What is a clinical pharmacist?

[Monsterdaddy]

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Hi folks, I am potentially engaged in a debate about the definition of a clinical pharmacist. One side is arguing that any pharmacist who receives clinical training is a clinical pharmacist which today means any PharmD graduate.

I think that definition is overboard and that clinical training does not equal clinical pharmacist. I looked up ACCP's definition of Clinical Pharmacist and the relevant parts of the unabridged version from 2005 is like this:

Clinical pharmacists care for patients in all health care settings.

At first I was thinking that is a very broad definition. But later on I think I see a clarification:

Accordingly, clinical pharmacists assume responsibility and accountability for managing medication therapy in direct patient care settings, whether practicing independently or in consultation/collaboration with other health care professionals.

IMHO, I think the key point is "direct patient care settings." I don't consider Walgreens and CVS to be direct patient care settings. Or is the key point patient vs. customer?

I have another question. Do you think clinical pharmacists are generally represented by ASHP? i.e. they are ASHP's target audience? And if so, then ASHP's focus on pharmacists who work in hospitals, HMO's, LTC's, and home care provide another definition of who is a clinical pharmacist? I know ASHP does not use the term clinical pharmacist but in your opinion are these settings what comes to your mind when you think of clinical pharmacist?

Thanks for all your opinions!

 

[steveysmith54]

one that does MTM 🙂

 

[Lubeckd]

I agree with your definition. My hospital told me not to join ASHP or clinicial pharmacy until my skills are good. Im just starting professional phase 1. However! in home infusion you dont need residency! and that is a direct patent care setting! 🙂

 

[xiphoid2010]

Hi folks, I am potentially engaged in a debate about the definition of a clinical pharmacist.

What's in a name.... well, a lot of it is what the management people decide.

Some hospital calls all pharmacists "clinical pharmacist". Other have tiers of staff, clinical pharm, clinical specialists. It really just what the management decide to go with.

 

[Monsterdaddy]

Thanks for the replies. I understand where your opinions come from.

I do think the title matters. A clinical pharmacist implies a setting and method of practice. Staff pharmacist, pharmacy manager indicates position within a hierarchy and doesn't mean you aren't a clinical pharmacist.

Would you consider the pharmacist at Walgreens and CVS a clinical pharmacist assuming they are all PharmD's? Assume they do MTM? If so, why?

Take it a step further, a pharmacist who switched jobs from a hospital to CVS, would you call their current occupation "clinical pharmacist?"

As an aside, I don't think residency is needed to be considered a clinical pharmacist. Now ASHP includes home care pharmacist in their mission statement so I think associating clinical pharmacist with direct patient care setting is still valid.

 

[Don Quichotte]

I think this word clinical gets thrown around a lot, so definitions aside and ignoring the turf war between different associations etc...
No matter what setting you are in you are a better pharmacist and better for your patients if you always are thinking clinically. and yes, that includes retail. I mean discharge counseling is treated as clinical domain at some hospitals but really, in principle how is it much different than what happens in retail when the pharmacist counsels a patient? And how can you argue that it is not direct patient care to be interacting with patients all day versus just looking at charts---which is what a lot of clinical pharmacists at hospital do.

 

[pharm B]

I agree with your definition. My hospital told me not to join ASHP or clinicial pharmacy until my skills are good. Im just starting professional phase 1. However! in home infusion you dont need residency! and that is a direct patent care setting! 🙂

Why would you not join now? I'm a member of our SSHP chapter, and I feel I've benefited from it greatly. You get to talk to people in clinical positions and elsewhere and start networking. In Texas, we even have a mentor program where you get paired up with a practicing pharmacist to stay in contact with during the year.

 

[Sparda29]

IMO, the true definition is just a separation between pharmacists who dispense and pharmacists who don't dispense. The latter are who are called "clinical pharmacists".

Now, dispensing pharmacists use clinical skills also, but not to the same degree as a pharmacist who is always on the hospital floor or in the ambulatory care clinic.

 

[owlegrad]

I just wanted to agree with the sentiment above that said, how is interacting with patients all day less clinical than reading a chart? Retail is by far the most direct patient interaction a pharmacist can have.

I also agree with Sparda - in practice non-dispensing pharmacists that work in a hospital are usually what people mean by clinical.

 

[Lubeckd]

I just wanted to agree with the sentiment above that said, how is interacting with patients all day less clinical than reading a chart? Retail is by far the most direct patient interaction a pharmacist can have.

I also agree with Sparda - in practice non-dispensing pharmacists that work in a hospital are usually what people mean by clinical.

It depends, I just got assigned homework on this topic, and finished it today for my healthcare course.

retail is kind of still trapped in the "count and pour era" because the big companies want to make money, immunization has to be sold like mcdonald "Do you want a large fries + soda with that?"

Consulting happens rarely because it's all about the scripts... even in outpatient hospital pharmacy the patient complains and wants their medication since they have work. Consulting takes time, and that is money. My supervisor dislikes the pharmacist consulting the patient unless the patient askes for it, he wants them on the computer typing scripts and verifying them.

 

[Lubeckd]

Why would you not join now? I'm a member of our SSHP chapter, and I feel I've benefited from it greatly. You get to talk to people in clinical positions and elsewhere and start networking. In Texas, we even have a mentor program where you get paired up with a practicing pharmacist to stay in contact with during the year.

Sorry for the double post, I joined APHA because they said they will help me find my "Niche"... I kind of regret it now. Im not even sure I want to work in the hospital even though I volunteered there for a year.

 

[Monsterdaddy]

Are the folks at CVS and Walgreens patients or customers? At hospital inpatient setting there is absolutely no doubt they are patients. At CVS, a friend who picks up a person's meds, that friend is just a customer without doubt. That isn't direct patient care interaction and I think it's a stretch that most of my retail customers feel they are in a direct patient care setting.

(I'd like to hear opinions about the ACCP definition of a clinical pharmacist.)

I absolutely agree that pharmacist should apply their clinical pharmacy skills in whatever setting they are in. But IMHO, that does not mean you are a clinical pharmacist.

Why do I feel it is important? I think it's the same as saying you are either a paramedic or fireman, both are public servants who respond to emergency situations, but scope and setting are different. Blurring the line for pharmacists sounds sexy but it isn't helpful and potentially confusing to patients and customers.

 

[Monsterdaddy]

IMO, the true definition is just a separation between pharmacists who dispense and pharmacists who don't dispense. The latter are who are called "clinical pharmacists".

Now, dispensing pharmacists use clinical skills also, but not to the same degree as a pharmacist who is always on the hospital floor or in the ambulatory care clinic.

I think that definition has issues though. Mail order pharmacists don't dispense and I don't think any one would ever consider them a clinical pharmacist.

 

[Don Quichotte]

patients and customers will often find themselves confused, but it could be due to stupidity.

 

[owlegrad]

Blurring the line for pharmacists sounds sexy but it isn't helpful and potentially confusing to patients and customers.

I doubt most patient/customers care if the pharmacist calls themself "clinical". Don't see how we could possibly confuse them, except by trying to explain it to them.

I think that definition has issues though. Mail order pharmacists don't dispense and I don't think any one would ever consider them a clinical pharmacist.

What do they do, if not dispense? That is all they do. 😕

 

[PharmaTope]

the word CLINICAL is used to apply to pharmacist the way

PROFESSIONAL DANCER is used to apply to strippers

you will see places call staffing "clinical pharmacy". it is a stretch from the way you are taught it is in school.

 

[nplx]

I have a question about LTC pharmacies. Would you guys consider working in a closed door LTC pharmacy( like omnicare, pharmerica..etc) as a clinical practice?? I have never worked in that kind of environment and am wondering if I work in that kind of environment for a while , would this be helpful to land a hospital job in the future??

Thanks

 

[flip33]

What's in a name.... well, a lot of it is what the management people decide.

Some hospital calls all pharmacists "clinical pharmacist". Other have tiers of staff, clinical pharm, clinical specialists. It really just what the management decide to go with.

This is the way it is.

But as the benevolent dictator of a small country, I have determined that a real clinical pharmacist is qualified to sit for board certification:

Completion of three years of practice experience with at least 50% of time spent in pharmacotherapy activities OR completion of a PGY1 residency.

 

[xiphoid2010]

This is the way it is.

But as the benevolent dictator of a small country, I have determined that a real clinical pharmacist is qualified to sit for board certification:

Completion of three years of practice experience with at least 50% of time spent in pharmacotherapy activities OR completion of a PGY1 residency.

No argument here. I would go with the same thing if I had the power to pick titles.

 

[BadgerFan]

Try this