With the revisions to the pay for performance of pharmaceutical service of inpatients in April 2012, the ward permanent time of pharmacists grew longer than previously; however, there are as yet few reports on the pharmaceutical outcome of the new medical service. To improve the pharmaceutical service requires that pharmacists collect useful medical information and extract the problems of pharmaceutical care for inpatients. Since many cases of treatment with multidrug regimens are regularly performed, pharmacists cannot contribute to medical treatment only by knowledge of a single disease. Therefore quick and comprehensive judgment of pharmacists is necessary in addition to acquisition of pharmaceutical knowledge. We especially highlight medical emergencies such as severe cases of sepsis and infection to which physicians require rapid judgment. Pharmacists alike require appropriate knowledge of drug administration to avoid medical treatment failure. Moreover, it is necessary for pharmacists to apply advanced drug monitoring in difficult cases. On the other hand, integrated team medical treatment is now advancing, although pharmacists' roles in clinical decision making are increasing, and pharmacists have a greater burden of responsibility than before.