Confessions of a counter-dealer, part 4: Be proactive!

Much has been written recently about the exponential growth in new pharmacy schools and accompanying concerns about a possible glut in the supply of pharmacists. Given all the pharmacists out there, will I have a job in the future?

It's easy to complain about our professional circumstances or career potential. It's another thing to take steps to address or to change a situation. Competition is good. It keeps us on our toes. It can also lead to opportunities.

Fifteen years ago, the progressive community hospital mentioned above asked me to work as a clinical pharmacist in an outpatient epilepsy center operating in a busy neurology group practice. On Wednesday mornings, under the supervision of three neurologists, the nurse practitioner and I saw patients with epilepsy and seizure disorders.

The neurologists used to ask me all kinds of questions about drug therapy, side effects, and drug interactions. They knew their anticonvulsants and neurology medications very well, but they needed help with the newer agents and with non-neurology medications. I researched the questions and came back to them with recommendations.

One day I said to one of the neurologists, "I hope you don't think less of me when I don't know the answer immediately." He looked at me, smiled, and said, "Mark, I didn't expect you to know the answer immediately. I knew you would know how to get the information I needed and get back to me."

The physicians grew to trust me. My involvement in the clinic expanded to include work with patients with other neurological conditions such as movement disorders and neuropathies. The neurologists would frequently call me from other hospitals where they were on staff, because they knew I would research the questions they posed and provide them with the answers they needed in a timely manner. Patients liked me because I explained complex things to them in a way that was easy to understand. The nurse practitioner and the neurologists also liked the fact that the patients appreciated my explanations.

Once patients understood the need to maintain a stable therapeutic blood level of anticonvulsant and the need for medication compliance, guess what? In most cases, seizure frequency decreased or the seizures became controlled. The patients were happy. The nurse practitioner and the neurologists were happy.

Patients routinely called me outside clinic hours. They wanted to know whether it was safe to take a new medication along with the existing anticonvulsant. They were being proactive; they wanted to check with me for any drug interactions that would affect their seizure medication and seizure control.

Wow! They were following my advice. I frequently asked the patients, "What made you think to call me?" They said, "My doctor told me to ask my pharmacist if it was OK to take the combination."

Sell yourself - and then deliver

Relationships are built on trust. Are you a credible individual? Are you clinically competent? How are your communication skills? Pharmacist-conducted medication therapy management (MTM) services are needed and are being reimbursed. Why not reach out to the local large medical group practice next door or across the street? Sell them on what you as a pharmacist can do to help manage their noncompliant or difficult-to-manage patients. And then show them what you're made of.

Mark Greg is a clinical pharmacist with Advocate Physician Partners in Oak Brook, Ill. E-mail him at mark.greg@advocatehealth.com
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