Tuesday, May 17, 2011

Recent encounter of the MTM-type

Well, it has been a while since I've sat down to offer some thoughts here on the blog. Over the last month or so work has been extremely hectic. One of the other pharmacists has been on medical leave and corporate has decided that it's not necessary to replace a full-time pharmacist with equal hours. We're lucky if we get 20 hours of floater pharmacist each week. With that, after any given day of work I haven't been feeling like sitting down with the blog.

I took a week off to attempt to recharge. During this time off, I tried to think about pharmacy as little as possible. If you follow me on Twitter, you would have seen very few pharmacy-related comments. Not thinking about pharmacy is relaxing, but when you are attempting to land clients for a medication therapy management business, that's not necessarily a good thing.

Especially after having discussions with pharmacists at the national level who are promoting the MTM side of pharmacy. After talking with these people, I get recharged on the MTM front. But then I return to my employer where I get beaten down with the dispensing side of the profession. With the lack of pharmacist hours, I haven't been able to offer even basic counseling to my patients let alone even think of the advanced level of patient care that is required with MTM-type services.

All that being said, at the end of my week off I was able to have an exchange that renewed my passion for educating patients and offering MTM services.

Every other week, my wife and I meet with four other couples from our church for our small group. We attend a large church that doesn't offer traditional Sunday school classes for adults. Instead, we meet in small groups to have, for the lack of a better description, a Bible study. It's not just a Bible study though, we are a support group for each other as we go through life.

When we were wrapping up Sunday night, one of the women in my group approached me with a question about her father's drug therapy. He has been having episodes lately where he has been passing out and falling and she was wondering if a change in his medications a few months ago might be contributing to the falls.

We talked for about fifteen minutes as she shared what had been happening and I questioned her further to get more information. She had contacted her father's cardiologist and primary care physician, but they were not able to determine a possible cause of the fainting spells and falls.

Then she said the magic words that may have helped us figure out what the cause of his falls might be. About two months ago, her mother decided that he needed to eat healthier. Instead of a sandwich, fruit, and pretzels for lunch, she was now feeding him chicken breasts and salad.

Now this would normally be good, but they didn't factor in one thing.....he has been on a fixed insulin dose (Novolin 70/30) for about 30 years.

Factoring in the time of day that his spells have been occurring (mid-afternoon) and his recent change in diet, our working hypothesis is that he is basically having hypoglycemic episodes every afternoon. I made a couple suggestions for her to relay to her parents and we'll see where things go from here.

This is an example of how pharmacists can have an impact on the lives of our patients, if we are able to take the time to talk with our patients. Recently some of the chains have started making moves that appear to be advancing the cause of MTM. I would like to remind these chains that the single-most important thing that they can do to allow pharmacists to provide these services is to give the pharmacist TIME to talk with the patients. Verifying 30+ scripts per hour does not allow the pharmacist the opportunity to have these discussions that can impact the lives of our patients.


Anonymous said...

Eric, I would like to know about pharmacist in Industries. From all the pharmacist blogs that I have read, every one of them are clinical. Does this mean that there are no pharmacist's in the pharmaceutical company, or do they choose not to blog about themselves? How about the pharmacist role in these industries, because, as far as i know, the pharmacist main role is to make drugs

Maha said...

It's my first time to read your blog. But I liked your post very much as you are discussing the issue exactly as we face it in Egypt, although i expected that the situation is better in US. I work to make myself and my pharmacists colleagues sufficiently informative in order to be able to do our job as patients' educators, so it would be my pleasure if see my (Diabetes Mellitus Concept Map Video) which is made to help in understanding the disease for the aim of better practice. The opinion of an experienced pharmacist like you really matters. Thanks