Pharm.D./Physician Collaborations

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themorphinerule

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Hello all:

I am a graduating pharmacy student in NC. I'm interested in getting some feedback from practicing professionals, or graduating students/residents. So our pharmacy curriculum has vastly changed and a focus on patient care is not at the forefront. Many of the new schools of pharmacy's have didactic and rotations based on the medical model. I think we learn the same things (probably not as in depth) but we learn it from a drug treatment aspect, and so we have a different thought approach to solving problems.

I'm currently on an oncology rotation and previously a surgical rotation. As last year students we are taught to extend medical practice by thinking outside the box and making interventions. For instance, just the other day our clinical pharmacist specialist was asked to pre-counsel a patient undergoing chemotherapy. So after looking over the regimen, verifying dosages and calculations and recommending the addition of more or more appropriate anti-emetic drugs (based on the emetogenicity of the regimen) or pre-medication to prevent certain infusion related complications. The hospital encourages the pharmacist to identify any discrepancies and to work them out beforehand with the physician.

It seems to be a good model, it offers great patient care and it extends the practice. Our doc's here seem to love us. But as a graduating student I want to go into ambulatory care and manage diabetic and HIV patients. Does anyone know of or are currently in a practice that employs pharmacists to provide these services? Are they helpful? and what do you perceive are the benefits of having a drug expert on staff? I'm wondering how to approach existing practices and sell myself so to speak, so I'm trying to figure out how desirable is this model. Any helpful comments? :idea:

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Personally, I'm an advocate of the collaboration & think it would be of great value to patients. You're most valued in settings managing high risk medications with narrow windows. Like you mentioned, that will be chemo, HIV, but also coumadin & rheum drugs. Also valuable in diabetes b/c of amount of counseling involved but if you can learn insulin & pump management, it'll help a lot. Obviously a practice with high geri population with polypharmacy would be helpful.

In my opinion, you'll find practices employ more & more non-physicians because of the patient centered medical home & health reform. It'll take off in large practices or academic practices once they figure out how to pay for your services. You might also be utilized for quality improvement projects at larger practices focused on reducing liability & generating cost savings. There're lots of ways the collaboration can go.

If you're looking for a job, start by calling up places designated as PCMH's. You can find a list on NCQA's website.
 
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