Commentary. The Washington Conference on Clinical Pharmacology

Profile of clinical pharmacologists in the United States

The need for clinical pharmacology in research and education, drug development, and health care delivery is well known. However, a current profile of those working in the field is not available. The ACCP authorized a survey of clinical pharmacologists to provide such a profile. Members of the ACCP or ASCPT were solicited by mail with a self-assessment questionnaire. A response rate of 37% was obtained. Demographic findings agree well with a previous study2 limited to those with the M.D. Our results reveal that most clinical pharmacologists are between 30-59 years of age, have an MD, PhD or PharmD degree; most of those with MDs list their primary specialty as internal medicine, pediatrics, psychiatry, or anesthesiology. They affiliate with the respective departments (including pharmacology) in academia or hold positions in industry or government, but few are in clinical therapeutics per se. About 20% of those with only a MD or PharmD degree cite employment in health care delivery. However, a higher percentage of these respondents work in research and education rather than in drug development or health care delivery. For those with only a PhD, more work in drug development and research and education than in health care delivery. The highest proportion of respondents with any doctoral degree work in the Northeast. The average income is a function of rank, doctoral degree, specialty, department appointment, and type and location of employer. The profile of a typical clinical pharmacologist is presented. An analysis of clinical pharmacology manpower from several perspectives reveals a marked deficit, but the field itself is professionally and economically attractive. Lack of a well defined career track in academia and a poorly defined clinical role for MD clinical pharmacologists are proposed as reasons limiting entry of trainees. These and other results of the survey support an increased emphasis on training programs. Clinical pharmacologist involvement in health care delivery and drug development must be increased if the safe and effective use of new drugs is to be realized. Nine assessments and initiatives are formulated to accomplish this goal within the next decade.

Anaesthesia and clinical pharmacology: related disciplines

The disciplines of anaesthesia and clinical pharmacology are related in as much as both have a mutual interest in the safe and conservative use of drugs in man. Anaesthetists have effectively been practising rational therapeutics for many years and they have much to offer academic departments of clinical pharmacology in terms of teaching and research programmes. Similarly, the clinical pharmacologist can usefully contribute to anaesthetic training and research programmes in relation to aspects such as education, precise analytical methods, data-handling and clinical trial techniques. The inter-relationship of the two disciplines can be of mutual advantage and has the potential to provide a stronger basis for sound therapeutic practice.