In defence of the drug, two hearts, one profession: Reintegrating medicines expertise and patient-centred care in pharmacy's professional identity.

For more than three decades, pharmacy has narrated its evolution as a movement away from the product and toward the patient. The pharmaceutical care era ushered in by Hepler and Strand in 1990 framed dispensing and product expertise as a chrysalis the profession needed to shed in order to mature. That framing has been useful, but it has also been misread, and the misreading has now been institutionalised. Some accreditation councils, regulatory and licensing bodies, and advocacy bodies have positioned the profession as one moving away from a so-called "product centric" past. The thesis of this commentary is otherwise. Pharmacy has never had a single heart; it has always had two, one beating for the drug and the other for the patient, and they have always beaten in the same chest, for four centuries and more. The pharmacist's claim to a place at the patient's bedside rests entirely on what the pharmacist knows about the molecule: medicinal chemistry, pharmaceutics, compounding, biopharmaceutics, pharmacokinetics, pharmacogenomics, radiopharmacy, pharmacognosy and now pharmaceutical artificial intelligence. The argument here is not nostalgic but expansive. Embrace them all. Without the drug, the diagnosis is a verdict, not a treatment; and without the pharmacist, no drug appears.