Your Pharmacy Career: Finding the Creative Corners

OCTOBER 27, 2014
Erin Albert, MBA, PharmD, JD
Lifelong learning is key for successful niche hunting.
Currently, there are nearly 10,000 different prescription products alone listed in the Orange Book, and over 6600 New Drug Applications. While pharmacy tends to attract the best and brightest, there is no way that any individual pharmacist can know every statistic, side effect, and pharmacokinetic profile of every drug on the market. Nor can a single pharmacist know everything about the profession—like being a strong leader, advocating for the profession, communicating to a wide variety of people, and managing others.

The need to specialize in this area of pharmacy practice isn’t just a luxury anymore—it is a necessity. The good news is that because pharmacy is so vast, it allows pharmacists to find their favorite niches, creative corners, and the areas of practice they are passionate about, which allows for higher job satisfaction and promotes lifelong learning for pharmacists. The challenge becomes the question, “Where can I find my own creative corner of pharmacy practice?”

There are many therapeutic board certifications and advanced degrees a pharmacist may now earn. Equally exciting, specializing in an area of pharmacy or health care practice provides more opportunities for pharmacists to speak, write, teach, and share their knowledge in order to grow and strengthen the profession. This, in turn, demonstrates the value proposition of pharmacy to the health care team, drives the profession forward in new and interesting ways, and ultimately, offers better care for patients.

How does a pharmacist find his or her particular corners of interest within the profession? Here are a few real-world examples from 4 different pharmacists in the trenches who have been lucky enough to discover their own creative corners of practice.

Find Your Niche
Amy Lenell, PharmD, CLC, a pharmacist with Walgreens in Indianapolis, found her creative niche by developing Well Babies, a woman and baby wellness service, out of frustration from her own personal experience as a mom.

“After having my first baby, I realized that breastfeeding was not as simple and intuitive as I originally thought. The lactation consultant was excellent, but other health care providers lacked training to provide appropriate advice,” she said. “Even as a pharmacist, there was so much I did not know. Upon returning to work, I provided education to a moms’ group on medication and lactation. My passion was born as I discovered the need for better access to support, better information for moms, and better training for health care professionals.”

Jim Eskew, RPh, MBA, director of pharmacy at Good Samaritan Hospital in Vincennes, Indiana, became a quick study of employee prescription drug formulary management when costs for the self-insured hospital were skyrocketing.

“Employee prescription costs are a significant expenditure for hospitals that are sometimes overlooked, as most pharmacy directors focus primarily on the pharmacy department budget and our inpatient/ambulatory care drug costs,” he said. “We traditionally have done an outstanding job of controlling inpatient costs with strategies, like therapeutic interchanges approved by our P and T Committees, but, at the same time, our hospitals are spending $7 per capsule for proton pump inhibitors for employee prescriptions when similar medications are available for $0.10. There are clearly opportunities for the pharmacy departments to impact hospitals’ health insurance expenses by becoming active in looking at ways to control employee prescription costs.”

Another driver for finding a passion in pharmacy relative to policy at a broader level was discovered by Tricia Lee Wilkins, PharmD, PhD, at the Office of the National Coordinator for Health Information Technology (health IT) at the Department of Health and Human Services.

“This is an exciting time in healthcare. Change is taking place and at a pace like no other time in history, and I want to ensure that our profession has a seat at the table,” she said. Dr. Wilkins earned her PhD in health outcomes research to help patients and the health care system at a broader level.

Carrie Maffeo, PharmD, BCPS, CDE, also wanted to improve wellness for patients at Butler University. “Every patient during my residency in southcentral Los Angeles had diabetes,” she said. “Coupled with my family experience of watching some diabetic relatives just giving themselves more insulin when they ate cake, I realized that no one was discussing preventive education at all with patients. There had to be a better way.”

The Niche Isn't Always Obvious
When asked if their creative niches were always obvious, a majority of these pharmacists did not think so.

“I would never have guessed this path for me at the time of graduation from pharmacy school,” Dr. Lenell said.

Jim Eskew found his niche in formulary management later in his career.

“As I moved from a large academic medical center to a smaller community hospital, I was challenged by our chief executive officer to look at ways to control and decrease our employee prescription costs, and then became very interested in formulary management.”

Dr. Maffeo cites her residency experience as key to finding her passion in employee and patient wellness programs.

“The residency really sparked it for me, where I had the opportunity to start tobacco cessation and diabetes risk prevention programs.”

Dr. Wilkins knew she had a passion for policy after taking a pharmacoeconomics class in pharmacy school. Working in health IT was not expected, nor does she claim to being an expert in the area. “It’s not about being an expert in the field. It’s understanding the needs of the patients, gaps in care, and then making the connections between desired outcomes and the technology that enables them.” She currently supports meaningful use of health IT in her policy work.

While all professionals ultimately became pharmacists, the niches arrived at various times and places throughout their professional careers.

Sharpening the Niche
If you’re lucky enough to have located your area(s) of pharmacy passion, which may not always be obvious, the next step to take to help you bloom in the niche is to seek extra training, learning, and development. While some can stay within the profession to find quality training, sometimes sharpening the saw of the niche requires seeking training outside of the profession. Both Eskew and Dr. Lenell cite training outside of the profession for their chosen niches.

Dr. Lenell learned more about breastfeeding and maternal and child health outcomes from public health professionals and conferences for lactation consultants, nurses, and pediatricians.

“I am usually the only pharmacist wherever I go, but I see that as an opportunity to show other health care providers how valuable the pharmacist is to the team.”

Eskew learned a lot about formulary management and employer-managed pharmacy benefit managers (PBMs) by working with the hospital’s consulting agency for health care insurance. “The consultants are very knowledgeable, and as pharmacists we can certainly learn a number of concepts related to overall employer health care costs from these organizations.”

Dr. Wilkins learns from everyone around her, especially in health IT, and was excited to find a PhD program within a school of pharmacy for policy. However, she also cites that there is value in learning from other professions.

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