Well don't that beat all...

Its my last day at Kerr Drug. I have been unhappy with the rotation most of the month, until about 3 days ago. We went to another store in Weaverville and I actually got to see patients! It was great. They came to their appointments, they actually talked and asked questions and I was able to help them understand.

I had the opportunity to teach them why its best to take their statin at night (when you're body is making its own cholesterol) and why its best to separate their calcium plus D from their thyroid medication (so both will be absorbed properly). We even gave out a few shots. I had one fella that is bipolar and has finally found a medication that works for him. The only problem is its so expensive he'll land in the doughnut hole in about June, but we're going to work on that.

Yesterday we had some folks come by for Shingles vaccines and we reviewed their medications with them as well. One lady was diagnosed with diabetes about 4 years ago and had never really been properly taught about the disease and all the damage it can cause in your body. My goal for today is to get her enrolled in the diabetes classes Anthony is starting.

Overall the rotation was not what I expected nor the best learning tool for me. But at least the last 3 days have shown me I am better at this than I think I am. I can talk to patients and they get what I'm saying and we all have smiles on our faces at the end of it. Whoo! Now on to March, only 2 more left to go!! :)

Residency Interviews

I know I haven't been talking much about this month. To be frank, I'm really not enjoying it. My personality and the personalities of my preceptors are just not getting along and I'm not getting the opportunities I thought I would get. So to avoid complaining all the time or being a super Negative Nancy, I'm just not talking about it.

On to more exciting things. This week I had my two interviews for residency programs. Last Wednesday was my interview at the Veterans Affairs Medical Center in Columbia SC. I didn't get to really get on the road Tuesday until about 6:30pm so I got to Columbia around 9pm, checked in to my hotel room and proceeded to freak out! Totally nervous and anxious all night, barely slept, hardly ate breakfast - bleh.

Once I got to the VA in the morning, I met the other candidate interviewing that day and we waited for the program director. We all talked about their program for a bit. They conduct the research portion of the residency a little different than most programs and I like that aspect. They also have a lot of flexibility in scheduling which seems like it will give me the oppotunities to do I want. Their scheduling, however, is in one month blocks, like my 4th year has been, not longitudinal like some other programs, which is not my favorite. I feel like I really connected well with the pharmacists and they really like to retain their residents after their residency year.

This weekend, Thomas and I went to Richmond VA. We both had interviews at the VA there on Monday. We arrived Saturday evening and a SUPER run down hotel. The windows were boarded up and it didn't look like people had been there in months so we ditched it and found something better. Sunday we drove around town. We found a Krispy Kreme and got fresh doughnuts and then found our way to the VA, the restuarant we were going to for dinner, and we drove around downtown.

Sunday night we went to dinner with a couple of the clinical pharmacists in The Fan District of Richmond, clost to VCU. Dinner was a BLAST! The pharmacists we were with were very entertaining and kept us laughing all night. On Monday, we took a tour of the Medical Center and then spent a couple hours with the program director in their clinic as they saw patients. I felt like the interview questions were a little tougher there at Richmond, but I absolutely LOVED the program and the people. Its mine and Thomas's top choice for next year. We'll find out on St. Patrick's Day.

On a side note:

Mom, here's a picture of the MAHEC house after the last snow

And below are pictures of the lilies Thomas sent me for Valentine's Day. Big smiles! :)

Clinical Community Pharmacy

This month I am at Kerr Drug here in Asheville. I am on my Advance Community rotation, which for most people is just another retail experience counting to 30 and all that jazz. Not for me. I am doing Clinical Community which to me is really a lot more like ambulatory care.

The pharmacists I am working with this month, Anthony and J.J., are there to do more than fill prescriptions. They spend the day doing medication reviews in multiple fashions. Patients that have Medicaid get "locked in" to a pharmacy when they get more than 11 prescriptions filled in one month. Once these patients are locked in, a pharmacist has to review all their medications every 3 months. Also. Medicare patients qualify to meet with a pharmacist once a year face to face to review all their medications. Anthony and J.J. also see City of Asheville and Mission Hospitals employees on a semi-annual basis to review their diseases states and medications as part of employee sponsored Wellness Programs.

After reviewing medications and disease management with the patients, we also contact the doctors. We fax them a note of what we talked about and make any recommendations we see. Usually we are trying to find cost savings alternatives for medications to reduce spending on the part of the patient and reduce healthcare dollars. And shots! LOTS of shots. Today, alone, we gave 9 Shingles vaccines, 6 H1N1, and 2 seasonal flu vaccines.

And there's follow up and billing. We also call the patients a few days or a week or so after our meeting or after their doctor has made changes to their medications to check up on them. We see how they're doing, how they like their medications, and have a way to hold them accountable to the goals they set with us for managing their disease. The best part is we can bill for these services. It has been a challenge for community pharmacists to show they know more than how to check pills and that they can make a difference in the lives of their patients. The federal government has acknowledged, to some degree anyways, that these are valuable services provided by pharmacists and they should be reimbursed for their time. Pharmacists know a lot more than they get credit for a lot of times, so remember to ask your friendly neighborhood pharmacist for help and advice next time you have a question about your health.