Pharmacy school graduates now have the opportunity to pursue a career as a transitions of care pharmacist. Here, a pharmacist trained and practicing within this emerging pharmacy specialty discusses her experience.
Authored By: Gloria Huh, Pharm.D., BCPS
Like most pharmacy students I was drawn to a variety of specialties within the pharmacy profession, including internal medicine, ambulatory care, infectious diseases, and oncology. It was not until later when I became a post-graduate year (PGY) 1 resident that I discovered a new and growing pharmacy specialty: transitions of care (TOC).
Once I learned of this specialty my interest was sparked. So, I read articles, asked questions to our TOC pharmacists and gathered all the information I could. Eventually, I came to the conclusion that a TOC position would allow me to do a little bit of everything and that there was a growing need for TOC pharmacists in the area, so it was worth giving strong consideration.
During PGY1 residency I decided to start a TOC rotation with one of my mentors. Having the chance to practice it, I instantly fell in love with the specialty. I eventually decided to pursue a PGY2 residency to become a TOC pharmacy specialist.
Since graduating from PGY2 I have been working as a transitions of care pharmacist and have also had the chance to work in several leadership positions. It has been an amazing journey, I have learned much along the way and I continue to learn much. I feel the future of the TOC specialty is bright and am excited to see what will come next.
To spread the word about the pharmacy specialty I am so passionate about and to help others understand what TOC has to offer, I have complied these 5 things, which are the reality versus expectation of what I have learned along the way. It is my hope that this may be helpful to others considering a career path which involves becoming a transitions of care pharmacist.
1. I thought I would receive more resistance from providers and leaders about the role of a transitions of care pharmacist.
Transitions of care is a field that is rapidly emerging and continually evolving. I thought providers would not see the value of TOC services and thus be opposed to TOC pharmacists identifying and intervening in opportunities to improve the continuity of care (i.e. discharge medication management, bedside delivery of medications, medication reconciliation, transitional care clinics, etc.). However, I have been pleasantly surprised to learn that providers are not only extremely grateful for TOC services, but they are usually the voice that strongly support the expansion of TOC pharmacy services. Additionally, I learned that most leaders have a shared goal of reducing readmission rates thus, this common goal quickly unites everyone to work together to improve patient care.
2. I never expected to collaborate closely with a variety of specialists.
I thought I would be working with a variety of specialists, but did not comprehend just how closely my relationships with them would be.
As my TOC services expanded I have had the tremendous opportunity to work with physician and pharmacist champions who provide care to patients with diabetes, heart failure, hepatitis C, and more. We collaborate for medication therapy management and to care for patients recently discharged from a hospital. It is a challenge but very professionally rewarding.
Being a TOC pharmacist is exciting to me, because I am constantly being challenged and there are always new opportunities to explore.
3. I thought being a preceptor for pharmacy students and pharmacy residents would take away from patient care.
While it may seem like a burden to take on trainees, it does not have to be this way.
I have learned that through use of a structured format within a learning experience, pharmacy students and pharmacy residents can not only gain valuable clinical experience but also add to the services a TOC pharmacist can provide, as pharmacy extenders.
The American Society of Health-System Pharmacists-American Pharmacists Association report entitled “Medication Management in Care Transitions Best Practices” (available here) also points out the value of students and residents in TOC services .
Admittedly, it does take some time in the beginning to orient students and residents, but if done well, they can be an enormous asset to the TOC team.
4. I thought I would never feel comfortable leading a transitions of care pilot program.
When I ran my very first TOC pilot program it was an overwhelming experience. I did not know where to start. Thankfully, I found that through the guidance of mentors and in pulling from experiences I had gained as a student and resident, I had the skills and confidence needed to launch and execute a TOC pilot program.
Running a pilot project will always be a unique challenge, because each one presents unique challenges and opportunities, but now having been through it, the idea of leading a pilot is not daunting. Rather, I see it as an exciting opportunity to further build the case in the value of TOC pharmacy services.
So the message here is to know that in times things get easier and instead of seeing barriers and challenges, you will start to see opportunities for innovation and collaboration. Pharmacists have an important role in TOC and you can definitely bring a perspective that elevates the standard of patient care.
5. I never thought the transitions of care process would be so different between health systems.
Every health system provides different services and serves unique patient populations. In turn, medication management during TOC varies tremendously between facilities or systems.
This means that a TOC pharmacist needs to be like a chameleon; able to adapt to the environment in which they are placed. In turn, it is very important for a transitions of care pharmacist to be adaptable to a variety of environments and willing to learn new systems. In addition, good communication skills are key to success in the TOC pharmacy specialty.
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