Think of it as an MTM but focused on one disease state. For example, my specialty pharmacy does oncology medications only and big portion of counseling focuses on the oncology regimen. All counseling covers administration, storage, precautions, side effects, and drug interactions, and depending on the medications, we make sure that patients are prescribed allopurinol, prednisone, dexamethasone, and other prophylactic measures to minimize tumor lysis syndrome. We also try to get antiemetics and antidiarrheal for patients proactively in case they do not have them handy. Counseling is usually very interactive since most cancer patients understandably have major concerns and plenty of questions about their chemo drugs. Also, this is the first job where I could genuinely feel that the patient or patient's caregivers are truly appreciative for the counseling I provide with almost every consultation session, which keeps my morale high and motivates me to provide better patient care and service. Definitely never been cursed out or yelled at like how it was when I was working in a retail setting. Also, since most specialty pharmacies do not handle controlled substances, you will not be part of any dramas involving narcotics and early fills. Also, pharmacovigilance is another huge aspect of our job. We do lots of adverse event reporting to various manufacturers and the FDA.
Upper management does time you to the exact second on your time on and off the phone. I know this sounds like micromanagement to the the next level, but it really isn't too bad because as long as you are logged into phones and ready to answer calls for the majority of the shift, they do not care (at least at my place). There is no phone quota such as how many calls you have to answer or dial out per shift as long as you are logged into the phone system, which is fair in my opinion since most pharmacists use and need the down time in phones to complete adverse event reports and other various documents. My company does not require calls to last for 5 minutes, but even if this was the case, it is not difficult to achieve because most counseling goes beyond 5 minutes without much effort. It would actually be much more difficult to finish the call within 5 minutes given the extensive counseling we must provide with oncolytic agents. Also, I heard if you make more than 3 mistakes per year, you can be shown the door although I have not seen this written anywhere. However, I've never seen or heard this happening to anyone, and frankly, this is no different from other practice settings. I know some places will say that they never fire anyone for making mistakes as long as its reported, but we all know that's not true. While all medications can cause serious adverse reactions, oncology drugs are on class of its own when it comes down to potential adverse events when taken incorrectly due to verification or dispensing error. I am sure companies do not want any law suits arising from medication errors either, so in order to protect patients and themselves, I am certain similar policies (written or unwritten) are at pretty much all specialty pharmacies. Also, you have to think about the amount of chargeback the specialty pharmacy will face when there is an error with the prescription. We are not talking about few hundred bucks or even few thousand bucks, but around 30k per a monthly prescription. If one pharmacist is causing near $100k loss to the company in a year due to not being careful, then I think it is fair for the company to reevaluate their staffing needs.
Hope this answers your questions!
