The antimicrobial stewardship pharmacist job market is looking better for job seekers, but the mix of positions and various unknowns can make the search for a position a major challenge. Here, a pharmacist going through the process of finding a stewardship pharmacist job discusses the topic.
Authored By: Tristan Timbrook, Pharm.D., MBA, BCPS
Pharmacists looking to land an antimicrobial stewardship (AMS) job are in a unique position today, where a demand for stewardship-trained pharmacists looks to be outweighing the supply. This is a situation that was previously predicted [1].
The Sudden Demand
A sudden influx of AMS pharmacist jobs is likely related to the new Joint Commission standard on AMS and the anticipated Centers for Medicaid and Medicare Services AMS requirement for hospitals (which suggest 0.25 AMS pharmacist FTEs per 124 beds [2]). With the abundance of positions available, many considerations arise in deciding on a job. The purpose of this article is to review several considerations for evaluation when choosing among AMS positions.
Getting Ready For The Job Search
Following the recommendations of the businessman and writer Stephen Covey in The 7 Habits of Highly Effective People, you should begin with the end in mind. Covey suggests that you should align your pursuits (in this case the AMS position of desire) with your personal goals and values. He continues that to achieve this, you should write a mission statement, an essential activity that has been reviewed on this site previously [3]. Writing your mission statement allows you to evaluate if potential jobs and culture align with what is right for you.
Different Types Of Stewardship Pharmacist Jobs
After defining your values and goals through drafting a personal mission statement, it is important to characterize what type of stewardship pharmacist job you would be interested in, so that you might narrow down your choices. With the expansion of stewardship to all acute care facilities, there are a multitude of heterogeneous AMS pharmacist position types which invariably result in different opportunities and challenges.
While the majority of large academic centers have established programs, many small community hospitals with as few as 100 beds are recruiting for a full AMS pharmacist FTE. It is important to consider the difference in patient mix at these smaller facilities and that often these smaller hospital positions include other responsibilities that may extend beyond stewardship due to the limited resources within the facility.
Another consideration is stewardship positions in teaching vs non-teaching hospitals as the former would have providers regularly change and thus require regular repeated education both formally and through prospective audit and feedback.
Other posted positions have included infectious disease consult responsibilities along with daily stewardship tasks, which would yield variety, but may also provide a challenging workload.
Finally, a new type of stewardship pharmacist job that has emerged is community outreach stewardship positions. These are a newer type of position that many larger academic medical centers (e.g. Duke, The Ohio State, Johns Hopkins) have created to serve smaller community hospitals without AMS resources. While some of these positions allow for active prospective audit and feedback opportunities, others may have the AMS pharmacist function as a clinical manager helping others develop their AMS programs and may lack the opportunity for direct patient care activities.
Assessing The Target Stewardship Pharmacist Jobs
Once you have selected which programs align with your values and goals on paper and are invited for an interview, it is time to elicit specifics on the fine details of these programs.
Specifically, it is pragmatic to start with management and C-suite expectations of the AMS program and your role in managing it. It is important to ask how will the performance of the program be measured and how will your personal success as an individual in the program be measured. The answers to these questions can provide valuable insight as if the goal of management is to indiscriminately decrease antibiotic expenditures and not focus on quality of patient care, then conflicts in the priority of your efforts may arise.
As the metrics of stewardship slowly shift from antibiotic usage of defined daily doses (DDDs) or days of therapy (DOTs) to quality and outcome measures (McGowan 2012, Barlam 2016), it is important to evaluate if the management is receptive of this paradigm shift as ultimately our commitment as clinicians is to improving patients’ outcomes [4,5]. If management is not receptive, job burnout may be inevitable.
As its been said, “it takes a village to raise a child”, beyond the buy in and support of the C-suite and pharmacy management, it takes commitment of all members of the ASP team (the ASP physician champion, clinical microbiologist, infection control, and information technology) to have a successful program. Therefore, its essential to evaluate the commitment and characteristics of these individual team members during your site evaluation. Some things to ask about:
- Does the physician champion regularly review the literature and therefore is seen as a source of reliable knowledge and best practices?
- Does the physician champion have an assertive personality that will be effective at having tough conversations on patient level interventions or institutional level committee proceedings?
- Is there a microbiologist and will they be willing to collaborate on optimizing microbiology processes for improving antibiotic use?
- How available and timely does the information technology group appear to be for completing AMS program tasks such as data mining and electronic health record modifications?
- Are clinical decision support systems (e.g., Theradoc) available to increase efficiency of routine stewardship activities?
Coming Full Circle
Finally, after vetting out the fine details of the position, you will be able to return to your mission statement to evaluate the alignment of the position to your personal goals and values.
Answer key questions such as:
- Would you be able to pursue your goals?
- Does the culture of patient care align with your values?
- Do you see the opportunity for personal and professional growth within this position?
While financial compensation and benefits are essential to personal security, the fit of the position with your personal mission is ultimately what will determine your long-term success.
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