The first thing you notice on entering Karen Acott's office at the Wallingbrook Health Centre in Chulmleigh, Devon, are the framed of pictures of Mount Kinabalu, one of Malaysia's most forbidding peaks. The picture that draws the eye, however, is a shot of Acott and her two sisters standing at the summit of the mountain in March 2004 with a giant banner that reads: "We made it."

Since graduating with a degree in pharmacy in 1988, Acott has consistently broken new ground, moving from managing a series of high-street chemists, to the position of pharmaceutical adviser for a primary care trust, to being offered a full partnership at a doctors' group medical practice.

"I'd suggested, almost tongue-in-cheek, that the doctors at Wallingbrook make me a partner," explains Acott. "I never expected to be taken up on it. As far as I know, I'm the first, and possibly only, pharmacist in the UK to have been accorded such an honour."

According to Acott, the days when pharmacists were content to prescribe drugs from behind the counter and leave key decisions about patients' health to doctors are behind us. Nowadays, she points out, pharmacists are expected to advise patients and, in some cases, adjust prescriptions. And with the setting of national obesity targets and the push for high street testing of everything from blood pressures to sexually transmitted diseases, pharmacists are also becoming increasingly important to the promotion of public health.

But it frustrates her that, for all these changes, many people still regard pharmacists as "glorified shopkeepers", hiding, as she puts it, "behind doctors' skirts".

Not something Acott could ever be accused of. In her role as superintendent pharmacist at the Wallingbrook - a rural practice with some 6,300 patients drawn from a 100-mile radius bisected by the River Tew - her main function is to manage the health centre's busy dispensary. But she also briefs doctors there on the latest drugs studies and recommendations from the National Institute for Health and Clinical Excellence.

"Having Karen around means that if I don't understand the latest circular from the government about some class of drugs, I can turn to her for advice," explains Dr Will Sherlock, one of five doctors in the practice. "It's like having a built-in safety mechanism."

Acott also runs weekly diabetes and epilepsy clinics where she consults with patients and makes adjustments to their drugs without having to refer them back to her colleagues. Finally, she's active in managing the care of the centre's elderly patients, many of whom are on multiple medications and need close monitoring.

Her partners like the system because it allows them to concentrate on more complex cases and to develop their specialist skills. She says: "The buzz word is 'concordance' - helping people make an informed choice. I try to explain in very simple language what the medications do - so that they understand the importance of taking the drugs long term."

But Acott doesn't believe in forcing this on people. "Quality of life means different things to different people. It should be what you want to have, not what the government thinks you should have, and about how far you want to go in your treatment."

Medicine runs in the family. Two uncles studied at Cambridge, but when it was time for her to go to university her parents didn't think doctoring a suitable career for a woman. Instead, they directed her towards pharmacy.

"They thought the hours would be too long and interfere with my being a housewife," she explains wryly.

However, Acott, who was raised in a traditional Christian family in Malaysia and came to Britain as a teenager to study science at A-level, is not the sort of person to bow to convention. Like her grandfather, an immigrant from Shanghai who built a successful business supplying furniture to embassies and palaces in Kuala Lumpur, she has a strong entrepreneurial streak. She also considers herself a bit of a rebel.

"I've always been the sort of person who believes in making it happen and exerting my own will on things. To be the first in anything is really hard, but because of my upbringing, I tend to see trends quicker than other people and use it to my advantage."

Acott first got the opportunity to display her flair for business working for Lloyds Chemist, now Lloyds Pharmacy. After graduating from King's College, London and a placement at Kingston Hospital, in southwest London, she joined a high-street branch in Birmingham.

By 1992, she'd risen through the ranks to become a district manager. Put in charge of developing and training staff at 20 outlets in and around Birmingham, she honed stock security and financial planning procedures, resulting in a 25% boost in profits.

However, it was a move in 1995, to Halletts, in Okehampton, Devon - not far from where she practises today - that brought Acott the opportunity to show she was no ordinary pharmacist. By now, in addition to her bachelor of pharmacy, Acott had obtained a certificate in homeopathy. Although she is firmly grounded in science, Acott says homeopathy appealed to her "artistic side" because it offered the opportunity to treat the "whole person".

She'd noticed that many patients were uncomfortable with the side-effects of modern drugs and were looking for alternatives. Acott helped Halletts introduce a range of complementary therapies - homeopathy and aromatherapy. It started with one bay and, in the end, became half the shop. It was the first time a chemist in the UK had had the idea for a range of alternative remedies. Its success earned a feature locally on BBC TV.

In 1999 she moved to North Devon Primary Care Trust and it was a significant step up. As a pharmaceutical adviser, Acott implemented national policies around the use of medicines and running a range of training programmes for local doctors. She was also asked to lead a review of acute services provision after the failed merger of North Devon District Hospital and the Royal Devon and Exeter Hospital, which faced stiff opposition from the local community.

Then there was the public awareness campaign she helped mount, drawing attention to wastage on so-called repeat prescriptions - the little green slips which allow patients to reorder commonly prescribed medications. To highlight the cost to the NHS, Acott's team borrowed two Landrover Freelanders, drove them to a local shopping centre, and stuffed them with wasted medicines collected locally to the value of the cars. The campaign cut losses to the PCT by pounds 388,000 in one year.

By now, Acott had made good contacts with GPs throughout Devon. However, like most pharmacists, it had never occurred to her that she might join a practice as a partner in her own right. But she was approached by Dr Chris Bowman, a senior partner at Wallingbrook and a board member on her PCT. "He said: 'Karen, why don't you come and work for us?' I said: 'I'll come and work with you if you'll make me a partner.'"

She was invited to meet the other partners at Wallingbrook. "It was trial by sandwiches," she jokes. Acott took some time to make her decision - a little nervous about the prospect of becoming self-employed and having to invest a portion of her own capital in the business. "I turned it inside and out but in the end I thought this is an opportunity no pharmacist has ever been given."

It is not a decision she regrets, even on weeks like the one just recently when new software installed in the dispensary for automatically reordering drugs broke down and she and her staff had to resort to checking stocks by hand.

As a partner she has her own consulting room on the same floor as the doctors, reflecting her status. "It feels good to be recognised by other healthcare professionals as an equal."

Despite her parents' fears that medicine would be detrimental to her "other" duties, she also gets every Monday off, which she spends with her husband and two children, Christopher, 15 and Kathleen, 13.

She sees no reason why every GP practice in the UK shouldn't have its own practice pharmacist - a goal she thinks could be realised within the next five years. "To be the first in anything is hard. But, hopefully, I'll have made it easier for people coming after me," she says.

Curriculum vitae

Born
Kuala Lumpar, March 21, 1965

Current position
Superintendent pharmacist, director and partner, Wallingbrook Health Centre

Qualifications
Bachelor of pharmacy, King's College, University of London, 1988
Certificate in homeopathy, first aid and home remedies, British Homeopathic Association, 1997
MSc in prescribing sciences, Faculty of Medicine, University of Liverpool, 2003
Supplementary prescribing, University of Bath, 2004

Career high
Becoming a partner in a traditional GP practice

Career low
The frustration when working in the high street of not being able to do more to help patients