Topics
Page Two
Masthead
|
Topics |
Page Two |
Masthead |
|
|
| ||
| ||
What Happens When a Clinical Pharmacist Leaves the Clinic (or the Hospital)? By Bennett Bain As pharmacy students receiving our education at UCSF, the birthplace of clinical pharmacy, we hear countless stories describing the joys of working on a multidisciplinary team in the hospital or clinic. There are an endless opportunities for patient interaction, an endless number of occasions that necessitate medication counseling, and infinite chances to save lives, or at the very least have a positive impact on the development and implementation of a treatment plan. It is this patient interaction that many clinical pharmacists thrive on. It is this desire for patient interaction that brought most of us to UCSF. But what happens when a clinical pharmacist is removed from direct patient care? What happens when a clinical pharmacist leaves the clinic? Well if you use Dr. Del Buono as a prototype, you’ll see an extremely bright and happy future. As part of the RAMPS project, I was able to shadow Cindy Del Buono, Pharm D, and explore an unconventional opportunity available to oncology clinical pharmacists. Dr. Del Buono’s position is unique in that she is a clinical pharmacist yet does not work inside a clinic or hospital, but in a collaborative office setting where she interacts daily with a team of clinical health care providers. In contrast to hospital clinical pharmacist, she has the benefit of a flexible four day per week schedule that occasionally allows her to work from home or on the go. By no means does this indicate that her job is easier, less grueling or less fulfilling – Dr. del Buono is simply a master of efficiency. Her strong work ethic and leadership qualities make her an asset to the pharmaceutical community. So what are the responsibilities of a clinical pharmacist outside of the hospital? As we all know, a setting like oncology involves therapies that are often drug intensive, medicines that are highly toxic and in dire need for education and patient compliance. Then consider a small, private oncology practice consisting of a handful of providers that can’t afford the luxuries of a P&T committee or a clinical pharmacist. Facilities like this are lacking an integral member of the health care team – the drug expert. Dr. Del Buono’s job is to provide these community based oncology practices with the knowledge & advice of a clinical pharmacist in situations where they can not afford to staff a clinical team in house. Unlike hospital practice, her job is not to deal directly with individual patients, but to have a greater scope of impact that will inevitably affect thousands of patients. One of Dr. Del Buono’s major contributions to oncology is the development of guidelines to serve as a framework for different types of cancers. She analyzes the literature, clinical trials and cutting edge therapeutics to stay on top of recent advances. Then she works intensively with other clinical pharmacists, nurses, physicians and the foremost experts in the nation to develop a comprehensive framework for diagnoses, treatment and management of different cancers. And these guidelines are extremely extensive and comprehensive! They include stage dependent protocols for diagnostic workup, risk reduction intervention, flow charts of treatment regimens, steps to ensure appropriate monitoring and follow up of the chosen treatment, recommendations for dosing, and supportive care resources. Not to mention handbooks on managing the nausea, vomiting and pain that are so prevalent in patients undergoing treatment and progression of terminal illness. As if this weren’t enough, she also spends her time developing patient friendly education materials describing in laymen’s terms these complex diseases while highlighting patient counseling points for drug therapy. The work of Dr. Del Buono and her colleagues affords providers with a consolidated yet all inclusive, up to date, scientific evidence based, quality driven comparison of multiple therapeutic regimens. And it is all done without setting foot in a hospital or clinic, without entering an exam room, but rather within a beautiful sunny office in San Rafael. So there it is in a nutshell, a clinical pharmacy job that takes place in an office setting and lacks direct patient care. No longer are pharmacists limited to the 20 or so patients they could possibly meet with or round on in a single day. In exchange for the lack of direct patient care, the pharmacist gains the opportunity to positively impact the quality of care of hundreds of patients in a single day. Bennett Bain is a second-year pharmacy student.
| ||
Synapse is part of the Office of Student Life and Student Academic Affairs. | ||