Ambulatory Care Pharmacist vs. Community/Retail Pharmacist

[pharmacyro]

Hello!

I have been looking into the different specialties in the field of pharmacy, and came across ambulatory care, which kind of confused me. I'm wondering what are the differences between am care and community pharmacist job responsibilities. They seem very similar to me.

What I know about Am care:
- direct patient care BUT community pharmacist also provides patient interaction
- treating chronic diseases (diabetes, heart disease, etc) BUT community pharmacist also interacts with patients with these diseases
- work in team with other health professionals (MD, NP, PA, RN, etc) BUT community pharmacist could also call up doctors regarding prescriptions.
- MTM (medication therapy management) ??

I am also confused after looking up what MTM is... is it like determining correct dosage/changing dosage?
Thank you for your help!!!

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[NextStepTutor_4]

Hi @pharmacyro! While I was on my clinical rotation, I was able to work with several ambulatory care pharmacists as well as community pharmacists. Community pharmacists focus on tasks such as fill/verify certain prescriptions, help maintain inventories, and provide patient counseling. An ambulatory care pharmacist does treat chronic disease but works more closely with the patient and the healthcare team. They take a holistic view of the patient including the entire medication list (which is part of MTM) and may focus on a specific disease state such as diabetes management. For example, a direct counseling session as an ambulatory care pharmacist in regards to diabetes management can take 15 minutes or longer whereas this is unlikely to occur during in a community pharmacy. Ambulatory care pharmacists are also able to communicate specific patient-related needs that may need to be changed to other health professionals (eg. MD, NP, PA, RN) since they usually work in close proximity with each other.

 

[pharmacyro]

Best way to find out is to shadow.

I work as a pharmacy technician at Walgreens, from my experience, a community pharmacist receives prescriptions, verifies them, fills, consults a patient, and also deals with major insurance rejections. Essentially a community pharmacy is an expert is drugs that treat all sorts of illness and disease.

An ambulatory care pharmacist works directly with other health care providers and they can choose to specialize on a specific disease such as diabetes. Back when I was pre-pharm I shadowed an ambulatory care, they work in hospitals rather than in retail. I shadowed one that specializes in diabetes. He had patients that were sent over to him by primary care physicians. These patients had uncontrolled diabetes. The pharmacist would prescribe, under a collaborative contract with the MD, diabetes medication and monitor the patients progress. Many times the issue was very complex and required the pharmacist to prescribe multiple types of drugs to control the diabetes. Essentially the pharmacist is an expert in diabetes medication. This helps physician and most importantly the patient. The physician is usually limited on time and can't spend enough time addressing this issue. The patient instead saw the pharmacist 2 times a month for help with controlling his or her diabetes and this frees up the physician to see other cases and decreases the patient wait time to see a physician.

A community pharmacist can have over 100 drugs memorized while an ambulatory care pharmacist probably only has less than 100 drugs memorized depending on their speciality

I had no idea that an ambulatory pharmacist usually only specializes in one chronic condition. I also did not know about freeing up time for the physician, so it was great to learn more about it. Thank you so much for your detailed and insightful response!!

May I ask how you were able to shadow an ambulatory pharmacist? I used to volunteer in an outpatient pharmacy at a hospital, but mainly was able to shadow the pharmacy technicians only.

 

[pharmacyro]

Hi @pharmacyro! While I was on my clinical rotation, I was able to work with several ambulatory care pharmacists as well as community pharmacists. Community pharmacists focus on tasks such as fill/verify certain prescriptions, help maintain inventories, and provide patient counseling. An ambulatory care pharmacist does treat chronic disease but works more closely with the patient and the healthcare team. They take a holistic view of the patient including the entire medication list (which is part of MTM) and may focus on a specific disease state such as diabetes management. For example, a direct counseling session as an ambulatory care pharmacist in regards to diabetes management can take 15 minutes or longer whereas this is unlikely to occur during in a community pharmacy. Ambulatory care pharmacists are also able to communicate specific patient-related needs that may need to be changed to other health professionals (eg. MD, NP, PA, RN) since they usually work in close proximity with each other.

Thank you so much for your insightful response!!! Could you explain what MTM is? I am still a bit confused about what responsibilities come with MTM. I looked it up online, and it seems as though MTM comes up more frequently when searching about ambulatory pharmacists rather than community pharmacists.

 

[princeafrica]

I had no idea that an ambulatory pharmacist usually only specializes in one chronic condition. I also did not know about freeing up time for the physician, so it was great to learn more about it. Thank you so much for your detailed and insightful response!!

May I ask how you were able to shadow an ambulatory pharmacist? I used to volunteer in an outpatient pharmacy at a hospital, but mainly was able to shadow the pharmacy technicians only.

Hey! The shadowing was through a program called "Health Interest Program" at Denver Health Hospital that I got accepted to. You should find local hospitals and county hospitals and ask if they have clinical pharmacists and ask if you can shadow them.

Yeah, clinical pharmacists are becoming a bigger part of a healthcare team! One hospital I shadowed at had multiple department floors such as ICU, neurology, emergency, trauma floor, birth floor, etc and they had a pharmacist for each floor that specialized in that particular floor needs

 

[FinallyOnTrack]

APhA Career Pathway Evaluation Program
for Pharmacy Professionals - APhA Career Pathway Evaluation Program for Pharmacy Professionals

Am Care - https://www.pharmacist.com/sites/default/files/files/Profile_04 Ambulatory Care Final 071213V.pdf

Take the assessment and be truthful about it - it’ll pair you with your most likely career pathways...

I have a passion for helping others and my top choice was Am Care..


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[PharmtoCS]

Ambulatory care pharmacy: makes up 1-2% of an jobs available to pharmacists

Community (retail) pharmacy: makes up 70% of all jobs available to pharmacists

 

[Corytrade]

Being an AmCare pharmacist is awesome. You work closely with the physicians and they respect you, you can prescribe and alter medications, order labs, no nights and weekends. The only downside is you don't touch the meds anymore, so when you get questions like if something is scored or not you have to look it up.