US Pharm. 2012;37(5):2.

For the past two decades pharmacists have landed at the top, or very near the top, of Gallup’s “Honesty and Ethics Survey,” an annual poll taken among Americans who vote for the professions they think exhibit the highest degree of honesty and ethical standards. Given the long list of professions on the survey, represented by doctors, police officers, clergy, judges, and many other notables, pharmacists’ standing at or near the top of this survey is a truly remarkable achievement. And while the rankings of some professions fluctuate year to year due largely to the fickleness of the consumers who take the annual survey, pharmacists have consistently reached their lofty position in the rankings despite the seemingly insurmountable economic and professional pressures they face daily.

Nurses have held the number-one position since 1999, with the exception of 2001 when firefighters were added to the list. In that year, firefighters achieved the number-one ranking, a tribute to their heroic efforts during the 9/11 disaster. Pharmacists held the top slot from 1988 to 1998, above clergy and medical doctors. I’ve never been particularly surprised by the results. Working as a hospital pharmacist early in my career, it was clear to me that nurses were vital to the success or failure of a patient’s progress during hospitalization. Nurses approached their job in a compassionate and professional manner, despite the depressing backdrop of sickness and suffering at every turn.

And as a licensed pharmacist for four decades, I wasn ’ t amazed that pharmacists placed so high on the list every year. As a retail pharmacist for about half of my career, I witnessed firsthand how patients put their faith in our consultations and follow-up visits to discuss their medication and overall health status. Probably one of the more startling rankings was that of physicians, who generally landed lower than both nurses and pharmacists.

A recently published survey in the journal Health Affairs uncovered that more than half of the doctors who participated in the survey admitted sugarcoating a patient’s prognosis. It also revealed that nearly 20% admitted they hadn’t fully disclosed a medical mistake for fear of being sued, and another 10% said they lied outright to a patient in the past year. It makes you wonder what other information physicians may be holding back from their patients. Perhaps their placement in the Gallup poll below nurses, pharmacists, and clergy happens for good reasons.

One of the things that always astounded me when I was practicing retail pharmacy was how often patients would ask me what medical condition the prescription they were having filled was prescribed for. Patients frequently ask this question of their pharmacist because they have a sixth sense that their doctor may not have been telling them the truth about, or may have been minimizing the severity of, their condition.  

Is it ethical for a pharmacist to discuss a patient’s medical condition based solely on the medication that patient is taking? The answer for me is an emphatic no. With off-label uses and a plethora of indications for many drugs today, it’s impossible for a pharmacist to accurately pinpoint the condition these agents may be treating, and so not directly answering the question is the most ethical response. Instead, pharmacists should be concentrating on consulting patients about the effects of their drug therapies.

Rising above other professions in honesty and ethics is a top priority for pharmacists, and that is obviously and consistently reflected in the Gallup poll year after upon year. Too many times I hear pharmacists condemning the profession instead of standing tall. I’m proud to be a part of this profession and to call myself a pharmacist…and you should be too.

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