- CONDITION CENTERS
Lt Col Scott Sprenger
Not all members of the US Air Force are pilots. In fact, the Air Force actively supports a thriving pharmacy service dedicated to caring for active-duty personnel, military retirees, and their dependents, ensuring a high quality of pharmacy care at Air Force bases across the country and for troops overseas. Deployment and travel are significant in the Air Force. To take full advantage of the opportunities the Air Force can offer, pharmacists should start with a love of their profession, mix in solid leadership abilities, and finally add a bit of the adventurous spirit. That is the life of an Air Force pharmacist.
A career in Air Force pharmacy can begin through a scholarship program where the last 1 or 2 years of pharmacy school are paid for in exchange for a commitment to the Air Force. Recruiters also may approach a student in the last year of pharmacy school with an opportunity to work in Air Force pharmacy. Once interested individuals are identified, the recruiter connects them with an active-duty pharmacist who can arrange a visit to an Air Force pharmacy where they can see everything firsthand.
The scholarship program is popular, but the Air Force has only a designated number of scholarships to award each year. Also available is a loan repayment option where a certain percentage of loans are paid in exchange for a commitment—an attractive option for students with debt.
Pharmacists also can enter the Air Force after working in civilian practice, perhaps with a desire to change their work environment. That is how Lt Col Scott Sprenger came to be an Air Force pharmacist.While in pharmacy school, a classmate was a technician in the Navy, and Sprenger was intrigued by his experiences and the benefits of working in the military.
After working for 4 years at a civilian retail pharmacy, Sprenger decided to make a career change. He has now been with the Air Force for 19 years, which gives him a unique perspective on civilian and military pharmacy. Today, he is the Commander of the 59th Pharmacy Squadron at Wilford Hall Medical Center in San Antonio, Texas.
An Air Force pharmacist would enter the service as a "direct commission" officer, as opposed to a pilot, who requires lengthy officer training. Direct commission officers have an abbreviated officer training school, known as Commissioned Officer Training School (COTS), which is 6 weeks of training and learning the customs and courtesies associated with a military career.
"They know you know how to be a pharmacist, so they bring you up to speed on being an officer—learning the rules and regulations that military is based on and what expectations the Air Force has," says Sprenger. It is in COTS where Air Force pharmacists begin to learn the basics of the levels of command, leadership expectations, and leading those who work for you. "Really, there is a dual career as a health care professional and as an officer."
When Sprenger worked in a retail pharmacy, he wanted to travel, and he had a patriotic desire to serve his country. He saw the Air Force as an opportunity to meet those goals and to get good experience in the practice of pharmacy and perhaps further his education. He had completed a bachelor's degree in pharmacy and, once in the military, applied to the Air Force Institute of Technology—a training program offered for a wide variety of careers to get graduate degrees and advanced levels of training.
As for the current state of travel, Sprenger says that many Air Force pharmacists are being deployed to Afghanistan and Iraq and are playing a big role in the Air Expeditionary Force, which he says is just a fancy name for the medical side of deployment, but says it is an important part of how Air Force pharmacists serve and care for the warfighters. "The Air Force is like any spectrum of society where [individuals have] different levels of desire to go there [to the Middle East]. I know that every pharmacist I have talked to said it was the best experience they ever had. It is the ultimate in teamwork in that deployed situation and how that operation works so efficiently. The Air Force pharmacists recognize their value on that team," Sprenger confirms.
Sprenger further describes how, at Wilford Hall, a constant deployment of pharmacists leave in 4-month cycles to Iraq or Afghanistan. He notes, however, that if one looks at how many active-duty pharmacists are in the Air Force (approximately 240), the number deployed at any time is relatively small—4 to 6 people deployed in any given 4-month window. "In today's world, you have to be aware that a good likelihood exists that you will be deployed. They don't send new people, however. They definitely want to make sure you are well trained, and a lot of training goes into that.... It takes at least 1 assignment to get to that level. That is not an environment to be ill-prepared," he advises.
When it comes to direct patient care, Air Force pharmacy follows the same federal and state laws regarding pharmacy practice that the civilian pharmacies follow. One main difference is that the Air Force does not charge for medication, because it is free for active-duty men and women, retirees, and dependents, so the money aspect of running the pharmacy does not exist.
Air Force pharmacies run clinics the same way a civilian pharmacy would, including offering flu shots, hypertension screening, hyperlipidemia screening, cough and cold clinics, and warfarin clinics. In addition, pharmacist-run refill clinics coordinate the refills, counsel patients, and schedule new appointments.
It is true that the Air Force has fewer pharmacists than technicians, but, because they are required to meet the same standards of care set forth by Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the Air Force is working diligently to migrate their ratio of pharmacists to technicians from about 1:3 or 1:4 to 1:2 as seen in the civilian world.
According to Sprenger, about 3 years ago, the Air Force had a huge push to standardize their automation and equipped all pharmacies to improve efficiencies and maximize safety. They wanted the latest technology— bar coding, on-screen prescription review. "We are proud to standardize and make significant improvements in safety," he said.
The Air Force also has felt the bite of the pharmacist shortage nationwide. Their recruiting efforts have not yet been able to meet their goals, as the market for entry-level pharmacists is highly competitive. "It is difficult to compete with civilian benefits," says Sprenger. As a result, the Air Force will continue to offer scholarship programs. Sprenger believes that the key is to get pharmacy students interested, because once they are actually working as an Air Force pharmacist, they have a high success rate for retention.
Another effort to adapt to the shortage of pharmacists is the Air Force's newly available contract pharmacist positions. This is where civilian pharmacists are working in military pharmacies. The Air Force has funded 125 contract pharmacists to increase the number of pharmacists needed for JCAHO requirements. So far, says Sprenger, that plan has been successful.
The most difficult thing to point out to pharmacists coming in is the base pay, because it does not seem comparable to civilian pharmacy. It is important to note that it is considered specialty pay, however, which increases the longer a pharmacist stays in the military, and it is offset by bonuses, such as those earned by becoming board certified. Other benefits include 30 days of paid vacation, which starts on day 1 and continues throughout the entire career. Air Force pharmacists also get commissary and Base Exchange privileges (groceries and other goods at reduced prices), as well as a housing allowance and income tax benefits. Once these benefits are factored in, the gap between civilian and military salaries closes considerably.
As Sprenger describes, "Say you are in for 5 years—in that time frame, your salary starts to equilibrate, and you start to live the benefits." Sprenger says he came to that realization after his first assignment. "I felt like I was in such a learning environment. [...] I liked the fact that the military sets you on a path for success ... you are on a road for always getting more responsibility and, in that regard, more job satisfaction. It helps you grow as a pharmacy professional and as a military leader. Often, people feel their careers becoming stagnant. Each new situation validates what you have learned and you can continuously apply that knowledge," he said.
From Sprenger's experience, he feels that to fully take advantage of what the Air Force has to offer, a pharmacist would need an adventurous spirit and personality. He or she should be dedicated and eager. For those individuals, the Air Force provides fertile ground to excel. "From a professional perspective, it is best to take advantage of every opportunity. You are pushed to excel—in a good way." He says that this is another way in which the Air Force does not differ from the civilian world—the highest achievers get the advancements.