Opening a pharmacist-lead clinic.

[themorphinerule]

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So, with the market the way it is.. I predict that the retail bubble will burst. All of my clinical specialist preceptors keep encouraging me to do a residency because they swear I'm just so brilliant (kidding). But I did retain a LOT of what I learned and I know how to use it creatively. I'm still up in the air about what I want to do. I'm not the average whiny pharmacy student, I'm a former Army Vet, so I know how to hustle when needed.

NC has become very progressive with pharmacy and allows many freedoms for pharmacist. After practicing and working with an MD's practice for a while you can actually apply to become a Clinical Pharmacist Practitioner (CPP) which is equivalent to a PA or NP (aka a mid-level practitioner). Yes, you get prescribing privileges, but obviously you have to maintain that relationship with the MD's practice because they are the supervising MD. I know pharmacists are used to having a good solid thing/job, but does anyone desire to work hard and open your own ambulatory care practice? I noticed medicine attracts a certain type of personality (type A's) and so does pharmacy (type W's - aka whiners lol).

Is anyone else interested in doing ambulatory care and working with an MD's office to extend their practice? (Notice I said "extend" because a lot of MD's are territorial). Maybe manage DM or HIV patients? I mean, we are taught to do that kind of stuff. But I have noticed that working with the MD's here at the hospital, I get the okay to write more orders that my preceptor can sign. So I'm hoping that PharmD's are welcome by medicine on the outside as well. Does anyone have this sort of practice? Also, I would be very interested in collaborating with anyone who is interested, so feel free to say hello.

 

[npage148]

who's going to pay you? Will your work be reimbursable by insurance companies?

 

[womp]

writing orders seems different from diagnosing

 

[SomeGuy]

Good Stuff

"Maybe manage DM or HIV patients?"
or: HTN, Dyslipidemias, warfarin dosing?

Or how about getting a generic prescription for "triptans", and then you can work with the patient/client to figure out which one works best for them?

I've thought about it, but where I am, the reimbursement issue is even worse (I think).

I think DM would be huge, since, at least around here, it's way undermanaged. Practitioners seem too afraid to start people on insulin without referring it out.

It's probably key to get chummy with an MD, and go from there.

 

[psychoandy]

Without knowing a damn thing about AmCare, the first thing that comes to mind is money and MDs. I'm not in a location where RPh's can write, but we have a couple amcare clinics; most are integrated with a larger heath care entity, such as anything with the VA, hospital outpt coumadin clinic, community health centers for indigent population, or managed care pharmacy.

To start one on your own, even with a decent sized MD practice, seems difficult because you're presumably going to be asking for 100k salary + office/desk space and other crap. Additionally, you have to attach a monetary value to your services; a lot of pharmacy school propoganda BS was about the cost savings due to the lower side effects from RPh management. However most people who would be willing to fund such things only care about how much medicaid/medicare/3rd party money they can get their hands on.

Not only that, but you'd have to get enough experience working as a pharmacist first, then finding cool MDs that don't follow AMA dogma of hating any type of midlevel provider, and then getting a legit office like on House, MD. Unfortunately, starting a practice is way harder than joining an already established one.

Finally, little things, I already think retail has burst due to a lot of ppl i know doing floating, nights, or both with CVS 1 year after graduating. Also, if your goal is to straight up make bank, I think independent retail is the best way; not that you can't make hella benjamins in AmCare, but figuring out how to bill for insurance money is the biggest hurdle IMO.