The What, Why and How of Being a Primary Care Pharmacist

Primary care pharmacist, MD office pharmacist, and General Practice pharmacist are all the same name for the same role: a pharmacist working with doctors!

It is a significant role that has been emerging in the past decade, yet, in my opinion, is still under-recognized.

I have had numerous questions about my part-time role as a primary care pharmacist, which was the driving force behind this edition.

I will talk about what my role is like, why it is so important, and how to get a role like this.

What is it like being a Primary Care Pharmacist?

Being a primary care pharmacist is like being a sieve that catches people before they end up in the hospital (again!).

We hear the phrase 'multidisciplinary care' so often in healthcare, but how often does it transpire into actual practice?

This is why I love being a primary care pharmacist, it is true 'multidisciplinary care'. It is pharmacy, just the way it should be.

I get to be in the depths of patient care, in the middle of clinical decision-making, making life easier for my retail pharmacist colleagues so they have a thorough and accurate prescription, reflective of the patient’s health needs.

I am a telepharmacist, so I practice my role fully remotely and work with teams across the country—it is amazing!

Here are my core tasks:

• Medicines Reconciliation post-discharge, and transitions of care

• Medication Management: CMM, MTAs, Medication-Use Reviews

• Asynchronous patient care: text messaging, emailing, remote patient-monitoring

• Synchronous patient care: virtual consultations, phone calls

• Clinical Bulletin - Education and updates to the clinical team

• Responding to clinical medication queries from prescribers and nurses

• Processing of repeat prescriptions alongside nurses for final prescriber approval

Who do I interact with daily in my role?

• Doctors

• Nurses

• Health Coaches

• Health-care Assistants

• Customer Experience Team (CET)

• Health Improvement Practitioners

• Product/Engineering team (make sure our medication app is up-to-date)

What is a day in the life of a primary care pharmacist like?

I have a part-time role alongside my private consulting practice, so I have a 5-hour working day 3–4 days per week.

Here is what a typical day would be like:

• Process a decent number of repeat prescriptions, deciding whether the patient needs to see the doctor for a review or whether we can process a prescription without a consultation. E.g.: when was the last time a patient's BP was measured if they're requesting a repeat of a BP med.

• Answer clinical queries from the clinical team, e.g.: medication interactions, appropriate therapy with x condition, and apply for funding for x drug..

• Answer queries from retail pharmacists about prescriptions we've processed, e.g., missing information, interactions, and oversupply of medications..

• Reach out to Ms X who appears to not be taking her medication correctly (or not taking it at all!), or Mr B who somehow ended up taking two anticoagulants after his hospital discharge because he was confused about having two at home. Talk about saving patients from harm, and health-cost savings!!!

• Write up my clinical bulletin for staff

• Text some patients who have started new medications or are being followed-up for changes in doses, etc

• Prepare a presentation on a recent medication review case

• Talk to our product team about an in-app improvement or update

• Reconcile a few hospital and specialist discharges, ensure our EHR is up-to-date and reflective of what the patient is taking, and reach out to the patient to ensure their med history is correct in the app.

• Reach out to CET to request that patients come in for review appointments.

That is just a glimpse of what my working day is like, it is full-on but incredibly satisfying as I leverage all my medicine knowledge and skills, actively contribute to patient care, and ensure medication safety.

Why is Primary Care Pharmacist an important role?

Primary care pharmacists have been recognized for their significant value in healthcare through various studies and reports, I would need another article to cover that evidence in-depth.

No doubt, this role is evolving, and with this, there will be higher quality evidence and studies, nevertheless, there is ample evidence about the positive impact of this role on patient care, such as reducing medication-related problems, improving chronic disease management, and enhancing patient satisfaction.

Anyone reading this should be able to put a time on each of the core tasks and think about the time savings, that allow other clinicians to focus on tasks in alignment with their scope. For example, why have a nurse answer a medication query, when she could be vaccinating or providing a diabetes annual review?

A primary care pharmacist frees up the time of other health practitioners so that we can all practice at the top of our scope, thereby, providing quality patient care, saving health system costs, reducing burnout, and improving clinician job satisfaction. It's a win for everyone involved in the cycle of care!

How to get a role as a Primary Care Pharmacist?

This is the slightly tricky part, and across the globe, there will be different requirements to obtain such a role.

As this role is in its infancy, primary care facilities may not actually have a role as such, at least, this is the case in my corner of the globe. There is a very limited number of facilities that understand the significance of this role and have an established position.

Three years ago, I created my own role as a primary care pharmacist.

I reached out to the CEO of a digitally-led primary care provider and talked about the contribution I can make to providing better patient care in primary care.

Two meetings later, I was writing my own job description.

So, here is my take on 'how' to get a role like this:

1. Reach out to recruiters in your region, is there a role like this advertised?

2. If not, tap into your networks and organizations to know where roles like this would be advertised.

3. If not, cold-reach out to primary care providers in your area.

Cold-reaching out refers to initiating contact with someone you have no prior relationship or connection with.

Basic Principles of cold-reaching out:

• Personalize your email/communication. Generic, impersonal messages are likely to be overlooked or dismissed.

• Research the provider you're reaching out to, do they have a website or information? What are their values, and ethos? How does your experience contribute to those values?

• What is your value proposition? What problems can you solve for them? How does a pharmacist contribute to better patient care? How do you save time and money? What does a pharmacist even do? (In my case they had no idea what a pharmacist does apart from counting pills - pretty sad!)

• Demonstrate genuine interest, and focus on the value you bring.

• Brevity is key, a CEO or practice manager has an overwhelmed schedule - be clear and to the point! Stagger your communication, make your initial email a brief intro and request to see them virtually or in person.

• Don't force yourself on them, no one likes to hire desperate people.

• Offer them a week's trial for free or a 'trial-period' - that's what I did!

• Follow-up and be persistent (but not desperate!) - in many cases, you may not receive an immediate response, allow some time to pass before sending a polite follow-up message to gently remind the recipient of your initial outreach.

• Evidence is key - if you are saying you are saving $$ or reducing medication harm, then what is the evidence this is even a problem? Back up your claims.

What skills suit this role?

• Effective communication is key - good communication builds trust in you, there will be some scepticism initially due to a lack of understanding of what the role entails, but with good communication, you can break barriers.

• Research skills - Precribers will come to you looking for answers, they will trust you to give them the right evidence-based answer

• Time-management - you can't spend an hour reviewing one patient's medications, balancing outcomes with efficiency is important.

• Competence and confidence in making decisions independently - you may have a colleague to second guess in a retail pharmacy environment, not the case here!

• Collaboration - focus on providing all that's in your scope to contribute to the team's efficiency and the patient. Think about the ramifications of every decision you make.

• Personal Integrity and trustworthiness - have the confidence to say 'I don't know the answer' when you have done everything you can to find it, or when you've made the wrong decision.

• Desire to continually improve personal and organisational practice

• Desire to contribute to the educational needs of other clinicians when it comes to medicines.

Being a Primary Care pharmacist is challenging, yet satisfying.

If this is a role you've been aspiring to reach, I hope that this edition has provided you with some insight and motivation to pursue it.

-Katrina

P.S.

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• And if you're after some help with finding a role as a Primary Care pharmacist, then DM me here or visit my website and contact me.