Internal Medicine vs. Pharmacy

[PharmEm]

I wasn't getting a response in the Pharmacy forum so I thought I'd try here.
I'm a pre-pharm student but I was curious to know what the difference and similarities were b/t someone studying pharmacy and someone being a doctor and specializing in internal medicine. Thanks.

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[tupac_don]

I wasn't getting a response in the Pharmacy forum so I thought I'd try here.
I'm a pre-pharm student but I was curious to know what the difference and similarities were b/t someone studying pharmacy and someone being a doctor and specializing in internal medicine. Thanks.

They are 2 different animals. Main difference is that if you are an internal medicine doctor, you can prescribe meds as a pharmacist you can't. As an internal med doctor, most of your responsibilities will be clinical, unless you are heavy into research or you only teach. As a pharmacist most of your time will be spent entering orders, and some clinical duties, unless you are a clinical specialist for which you have to take a residency. All in all the two are very different. Also as a pharmacist you can't prescribe and you only enter, verify and call doctors if something needs to be corrected. That's the jist of it, if you have more specific questions let me know.

 

[IlianaSedai]

In all honesty, I don't know very much about what being a pharmacist entails. I do know one guy who used to be a pharmacist and career changed into medicine.

I don't agree that "the MAIN difference between a pharmacist and a doctor is that the pharmacist can't prescribe." That's oversimplified. The differences are MUCH BIGGER than that. Pharmacists don't just enter orders -- obviously, you already know that if you're thinking about pharmacy. In medicine, the pharmacist (i.e. at the hospital) can save your butt and be a huge help. But they ARE very, very different with very different responsibilities. A few that I can think of:

MEDICINE: Understand the disease process, prognosis, and treatment rationale.
PHARMACY: Understand pharmacologic treatment, mechanisms, delivery methods, half-life, etc.

MEDICINE: Long(er) term relationships with patients in certain specialties.
PHARMACY: Short term or minimal relationships with many patients.

MEDICINE: Ultimate responsibility for diagnosis, treatment & coordination of care in certain specialties.
PHARMACY: Usually a clinical consultant in the hospital, but patients do come to you for help, especially outside the hospital.

MEDICINE: You usually need to SEE the patient to do most of your job.
PHARMACY: You might need to, but oftentimes you don't. It's worth getting a history though -- for example, you want to know what the patient has before suggesting the right antibiotic for good bacterial coverage or to avoid allergic cross-reactions.

This is probably not nearly enough information to make a decision. The only other thing I would suggest is spending a day shadowing both pharmacists and physicians. Their jobs are very different, and you probably need to see it to understand.

 

[Samoa]

I don't agree that "the MAIN difference between a pharmacist and a doctor is that the pharmacist can't prescribe."

I disagree. I think that's the primary difference between a clinical pharmacist and an internal medicine physician. Another major difference is that, while an internal medicine doctor will follow a patient as both an inpatient and in the clinic, a clinical pharmacist will usually only see them in one or the other setting. And even with liberal prescribing-under-protocol privileges, the pharmacist is not the patient's primary care provider.

MEDICINE: Understand the disease process, prognosis, and treatment rationale.
PHARMACY: Understand pharmacologic treatment, mechanisms, delivery methods, half-life, etc.

Not true. A clinical pharmacist needs to know both of these, and so does an internal medicine physician. Each may know their respective body of knowledge better than the other, but they both have to have a solid understanding of all of it.

MEDICINE: Long(er) term relationships with patients in certain specialties.
PHARMACY: Short term or minimal relationships with many patients.

Yeah. Although in retail you can get to know some people pretty well if you're not working in an insanely busy pharmacy. It's one of the reasons I like retail.

MEDICINE: Ultimate responsibility for diagnosis, treatment & coordination of care in certain specialties.
PHARMACY: Usually a clinical consultant in the hospital, but patients do come to you for help, especially outside the hospital.

This is also pretty much on target.

MEDICINE: You usually need to SEE the patient to do most of your job.
PHARMACY: You might need to, but oftentimes you don't. It's worth getting a history though -- for example, you want to know what the patient has before suggesting the right antibiotic for good bacterial coverage or to avoid allergic cross-reactions.

Heh heh heh. This is completely true. I used to get so annoyed with my pharmacy preceptors for insisting that I go interview the patient. It's like doing lab tests if you're a doctor--if it's not going to change your assessment or plan, it's a waste of resources (in this case, your time). whereas, in medicine, the patient's symptoms are what drive a lot of your clinical decisions. So I never feel like it's a waste of time now.

This is probably not nearly enough information to make a decision. The only other thing I would suggest is spending a day shadowing both pharmacists and physicians. Their jobs are very different, and you probably need to see it to understand.

In particular, if you want to compare and contrast their roles, it would be useful to find an internal medicine team with a clinical pharmacist, and spend a day or two following the physicians, and then a day or two following the pharmacist. And keep your eyes open regarding the team dynamics, as well. You'll figure it out pretty quickly.

Really, the bottom line is you can do small pieces of an internal medicine physician's job in various settings as a pharmacist, but in that profession, there is no single practice setting where you can do all of it.

 

[FrkyBgStok]

i go to a pharm school (drake) and most of my classes were with pharm students and the bad thing is if they do switch to medicine at 4 years they have no degree and if they don't make it in medicine they can't get back in. also i think it is the area but i have talked to many people that say pharmacy isn't paying what they thought it would. but it could be one or two people as well.

 

[OSUdoc08]

I wasn't getting a response in the Pharmacy forum so I thought I'd try here.
I'm a pre-pharm student but I was curious to know what the difference and similarities were b/t someone studying pharmacy and someone being a doctor and specializing in internal medicine. Thanks.

Pharmacists don't practice medicine.

 

[Samoa]

Pharmacists don't practice medicine. That is why they take your orders at Walgreen's.

And may every order you write be carried out exactly as you wrote it.

 

[tupac_don]

Pharmacists don't practice medicine.

They don't practice medicine, they just save interns and residents from writing inappropriate orders.

 

[OSUdoc08]

They don't practice medicine, they just save interns and residents from writing inappropriate orders.

Yeah, but that's all.

Giving meds is only a small part of the practice of medicine anyway.

There is always the diagnosis of disease and the medical procures that internists do.

 

[Jack Daniel]

There is always the diagnosis of disease and the medical procures that internists do.

The short answer I would offer:
Internists diagnose, pharmDs help choose the best pharmacological treatment, and nurses administer.

This would be if collaboration were possible; if not, the internist would do all three duties.

 

[tupac_don]

Yeah, but that's all.

Giving meds is only a small part of the practice of medicine anyway.

There is always the diagnosis of disease and the medical procures that internists do.

Maybe so, but I guarantee you that you would have more deaths and side effects if pharmacists didn't intervene. You know how many times, interns would write Penicillin on PCN allergic pt or Bactrim on a sulfa allergic pt. Also plain wrong doses are often written for many drugs, amingolycosides (that can shut down kidneys), LMWH and heparins written at the same time. There is many errors made that pharmacy intercepts. Doctors of course do all the other important stuff. But quality control that pharmacists do is very important. You'll be glad you have them on your side once you are a doctor, and so will I.