The final two
“36-year-old female, 27 weeks pregnant with multi-drug resistant tuberculosis. Resistant to isoniazid, ethionamide, pyrazinamide and rifampin. What can we administer? Additionally, she is an undocumented immigrant with no insurance coverage.
“Yes, the diagnosis code. We cannot bill to Medicare Part B without the diagnosis code on the script.”
“The new shingles vaccine. Do you have it?”
“Only one dose of patiromer was given. The potassium didn’t lower fast enough, so we lost her.”
Caregiver. Problem solver. Advocate. Learner. Educator. Leader. Provider.
These are just a few of the many words used to describe the pharmacist. However, these words are not just words. Each pharmacist I have encountered these past 2 months has embodied these qualities and dedicated their daily doings to provide the highest level of patient care.
I intentionally chose to complete my hospital dispensing and community pharmacy rotation requirements towards the end of my journey to “hAPPEness.” I thought front-loading my critical care and emergency medicine rotations would give me a better idea of what I wanted to do after graduation, but little did I realize that these last two “required” rotations would be pivotal in reminding me of why I chose the field of pharmacy and exactly why I fell in love with pharmacy in the first place.
Being a pharmacist alone does not make you the medication expert. Being a pharmacist means you communicate well (with patients and other health professionals), you advocate for your patients, and you continue to search for improvements in systems (treatment approaches or technology advances) to improve health care for all. Whether a hospital staff pharmacist or community pharmacist, these individuals are constantly looking for ways to evolve a patient’s pharmacotherapy, not just clinically but also economically.
From the constant insurance issues, the latest backorder, or the skyrocketing price of a maintenance medication, my preceptors have shown great resilience and patience as they attempt to alleviate or resolve the growing burden of cost for patients. While handling the technical failures of the computer system, they always find the time to step aside and talk to their patients: “How is your daughter doing? How is the new hip treating you?” No wonder every time I pick up the phone and introduce myself at the community pharmacy, the patient’s first request is to find out which pharmacist is working and if they are available to speak instead. Baffled at first of why no one wanted to speak with me, I soon realized how powerful and trusting the relationship between a pharmacist and patient can truly be.
Educating each other
It is not just about the patients, though. It is also about my preceptor and me. A mutual symbiotic relationship has formed these past two rotations with preceptors looking to not only educate and mold me as a future pharmacist, but also be a lifelong learner and use my knowledge to expand theirs. “It is not a trick question, I really want to know,” my preceptor would respond every time a question that I actually knew the answer to was asked.
Being a student himself 37 years ago, my preceptor made it clear to me that there are things I know that he does not and might never, so he trusts me to educate him over the course of 5 weeks just as much as he intends to educate me.
Why I fell in love with pharmacy
Provider. Although not recognized as health care providers, are we not? Despite the lack of incentives or compensation to implement pharmacist patient service, do we not provide these services? Each time we counsel a patient on which tobacco cessation product would work well for them or sit down with them for 20 to 30 minutes to discuss their list of eleven, twelve plus medications, we are taking time away from our daily requirements in order to provide services with the intention of promoting safe medication use and helping them reach their treatment goals. Yet despite these demonstrations of public service by our pharmacists, we are not recognized, and that is why I fell in love with pharmacy.
Pharmacy is a young profession with many advancements yet to be made and many more patients to be treated. How many other health professional students have you met that have been actively engaged in the policy and advocacy realms of their profession as well as the clinical education? Not many. But being a student pharmacist and a future pharmacist has given us a voice and extra stretch of knowledge beyond the classroom and pharmacy settings, all the way to Capitol Hill. This is another reason why I fell in love with pharmacy and this is why I hope to remain actively involved with APhA no matter which career area I work in.
For our Preceptor Feedback author, I am wondering: what steps have you taken to align your involvement in APhA with your respective work environments and daily demands? How do you know which APhA Academies you fit into best moving forward? If I were to enter a path of pharmacy that does not necessarily involve direct patient care or pharmacist-provided services, how can I contribute to APhA’s mission? And finally, how have you been able to continually engage with legislators and policymakers to continue your advocacy for the profession?