Author: Bert McClary
A child sometimes asks a parent, “Mommy, where did I come from?” I rarely get asked directly, “Where did MSHP come from?” but members do express an interest when they hear facts about the early days of MSHP. I’m not one of the parents—we have three founding fathers—I’m more like one of the uncles and aunts who were there watching and helping, but I’ll try to get you interested in our history with a few anecdotes during the next year. We will be celebrating 50 years of activity in the spring of 2020.
You’ve heard the pharmacy history of early man using plant medications, Egyptian papyrus documents, Greco-Roman scientists/healers/apothecaries, Arab apothecary shops and European separation of pharmacy and medicine. The first hospital in the U.S. was in Philadelphia in 1751 and the first hospital pharmacist was appointed in 1752. Hospital pharmacists in Colonial America received little pay and little recognition from the public, the health professions or the American pharmacy profession. The use of formal medicines, development of specialized hospital pharmacy standards of practice, and development of overall practice standards for hospitals was slow.
In the 1930s, the APhA Sub-Section on Hospital Pharmacy was founded by Harvey A.K. Whitney and other progressive hospital practitioners. A Minimum Standard for Pharmacies in Hospitals was developed and was approved by the American College of Surgeons. The American Society of Hospital Pharmacists (ASHP) became an autonomous affiliate of APhA in 1942 with three constitutional goals: Establishing minimum standards, providing interchange among pharmacists and encouraging new program development, and extending the economic and rational use of medication. Results of a 1957 study by ASHP were published in the 1964 Mirror to Hospital Pharmacy, written by Francke, Latiolais, Francke and Ho. The Mirror provided many recommendations based on six broad goals to enhance the development of hospital pharmacy.
Nationwide in the 1950s all hospitals larger than 300 beds had a full-time pharmacist, but only 39% of all hospital beds had the services of a pharmacist. Only 3.5% of hospitals under 50 beds did. Small rural hospitals were sometimes serviced by local community pharmacists or not at all.
Local and area hospital pharmacy societies had been formed nationwide beginning in 1925, and some were affiliated with ASHP. There were pockets of progress in Missouri and the Metropolitan Society of Hospital Pharmacists of St. Louis, 1942, and the Greater Kansas City Society of Hospital pharmacists, circa 1950s, were founded by groups of nuns. Outside the two major metropolitan areas there was little progress until the late 1960s.
Hospital pharmacy services in the 1960s were primarily focused around drug distribution. Drug distribution in hospitals with no pharmacist or minimal pharmacist staffing was by a floor stock (ward stock) system. In facilities that had no pharmacist, nurses managed the acquisition, storing, repackaging and distribution activities. Even in the larger hospitals, twenty-four hour pharmacist staffing was rare, and often there was little or no weekend coverage. Sterile intravenous and irrigating solutions were prepared by the pharmacy in larger hospitals, or by the central sterile supply department.
The Missouri Board of Pharmacy had little interest in hospital pharmacy. The BOP did not license or inspect hospitals for inpatient pharmacy services and hospitals that did not fill outpatient prescriptions generally did not maintain a BOP license.
A few rural hospital pharmacists were active in local retail organizations and the Missouri Pharmaceutical Association. Politically active establishment retail pharmacists controlled both the MPA and BOP and were not truly interested in hospital practice issues.
There were three forward-thinking hospital pharmacy practitioners, our founding fathers, in three distinct areas of the state and in distinctly different practice settings, who sought to improve services in their local areas and began to interact with each other on a statewide level: Thomas J. Garrison, Director of Pharmacy at the small Lakeside Hospital in Kansas City; Garf Thomas, Chief Pharmacist at the University of Missouri Medical Center in Columbia; and Harvey A.K. Whitney, Jr., clinical pharmacy professor at St. Louis College of Pharmacy.
During the fall of 1969 Harvey organized a “Joint Committee for the Unification of Hospital Pharmacists in Missouri.” The first “Statewide Meeting of Missouri Hospital Pharmacists” held in Columbia on February 21, 1970 attracted 54 registrants.
In April when the Missouri Pharmaceutical Association (MPA) learned that MSHP was being organized, the MPA Executive Director made an initial effort to bring the group into the MPA, but there was little interest by MSHP leadership in affiliation at that time. Some members of the St. Louis and Kansas City hospital pharmacist societies were opposed to affiliation of their local organizations with MSHP.
The first annual meeting of MSHP was May 16, 1970 at StLCOP. At the successful business and dinner meeting an Enabling Resolution and the proposed Constitution and By-Laws were approved. George Heine of St. Louis and Garf Thomas of Columbia were elected and installed as President and President-elect. The Board of Directors and appointed committees met during the year and these goals were established:
We’ve been successfully pursuing these goals for almost 50 years.