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Citius, Altius, Fortius

Faster, Higher, Stronger, the motto of the modern Olympic games was suggested in 1894 by Pierre de Coubertin, the founder of the International Olympic Committee. The Latin phrase Citius, Altius, Fortius was used for the first time at the 1924 Paris Games.

About the same time, pharmacy education in the United States was moving beyond short course studies and apprenticeships into structured educational programs. By the time the 1930 Olympics opened in Berlin, American pharmacy schools were instituting 4 year degree programs with formal internships. In 1932 with the founding of the Accreditation Council for Pharmaceutical Education, national standards for a uniform degree program were established and pharmacy was on the way to its own version of Citius, Altius, Fortius.

With a foundation in chemistry, early 20th century pharmacists were heavily involved not only with the preparation and dispensing of medications, but with biochemical processes also, often performing the analyses of such tests as urinalysis, blood counts, and basic blood chemistries. By the time the Olympic Games opened in Helsinki in 1952, these non-drug responsibilities were taken over by more specialized technicians or by the physicians themselves, and the pharmacist again concentrated on drug preparation and dispensing. Sometime between the 1960 Rome Olympics and those hosted by Tokyo in 1964, pharmacology replaced chemistry as the focal point in education and information services began to be included among pharmacists’ responsibilities.

Pharmacists began more concentrated, although often indirect, patient care through the 1960s and since the time Montreal hosted the Olympic competitions in 1976, have had the opportunity to formally specialized. Pharmacy residencies and the introduction of clinical pharmacy services including drug information and evaluation opened more clinical roles for pharmacists. Through the 1970s and 1980s, clinical pharmacy services increased and garnered significant attention the year following Los Angeles games at the ASHP Hilton Head Conference on clinical pharmacy in 1985. Heralded by the 1990 report by Helper and Strand that the pharmacist should accept responsibility for directly assisting patients to obtain the best outcomes from medications, pharmaceutical care became the new hallmark in pharmacy operations. (Hepler CD, Strand, LM. Opportunities and responsibilities in pharmaceutical care. Am J Pharm Educ 1990;53:7S-155.) The 1990s saw a revolution in patient care expectations and education to support the new patient-centric roles.

In the year preceding the modern Olympiad's 2004 return to Athens who hosted the first games in 1896, it was expected that the sweeping Medicare Modernization Act of 2003 (MMA) would include pharmacist payment for patient counselling in select circumstances. It did not go so far in its initial iteration but did require drug utilization services from providers offering Medicare Part D plans, opening new career opportunities for pharmacists in the commercial insurance service area. At about that same time, several reports of significant adverse effects were surfacing suggesting major drug safety concerns notably with rofecoxib (Vioxx) and pharmacists were engaged to dispense specific safety and use information for select drugs with consideration to RiskMAPs (Risk Minimization Action Plans, the precursors to the REMS program).

The modern Olympic Games have grown from 280 athletes from 13 countries participating in 43 events in Athens in 1896 to over 11,000 athletes representing 205 nations competing in 339 events at Tokyo this year. This era has also seen enormous growth in pharmacy and has often shifted the expectations of pharmacy by pharmacists and by those served. At the heart of the profession, the pharmacist is a dispenser. Whether of medications or information, whether to ambulatory patients, hospital patients and staff, nursing home residents, students, residents, or even to the International Space Station, the pharmacist’s role is to give.

New expectations are our constant. Changes come faster, standards are set higher, and our patients’ reliance on us is stronger than ever. Faster, higher, stronger. It’s how pharmacy responds to every challenge.

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