Transitions in pharmacy practice, part 2: who does what and why.

The competencies required by the five practice models that constitute the total pharmacy care (TPC) model are discussed. Understanding the differences among the competencies required by the five practice models can help pharmacy's leaders estimate the extent of change that may be necessary whenever a change in practice is contemplated. Professional competence in any of the practice models is defined as the sum of skills, professional socialization, and judgment rooted in experience pertinent to the model. Possibilities for practice change are ideational and do not necessarily follow a straight line from other practice models to pharmaceutical care. The key competencies for each of the five practice models--drug information, self-care, clinical pharmacy, pharmaceutical care, and distribution--demonstrate a clear distinction among the five models. The models draw on different knowledge and skills, are characterized by different attitudes and values about the work of pharmacy, and are grounded in different practice experience. While sharing a common underpinning of theory and practice, professional competence within each of the five models that make up TPC requires distinctly different knowledge and skills, professional attitudes, and values, as well as judgment that is developed through experience.