Featured Career: Pharmacist

Here are the last five careers I’ve featured and you can find ALL my career features HERE! If you are interested in being featured please don’t hesitate to contact me!

• Medical Secretary
• Scientist
• Speech Language Pathologist
• Music Therapist
• History Professor

Today I’m featuring Grace from How I Complicated My Life Today. Grace is a pharmacist!

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What is your official job title and what exactly does your job entail?

Most pharmacists go by “RPh” (registered pharmacist) or “PharmD” (which entails the doctor of pharmacy degree) behind their names. Because I have additional responsibilities in my company, my actual job title is Market HIV Pharmacist. There are broadly three types of pharmacists: those who work in hospitals, those who work in retail dispensing settings, and those who work in clinical settings. Clinical pharmacists may have an advisory role and work with a multidisciplinary healthcare team in a hospital or clinic; often clinical pharmacists teach in universities as well. Most clinical pharmacists have obtained a one or two year residency in their specialty in addition to their degree.

Clinical pharmacists are relatively rare. The other two jobs – hospital and retail – are more common, but they differ greatly. Hospital pharmacists input orders to be given to patients in the hospital, including IV medications, TPNs (total parenteral nutrition – used to “feed” a person intravenously when the gut cannot be used), tablets and capsules, and fluids like saline solution to keep a patient’s fluid status in balance. They also make sterile IVs and chemotherapy and may start IV pumps, fill automated medication machines, and give drug assistance during surgery or for a Code Blue. Retail pharmacists spend much more time with the patient. They type and fill prescriptions, counsel patients, recommend OTC products, compound drugs and topical preparations, and answer many, many questions from patients and healthcare providers alike. Pharmacists are branching out into other roles, too, so now you will often see them taking blood pressure, giving immunizations, or fitting patients for compression stockings. In the USA, pharmacists are also insurance experts – and sadly, retail pharmacists spend hours a day on the phone with ornery insurance plans!

I have worked in both hospital and retail, but my current position in a mix of both, with a dash of clinical thrown in. I manage a retail pharmacy located within a hospital. Because of our location, we deal with a lot of specialty medications like oral chemotherapy and serious disease states like pulmonary hypertension. We fill plenty of regular prescriptions, of course, but much of my time I am counseling patients being discharged after a heart attack or those who are about to start a complex hepatitis C regimen. In addition to managing my pharmacy, I am also my company’s market HIV pharmacist. My area stretches from Florida to Texas, but our HIV stores are located only in HIV hot spots, so I am a clinical and third-party expert for 24 stores in two states. This means that I get calls about tough problems – for example, last week one of my stores had an HIV positive pregnant woman who was resistant to the first-line drugs used on pregnancy. They called me for my recommendation for her doctor so we could choose drugs that were safe for her baby and would control her HIV virus.

How did you get into your field of work?

I went to college on an art scholarship and chose to major in graphic design. Most student jobs at the school paid minimum wage, so to make a little more spending money I got a job as a pharmacy technician. I was comfortable in a pharmacy, because I had worked at an old-time pharmacy soda fountain in high school, and I knew that technicians made better pay than many other jobs. In my state, technicians have to pass a credentialing exam and maintain continuing education requirements in order to assist pharmacists. I passed the exam, and I ended up enjoying my job so much, that after a year and a half I changed my major to pre-pharmacy. I was lucky enough to get accepted to several pharmacy schools, and because I had a background as a tech, the transition to pharmacist was easy.

You said that pharmacy is really different in Canada and the US. Can you explain how it differs?

The main difference is licensure – while in Canada, pharmacists need a five-year bachelor’s degree, in the US schools have converted to the Pharm D. That means all pharmacists must obtain a doctorate, and school includes a full year of internships – as opposed to the three to four months required in Canada. However, Canadian pharmacists may earn a Pharm D after their bachelor’s; I am unaware of any Canadian colleges offer the Pharm D as an entry-level degree. Most pharmacists in the US graduating now have between 7 and 8 years of college and may or may not have some post-graduate work. Although a bachelor’s degree isn’t required for most pharmacy schools, many students feel they are better candidates if they have the degree. But despite this extra schooling, pharmacists in the US may actually have a narrower scope of practice than Canadian pharmacists do! It all depends on the state in which you work.

I assume there is also less work involving insurance claims in Canada – only because the healthcare system is more streamlined. Some days I feel like I spend more time dealing with insurance companies than patients!

Describe a typical day in your work life?

I am one of the rare pharmacists with sort of normal work hours. I open my pharmacy at 9:00, so I’m usually there by 8:50 or so to check voicemails and get my reports started. Since I’m the store manager, I spend the first hour doing my cash reports, bank deposits, and other paperwork. After that, I sometimes do up to the hospital floors to visit patients who are being discharged soon. They have the option to have their prescriptions delivered to their bedside before they leave, so I like to meet them and talk about drug interactions and allergies before they’re ready to go home. If I have any meetings, they are usually scheduled late morning. I sit on a few committees in the hospital, even though I am not actually a hospital employee, to give the pharmacy perspective. keep in mind that while I am dashing around the hospital I have to keep popping back into my pharmacy! I still have prescriptions to fill! Luckily, we are not a busy store – since we just opened last April, we fill less than 100 rx’s a day on average. This lets me do more of the clinical work I do. I usually eat at the counter since pharmacists don’t get lunch breaks, but I’m one of the few pharmacists who even has time to eat, so I’m ok with that.

In the afternoon, clinic appointments wrap up, so we get an influx of patients leaving the clinics with new therapy. I have a partnership with the gastroenterology clinic that requires I counsel all of their hepatitis C patients upon starting treatment. The drugs that can cure hep C are very hard on the body and have extreme side effects, so counseling a new patient can take an hour and a half. During the afternoon, discharges start as well, and my technician does a lot of running up and down stairs to pick up prescriptions and deliver drugs. By the time she leaves at 5:00 pm, my day is winding down. I spend the last hour placing orders for drugs we’ll need the next day and counting the cash. I close at 6 pm, but I often have to stop at another pharmacy on the way home to pick up a drug I need to borrow that I couldn’t order. It’s a long day but it’s fulfilling work!

What’s your least favourite thing about your job? What is your favourite thing about your job?

My least favorite part is getting yelled at by patients who are angry with me when they should be angry with their doctor or insurance! For example, if the doctor prescribes a drug and forgets to write the strength, I get scolded for the delay caused when I have to call the prescriber and get the information. My favorite part is counseling new HIV or Hepatitis C patients. These conditions require a lot of counseling and input, and I like to see results when my patients listen and learn.

What is something about your job that surprises people?

You may not realize it, but pharmacists might as well be law enforcement! In this age of rampant prescription drug abuse, we put ourselves at risk to prevent drug diversion. In the USA, pharmacists have what is called “corresponding liability”, which means we and the prescriber are equally responsible for safe drug use. That means that many times I have to refuse to fill a prescription that I believe will be abused, sold on the street, or both. Drug abuse is an enormous problem, and I deal with these situations over a dozen times a day.

If you could describe your career in one word, what would that word be?

Fun. I mean it. Many pharmacists get overwhelmed by the stress of the fast-paced, high-stakes job, but any job is only as fun as you make it. Sometimes I start a goofy-faxes war with the nurses in your hospital or the pharmacy across the street or prank call other pharmacists I know (usually asking a really embarrassing health question or playing angry patient). I like to enjoy my time at work!

Anything else you’d like to add?

For those considering a career in pharmacy, it’s time to look outside the box. Healthcare costs are forcing more and more tasks onto auxiliary health care workers – tasks that doctors used to do. While their is currently an oversupply of pharmacists in the US, future changes in healthcare policy could change all that. But pharmacists will have to be willing to do more health screenings and primary care and less typing and counting.

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As someone who goes to the pharmacy fairly often I found this career really interesting to read about! How about you guys?

How often do you go to the pharmacy?