Question for Pharmacists Working in a hospital after completing a residency

[ladybug19]

Hi Everyone,

I was wondering if anyone can comment on their personal experiences of working in a hospital setting. Do medical doctors actually include the pharmacists in their decision making? If so, to what extend do the pharmacist with residency experience get to contribute? thx.

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[Priapism321]

Hi Everyone,

I was wondering if anyone can comment on their personal experiences of working in a hospital setting. Do medical doctors actually include the pharmacists in their decision making? If so, to what extend do the pharmacist with residency experience get to contribute? thx.

I currently work in a world renowned hospital (actually rated #1 in its field most years), and almost all pharmacists with residency training (mostly two years) have nearly unrestricted prescribing privileges (including CIII-V). Orders from us require no co-signature, no pre-authorization from a physician, no nothing. Our "team" that rounds consists of an Attending, a Pharmacy Clinical Specialist, a PA/NP, +/- a Fellow.

Just to give you a solid "example," this guy seems to have a substantial impact on patient care/medical decision making (different field than described above of course):

http://www.opa.medicine.arizona.edu/news/feb08/erstad.htm

Not sure as to why you are asking the question, which is why this response is fairly vague.

 

[ladybug19]

Thanks for your feedback. Having heard so many stories about physicians undermining other medical professions, I was just trying to understand the environment and the amount of team work between different medical professions in a hospital setting.

 

[Priapism321]

Thanks for your feedback. Having heard so many stories about physicians undermining other medical professions, I was just trying to understand the environment and the amount of team work between different medical professions in a hospital setting.

I will be honest, it certainly depends on the institution and the individual physician when it comes to questions like this. I currently work in a fairly unique environment, but in most major academic medical centers (where you would expect a true "team" concept, where I also happen to believe the best care takes place), senior clinical pharmacists have substantial credibility with the medical and nursing staff. This is all just my opinion, of course.

On a more global level, if you really would like to know what influence a pharmacist can have on decision making, note the lead author of the guidelines on sedation in intensive care units (http://www.sccm.org/professional_resources/guidelines/table_of_contents/Documents/Sedatives.pdf); this is where most clinicians go to seek a foundation for their clinical practice. Although you are just listed as pre-medical, you may know how important and influential the New England Journal of Medicine is when it comes to decision making; this was their most recent review article on how to mange acute lymphoblastic leukemia (http://content.nejm.org/cgi/content/extract/354/2/166).

 

[pharmdjl]

May I ask what hospital you work at, Priapism321?