Is the role of pharmacy confused?

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sillymarin

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I'm a pharmacy student right now, doing my fourth year rotations. I've come to have an existential crisis with regard to our profession. What is the definition of pharmacy exactly? I mean look at medicine. Despite being one of the most diverse professions in terms of specialties and subspecialties, all the disciplines of medicine are unified by the common thread of examination and diagnosis. All start out with the foundation of pathological inquiry and symtomatology before diverging into the multitude of foci which make each specialist so uniquely knowledgeable.

It seems to me that pharmacy doesn't have as surefooted an idea of what it is. The leaders of our profession, whether we're speaking of lobbyists, professional orgs, advocates, etc, seem almost desperate to take what opportunity for clinical expansion comes our way, as though we as a profession are collectively picking up scraps, so to speak, and defining ourselves accordingly. We can't and don't diagnose as a profession because frankly speaking, we're not trained to. We can't treat as a profession because hoarding that responsibility assumes that every clinical manifestation has its panacea drug - which would be an irresponsible assumption. That was the fundamental flaw our forbearers made in founding a profession on something as tenuous as a pharmaceutical product, which is not as fundamental as say the human body in a pathological state is for medicine. And to be completely honest, I'm still not convinced we need 4 years of post-graduate education, at least in its current iteration, to dispense pills and counsel for AEs. As much promise as MTMS holds let's be honest, the confusion over how to implement MTMS is as much a victim to this confusion as our profession itself is.

I'm frustrated. Are we doctors by practice or doctors in name only? If 96 percent of law grads went on to do clerical work while the remaining 4 percent actually went on to practice legal research and counseling, would we call all JD's "lawyers"? I ask this because with pharmacy, that's probably the rough percentage of clinical pharmacy graduates who actually go on to use the stuff they learn - in the clinical setting, pursuing their craft as an art as much as a science. The remainder forget all they knew about D-tests and T-tests.

And for me, to be a doctor means to know your subject to the highest degree known to humankind, to the point of being theoretical. To the point at which art and reason converge. To be a scholar. In my opinion perhaps 4 percent of pharmacists, those who work in the clinical setting and go beyond staff-level may approach a level of expertise for which they were in theory trained. But the fact that so few of us have this opportunity suggests that such people are exceptions. And exceptions are found in every profession, professions which they don't define.

It seems to me pharmacy is still a work in progress. Many want to be called doctors just because we have a sheet of paper. How about the reality of the situation? I'm not going by what someone told me I am. I'm going by the facts. Perhaps our pharmacy education jumped the gun on reality?
 
No, the role of pharmacy is not confused...

But you may be confused about the role of pharmacy.
 
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The girl is having an existential crisis and this is the best you can offer....

Oh..I didn't know it was a girl.. was reading it on my phone..didn't see the avatar. If I would've known, then I would've been more eloquent... like,

"I'm not a smart man..but I know what Pharmacy is..." [/gump]
 
Oh..I didn't know it was a girl.. was reading it on my phone..didn't see the avatar. If I would've known, then I would've been more eloquent... like,

"I'm not a smart man..but I know what Pharmacy is..."
[/gump]
That's not eloquent you doofus.
 
Well Sillymarin,

Eloquently written argument I have to say. But if I may ask, what is your definition of role of pharmacy? Perhaps it's not because the profession of pharmacy is undefined, rather your crisis rose because pharmacy practice does not parallel medicine.

Here is how I see it:

  • Correct medication, right dose, and right route to right patient at the right time to ensure pharmaceutical treatment is most efficacious.

Where do you see yourself in that role?

I'm responsible for determining the most cost effective medications for hospitals through analyzing industry contracts. Then I implement clinical protocols to ensure correct medications are efficiently utilized to optimize patient care.

Did 4 years of pharmacy school teach me how to do this? No. But the education provided opportunities to learn where my contribution to pharmacy is right for me.

I see your frustration because I was there. My critical care rotation preceptor put it best. She said "some attendings, residents, and interns will ask you what your role is while rounding." "You better have answers."

Keep searching little one.
 
What is the definition of pharmacy exactly?
I don't think there is a straightforward definition of pharmacy. Pharmacy can mean the art of preparing and dispensing drugs, a place where drugs are sold, the synonym of apothecary, the profession that links the health sciences with the chemical sciences(wiki). The Pharmacy Council of New Zealand says that "The ultimate concern of pharmacy is to ensure that the patient receives the appropriate medicines and benefits from the proper use of these."

I'm frustrated. Are we doctors by practice or doctors in name only?
You should be frustrated. The state of all professions is never rooted. The MDs have to fight to keep their hold on the practice of diagnosis, because of the increasing roles and responsibilities given to the PAs and nurse practitioners. Pharmacists have to fight to keep that final check, which could one day be performed by a computer.
Pharmacists are doctors for both of those reasons.

It seems to me pharmacy is still a work in progress. Many want to be called doctors just because we have a sheet of paper. How about the reality of the situation? I'm not going by what someone told me I am. I'm going by the facts. Perhaps our pharmacy education jumped the gun on reality?

Pharmacy is a work in progress. You are part of a transition that may or may not lead to a higher level of pharmacy across the board. I think they should allow for concentrations in pharmacy school. It would make more sense, in my opinion, for a person to gain focused study rather than having an overdone, broad idea of all pharmacy disciplines. A PharmD is still a PharmD, so I don't think they would be limiting students too much by allowing for concentrations.
The reality of the situation is that we are unsure about the ultimate fate of pharmacy. There have been great strides made in the movement towards clinical pharmacy, but they still have a ways to go.
 
This is a little off-topic, but I've always wondered. Do those of you with your Pharm.D call yourself "Dr. Epic" or "Dr. Old Timer" or "Dr. Smith..." Because I plan on it.
 
....if you were having an existential crisis, you'd already have your answer because you would be conjuring up your own meaning....or so says Sarte....

Pharmacy doesn't need an identity. It would just hold us back.
 
Sillymarin,

As odd as it may seem, I'm not one of the forefathers you spoke about - those folks who turned pharmacy upside down from the product DISPENSING end to the product KNOWLEDGE end came about 6-7 years ahead of me. I knew & still know some of them personally though. They knew exactly what they wanted to do, but didn't know where it might take them. I was at Jere Goyan's home once (he was the Dean at UCSF & also the FDA Commisioner at one time) and he said the fun part of this adventure is discovering how far we will go. We are still discovering that.

I think Epic touched on this a bit, but the profession of pharmacy will always be centered around a product. We have our knowledge base in drugs. We may not all dispense them, but all of us somehow have our work revolving around them.

The profession will always be in flux. I don't ever want to say "well, in the old days....it was like this....and it was better!) No - I'm depending on you to move the profession into areas we've yet to know about. To me this does not seem to be grasping or scraping, but rather filling a need when the need arises.

We are in flux, as is medicine by the way, because our field changes as much and as often as medicine changes. Sometimes it involves less drugs - like kidney stones which are "blasted" today. Sometimes, it involves more or better ones - like biologics for psoriasis rather than steroid goops. But, the underlying & uniflying thing all pharmacists get is the education which is as complete and as comprehensive as it can be at the time you get it.

Epic mentioned that he took his & went a different way. I took mine & got involved in the intensive care/acute/OR portion & then many years later, got involved in outpt when I realized I had lost touch with patients who really needed someone who had knowledge like mine.

I think you compare yourself to medicine and often there are misunderstandings. When you get your PharmD next spring, you will have the ability to dispense & counsel patients. When my daughter receives her MD in 18 months, she won't have the ability to do anything at all except serve coffee in a diner. She must go on because her degree is not worth much without a residency. You, however, can make that decision to go on to a residency, do a JD or an MPH, get some job experience, do a fellowship - lots and lots of things.

But, you are very mistaken if you think you will know your subject to the highest level possible. There will be someone who knows it better than you - count on that! You will always have to learn - every year, endlessly (same as medicine). But, you can find that niche within pharmacy which interests you & drives you and makes you want to go farther. You may decide you want to really pursue a field of pharmacy and be one of the "names" who knows that field the very best. There aren't that many, but those doors are open if that is what interests you.

This is what your 4 th year rotations are about - finding out what you like so you can decide what you want to do.

Unfortunately, no one told you this would be a journey, not an end. This journey you decided to take 4 years ago would last a lifetime and in that lifetime, you'll also fit in significant others, children perhaps, funerals, weddings, holidays and baseball games.

This can be a pleasant part of your life which I've found continues to hold my interest even 30 years later. No - you won't have that perfect job and yes, you will have to compromise on your expectations with real life. But, my daughter is facing those same conundrums. If she chooses opthalmology, she really will turn her back on orthopedic surgery. We all face crossroads at times - this is just yours.

I do believe Epic was very eloquent when he said perhaps you are confused about the role of pharmacy. He and I know very well what the role of pharmacy is and we both play significant parts, altho different in the profession. He may have forgotten what D-tests are, but he relies on people like me to know. I rely on people like him to work out the business end so I have what I need and when I need it. You need to get yourself clear about what role you want to play in the profession.

Good luck! I hope you find what you're looking for & find as much pleasure out of the field as I've had in my career. Remember - this is a journey.....
 
This is a little off-topic, but I've always wondered. Do those of you with your Pharm.D call yourself "Dr. Epic" or "Dr. Old Timer" or "Dr. Smith..." Because I plan on it.

Not just off topic, but on to an old tired topic. OK - we'll call you Dr. Candita. I call folks by their first names normally & they do likewise to me. Yep, that also includes the chief of medicine & the CEO of the hospital. But, I've been there a long time.....
 
Not just off topic, but on to an old tired topic. OK - we'll call you Dr. Candita. I call folks by their first names normally & they do likewise to me. Yep, that also includes the chief of medicine & the CEO of the hospital. But, I've been there a long time.....

Sorry. Some of us are new around here.
 
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I'm a pharmacy student right now, doing my fourth year rotations. I've come to have an existential crisis with regard to our profession. What is the definition of pharmacy exactly? I mean look at medicine. Despite being one of the most diverse professions in terms of specialties and subspecialties, all the disciplines of medicine are unified by the common thread of examination and diagnosis. All start out with the foundation of pathological inquiry and symtomatology before diverging into the multitude of foci which make each specialist so uniquely knowledgeable.

It seems to me that pharmacy doesn't have as surefooted an idea of what it is. The leaders of our profession, whether we're speaking of lobbyists, professional orgs, advocates, etc, seem almost desperate to take what opportunity for clinical expansion comes our way, as though we as a profession are collectively picking up scraps, so to speak, and defining ourselves accordingly. We can't and don't diagnose as a profession because frankly speaking, we're not trained to. We can't treat as a profession because hoarding that responsibility assumes that every clinical manifestation has its panacea drug - which would be an irresponsible assumption. That was the fundamental flaw our forbearers made in founding a profession on something as tenuous as a pharmaceutical product, which is not as fundamental as say the human body in a pathological state is for medicine. And to be completely honest, I'm still not convinced we need 4 years of post-graduate education, at least in its current iteration, to dispense pills and counsel for AEs. As much promise as MTMS holds let's be honest, the confusion over how to implement MTMS is as much a victim to this confusion as our profession itself is.

I'm frustrated. Are we doctors by practice or doctors in name only? If 96 percent of law grads went on to do clerical work while the remaining 4 percent actually went on to practice legal research and counseling, would we call all JD's "lawyers"? I ask this because with pharmacy, that's probably the rough percentage of clinical pharmacy graduates who actually go on to use the stuff they learn - in the clinical setting, pursuing their craft as an art as much as a science. The remainder forget all they knew about D-tests and T-tests.

And for me, to be a doctor means to know your subject to the highest degree known to humankind, to the point of being theoretical. To the point at which art and reason converge. To be a scholar. In my opinion perhaps 4 percent of pharmacists, those who work in the clinical setting and go beyond staff-level may approach a level of expertise for which they were in theory trained. But the fact that so few of us have this opportunity suggests that such people are exceptions. And exceptions are found in every profession, professions which they don't define.

It seems to me pharmacy is still a work in progress. Many want to be called doctors just because we have a sheet of paper. How about the reality of the situation? I'm not going by what someone told me I am. I'm going by the facts. Perhaps our pharmacy education jumped the gun on reality?

Well written! I think you delineated perfectly the state our wonderful profession finds itself today. Granted, we've made tremendous progress to where we are today (clinically speaking) and there is much more to be done.

I wrestled with the idea about studying pharmacy or medicine. I was afraid that one day, I'd be saying the same things you are wrestling with today. SDN1977 contrasted pharmacy and medicine; the longer training beyond medical school did not suit me (or so I think). Having said that, I'm not just 'settling' for pharmacy. I aspire to be a clinical pharmacist with opportunity for patient interaction and to really apply what I learned in pharmacy school in a hospital setting (although I realize retail pays more). As a student you are starting to see the realities of your field and will pick appropriate path to ensure a greater yield of return satisfaction and fortunately, there are many paths to choose from. Judging from what you wrote, perhaps, clinical pharmacy might be a good choice for you. I understand your frustration. For all the academic and experiential training a pharmacist acquires, the corporate pharmacies are the very reason why the value of our profession is far from being respected.

I learned something in my economics course recently. Businesses are in business to maximize profits. According to Life Extension Pharmacy: 'Walk in to your typical large drug store, and the first items you usually see on the wall behind the front cashier are cigarettes and cigars.'

You have gone to school that long, taken most of the same prerequisites as physicians, and you are reduced to a cashier with all sorts of weird questions about non pharmacy products from consumers. In addition, like a fast food restaurant with grumpy employees who do not care about their jobs, the pharmacy drive-thru is turning our field into a fast dispensing drug machine where there is hardly anytime to check on drug dosage, interaction as there are quotas to meet. Ok, physicians are having less time with patients, true, but it continues to be more respectful than pharmacists. It is not about paralleling pharmacy and medicine. We have extensive training and the last thing I want to do is to be reduced to a simple cashier, albeit a high paying one if that may console some of you. Simply put, the multi-billion dollar pharmacy chains, the forefathers who envisioned a pharmacy to provide care, are concerned with price and liability insurance!

We need retail pharmacies; it would be great if they hired enough people so pharmacists could do their job. If I become a retail pharmacist, I'd like to know that I can at least do what I set forth to do when I filled the pharmacy application: to serve others using my extensive education, just like physicians do.

No, the role of pharmacy is not confused...

But you may be confused about the role of pharmacy.

Anyone who responds with two fragment sentences to such a well written topic is both arrogant and contributes in no way through his/her professionalism the advancement of pharmacy, his field! Now had you responded the way you did below, you would have gotten a little bit more respect. At least from me. If you can't write a counterargument, then you would do us a favor and not post at all (although it's your prerogative)! Say, how do you think you helped a future pharmacist today by your arrogant post? I find you 'loud-mouthed' and uncouth. 👎
 
Lol

I don't need respect from u..nor do I need a lengthy reply 2 get my point across.

But u r right, I'm arrogant, but not loud..
 
Anyone who responds with two fragment sentences to such a well written topic is both arrogant and contributes in no way through his/her professionalism the advancement of pharmacy, his field! Now had you responded the way you did below, you would have gotten a little bit more respect. At least from me. If you can't write a counterargument, then you would do us a favor and not post at all (although it's your prerogative)! Say, how do you think you helped a future pharmacist today by your arrogant post? I find you 'loud-mouthed' and uncouth. 👎

Who in the hell is this?!?!?! Wow! Bold statements from someone who just joined the board. I suggest lurking around for awhile and getting to know everyone before slinging around uninformed insults.

Perhaps, to those of us who have been on this board for awhile, this is a tired topic and discussion that has occured on here ad nauseum. Sometimes the shortest replies contain the most information. Not to disrespect sdn1977's War and Peace responses!
 
Anyone who responds with two fragment sentences to such a well written topic is both arrogant and contributes in no way through his/her professionalism the advancement of pharmacy, his field! Now had you responded the way you did below, you would have gotten a little bit more respect. At least from me. If you can't write a counterargument, then you would do us a favor and not post at all (although it's your prerogative)! Say, how do you think you helped a future pharmacist today by your arrogant post? I find you 'loud-mouthed' and uncouth. 👎

Personally, I'm far too lazy to write more than a paragraph.
 
Laugh all you want! This is a marital technique I've honed for more than 30 years! For all you young wives.....listen up!

My husband gives up now much earlier in our "discussions" because he knows I can "out-talk" him😀. (A piece of what - I give him a piece of my mind!😉😛).

It works with dops as well😛 - sorry Epic!.

But, I really can be short & succint too. Thats how I respond to prescribers - I give them the nuts & bolts of what they need. Now..if they argue, I pull out my long winded explanations. Usually not necessary😀.
 
Well written! I think you delineated perfectly the state our wonderful profession finds itself today. Granted, we've made tremendous progress to where we are today (clinically speaking) and there is much more to be done.

I wrestled with the idea about studying pharmacy or medicine. I was afraid that one day, I'd be saying the same things you are wrestling with today. SDN1977 contrasted pharmacy and medicine; the longer training beyond medical school did not suit me (or so I think). Having said that, I'm not just 'settling' for pharmacy. I aspire to be a clinical pharmacist with opportunity for patient interaction and to really apply what I learned in pharmacy school in a hospital setting (although I realize retail pays more). As a student you are starting to see the realities of your field and will pick appropriate path to ensure a greater yield of return satisfaction and fortunately, there are many paths to choose from. Judging from what you wrote, perhaps, clinical pharmacy might be a good choice for you. I understand your frustration. For all the academic and experiential training a pharmacist acquires, the corporate pharmacies are the very reason why the value of our profession is far from being respected.

I learned something in my economics course recently. Businesses are in business to maximize profits. According to Life Extension Pharmacy: 'Walk in to your typical large drug store, and the first items you usually see on the wall behind the front cashier are cigarettes and cigars.'

You have gone to school that long, taken most of the same prerequisites as physicians, and you are reduced to a cashier with all sorts of weird questions about non pharmacy products from consumers. In addition, like a fast food restaurant with grumpy employees who do not care about their jobs, the pharmacy drive-thru is turning our field into a fast dispensing drug machine where there is hardly anytime to check on drug dosage, interaction as there are quotas to meet. Ok, physicians are having less time with patients, true, but it continues to be more respectful than pharmacists. It is not about paralleling pharmacy and medicine. We have extensive training and the last thing I want to do is to be reduced to a simple cashier, albeit a high paying one if that may console some of you. Simply put, the multi-billion dollar pharmacy chains, the forefathers who envisioned a pharmacy to provide care, are concerned with price and liability insurance!

We need retail pharmacies; it would be great if they hired enough people so pharmacists could do their job. If I become a retail pharmacist, I'd like to know that I can at least do what I set forth to do when I filled the pharmacy application: to serve others using my extensive education, just like physicians do.



Anyone who responds with two fragment sentences to such a well written topic is both arrogant and contributes in no way through his/her professionalism the advancement of pharmacy, his field! Now had you responded the way you did below, you would have gotten a little bit more respect. At least from me. If you can't write a counterargument, then you would do us a favor and not post at all (although it's your prerogative)! Say, how do you think you helped a future pharmacist today by your arrogant post? I find you 'loud-mouthed' and uncouth. 👎

Dear New - you have sooooo much yet to learn.

First - we are all "clinical" no matter our practice setting (did someone mention a dead horse?) - this is a pet peeve of mine & one I won't go into here.

Epic does not need my support here, but I have been subject to disparaging comments on this board because of my age & experience not meaning anything. So, as an older pharmacist who recognizes the wisdom that comes with age & the many ways of expressing that wisdom, I will actively support him.

Your comments obviously regarding epics style of posting are of validity because you feel that way. However, you might find that there are many of us who have worked with people as experienced & well respected as Epic & don't find his postings arrogant, uncouth or anything other than accurate.

I felt exactly the same way that Epic did, but I knew Silly was female & wanted something different (I also talk a lot as Caverject & WVU have been known to mention & now they have enlisted Mountain:meanie:). Epic's response was appropriate to his position, gender & actually cut right down to the situation.

As Mountain mentioned, many of us here have responded to this very same topic numerous times. I can count on one hand here the #s of pharmacists who have 10 years experience (well maybe more than 5, but certainly not more than 10).

We get tired of saying the same thing. The stickys are old & the search function stinks. So - we get glib & say things off the cuff. Perhaps we should just not post - that might be an idea. But, you really do learn things from others in the field, even if they don't have your same "style".

Of course, Epic's style may not be your own. But, know this - he was a dop for probably more years than you've been a pharmacist. Be very careful. Our world is small. You have every right to not like the way he said what he did, but I personally did not. Silly might get that same response in person from someone on her rotation & she needs to know it is not reflecting arrogance anymore than my post did.
 
The girl is having an existential crisis and this is the best you can offer....

Who in the hell is this?!?!?! Wow! Bold statements from someone who just joined the board. I suggest lurking around for awhile and getting to know everyone before slinging around uninformed insults.

Perhaps, to those of us who have been on this board for awhile, this is a tired topic and discussion that has occured on here ad nauseum. Sometimes the shortest replies contain the most information. Not to disrespect sdn1977's War and Peace responses!

Relax! :laugh:

Since I'm new on this site, perhaps I am naive. Perhaps, I still believe SDN can be a place for good constructive sharing of ideas. C'mon people, this is a thread where someone has legitimate concerns about a career and how does one reply? I never said a short reply was a wrong reply. I'm not the only who thought it was cold (sarcasm or not). See above. I didn't realize there were seniority on this site. I'll think twice next time. Here, this is what I posted some time ago:

To the board: Sometimes, someone may post something that comes across the wrong way. I think it is nice to be motivated and aim high. I think socom could have written the post better. I don't think socom however was belittling the dreaded PCAT. I think frustration leads to determination. That's allowed sometimes. This forum creates a place for everyone to vent. Let's all forget about the post and think how we can help each other (study resources, websites used to prepare, word of encouragement, etc...)

I like to spread peace, not division.

But epic said himself, he was trying to be arrogant. That's hardly amusing... that's tough luv to a young woman seeking to exchange intuitive ideas. 😉
Perhaps, I overreacted. Here, I'll even apologize if I offended Epic, MountainPharmD, SDN1977. I'll bet that such a reply would hardly faze me. Aiight, I admit, I have a soft spot for the ladies, especially when they're smart. 😍

Be sweet, be gentle to them. :laugh:
Lol

I don't need respect from u..nor do I need a lengthy reply 2 get my point across.

But u r right, I'm arrogant, but not loud..

Ok. I and oldtimer may have misunderstood your point. No problem.

Personally, I'm far too lazy to write more than a paragraph.

That's allowed in the world of blogging! :laugh:


To SDN1977,

I was not downplaying anyone's skills as pharmacist. In fact, I respect that. This was the OP's first post. Now it would be nice if we all were nice. When I first started, I did not know about the search features and even now, I don't fully know how to search for specific topic as I get many convoluted links. Fortunately, I held off posting. Next time, I'll kindly refer someone to the search function. :scared: :meanie:

You all are great really! What would we be like w/o disagreements? Everyone wants the upper hand. Hence, War & Peace a la SDN1977! :laugh:
 
Relax! :laugh:

Since I'm new on this site, perhaps I am naive. Perhaps, I still believe SDN can be a place for good constructive sharing of ideas. C'mon people, this is a thread where someone has legitimate concerns about a career and how does one reply? I never said a short reply was a wrong reply. I'm not the only who thought it was cold (sarcasm or not). See above. I didn't realize there were seniority on this site. I'll think twice next time. Here, this is what I posted some time ago:

To the board: Sometimes, someone may post something that comes across the wrong way. I think it is nice to be motivated and aim high. I think socom could have written the post better. I don't think socom however was belittling the dreaded PCAT. I think frustration leads to determination. That's allowed sometimes. This forum creates a place for everyone to vent. Let's all forget about the post and think how we can help each other (study resources, websites used to prepare, word of encouragement, etc...)

I like to spread peace, not division.

But epic said himself, he was trying to be arrogant. That's hardly amusing... that's tough luv to a young woman seeking to exchange intuitive ideas. 😉
Perhaps, I overreacted. Here, I'll even apologize if I offended Epic, MountainPharmD, SDN1977. I'll bet that such a reply would hardly faze me. Aiight, I admit, I have a soft spot for the ladies, especially when they're smart. 😍

Be sweet, be gentle to them. :laugh:


Ok. I and oldtimer may have misunderstood your point. No problem.



That's allowed in the world of blogging! :laugh:


To SDN1977,

I was not downplaying anyone's skills as pharmacist. In fact, I respect that. This was the OP's first post. Now it would be nice if we all were nice. When I first started, I did not know about the search features and even now, I don't fully know how to search for specific topic as I get many convoluted links. Fortunately, I held off posting. Next time, I'll kindly refer someone to the search function. :scared: :meanie:

You all are great really! What would we be like w/o disagreements? Everyone wants the upper hand. Hence, War & Peace a la SDN1977! :laugh:

A lengthy post sdn1977 would be proud of!!! :laugh:
 
In my opinion perhaps 4 percent of pharmacists, those who work in the clinical setting and go beyond staff-level may approach a level of expertise for which they were in theory trained. But the fact that so few of us have this opportunity suggests that such people are exceptions.

In response to the lack of opportunities for a "clinical" position, I think if someone truly wants it, they can obtain that clinical expertise. It does involve a sacrifice though. I want to be a clinical specialist in the field of Critical Care. This is going to require a 2 year residency so that I can be trained at the kind of level that I want to be. It's going to take 2 years of me busting my butt and putting my heart and soul into it but it'll be worth it for me. I am also in my fourth year but I knew the realities. I knew from my first day of starting pharmacy school that I was going to need a residency for what I aspire to do. Now I've realized that I'll need two years. I believe the residencies are out there for those who want them, they just might require sacrifice. I am applying both instate and out of state and am really only looking at sites that have a 2nd year Critical Care specialty since that's what I want to do. I don't think pharmacy is confused. We are at a point in the profession where a residency is pretty much required if you're coming right out of school to get those more "clinical" positions. Rotations do not teach us all those nuances that we need for those more clinical positions. Sure we know the book work well but what I've learned on rotations is that the book work is just that- there is so much more that cannot be taught soley in a classroom. Just like MD's, PharmD's will need to have further training outside of the classroom if they want to specialize. I think this is a very positive thing for our profession. Also, I don't think many of my classmates are even interested in furthering their knowledge, this is ok for those that want to do retail or staff. But for those in my class that complain about a lack of opportunities I think it's the person's unwillingness to sacrifice rather than the lack of opportunities. I also feel that after my residency training I will be able to go into many health-systems and show them what benefit a highly trained pharmacist can be. I've been in health-systems where the pharmacist rounds with physicians and because of the pharmacist's training and knowledge the physician looks to the pharmacist to suggest what meds to prescribe. This is where I see the future of our profession: we are the trained drug experts so why now be utilized as such? I think it will take lots of work but I feel like the right pharmacists can earn that type of respect from physicians and I hope to be able to do that someday.
 
But epic said himself, he was trying to be arrogant. That's hardly amusing...

Where did I say I was trying to be arrogant? I may come off arrogant. But it comes from being confident in what I do. My audience is large and I influence a lot of decision makers. But I don't make personal insults like you did..without ever knowing the background of where one is coming from. Despite my legit post, you felt the need to throw in insults.

Ok. I and oldtimer may have misunderstood your point. No problem.

I don't think so. Oldtimer was just jiving me... unlike you. Oldtimer is much smarter than that.

Welcome to SDN. Don't let my recent sign up date fool you.
 
In response to the lack of opportunities for a "clinical" position, I think if someone truly wants it, they can obtain that clinical expertise. It does involve a sacrifice though. I want to be a clinical specialist in the field of Critical Care. This is going to require a 2 year residency so that I can be trained at the kind of level that I want to be. It's going to take 2 years of me busting my butt and putting my heart and soul into it but it'll be worth it for me. I am also in my fourth year but I knew the realities. I knew from my first day of starting pharmacy school that I was going to need a residency for what I aspire to do. Now I've realized that I'll need two years. I believe the residencies are out there for those who want them, they just might require sacrifice. I am applying both instate and out of state and am really only looking at sites that have a 2nd year Critical Care specialty since that's what I want to do. I don't think pharmacy is confused. We are at a point in the profession where a residency is pretty much required if you're coming right out of school to get those more "clinical" positions. Rotations do not teach us all those nuances that we need for those more clinical positions. Sure we know the book work well but what I've learned on rotations is that the book work is just that- there is so much more that cannot be taught soley in a classroom. Just like MD's, PharmD's will need to have further training outside of the classroom if they want to specialize. I think this is a very positive thing for our profession. Also, I don't think many of my classmates are even interested in furthering their knowledge, this is ok for those that want to do retail or staff. But for those in my class that complain about a lack of opportunities I think it's the person's unwillingness to sacrifice rather than the lack of opportunities. I also feel that after my residency training I will be able to go into many health-systems and show them what benefit a highly trained pharmacist can be. I've been in health-systems where the pharmacist rounds with physicians and because of the pharmacist's training and knowledge the physician looks to the pharmacist to suggest what meds to prescribe. This is where I see the future of our profession: we are the trained drug experts so why now be utilized as such? I think it will take lots of work but I feel like the right pharmacists can earn that type of respect from physicians and I hope to be able to do that someday.


Paragraphs are your friends..:meanie:
 
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Where did I say I was trying to be arrogant? I may come off arrogant. But it comes from being confident in what I do. My audience is large and I influence a lot of decision makers. But I don't make personal insults like you did..without ever knowing the background of where one is coming from. Despite my legit post, you felt the need to throw in insults.



I don't think so. Oldtimer was just jiving me... unlike you. Oldtimer is much smarter than that.

Welcome to SDN. Don't let my recent sign up date fool you.


Yo relax! :laugh:

Your attitude scares people. :scared:

You've probably scared SillyMarin and she did not come back to a thread she started. 😱

Ok! You had the last word. I mind you... you are on a slippery slope if you continue to babble all the while ignoring my previous post. Again, if I insulted you, I apologize. 🙁
 
Just my .02 cents.

One of my professors said that MD's are the interface between man and disease, Lawyers are the interface between man and man, and Pharmacists are the interface between man and medicine. We don't diagnose. That is the MD's job. It just so happens that MD's prescribe also. Many many years ago pharmacists could alter drug treatment based on their knowledge of drugs. We can no longer do that (unless under certain protocols and in certain states) because they assumed that MD's were at a "higher" level than the rest of the medical world. Many MD's just prescribe drugs that they know are for a particular indication without knowing if it may cause a drug interaction.

The way it should be, in my opinion, is the MD can diagnose the patient and confers with the pharmacist on the best drug therapy for that particular condition. This is probably best in a clinical setting like a hospital and in regards to the cases that are above the norm. For doctor's private offices it wouldn't be practical and that is were the community pharmacists come into play. And in that case community pharmacists should have a little more power to change drug treatment but, on the other hand we only know that they want that particular drug for that indication. There may be other things going on that we don't know about with the patient and therefore a reason the MD might have prescribed a medication that we might not have. To complicated.
 
sillymarin you bring up some good points on the future of pharmacy. I had to think about these same things before changing over to pharmacy school. For the sake of back round information, I have been an LPN for several years and was starting my last year in school for BSN when I was accepted to pharmacy school. I came to the conclusion, before entering Pharm school, that health care is much too big and has way too many opportunities for patient care to fit into a neat definition. I'll explain what I mean. Had I stayed with nursing, I could have gone on to become a nurse practitioner, done research and get a PhD, became a pain management expert, or any number of avenues that could or could not be involved with patient care. Another example is the concept of specialty. Some M.D.'s, nurses, pharmacist, etc... Specialize in fields where their general knowledge in other areas is severely lacking.
A person can also stay very generalized and work within a limited scope over a broad range of situations, for example a nurse on a medical floor or a community pharmacist working with a broad range of disease states everyday. Don't start thinking at just because a person has an M.D. they are a subject matter expert in every disease state. M.D.'s have their specialties too and they, usually, stay within their specialty to provide the best patient care they can.
A common theme I've been reading, and one I totally agree with is that you have to find your niche in whatever profession you choose. Try not to let it be about money, fame, popularity, respect, or pressure from out side sources. The important thing is that as a professional, you are happy and, at the very least, competent in the niche you find in your profession. For me, pharmacy has the right proportions of attributes for a career that I can be successful and happy in. That is why I choose pharmacy.
As a side note, some people are under the opinion that some health care professions are self governed and others are controlled by outside forces (politicians). To the best of my knowledge, every health care profession is licensed by the state that a person works in. The regulations are clearly (sometimes vaguely) written out and there are punishments for operating outside of the "scope of practice". The scope changed based on the need of the community and so, all professions are constantly in flux. If you don't agree, just ask a physician what their opinion is on nurse practitioners working under their own license, without being under a M.D... Chances are very good you are not going to get a very pleasant response. Then think about the situation from the smaller community's side. They need a health care provider, but can not afford to have a physician working full time in their community. I know this is happening in the state of Washington, more and more. Just some long winded ideas to think about.
😀
 
sillymarin you bring up some good points on the future of pharmacy. I had to think about these same things before changing over to pharmacy school. For the sake of back round information, I have been an LPN for several years and was starting my last year in school for BSN when I was accepted to pharmacy school. I came to the conclusion, before entering Pharm school, that health care is much too big and has way too many opportunities for patient care to fit into a neat definition. I'll explain what I mean. Had I stayed with nursing, I could have gone on to become a nurse practitioner, done research and get a PhD, became a pain management expert, or any number of avenues that could or could not be involved with patient care. Another example is the concept of specialty. Some M.D.'s, nurses, pharmacist, etc... Specialize in fields where their general knowledge in other areas is severely lacking.
A person can also stay very generalized and work within a limited scope over a broad range of situations, for example a nurse on a medical floor or a community pharmacist working with a broad range of disease states everyday. Don't start thinking at just because a person has an M.D. they are a subject matter expert in every disease state. M.D.'s have their specialties too and they, usually, stay within their specialty to provide the best patient care they can.
A common theme I've been reading, and one I totally agree with is that you have to find your niche in whatever profession you choose. Try not to let it be about money, fame, popularity, respect, or pressure from out side sources. The important thing is that as a professional, you are happy and, at the very least, competent in the niche you find in your profession. For me, pharmacy has the right proportions of attributes for a career that I can be successful and happy in. That is why I choose pharmacy.
As a side note, some people are under the opinion that some health care professions are self governed and others are controlled by outside forces (politicians). To the best of my knowledge, every health care profession is licensed by the state that a person works in. The regulations are clearly (sometimes vaguely) written out and there are punishments for operating outside of the "scope of practice". The scope changed based on the need of the community and so, all professions are constantly in flux. If you don't agree, just ask a physician what their opinion is on nurse practitioners working under their own license, without being under a M.D... Chances are very good you are not going to get a very pleasant response. Then think about the situation from the smaller community's side. They need a health care provider, but can not afford to have a physician working full time in their community. I know this is happening in the state of Washington, more and more. Just some long winded ideas to think about.
😀


Very Good.
 
as far as wrong profession choices go, i think everyone who has contributed to this thread should have been lawyers not pharmacists. look at the way you are picking apart each others words trying to get an edge in the arguements. I am a new inductee to the profession of pharmacy, a PS1 and I thought this thread might be informative, but like all the other threads on this site it turns into a who' balls are bigger war not a discussion on issues relavant to pharmacy. Maybe pharmacy and pharmacists lack a strong definite identity in the health delivery system because we ouselves can not unite. If you are a seasoned veteran that is a highly distinguished pharmacist and are tired of answered the questions of young impresionable future pharmacists and pharmacists, you should resign yourself from contributing to the discusion. If you are a highly regarded, experienced professional and want that respect than you should not be seeking it in an anonymous post.
 
as far as wrong profession choices go, i think everyone who has contributed to this thread should have been lawyers not pharmacists. look at the way you are picking apart each others words trying to get an edge in the arguements. I am a new inductee to the profession of pharmacy, a PS1 and I thought this thread might be informative, but like all the other threads on this site it turns into a who' balls are bigger war not a discussion on issues relavant to pharmacy. Maybe pharmacy and pharmacists lack a strong definite identity in the health delivery system because we ouselves can not unite. If you are a seasoned veteran that is a highly distinguished pharmacist and are tired of answered the questions of young impresionable future pharmacists and pharmacists, you should resign yourself from contributing to the discusion. If you are a highly regarded, experienced professional and want that respect than you should not be seeking it in an anonymous post.
I wouldn't call myself an expert of anything, but I know how the world works. It's a bad idea to say that you're new to pharmacy, and then tell a "highly distinguished pharmacist" what to do. There was a sour taste in my mouth after reading your post.

I work with a pre-pharm who loves to tell me how I should have done something, but since I can only take so much of a bad thing, I snapped at them the last time they tried to dictate what to do. I already have a boss to follow, and therefore, I don't need another one.

This is my word of advice to you: don't try to be the boss of SDN. A few people around here already have that role.
 
as far as wrong profession choices go, i think everyone who has contributed to this thread should have been lawyers not pharmacists. look at the way you are picking apart each others words trying to get an edge in the arguements. I am a new inductee to the profession of pharmacy, a PS1 and I thought this thread might be informative, but like all the other threads on this site it turns into a who' balls are bigger war not a discussion on issues relavant to pharmacy. Maybe pharmacy and pharmacists lack a strong definite identity in the health delivery system because we ouselves can not unite. If you are a seasoned veteran that is a highly distinguished pharmacist and are tired of answered the questions of young impresionable future pharmacists and pharmacists, you should resign yourself from contributing to the discusion. If you are a highly regarded, experienced professional and want that respect than you should not be seeking it in an anonymous post.

I think there are 3 of us who a very seasoned which your disparaging remarks might have been directed against. I'm not sure exactly if it was to all of us or just one or two.

Nevertheless - you are highly misguided if you think the profession of pharmacy does not have a strong identity, is not united or that any of the three of us seek respect from people like you, who also hides behind anonymity by telling us what to say, when to say it or how to say it.

The comments on here have been thoughtful & considered. Epic has had a long & distinguished career & is typical of most dops I've ever met. He doesn't mince words & will speak to the point.

I've tried to elaborate & did indeed mention this has been addressed in the past & is probably more an issue of the OP than the profession. Noticeably, the OP has not returned......that in itself speaks volumes.

In your ignorance of the profession you've chosen, you can go along and criticize all you want & have your own opinion. Each one of us gets one. Fortunately, I enjoy the respect IN REAL LIFE of my colleagues, employers and am regarded as an expert in my very narrow field. I obviously don't have yours, yet I never sought it out. Someday, though, you might seek our mine - just a thought.

Like PharmD said.....your post left a bad taste & contributed nothing - just as you indicated of our posts.
 
as far as wrong profession choices go, i think everyone who has contributed to this thread should have been lawyers not pharmacists. look at the way you are picking apart each others words trying to get an edge in the arguements. I am a new inductee to the profession of pharmacy, a PS1 and I thought this thread might be informative, but like all the other threads on this site it turns into a who' balls are bigger war not a discussion on issues relavant to pharmacy. Maybe pharmacy and pharmacists lack a strong definite identity in the health delivery system because we ouselves can not unite. If you are a seasoned veteran that is a highly distinguished pharmacist and are tired of answered the questions of young impresionable future pharmacists and pharmacists, you should resign yourself from contributing to the discusion. If you are a highly regarded, experienced professional and want that respect than you should not be seeking it in an anonymous post.


Wow.. this is by far the most insightful and helpful post on this thread! 👍

Thank you for your contribution! 👍
 
as far as wrong profession choices go, i think everyone who has contributed to this thread should have been lawyers not pharmacists.

You see... what a lawyer does and what I do isn't much different. When we make a presentation to a committee to get an approval for a drug or a protocol, there usually are strong opposition to what we want to accomplish. We prepare countless hours going over every single possible opposing view and then we rehearse our response. Of course the issues aren't criminal or civil in nature rather clinical and financial. It's dynamic and exciting. Something I hope all bright, young, and new pharmacist will experience in the future.

At the same time, we're not going to sit here and explain and spoon feed answers every single query someone pops in. Especially the issue OP raises...and it's something she will have to find on her own.

And if you can't handle little sarcasm and jabs we throw here, you've got a long road ahead of you. Get used to it. You're going to get beaten down in the real world of healthcare.

The funny thing is, I would probably be much harsher to you in real work place. But you wouldn't even be able to talk to me the way you responded on this post. Only when you're hiding behind anonymity, you're so brave to criticize seasoned members on this board who've been very helpful to many of you.

Now go study.
 
but like all the other threads on this site it turns into a who' balls are bigger war not a discussion on issues relavant to pharmacy.

And with this statement, we realize you have no credibility...

It's obvious you haven't read "all the other" threads..
 
Does no one have a sense of humor anymore? If you don't like the way someone says something or what they say then kick back and smile, pat yourself on the back and congratulate yourself on being a superior human.
 
I wouldn't call "bigger balls" an advantage. They can get in the way 😉. Besides, no one likes an egotistical maniac.


No.. it's Egotestical.. and Mountain can take that title..as the Egotestical maniac..if he would like.
 
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as far as wrong profession choices go, i think everyone who has contributed to this thread should have been lawyers not pharmacists. look at the way you are picking apart each others words trying to get an edge in the arguements. I am a new inductee to the profession of pharmacy, a PS1 and I thought this thread might be informative, but like all the other threads on this site it turns into a who' balls are bigger war not a discussion on issues relavant to pharmacy. Maybe pharmacy and pharmacists lack a strong definite identity in the health delivery system because we ouselves can not unite. If you are a seasoned veteran that is a highly distinguished pharmacist and are tired of answered the questions of young impresionable future pharmacists and pharmacists, you should resign yourself from contributing to the discusion. If you are a highly regarded, experienced professional and want that respect than you should not be seeking it in an anonymous post.


I'm not seasoned, but does your remark pertain to me, too? 😳
I've tried to upheld the integrity of Sillymarin's post, but to no avail. Perhaps, I lack 'seniority.' But I'm mostly sad that our beautiful young lady have simply vanished and left a thread that sought original ideas in vain and in ruins.
 
Why worry about if she has come back or not. For someone who has only posted once she may not even check back for several days. I have been posting off an on and miss weeks at a time!
 
Why worry about if she has come back or not. For someone who has only posted once she may not even check back for several days. I have been posting off an on and miss weeks at a time!

She just seems so sweet....:laugh::laugh:

Aiight... Let SDN have a forum for sarcasms and others for 'da' serious. 🙂
The point is, we can't assume how someone will react to sarcasm. In my view, perhaps SillyMarin was really serious about her post. Sobegekko, a medical student, convinced that medicine was no longer for him, QUIT 1 1/2 year into residency. He is now a P1!!. SillyMarin, perhaps was looking at the big picture of pharmacy. I can honestly say that if sarcasm was intended, then I did not get it (perhaps because I'm new, and I'm not familiar with Epic's style on this board).

I like the post because it allowed for a good discussion on the issue. The OP took time to write beautifully on the matter because she cares about the future of the profession. I'm sure most seasoned bloggers (pharmacists) can attribute to that. In my view, some of us log on SDN naturally for all sorts of reasons; it can even be intellectual experience! You, the pharmacists, for sure have had long days negotiating at your company, advising patients etc... and you come to SDN to 'chill', rightly so. I've learned from SDN1977 and think she does a good job balancing sarcasm and thoughtfulness. You'll see sarcasm when you have a thread started by Zpacks, Epic, MountainPharmD etc... You'll also find from her concise and at times (long) responses to wonderful posts such as this one. Too bad, someone got to SillyMarin first! Perhaps, the sarcasm (or to the point) was botched. :idea:

Remember: be nice to the ladies, starting with SDN1977!

Here's to SDN👍
 
get over it. We don't know if sillymarin is a female or not. Besides, that won't change my response.. I'm not going to be nicer just because you're a girl. And not all of my threads contain sarcasm.

And stop bringing up my style of posting and others. Like I said, get over it and move on. Sillymarin hasn't even come back since she posted.