shifting back to giving pharmacists more leeway, and the 2003 Medicare Prescription Drug Improvement and Modernization Act not only restored their ability to discuss all medications with their customers but allowed them to administer vaccines as well.

Today, a pharmacist is considered a highly skilled medical professional, and to become a licensed pharmacist takes many years. An aspiring candidate has to:

• Complete a four-year undergraduate degree with a major in a field such as biology or medicinal chemistry.
• Take the Pharmacy College Admissions Test (PCAT).
• Receive a Pharm.D. from a pharmacy school recognized by the Accreditation Council for Pharmacy Education.
• Complete an internship/residency program under a licensed pharmacist.
• Pass one to two exams, depending on where they hope to practice. The North American Pharmacist Licensure Exam (NAPLEX) is required in all states. The Multistate Pharmacy Jurisprudence Exam (MPJE) is required in most states, and in addition to the NAPLEX will give a candidate the most flexibility when trying to obtain a job.
• Participate in continuing pharmacy education programs after licensure.

Pharmacists make, on average, around $119k per year (2022) — although men in the field make considerably more than women ($130k vs. $111k, respectively). There are currently about 346k individuals employed as pharmacists (about 60% of whom are women) with the average age just over 40. Approximately 14k people obtain a Pharm.D. each year, but a 2020 report from the American Journal of Pharmaceutical Education states that the number of graduates will exceed the number of job openings through at least 2030.

18th-century apothecary mixing ingredients in The Book of Trades or Library of Useful Arts (1807) published by J. Johnson

Filed under Medicine, Science and Tech

This article relates to The Love Elixir of Augusta Stern. It first ran in the December 4, 2024 issue of BookBrowse Recommends.