Ambulatory Care Pharmacist - AMA

[rxrhino]

Hi everyone,

I graduated from pharmacy school in 2015, completed a PGY-1 Residency in 2016 and now working as a full time ambulatory care pharmacist, if interested, please AMA.

This thread is meant for questions and advice.

Thanks!

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[Selladore]

Hi, here are my questions:

1) What type of ambulatory care services do you provide?
2) Is this your first jobs post-residency?
3) Did you feel like your residency prepared you for this position?
4) I just completed my PGY-1 residency and in the process of applying for ambulatory care positions, any advice on the job search?

Thanks for doing this!

 

[Sparda29]

1. Where in the US is your practice located?
2. Salary or hourly? How much do you get paid + benefits?
3. Have you met any ambulatory care pharmacists who did not do a residency?

 

[rxrhino]

Hi Selladore,

1. I am a diabetes specialist but also adjust medications for HTN and HLD.
2. I started as per diem about then transitioned to full-time after about year of working pretty much full time hours at the same organization I did my residency at
3. My residency definitely provided me with the foundation, but most of what I do I learned on the job from co-workers/training
4. Keep your search wide and be OK to move, many people say the job market is saturated, especially hard to find amb care job, I did not feel that is the case. Just need to have an open mind, apply broadly and be persistent.

Thanks for the questions!

 

[gwarm01]

1. How do you sleep at night?

edit: I was just being silly with my post, but one of your answers to a previous question was interesting..

3. My residency definitely provided me with the foundation, but most of what I do I learned on the job from co-workers/training

I appreciate your honesty with this answer. You could infer many things from it, but if nothing else I'd say it reinforces the idea that residency training is just an easy way to offload the cost of basic workplace training onto the employee.

I also suspect that your answer would remain the same even if you had completed a PGY2 in ambulatory care at a different facility before accepting this position.

 

[rxrhino]

1. Where in the US is your practice located?
2. Salary or hourly? How much do you get paid + benefits?
3. Have you met any ambulatory care pharmacists who did not do a residency?

Hello Sparda29.
1. I am located in Southern California
2. I am hourly - close to 70/hr with benefits
3. None, every position I ever applied to requires at least a PGY-1 residency.

 

[rxrhino]

1. How do you sleep at night?

Very well, thanks for asking.

 

[gwarm01]

Very well, thanks for asking.

I need tips because I'm lucky to get even six hours a night. I find myself waking up at 0430, 0500 even on days where I'm not scheduled to work at all. I'm practicing good sleep hygiene, but I think its stress related. I'd rather avoid sleeping pills because the hangover affect is worse than being tired in my opinion.

 

[CetiAlphaFive]

Hi everyone,

I graduated from pharmacy school in 2015, completed a PGY-1 Residency in 2016 and now working as a full time ambulatory care pharmacist, if interested, please AMA.

This thread is meant for questions and advice.

Thanks!

Serious question:

How do you keep from getting bored?

The Amb care I did was only shuffling warfarin and Lantus/Levemir doses.

Do you do anything more in depth?

 

[rxrhino]

Serious question:

How do you keep from getting bored?

The Amb care I did was only shuffling warfarin and Lantus/Levemir doses.

Do you do anything more in depth?

Hi!

Very good question. Don't get me wrong I have my slow days but I cherish those since most of my days are pretty fast pace.

The great thing about my clinic is that I work one-on-one with doctors. I actually have an office within the internal medicine clinic and have doctors come to me with referrals, to see their patients while they are in clinic or just get random other drug related questions.

It does get tedious at times, but I try to keep myself busy by seeing more patient in clinic and going to lunch CMEs for MDs. Beats standing on my feet all day.

 

[rxrhino]

I need tips because I'm lucky to get even six hours a night. I find myself waking up at 0430, 0500 even on days where I'm not scheduled to work at all. I'm practicing good sleep hygiene, but I think its stress related. I'd rather avoid sleeping pills because the hangover affect is worse than being tired in my opinion.

when I work with geriatric patients, I would also recommend melatonin 3 mg qHS 30 min before sleep. Not sure how this relates to this thread, but thanks for the question and good luck with your sleep!

 

[rxrhino]

1. How do you sleep at night?

edit: I was just being silly with my post, but one of your answers to a previous question was interesting..



I appreciate your honesty with this answer. You could infer many things from it, but if nothing else I'd say it reinforces the idea that residency training is just an easy way to offload the cost of basic workplace training onto the employee.

I also suspect that your answer would remain the same even if you had completed a PGY2 in ambulatory care at a different facility before accepting this position.

I would agree with your comment. Coming out of pharmacy school, I did not yet feel prepared to work autonomously to be honest, so residency gave me an extra year of practice with preceptor oversight to really become comfortable with my role as a pharmacist.

 

[CetiAlphaFive]

Hi!
Very good question. Don't get me wrong I have my slow days but I cherish those since most of my days are pretty fast pace.
The great thing about my clinic is that I work one-on-one with doctors. I actually have an office within the internal medicine clinic and have doctors come to me with referrals, to see their patients while they are in clinic or just get random other drug related questions.
It does get tedious at times, but I try to keep myself busy by seeing more patient in clinic and going to lunch CMEs for MDs. Beats standing on my feet all day.

Nice. That sounds better than the ones I rotated through.
I never even saw the MDs that gave the standing orders.

 

[rxdawg21]

I also work in ambulatory care as a pharmacist. I was fortunate enough to get a position without a residency but also work in a smaller town but enjoy the area and what I do. I do DM, CHF, HTN, LIPID management and prescribe for the patients. I also occasionally will do vitamin D deficiency or hypothyroidism. I don't make $70 an hour but also don't live in southern California.

I think it is a joke that a residency trained person is considered to have more experience then someone without residency that has been doing the job 6 months to a year. I know plenty of residency trained pharmacists and all have said they learned more in the first 2 months on the job then in residency and they all did ambulatory focused PGY1s. Also many non-residency pharmacists have actually hit the ground running faster then residency trained ones. It has a lot more to do with knowing the guidelines, confidence, and efficiency/time management. The latter is much harder to teach/relearn through a year of residency and really makes a difference between leaving on time and staying late.

 

[pharm B]

Who pays for your services? What source of money provides payment to the practice for what you provide?

 

[gwarm01]

when I work with geriatric patients, I would also recommend melatonin 3 mg qHS 30 min before sleep. Not sure how this relates to this thread, but thanks for the question and good luck with your sleep!

To continue our tangent a little further..

I'm currently taking 30 mg of melatonin most nights. It helps me fall asleep, but staying asleep is another matter. If I take an antihistamine (doxylamine usually), I will still wake up but am able to fall back asleep.

Stress really messes with you. Six months ago I was sleeping like a baby. With any luck I'll return to normal in the next few months when this big project wraps up.

Slightly back on topic: I did a rotation through an AHEC clinic during my 4th year of pharmacy school. It was a lot of routine stuff, yes, but it also consisted of a lot of face time with patients. The pharmacist would see patients for warfarin, COPD, diabetes, and other chronic conditions. We did INR testing but also things like spirometry. She also participated in the education of the medical residents that worked in the clinic and was treated with a lot of respect. They actually called her Dr. without being facetious. It was an interesting month and proved to me that pharmacists could definitely have a role in managing chronic conditions in a clinical setting.

 

[Rouelle]

Who pays for your services? What source of money provides payment to the practice for what you provide?

And the follow-up question: Are you profitable to your employers?

 

[rxrhino]

And the follow-up question: Are you profitable to your employers?

I would think so, there about a dozen other pharmacists that are doing the same thing as me in this clinic. PCPs really enjoy having us around.

 

[rxrhino]

Who pays for your services? What source of money provides payment to the practice for what you provide?

The health system I work for.

 

[PharFromNormal]

How do you drive revenue for your institution or provide cost savings (over your cost of employment) for your institution?
Does your institution have any connections with any colleges of pharmacy and do you have any appe students?

 

[pharm B]

The health system I work for.

That's who pays you.

How do you drive revenue for your institution or provide cost savings (over your cost of employment) for your institution?
Does your institution have any connections with any colleges of pharmacy and do you have any appe students?

This is closer to what I was asking. How is the institution paid for your services, and who pays for it?

Not trying to pin you down. If you're in a setting with a dozen AmCare RPhs, how is it paid for? I'm sure there's at least a few of us in the audience that would be able to put the knowledge to use.

 

[nampa]

Hi Selladore,

1. I am a diabetes specialist but also adjust medications for HTN and HLD.
2. I started as per diem about then transitioned to full-time after about year of working pretty much full time hours at the same organization I did my residency at
3. My residency definitely provided me with the foundation, but most of what I do I learned on the job from co-workers/training
4. Keep your search wide and be OK to move, many people say the job market is saturated, especially hard to find amb care job, I did not feel that is the case. Just need to have an open mind, apply broadly and be persistent.

Thanks for the questions!

What resources can one use, including which guidelines, to self-learn this job?

 

[RxAddyCt]

Did you ever consider acute care? Or just amb care?

Like you, I completed a PGY-1 in 2017 at the VA. I did rotations with PACT, HBPC, geriatrics, pain clinic, anti coag, etc. They were BORING. Felt like I was learning how to write notes rather than becoming a better pharmacist. I'm now the evening ICU pharmacist with pending scope to GS-13.

 

[rxrhino]

What resources can one use, including which guidelines, to self-learn this job?

Specifically for my line of work I refer to the ADA guidelines that are updated yearly. They are dense but easy to read through.

 

[rxrhino]

Did you ever consider acute care? Or just amb care?

Like you, I completed a PGY-1 in 2017 at the VA. I did rotations with PACT, HBPC, geriatrics, pain clinic, anti coag, etc. They were BORING. Felt like I was learning how to write notes rather than becoming a better pharmacist. I'm now the evening ICU pharmacist with pending scope to GS-13.

That's great that you work in critical care. I personally never enjoyed the acute care setting unless it was in a specialty like ID or cardio. The one-on-one patient interactions I get in clinic are fantastic. Working with so many chronic patients allowed me to build strong relationships with them and their families.

 

[RxAddyCt]

That's great that you work in critical care. I personally never enjoyed the acute care setting unless it was in a specialty like ID or cardio. The one-on-one patient interactions I get in clinic are fantastic. Working with so many chronic patients allowed me to build strong relationships with them and their families.

Each their own. Glad you like it!