Best work setting for a pharmacist?!

[wsbkp08]

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Where do you guys think is the best place to work as a pharmacist?!

1. Hospital
2. Retail and grocery including costco, sam's
3. Long term care/mail order
4. PBM
5. Compounding
6. Industry

and why?!

 

[PumpkinSmasher]

IMO: Ambulatory care pharmacist in a family medicine clinic

Reasons:
-direct patient interaction for office visits. Build relationships with pts and provider staff
-collaborative prescriptive authority for certa in dxs: dm, chf, htn, copd, asthma, gout, etc
-on site, collegial environment among docs, nps, nurses, etc
-able to perform in office mtm with full access to chart and refill hx
-drug info service for large group of providers. Population mgmt aspects through provider education presentations
-clinically challenging
-go home feeling good about helping my pts and having the time to really explain things to them one on one

QoL reasons:
-8to5 hours, no weekends, holidays or nights
-office based, able to sit or stand at desk
-vacation is usually tied to the hospital, college or FQHC you are affiliated with, which is usually very generous

Overall I think it is the best pharmacist practice site, for me at least. I really enjoy my job 😉 I feel blessed to be able to truly mean that statement.

Negative:
-Small amount of jobs
-If you like acute care, then not for you

 

[Topcat15]

The best place for a pharmacist to work is the place which that particular pharmacist enjoys working in.

Where you like working will be so dependent on your interests, personality, likes/dislikes, etc. You see people all the time trying to get out of retail, but I had a friend who went from retail to hospital and immediately went back to retail because she was so bored and didn't like sitting down so much. I personally don't like working in a hospital in a decentralized position because I'm really sensitive to smells and it always smells like ****. If you like interacting with patients a lot, you probably won't be happy at a mail-order, but if you don't like patient interaction, then you will. And so on and so on.

 

[wsbkp08]

I have job offers from a hospital, ltc, and a grocery store.
I didn't do residency, but I got an offer from a hospital for a full time position (3-11pm). I really don't like the hours but I can sacrifice few years if I have to.
LTC is a full time day job from 10-6pm but it's a dispensing pharmacist job and I've heard it's kind of boring.
Grocery store is also a full time job that does about 200 scripts per day. Enough said.
I also did an interview for a compounding pharmacist job not sure about that.
I wanted to work in an industry but... yeah.. not happening now lol

I've worked at a hospital and at a retail for the past 4 years in pharmacy school and I guess my hard work paid off. I kind of regret that I applied every where but I was scared bc job market is tight in my area.
I need current pharmacists' insights, recommendations, and tips for this newbie pharmacist!
Thanks!

 

[confettiflyer]

Hospital, hands down. Intellectually stimulating, long-term working relationships with your docs and nurses, 6 weeks of vacation per year, higher pay than retail, 4x10hr schedule, no "retail like" metrics to adhere to, a chair to sit in.

Negatives: good luck finding a job, and most new grads will be stuck working less desirable shifts (evenings and weekends, usually). Sometimes an a-hole physician, nurse, or patient will ruin your day, you see lots of people die.

But I stand by the adage that the worst operational day in the hospital is still better than retail.


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[ldiot]

I think compounding would be fun; you'd likely work for an independent with better working conditions and would fill a lower volume of scripts than chain retail, same would apply for some grocery chains. LTC/Mail-order is probably the easiest job but also the most boring and mind numbing. I don't like how competitive hospital has become and in most cases I feel like the clinical involvement of the pharmacists fall short of the expectations that are set in school. Chain retail isn't a good working environment but it does pay well, easier to get a job, and for me personally suits my strengths (task-oriented/efficient).

It really depends on your strengths and what you would most like to do.

 

[steveysmith54]

Any 24 hour cvs 😉

 

[CetiAlphaFive]

Independent is amazing.

For some reason they treat pharmacy staff like human beings; even the patients that were horrible at cvs smile and act friendly here.

 

[mustang sally]

Go for the one that you think will be the most intellectually challenging. It's hard to go up but easy to go down.

 

[Lnsean]

Hospital, hands down. Intellectually stimulating, long-term working relationships with your docs and nurses, 6 weeks of vacation per year, higher pay than retail, 4x10hr schedule, no "retail like" metrics to adhere to, a chair to sit in.

Negatives: good luck finding a job, and most new grads will be stuck working less desirable shifts (evenings and weekends, usually). Sometimes an a-hole physician, nurse, or patient will ruin your day, you see lots of people die.

But I stand by the adage that the worst operational day in the hospital is still better than retail.


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Definitely not if it's traditional hospital dispensing. I think if you're on the floors rounding with doctors and a team...then hell yes...it's stimulating and challenging work...but if you're down in the basement...it makes for a toxic environment from my experience rotating there and what others have told me.

But to each his own...i guess...that's just my 2 cents.

 

[a student]

Even retail, if you find a well organized store with good techs and polite customers, it's not too bad. I wouldn't say I love my job, but I'm not nearly as stressed as I was when I worked at busy unorganzied ghetto stores with untrained staff.

 

[cj98]

Government! You get to experience a little bit of everything in one place- inpt, outpt, amb care, managed care. Good benefits and good work life balance. Cons: huge paycut, very tough to find an open permanent position.

 

[wagrxm2000]

Stay away from hospitals, you will go crazy from boredom.

 

[DesiRX]

hospital. hands down.

 

[pharmdit]

LTC Informatics. I work with leadership to improve the medication ordering cycle from beginning to end for thousands of patients. I get to implement pretty cool technology (packaging robots, ADCs). I am also able to hone my IT skills and have essentially become a systems administrator for our pharmacy servers. On top of that, pay is better than retail, regular hours, etc. Downside is that I haven't come across anyone else who has the same position. Informatics pharmacists are generally hospital based.


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[jackblack12]

What about IV outsourced pharmacy manufacturing places?
Anyone know about them?

 

[Dred Pirate]

Stay away from hospitals, you will go crazy from boredom.

why do people say this? I have worked in a hospital for 10+ years - it is a mixed model, time on the floor (ICU/ER), and time in "the basement". I love it. I rarely bored. I bust my butt on the floors, and a day in the basement helps keeps me sane but having an "Easy day". I moonlighted for two of the big chains and I think I had one "easy day" and that was at a store who closed it doors due to a lack of business.

 

[Dred Pirate]

What about IV outsourced pharmacy manufacturing places?
Anyone know about them?

I would stay away from them. They are getting cracked down on with increased regulation. I believe the recent FDA rule wanted to all but close them down.

Plus- that, to me, would be boring as hell. Today we are going to make and check 1,000 heparin drips. Tomorrow - 3,000 neo drips....

 

[gwarm01]

why do people say this? I have worked in a hospital for 10+ years - it is a mixed model, time on the floor (ICU/ER), and time in "the basement". I love it. I rarely bored. I bust my butt on the floors, and a day in the basement helps keeps me sane but having an "Easy day". I moonlighted for two of the big chains and I think I had one "easy day" and that was at a store who closed it doors due to a lack of business.

I agree. Maybe it depends on the hospital. I do part time work at a small community hospital and I could see people getting bored, although there is a lot of clinical work because pharmacy does kinetics for all of the hospitalists.

When I worked in the ICU of a level 1 trauma center it could be very exciting. Some days were just nonstop. Researching something for a doc, coordinating meds, following kinetics, writing TPNs, transplant counseling.. you name it. Of course, other days you could just sit around and do nothing all day.

 

[CetiAlphaFive]

What about IV outsourced pharmacy manufacturing places?Anyone know about them?

Ehhh... I would stay away from them.

You can have 100% accuracy, safety, and cover all your bases for sterile compounding.

Guess who gets nailed when your product hits the hospital floor and the nurse sneezes on every spike and every port of every bag before administering it?

Suddenly you have the board and fda up your butt.

 

[Topcat15]

why do people say this? I have worked in a hospital for 10+ years - it is a mixed model, time on the floor (ICU/ER), and time in "the basement". I love it. I rarely bored. I bust my butt on the floors, and a day in the basement helps keeps me sane but having an "Easy day". I moonlighted for two of the big chains and I think I had one "easy day" and that was at a store who closed it doors due to a lack of business.

As someone who works in both retail and hospital, and finds hospital fairly boring and unfulfilling, I'll tell you why I would say that:

- Rounds are boring beyond all belief. I have a pretty short attention span for listening to someone (especially an intern or a new resident... lord save me) present a patient and it makes me want to gouge my eyes out having to listen to it. Plus most of the patients are usually pretty depressing to hear about. I would be so happy if I never had to go to rounds again in my life.

- Limited formulary. In retail, I need to know about immunizations, OTCs, and pretty much any med under the sun that a provider could write for, and for any population (peds/adult/geriatric, male/female/transgender, etc). And patients are always asking crazy and interesting questions about their meds. In hospital, I feel like I see the same meds over and over and over again. Zosyn, Vanco, PPIs, and warfarin are like 75% of my day, I swear.

- I don't think doing kinetics, anticoag monitoring, or antimicrobial stewardship are interesting, intellectually stimulating, or rewarding in any way, yet most hospitals seem to emphasize how "clinical" they are with these activities. Yawn.

- So many protocols. I could probably program a robot to follow an algorithm and have it do like half of my work. Sure there are cases that require clinical judgment, but most of the time, the processes are written out in such detail that you rarely get the chance to do so.

- Limited patient interaction. I love speaking to patients and counseling them. And believe it or not, 99% of the patients I speak to in retail are very grateful and appreciative of my help. Even in a hospital that emphasizes a lot of patient med recs and discharge counseling, I don't get the same fulfillment from my patient interactions, and most of the time you can tell you're just annoying these poor patients who are already overwhelmed with everything else going on in the hospital. This is probably the biggest factor for me.

Obviously this is all subjective and dependent on your particular institution, so I'm glad you enjoy your job, but I don't think it's unimaginable that other people would find it boring. Everyone likes different stuff.

 

[CetiAlphaFive]

As someone who works in both retail and hospital, and finds hospital fairly boring and unfulfilling, I'll tell you why I would say that:
- Rounds are boring beyond all belief. I have a pretty short attention span for listening to someone (especially an intern or a new resident... lord save me) present a patient and it makes me want to gouge my eyes out having to listen to it. Plus most of the patients are usually pretty depressing to hear about. I would be so happy if I never had to go to rounds again in my life.
- Limited formulary. In retail, I need to know about immunizations, OTCs, and pretty much any med under the sun that a provider could write for, and for any population (peds/adult/geriatric, male/female/transgender, etc). And patients are always asking crazy and interesting questions about their meds. In hospital, I feel like I see the same meds over and over and over again. Zosyn, Vanco, PPIs, and warfarin are like 75% of my day, I swear.
- I don't think doing kinetics, anticoag monitoring, or antimicrobial stewardship are interesting, intellectually stimulating, or rewarding in any way, yet most hospitals seem to emphasize how "clinical" they are with these activities. Yawn.
- So many protocols. I could probably program a robot to follow an algorithm and have it do like half of my work. Sure there are cases that require clinical judgment, but most of the time, the processes are written out in such detail that you rarely get the chance to do so.
- Limited patient interaction. I love speaking to patients and counseling them. And believe it or not, 99% of the patients I speak to in retail are very grateful and appreciative of my help. Even in a hospital that emphasizes a lot of patient med recs and discharge counseling, I don't get the same fulfillment from my patient interactions, and most of the time you can tell you're just annoying these poor patients who are already overwhelmed with everything else going on in the hospital. This is probably the biggest factor for me.
Obviously this is all subjective and dependent on your particular institution, so I'm glad you enjoy your job, but I don't think it's unimaginable that other people would find it boring. Everyone likes different stuff.

This is how I felt about My ICU rotation.
There was a ton of interesting cases, but the actual work my preceptors & I did was super boring.
Granted, it's not actual RPh work, but what I observed was.

Even when we did do something interesting, we got ignored.
ID didn't care about our recommendations, and the intensivists wouldn't even look up from their iPads.

The worst was responding to codes. Never felt more awkward or useless than standing outside the room during a code blue.

I'm glad I had that rotation first, as it shattered the illusion of clinical pharmacy for me.

(Amb care was fun but repetitive)

 

[lord999]

7. Feds

After the three year career tenure mark, fairly unaccountable besides committing a felony or dying in office (haven't found a single source incompetent way yet from the reports I read). Allowed to go into other lines of work, live in different places (even out of the country if you go the DoD route). Does not have to necessarily be in the dispensing or clinical roles. Great position changes for the continually bored (know a couple of pharmacists who rotate between NIH, FDA, VA, and USAID depending on their sense of adventure). Company benefits are considered good, promotion opportunities abound for the ambitious. Power trips for the sociopathic. Failure is tolerated (and some pharmacists who work fed are nothing but successful at being a failure). Legend has that there are pharmacists that do work that isn't on the up and up authorized for DEA and other organizations (I've only met one in passing who had the Walter White job at Reston). Pay "sucks" relatively and you are working for a democracy, so there are some downsides, but rather different than plain hospital or retail jobs.

 

[UofK]

As someone who works in both retail and hospital, and finds hospital fairly boring and unfulfilling, I'll tell you why I would say that:

- Rounds are boring beyond all belief. I have a pretty short attention span for listening to someone (especially an intern or a new resident... lord save me) present a patient and it makes me want to gouge my eyes out having to listen to it. Plus most of the patients are usually pretty depressing to hear about. I would be so happy if I never had to go to rounds again in my life.

- Limited formulary. In retail, I need to know about immunizations, OTCs, and pretty much any med under the sun that a provider could write for, and for any population (peds/adult/geriatric, male/female/transgender, etc). And patients are always asking crazy and interesting questions about their meds. In hospital, I feel like I see the same meds over and over and over again. Zosyn, Vanco, PPIs, and warfarin are like 75% of my day, I swear.

- I don't think doing kinetics, anticoag monitoring, or antimicrobial stewardship are interesting, intellectually stimulating, or rewarding in any way, yet most hospitals seem to emphasize how "clinical" they are with these activities. Yawn.

- So many protocols. I could probably program a robot to follow an algorithm and have it do like half of my work. Sure there are cases that require clinical judgment, but most of the time, the processes are written out in such detail that you rarely get the chance to do so.

- Limited patient interaction. I love speaking to patients and counseling them. And believe it or not, 99% of the patients I speak to in retail are very grateful and appreciative of my help. Even in a hospital that emphasizes a lot of patient med recs and discharge counseling, I don't get the same fulfillment from my patient interactions, and most of the time you can tell you're just annoying these poor patients who are already overwhelmed with everything else going on in the hospital. This is probably the biggest factor for me.

Obviously this is all subjective and dependent on your particular institution, so I'm glad you enjoy your job, but I don't think it's unimaginable that other people would find it boring. Everyone likes different stuff.

Hit the nail on the head.

 

[BidingMyTime]

What is "best" is going to vary wildly based on the individual pharmacists personality, goals, and interest. All of those areas are going to be the "best" for some pharmacist and at the same time the "worst" for another pharmacist.

 

[Unchained]

8. Medical Marijuana Dispensary. Everyone is so chill. There is very little pressure. Its a med that makes you happy. It's much less addictive than the narcotics we presently dispense. You don't have to deal with insurance companies. R&D capital is pouring into it. Massive growth potential. Pharmaceutical potential is only beginning to be investigated.

 

[wsbkp08]

What about IV outsourced pharmacy manufacturing places?
Anyone know about them?

What is this?

7. Feds

After the three year career tenure mark, fairly unaccountable besides committing a felony or dying in office (haven't found a single source incompetent way yet from the reports I read). Allowed to go into other lines of work, live in different places (even out of the country if you go the DoD route). Does not have to necessarily be in the dispensing or clinical roles. Great position changes for the continually bored (know a couple of pharmacists who rotate between NIH, FDA, VA, and USAID depending on their sense of adventure). Company benefits are considered good, promotion opportunities abound for the ambitious. Power trips for the sociopathic. Failure is tolerated (and some pharmacists who work fed are nothing but successful at being a failure). Legend has that there are pharmacists that do work that isn't on the up and up authorized for DEA and other organizations (I've only met one in passing who had the Walter White job at Reston). Pay "sucks" relatively and you are working for a democracy, so there are some downsides, but rather different than plain hospital or retail jobs.

Does this job setting available in like NJ, NY area?

What is "best" is going to vary wildly based on the individual pharmacists personality, goals, and interest. All of those areas are going to be the "best" for some pharmacist and at the same time the "worst" for another pharmacist.

Again, I just wanted insights, opinions from current pharmacists' jobs. It's interesting to see different pharmacists in their different jobs and what and how they like and dislike about their jobs. It definitely helps for new grad and the directions that I will take in the future.

 

[Dred Pirate]

8. Medical Marijuana Dispensary. Everyone is so chill. There is very little pressure. Its a med that makes you happy. It's much less addictive than the narcotics we presently dispense. You don't have to deal with insurance companies. R&D capital is pouring into it. Massive growth potential. Pharmaceutical potential is only beginning to be investigated.

I thought you preferred to be a vaccinating specialist?

 

[Unchained]

I thought you preferred to be a vaccinating specialist?

I thought you were ignoring my posts? I'm irresistible aren't I?

 

[PharmDBro2017]

8. Medical Marijuana Dispensary. Everyone is so chill. There is very little pressure. Its a med that makes you happy. It's much less addictive than the narcotics we presently dispense. You don't have to deal with insurance companies. R&D capital is pouring into it. Massive growth potential. Pharmaceutical potential is only beginning to be investigated.

What state are you in? Curious.

Retail lovers ITT... blows my mind honestly. Diff strokes for diff folks. Whatever floats y'alls boat.

edit: I despise retail due to being on rotation there currently... doing technician duties (register, drive thru, etc.) ...and not getting paid for it while I pay school way too much money.. I'm getting pissed just thinking about it.

 

[CetiAlphaFive]

What state are you in? Curious.

Retail lovers ITT... blows my mind honestly. Diff strokes for diff folks. Whatever floats y'alls boat.

edit: I despise retail due to being on rotation there currently... doing technician duties (register, drive thru, etc.) ...and not getting paid for it while I pay school way too much money.. I'm getting pissed just thinking about it.

It's like anything. You get out what you put in.

 

[PharmDBro2017]

It's like anything. You get out what you put in.

I put in full effort, enough to where boss said they would hire me. That said, I still couldn't stand doing retail 40 hours a week.

PRN, 8-12hrs/week, sure. Props to you guys that can do it full time.

 

[lord999]

What is this?


Does this job setting available in like NJ, NY area?

Again, I just wanted insights, opinions from current pharmacists' jobs. It's interesting to see different pharmacists in their different jobs and what and how they like and dislike about their jobs. It definitely helps for new grad and the directions that I will take in the future.[/QUOTE]

VA - Five major hospitals and the nationally third largest one (Harbor) in the area. Region (VISN) HQ in Manhattan
FDA - Branch HQ, Division HQ at Piscataway
CMS - Region HQ
USAID - Decentral Office
DHS (Homeland Security) - Special HQ
IHS - Eastern HQ
BoP - Eastern HQ, Special HQ
DoS (State) - Health HQ in conjunction with WHO in NYC

It's better to ask which federal offices that employ pharmacists DON'T have NY/NJ offices. Pay is good, but considering that most are NYC and its satellites, it's like making $50-60k anywhere else.

 

[woosiecg]

What a pharmacist does in a hospital is very dependent on state, health system and type of hospital (community vs academic medical center). I did my residency and currently work at a community hospital in a very progressive state. There are only a few medical residents (family medicine) so pharmacist are heavily relied upon. We are very involved in rounds and are always in dialogue with both RNs and intensivists during rounds. We participate in codes and rapid responses. We help determine the most appropriate medication for RSI and also administer them. We order medication for post intubation sedation, spike the bags and set the pumps.

Our hospital also has an overarching CDTA that is for "pharmacy to dose" so physicians ask us to dose almost anything. With cost being a large issue these days in hospitals, they are pushing physicians to see more patients per day so they physicians have come to utilize the pharmacists for the skills we can provide to help them better care for their patients.

Like I mentioned earlier, what you get to do as a pharmacist is very dependent on the hospital environment you work in. A friend of mine just moved out of state and is at a community hospital in the southwest where they have very little pharmacy protocols and don't respond to codes, etc. I did most of my APPE rotations at a teaching hospital where pharmacists were fairly involved but nothing like my current practice setting.

 

[CetiAlphaFive]

I put in full effort, enough to where boss said they would hire me. That said, I still couldn't stand doing retail 40 hours a week.

PRN, 8-12hrs/week, sure. Props to you guys that can do it full time.

Oh, I meant in terms of fulfillment, not effort.

If all a retail pharmacist does is play matching during verification and be a slave to corporate metrics, I agree.

 

[PharmDBro2017]

Oh, I meant in terms of fulfillment, not effort.

If all a retail pharmacist does is play matching during verification and be a slave to corporate metrics, I agree.

While counseling patients and even getting immunizations (small talk) with patients is enjoyable and rewarding, it doesn't make up for the metrics they are pushing, MTM/stars crap they have you doing (calling patients to ask why they aren't on a statin in diabetic populations...).

It makes it hard for me to enjoy the retail setting knowing insurance companies and the man are breathing down my neck wanting me to push zostavax everytime a patient comes up, etc. Feel like a slave.

 

[CetiAlphaFive]

While counseling patients and even getting immunizations (small talk) with patients is enjoyable and rewarding, it doesn't make up for the metrics they are pushing, MTM/stars crap they have you doing (calling patients to ask why they aren't on a statin in diabetic populations...).

It makes it hard for me to enjoy the retail setting knowing insurance companies and the man are breathing down my neck wanting me to push zostavax everytime a patient comes up, etc. Feel like a slave.

Yeah, that's why I went independent