I would really appreciate if folks who work in these areas would give a brief description of duties, how much money they make, and what do they think about the future in these particular pharmacy areas. Thanks.
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LTC, Home infusion?
- Thread starter konkan
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- Jan 6, 2006
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konkan said:I would really appreciate if folks who work in these areas would give a brief description of duties, how much money they make, and what do they think about the future in these particular pharmacy areas. Thanks.
Long Term Care (LTC)/Home infusion (HI) is basically the ideal place for someone who meets the majority of the following criteria:
1-Burned out in retail, but really isn't trying to work in a hospital setting
2-Typically looking for hrs during the day (i.e. 9-5pm w/ some possible on-call duties)
FYI...On call is common at places or can also be completely absent in others (depends who you work for)
LTC/HI can be great or really bad. Typically gets old really quick if you work for one of the big companies (i.e. Omnicare, NeighborCare (now owned by Omnicare), Apria, Pharmerica, etc). From a staffing perspective you can typically get in straight out of school and you typically do the same thing everyday w/o any variation (i.e. make about 10-15 TPNs, 20 Ancef, 20 Vanco, etc). Everything is in bulk as the population you provide for is off site so whatever orders the pharmacist processess tend to be repeats of the previous day. In short the staffing portion in LTC/HI is really boring (just my opinion so it depends what you like).
The interesting part of LTC/HI is in consulting where you go to nursing homes and/or assisted living facilities. If you are lucky enough to work for a smaller indpt company then the HI side gets more interesting as you may make home visits and become more involved in individualizing the care. Example see Espirit Homecare in Virginia (http://www.esprithomecare.com/home.html). However this is kind of rare as just like in retail the big companies (i.e Omnicare) are buying out all of the independents. So when working for the "big company" you as a consultant are typically expected to do drug regimen reviews on ~100charts/day (8hrs/day = ~12 charts/hr = ~1chart/5min) and are rarely involved in the day-to-day care of the pt as you typically only have time to go to review the chart 1-2 times per month. Not a lot of time for much else??
Secondly since eveything is detached the clinical stuff in LTC/HI tends to get there last as you are typically on your own so you don't have other people (like in retail/hospital) to bounce other clinical ideas off of and/or share information nor do you have a lot of room to grow (i.e. develop additional clinical services). The other side of the coin is that you have a fair amount of flexibility w/ scheduling as long as you get the work done, but some companies have shifted to a more strict regimen of requiring you to be at the facility for the day by a certain time (typically 9am so still not that bad).
Other potential con's are that the consulting portion is typically driven by incentives (i.e. therapeutic interchanges) that switch from one drug to another b/c the other is currently cheaper. This common practice in managed care settings and in Veterans Affairs settings, but in consulting some companies actually track your number of conversions (i.e. enalapril to lisinopril) and consider it in reviews during monthly meetings and/or during your next evaluation (this just depends on the company and the opinion of management).
Benefits (i.e. healthcare, vacation, sick leave) are ok, but typically don't compare well to hospitals. As from a historical perspective you have to understand the history of long term care/home infusion. It was started by retail pharmacists who recognized NH as a potential profit source so in many ways LTC/HI resembles retail in regards to benefits (i.e. making you wait until after probation (3-4 months) to start receiving healthcare and or only starting out w/ 2wks of vacations and maybe only 5 days of vacation w/ no annual accrual so you don't get 3 wks of vacation until after a number of yrs of service (~5yrs or more) which sucks. Most hospitals you have a max on sick leave which you use or loose each yr or it goes into an extended leave bank for when you have a baby or get real sick (i.e. a stroke and don't want to do into disability (since that doesn't pay you your full salary (typically just 60%)). Most hospitals also have an accrual process where your vacation accrues annual (typically starts at 2wks, but often accrues to 3wks after 1st yr depending on how much vacation you take) to some max number based on yrs of service and then any extra time w/i that yr is either pd out annually, lost, or sent to an extended leave pathway.
Pay is variable w/ most paying on the lower end of the normal scale (i.e. 80-95k, w/ alot still in the 80s) whereas avg hospital/retail is typically paying 90-110k). Once again these estimates may vary w/ geographic location, but LTC/HI pharmacists are very rarely the highest pd in the area and are typically below the median. Depending on the area NeighborCare is typically fairly aggressive in maintaining a competitive pay w/ other sectors in pharmacy. Why is the pay typically lower?...b/c most of demand is in retail so retail has to pay highest to meet the demand and secondly the person w/ clinical/residency training is rarely going to do to LTC/HI unless they are really into consulting.
LTC/HI has its pro's and con's, but you should also check out American Society of Consultant Pharmacists for more comprehensive info (www.ascp.com). You can probably get straight into LTC/HI straight out of school. Most of the consulting jobs however are typically reserved for those that have previous hospital experience, but there are always exceptions.
