There are times when I get frustrated with my profession, as I'm sure you do too. This blog has enabled me to make connections with pharmacists from all over the world. A few months ago I had an email conversation with a fellow pharmacist who is frustrated. I was actually looking into other career options at that time.
The following is copied/pasted from one of the emails. I have permission to share this from the other pharmacist.
What are your thoughts? Are you as frustrated with your profession as this pharmacist is?
My quest is to get out of pharmacy too. I went back to graduate school at age 53 and got a Masters in Mental Health Counseling with an AODA concentration. I graduated 3 years ago and have had to stay in pharmacy to pay the bills for graduate school. My wife is about to start a job as a nurse and if I could find a job at $60,000 per year I'd be gone tomorrow. I've done AODA counseling as part of our graduate training. The satisfaction I get from working with alcoholics and addicts is way beyond any satisfaction I have gotten from pharmacy. Plus, we actually use much of what we were taught in school. What a novel idea. With the economic downturn, finding an AODA job in my area (NE Wisconsin) is tight but I keep looking and hoping. Good luck in your quest. Do you know why they call it the "Asheville Project"? OK, neither do I but one of the reasons has to be because it never ever came close to reaching the controls necessary to qualify it as a study. That pharmacy would trumpet it as "evidence" of anything is further proof of how little proof MTM has as a viable model. In graduate school, I had to take a stats course and several research courses. "Asheville" as a study would have little internal or external validity because there were so many variables that were not controlled (confounders) and its widespread applicability (generalizability or external validity) to other practice types is extremely low. To answer your question as to where the MTM model came from, it was a paper Hepler and Strand wrote in approx 1990 about pharmaceutical care and its application, MTM. Only someone in pharmacy would consider it even a remotely possible practice model. Unfortunately, all pharmacy schools subsequently did. Now we have Doctors taking orders from Med Techs--they had to come up with a degree appropriate to all the new responsibilites pharmacists would have--hence, the 6 yr. PharmD. If I was a PharmD, I'd be pissed.
Friday, June 10, 2011
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6 comments:
It is easy to get frustrated these days. I think we are at a crossroads and what happens to our profession in the next couple of years is critical for our collective futures. And FYI, The Asheville Project is named afer Asheville, NC where the project originated.
Here's what MTM will be and is becoming right now. I am being forced into "MTM" just like injections. I put it in quotes for sarcastic emphasis. Rite Aid as well as all the rest will now have their RPh's calling customers to try and convince them to switch to cheaper meds. If you are successful, you get paid x amount of dollars by the insurance company. That, my friends, is MTM.
I ******* hate pharmacy. It is a soul stealing job at best. I would gladly do anything if I could get a similar paycheck but we all know that story.
I agree with the above poster, MTM will turn into an insurance driven small fee for service where you try to switch pts to cheaper meds, often being a waste of time. Asheville has almost no external validity. True MTM is going to take place within medical home clinics and hospital settings. I still do not see how MTM services can work in retail but who knows if you get chain pharmacies connecting with medical centers, MTM could happen! It all demands on access to information.
The hospital/clinic setting I am working in can not keep up with the current physician demand for poly-pharmacy review, mtm and drug information pharmacy services. They rely on these services and are advocating to administration for more pharmacists decentralized on the floor and available for consult. They see and respect what pharmacy services can do for patient care!
To the above poster, don't hate pharmacy as a whole because you chose to pursue the soul sucking chain-retail path.
I'm concerned about the chains getting involved in MTM. This a service for pharmaCISTS to provide.
I agree that as corporate pharmaCIES enter the market, the reimbursements will fall as they either drop the price for competative purposes or sign contracts at ridiculously low rates.
Rite Aid tried to use pharmacists to switch meds back in the early 2000s when they owned CVS. Complete waste of pharmacist time. Six phone calls and 30 minutes of labor to gain a one-time $12 fee.
Last time I looked, the purpose of MTM was to help manage drug therapy, not be an insurance company's formulary bitch.
Without access to medical records and labs, true MTM can not take place. In a chain retail setting MTM for fee will almost always be formulary bitch work.
A great deal of important interventions are made every day in retail pharmacy but they are not billable and probably never will be. Retail does a terrible job showing clinical pharmacy services value. You need to track your interventions and time. You have to have a record of your value.
Over the years of my working life, I have had moments when one of my supervisors has called out my name, but continues to talk to someone else. I have always thought of that as tht end-all of disrespect. If you are going to talk to me, you should continue talking to me after you have asked for me by name. It makes me feel like a Sharpie. You've picked me up, but you haven't started interacting with me yet. Such is pharmacy iteelf---often the tool, but seldom the practitioner. And, for 35 years, I have heard the phrases "free up the pharmacist," "crucial role," and
"the value of pharmacist input," or similar phrases, and, like the old Pepsodent toothpaste ad, I wonder where the yellow went.
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