Drug administration is an essential clinical competence

Quotidian clinical practice implies at least four essential activities: i) integration of diagnosis; ii) design of the therapeutic regimen; iii) following up therapeutic outcomes; and, iv) keeping updated on medical knowledge. The therapeutic regimen may include the use of drugs among other forms of treatment. A competent clinician is expected to be knowledgeable, skillful, dutiful and altruistic when deciding to use drugs. In this work, drug administration is proposed to be redefined as an ssential clinical competence that integrates basic medical pharmacology knowledge (BMPK) along with pharmacotherapy's abilities and skills. Medical students should learn and become efficient in deciding what drugs are useful for specific patients; how drug(s) should be administered, i.e., dosing and duration of treatment; when drugs should be withdrawn or not used; and, how physicians are to keep updated for a sound balance when deciding between old or new drugs. Medical Pharmacology texts review these topics in the sections of clinical pharmacology, clinical pharmacokinetics, pharmacotherapy and pharmacoeconomics. However, an integrated view on how BMPK relates to their clinical application is not clearly stated. By the same token, legal and ethical aspects of drug administration are narrowed to prescription writing skills, either for the patient or for the clinical file; thus, attenuating the appraisal of the impact on therapeutic adherence of physicians' communication skills, as well as availability and/or accessibility of recommended drugs. These issues are obviously related to therapeutic outcome but their integrated articulation occurs only if drug administration is considered as an essential clinical competence.