Q&A: How Bringing Medical Students Into the Pharmacy Can Enhance Collaboration

Rebecca Lahrman, PharmD, MS, BCACP, assistant professor of clinical pharmacy at the Ohio State University, worked in a community pharmacy in Athens, Ohio during the peak of the COVID-19 pandemic. A nearby medical school was struggling to find preceptors, so they asked Lahrman if she would be willing to take students on rotations in her pharmacy. She accepted, and through the experience, provided medical students with a newfound respect for community pharmacists. She now encourages other community pharmacists to bring in health care students to foster greater relationships and improve patient care.

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Lahrman, who is now an ambulatory care pharmacist at OhioHealth, sat down with Drug Topics to discuss her experience being a preceptor, what medical students can gain from experiencing pharmacy operations firsthand, how interdisciplinary experiences can impact the healthcare system, and what can be done to foster greater relationships between pharmacists and other health care providers.

Drug Topics: What do you think medical students gain from experiencing pharmacy operations firsthand?

Rebecca Lahrman, PharmD, MS, BCACP: They get the opportunity to see exactly what happens after they send a prescription to the pharmacy. I think one of the biggest things they didn't realize before they came to the pharmacy was that I didn't have any access to their medical records, and so all I had was prescription record information to go off of. I don't think they had a strong appreciation for what that cross communication link looks like between the electronic medical record and the pharmacy dispensing software, and how things go through that exchange system. I gave them insight into what that looked like. A lot of them had never seen how insurance gets processed, and it's very different in a pharmacy compared to the medical end. I got to walk them not only through how pharmacy bills, but then also how medical offices bill and what would be expected of them as physicians. I told a lot of them at the very beginning of the rotation, “I need you to learn one thing before you leave today, and that's being a provider is really hard. Being a nurse is really hard. Being a pharmacist is really hard. We need to be kind to each other in order to help our patients get where they want to go.”

Drug Topics: Can you share an example of a particularly impactful or memorable moment with a. student during their rotation?

Lahrman: One of my favorite questions came about an hour and a half into the experience. I was going through my outline with the student, and I do that while I'm in my workflow, so I'm checking prescriptions as I'm going, answering phone calls, coming to the counter, talking to patients about their medications. About an hour and a half in, she's like, “So when does the basket stop?” And I was like, “Oh, they don't stop. This is what we do. We check 800 plus prescriptions a day. We answer 500 phone calls. We manage drug inventory.” I kind of went through it all and gave her an appreciation that, just like how patients don't ever stop coming into the ER, they don't stop coming into the hospital or seeing their physicians, it's very similar on the pharmacy end as well.

Drug Topics: How did being a preceptor enhance your own understanding of your role as a pharmacist?

Lahrman: It reminded me of the value that we have to the system, as well as the insight that we can offer back to providers, and how that communication can be really difficult. One of the examples that I always highlighted for the students was when a patient comes into the pharmacy, a lot of times they might say, “Oh, my provider said it would be ready,” even though the prescriptions somewhere working on being adjudicated, counting, maybe it's on back order and we're waiting for the medication to come in. I kind of explained to the students, I know that you never told the patient that it was going to be ready. You probably told them you sent the prescription. That easy little miscommunication or that interpretation kind of comes across a little differently in the pharmacy. Telling patients that you sent the prescription and to call the pharmacy and find out if it will be ready can be just that little, small thing that can change to help patients understand a little bit better before they get to the pharmacy.

Drug Topics: How do you think interdisciplinary experiences like these can impact the overall health care system?

Lahrman: I hope that it creates compassion for what others do within the healthcare system, as well as help offer stronger referrals. One of the really interesting things that came out when taking medical students in the pharmacy, is at the time, I was also seeing a physical therapist, and he was like, “Oh yeah, I'll take some medical students.” He ended up actually taking way more medical students than I was taking, and it was interesting to see his reflection on what he was teaching the medical students while I was reflecting on what I was teaching them in the pharmacy. Just the fact that, when we send a patient to a new opportunity, a new referral service, if we don't really know what happens in that, it's kind of hard for us to make those strong recommendations or referrals, and so I think it creates a little better compassion. It also helps physicians set better expectations for their patients when they know what happens.

On the other side, I would encourage providers to visit their pharmacies and introduce themselves to the pharmacist there, if possible. Especially if you're commonly recommending an over the counter item, go to the pharmacy, see if it's even in stock and if it's not, talk to them about how it could be in stock or see why it's not in stock. A really good example is sometimes that it's just not commonly recommended, so we don't carry it, but if they come to the counter, we can order it for them and get it in for them. If a local provider told me, “Hey, I need this product, I tend to recommend it a lot,” I would put it out on the shelf and make sure that we had in stock for them. I think that that helps build relationships. I know working in an independent community pharmacy, I got a lot of opportunity to get to know my doctors in the area, not only their prescribing habits, but they would come to our pharmacy, and so I can actually recognize them or get to talk to them about mutual patients that we had.

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