Wednesday, May 23, 2012

What does a pharmacist do in the community setting?

This year I am going to be spending a ton of time in all different areas of pharmacy to prepare me for my career. I have a few required rotations and a few elective ones in order to accomplish this. Over the next few months, I am starting a new mini series to give you all a "small dose" of what pharmacists do in each area of practice that I am in. Hopefully you all will learn that we do so much more than "count, pour, lick, and stick" and also get a taste of what I am doing during the day!

"What does a pharmacist do in the community setting?" By community, I mean "retail", or where you would go as an outpatient to get a prescription filled. I once heard our jobs summed up as preparing medication for a patient and then preparing the patient for the medication. I think that is a great one-liner, but I would like to dig in and tell you what that means.

Prescriptions arrive at a pharmacy through patient delivery, phone calls from physicians, or over an online system. When all goes well the process usually goes like this: A trained technician interprets the handwriting (I feel sorry for all of you pharmacists that have to read my husband's handwriting one day!), bills insurance, and packages the medication. The pharmacist then double checks everything, assessing the appropriateness of therapy and any possible drug interactions. For this reason, I am a huge proponent of getting ALL of your medications filled at the same place!! Our clinical knowledge mainly goes into this part. Then, when a patient comes to pick up a prescription, a cashier handles the transaction and the pharmacist answers any questions the patient may have.

More often than you would think, things don't go this perfectly! We call the prescriber to have various things changed and errors fixed. One really annoying thing is insurance problems, and we end up spending a lot of time on the phone trying to get medications covered for people. In the community setting, pharmacists also recommend treatments for over-the-counter products, give immunizations, and manage inventory.

One of my passions is a new idea in pharmacy called Medication Therapy Management (MTM) where a pharmacist and patient do a complete medication review together. There are currently many barriers to this, but it is becoming more common and I am excited about it!

My most favorite thing about community pharmacy is building relationships with people. In a community setting, pharmacists are the most accessible health care professionals. Most pharmacies are open at least 12 hours a day, if not all 24, and no appointments are necessary. What a cool thing to be able to meet people where they are when they are the sickest and weakest and be able to provide help and encouragement!

One of my least favorite things about community pharmacy is the push for productivity. Let's be honest, have you ever had your pharmacist spend much time counseling you?! Probably not. Unfortunately pharmacies, like any other business today, is ultimately about the money. This means overworked pharmacists and understaffed pharmacies... and little time to spend time with patients.

As mentioned here, I am currently on a rotation at Barney's Pharmacy, an independently-owned community pharmacy in Augusta, GA. Barney's has given me a great vision of how pharmacists can expand these traditional roles. Among many other things, I have received training for the Omnipod (the new cordless insulin pump), counseled patients, communicated with doctors' offices, administered immunizations, taught health and wellness classes, participated in chair aerobics, and seen patients with the PA in the medical clinic to determine treatment decisions. They have incorporated clinical services into the community setting very well!

Hmm...I am sure I have left some things out, but this is all for tonight! Sorry for the lack of pictures, but I hope you found this interesting!!


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