Find what drives you
Alison R. Knutson, PharmD, BCACP, is a Medication Therapy Management Pharmacist and Family Medicine Residency Faculty at Park Nicollet Creekside Family Medicine Clinic in St. Louis Park, MN.
Lynette is a 68-year-old female, seeing me in the family medicine clinic for follow-up care of her diabetes and heart failure medications. Today she is struggling with itchy eyes from her seasonal allergies, which are made worse by spending most nights at the park watching her two grandsons play baseball. Since our last visit 3 months ago, when Lynette and I discussed diabetes medication options and decided together to start a once-weekly GLP-1 agonist, her A1C has decreased from 8.4% to 7.1% and she has lost 8 pounds. In my role as a board-certified ambulatory care pharmacist in a family medicine clinic, I recognize that Lynette is similar to so many patients I see on a regular basis.
During our visits, I learn both her medical and personal histories, like the names and hobbies of her grandsons. Lynette trusts me as a valued member of her care team and relies on my medication education and expertise in order to feel confident in managing her medications. Her primary care physician considers me an integral part of her team, and I work closely with all other team members—registered nurse care coordinator, social work, and clinic staff—to provide the most compassionate and comprehensive care possible. Our care team consists of many individuals working in concert to ensure the patient stays at the center of all that we do.
The health system in which I work has ambulatory care pharmacists fully integrated in a majority of its primary care clinics to provide comprehensive medication management. We take responsibility for the medication outcomes of our patients, evaluating each medication at each encounter for indication, efficacy, safety, and adherence. We sit side-by-side with our prescribers in the clinic, we see our patients in the same exam rooms where those patients see their physician, and we represent our expertise on committees that make organization-wide decisions.
Pharmacists' value on display
During my first year of pharmacy school, I remember a professor stating something along the lines that medicine has become too complex for one care provider to manage it all. One key aspect to success in ambulatory care has been full integration, allowing all team members and patients to see the value pharmacists provide.
Another key aspect to our success is access. The pharmacists use the same electronic health record as our primary care and specialty clinicians. The electronic health record provides the pharmacist with full access to patient medical information, but also serves as a crucial communication tool for all care team members. We continue to have an increase in payers that reimburse for comprehensive medication management services, which continues to expand the pool of patients we can serve. The drive to obtain provider status for pharmacists will expand coverage for patients, further increasing patient access to comprehensive pharmacist clinical services.
Relationships and communication drive me
In addition to direct patient care, I spend a large amount of my time providing medication education to training family medicine physicians. In full disclosure, I have a slight ulterior motive that these future physicians will enter the workforce seeking a pharmacist on their care team. Not only will they be skilled prescribers optimally managing chronic disease, but they will also learn that other care team members, especially pharmacists, are vital to provide optimal patient care. To that end, I have some professional tips to help guide you along your career path, based on my own experiences as a faculty pharmacist and associate program director for a family medicine residency training clinic.
Relationships and communication are my drive. I thrive on interactions with care team members, clinicians, and, most importantly, patients. Identifying the source of satisfaction in my work led me to my current role working in a family medicine ambulatory care clinic. Pro Tip 1: Choose a role that you want and that gives you joy, not one that you feel you are “supposed” to do. I have considered work opportunities that engage my skillset, but realize that I thrive on relationships with colleagues and patients, so I ensure this is part of my daily work.
Pro Tip 2: If possible, choose your final year rotations wisely. Ambulatory care was the top of my list for my future practice, but I had interests in inpatient psychiatry and pediatrics as well, so I arranged to have significant exposure to those areas. Ultimately, exposure to those areas further defined my interest to pursue ambulatory care. As I have been in my practice, I have realized that exposure to some of those specialty areas on rotations provided me a great clinical education that I can regularly apply to my patients’ care today.
Pursue passions outside of pharmacy
Pro Tip 3: Work isn’t life; work is a part of life. Find things you can enjoy that do not involve pharmacokinetics and medication fill history. Cooking is a very therapeutic activity for me, maybe because sometimes it reminds me of chemistry lab. Running while listening to an audiobook places me in a different world. Playing a board game with my 6- and 8-year-old children gives me joy and laughter. Finding fulfilling, joyful interests outside of pharmacy will ultimately make you a significantly better pharmacist.
Seek out unique opportunities you might not think you will like. Meet all the people you can. Pharmacy continues to change at a rapid pace, but find your passion and what drives you, and you will be an impactful pharmacist no matter where that change leads.