In 1852, American pharmacists’ met at a conference in Philadelphia, Pennsylvania to create a pharmaceutical profession that would preserve their craft and separate it from the commercialization of drugs and remedies. American medicine was full of replication by ordinary folks who aimed to make a living selling a cheap or convenient product. Most of these products, peddled by salespersons, were not legitimate, but placebos labeled to deceive the buyer and rob them of their hard-earned money. (1)
To understand how the pharmaceutical profession came to be, as we know it in our current time, consider how the evolution of American pharmacy influenced the need to professionalize the medicine trade. Early American doctors came to America already trained, so medicine was not new, but it was made very different than today. For example, doctors had to make medications in their kitchens. But as populations of settlers increased so did the demand for medicine. As a result, apothecary shops opened and druggists’ (commonly known at the time) began selling medications and medicinal remedies wholesale to the apothecaries and general stores. Some doctors and druggists’ began to patent their medicines because drugs, imported from overseas, were unregulated, and anyone could purchase them and sell them. The Revolutionary War, too, changed the availability of medicinal products because of high demand.(2)
By the early 1800s, physicians began to attend medical schools for professional training. A portion of their courses taught them to write prescriptions for medications and send them to the apothecaries. The apothecaries could oversee the dispense of medications to many individuals at once rather than one individual or household at a time. In 1820, pharmacists’ endorsed the Pharmacopoeia of the United States of America and by 1828, they published one standard for drug production across America. Increased demand and specialization of pharmaceutical production spurred the establishment of college programs created for the specific study of medications. By taking the production of and marketing of drugs solely away from physicians, druggists’ created a way to specialize in medicine beyond doctors, clinics, and hospitals. This change was a critical turning point in the commercialization of medicine in America because specialization meant greater amount of production, and it provided increased availability to the buyer. (3)
The commercialization of pharmacy in America inadvertently changed the relationship between physicians and pharmacists. As doctors increasingly attended medical school, they were able to broaden their clinical experiences with patients in hospitals and offices. Between 1808 and 1820, a national convention of physicians created a central book explaining all the necessary information about drugs. The book created a way for the physicians to separate themselves from the pharmacists. Doctors began to rely more on the pharmacy to dispense medications thus giving them more time to tend to patients. Druggists could now devote their time to a pharmaceutical career. The War of 1812 further spurred specialization of both careers because of the need for mass production of medicines. (4)
Soon after the end of the war, pharmacists established pharmaceutical colleges and American Pharmacy began its marketing. Between 1820 and 1860 grocery stores, apothecary shops, and drug stores all added specialized medications and treatments in order to make them more readily available to consumers. Pharmacy became big business and because pharmacists’ patented their medications they separated the real ones from fake. Patenting secured their sales because the buyer could purchase a trusted and legitimate product. However, these businesses drove a wedge between pharmacists and physicians who increasingly competed for business. Pharmacists began writing prescriptions without a doctor’s note and with the number of physicians increased by medical school training, Americans had access to more doctors than ever before.(5)
When the American Medical Association noted the amount of shoddy drugs that Europe imported into America, Congress enacted The Drug Importation Act of 1848. This act set standards for how drugs were imported, manufactured and sold in the United States. In 1852, pharmacists established the American Pharmaceutical Association.(6)
Between 1800 and 1952 innovative physicians and druggists changed the American pharmacy from private to public enterprise. These professionals not only improved the availability but also the quality of medication for buyers. Pharmacists established business models and improved the welfare of Americans by separating the profession of doctor and pharmacy. Physicians and pharmacists made changes to better regulate how medication was to be dispensed. Even the federal government intervened to enforce laws to protect buyers against fraud. As the pharmacy became well established in American society, people could now choose for themselves which way they preferred to have their medications prescribed. They could choose physician or pharmacist for this. Either way, American consumers could trust doctors and pharmacists to sell them a product they could expect to be pure and legitimate.
1. American Pharmacy Before 1852 in Gregory Higby and Elaine Condouris Stroud, American Pharmacy (1852-2002): A Collection of Historical Essays (Madison, WI: American Institute of the History of Pharmacy, 2005), pg. ix.
3. Ibid., x.
5. Ibid., xi.
6. Ibid., “Significant Dates in U.S. Food and Drug Law History,” Significant Dates in U.S. Food and Drug Law History, section goes here, accessed March 26, 2015, http://www.fda.gov/AboutFDA/WhatWeDo/History/Milestones/ucm128305.htm.; “The Story of the Laws Behind the Labels.” The Story of the Laws Behind the Labels. Accessed March 26, 2015. http://www.fda.gov/AboutFDA/WhatWeDo/History/Overviews/ucm056044.htm.