The clinical doctorate is an emergent trend in many health profession disciplines. Collier (2008) projects continued momentum toward higher degrees for entry into practice and advancing the field in health professions. There has been minimal research on how the trend of doctoral education in health professions will affect health professions education, delivery of services, and interdisciplinary relationship among health care providers, or the wider society (Freburger, King, \u26 Slifkin, 2008). This research focused on the transition to the clinical doctorate in one profession, Pharmacy, retrospectively examining the inception and enactment phase of the Pharm.D. The study provides important insight into the perceptions of the leaders and policy makers who were involved in the changes that led to the Doctor of Pharmacy as the entry-level degree for the practice of pharmacy. The qualitative methods of data collection, primarily 14 high-quality interviews, allowed the researcher to search for commonalities and patterns related to this policy mandate: development and implementation phases in both the educational institutions and the practice of pharmacy. The findings from this research provide evidence that these leaders are confident that establishing the Pharm.D. as the sole entry into pharmacy practice was the right decision for the profession, but acknowledge that requiring the Pharm.D. was only the starting block, that more work remains to maximize the knowledge, skills, and abilities of the Doctor of Pharmacy in the U.S. healthcare delivery system. The discovery of 18 patterns and 71 attendant themes documented the implementation of the Pharm.D., with major changes at four levels: health professions education, delivery of services, interdisciplinary relationships, and society as a whole. Decisions at each level acted as building blocks for modifications at the next level, but in a non-linear fashion. Changes that resulted at each step necessitated constant reflection and on-going improvements, but the profession continues to move forward. Recommendations derived from this empirical investigation provide extensive guidance to leaders in other healthcare disciplines who are contemplating the clinical doctorate as the entry-level degree into practice. Many of the anticipated outcomes at the time of the mandate were inaccurate, and numerous findings were unanticipated