Beyond the counter: Pharmacy Week spotlights diverse contributions of pharmacy

When Karen Li moved from China to the United States at the age of 18, she’d already seen the consequences of medication mismanagement. “There were multiple incidents where in my family, my direct family member had a medication dosing error and issues with the health care system, which led to death. So that's always been something that stuck in my head,” she said.

“I didn’t know until I moved to the United States that there is a profession called a pharmacist, where you make sure that the patient gets the right dose, right medication; you tell the patient the information they need to know about medication.”

She joined that profession after several years of training. Li now works as a clinical specialist at the MUSC Specialty Pharmacy, helping people with pulmonary hypertension and those with the rare heart diseases amyloidosis cardiomyopathy and hypertrophic cardiomyopathy.

“I provide patient counseling, education, side effect monitoring and dispensing the medication to our patients. I also work directly with our pulmonary hypertension provider in the clinic to see patients in person.”

 

It’s not what most people probably imagine when they think of the field of pharmacy. Marva Williams-Lowe, Pharm.D., chief pharmacy officer and associate dean of Clinical Affairs in the Medical University of South Carolina’s College of Pharmacy, wants to change that. She said National Pharmacy Week, the third full week in October, is the perfect opportunity to showcase the range of roles, from entry-level to top management.

“I love pharmacy and every aspect of it. The field of pharmacy requires constant learning and adaptation, and that’s one of the things I love about it,” Williams-Lowe said. “The ever-evolving landscape of health care challenges us to stay ahead, innovate and embrace new ways to improve care. It requires the expertise of our diverse team of pharmacists and pharmacy technicians.”

What follows are snapshots of some of the different paths people working in the pharmaceutical field can take.

Compassionate pharmacy tech leader on the midnight shift

Angela Washington has been working overnights in University Hospital’s inpatient pharmacy for more than two decades. “I love, love, love it. I think I was born to do midnight.”

Washington, the lead pharmacy technician for her area, calls her shift “midnight,” but it actually starts earlier than that – and goes on for 10 hours. “It is from 8:45 in the evening to 7:15 in the morning.”

 

A pharmacy technician’s basic job is an essential part of health care – helping pharmacists fill prescriptions quickly and accurately. But as Washington said: “It is much, much more than that.”

Washington has a live-in nanny who helps with the kids when she’s working. It puts the pharmacy technician’s mind at ease while she not only fills prescriptions but also refills dispensing machines in the hospital, ensures things run efficiently and safely and talks with patients’ family members and friends.

“I work on the floor where our trauma unit is. And right outside my pharmacy is the waiting room for the patients that are in the burn unit and in the trauma unit and in the recovery rooms. So even though we don't interact with the patients, we do interact with their loved ones,” Washington said.

“As soon as we walk out the door, they're coming to us for answers and questions. I've dealt with families in tears. We've cried together; we've laughed together. And at the end of the day, it's a good feeling. It's a good feeling because you made a difference in somebody's life. And that's a part of my job that a lot of people don't know about.”

Concierge pharmacist

Claire Robke, Pharm.D., works in Pharmacy Concierge Services in Rutledge Tower at MUSC. She knows she makes a difference, too – one that some patients desperately need.

“Picture what happens when patients go to their clinics. The doctor prescribes medications. They return three months to a year later, and they say, ‘Oh, well I never got that medication. It was too expensive. I couldn't afford it. My insurance didn't cover it. The pharmacy did not have the medication. I did not understand the importance of the medication, or the regimen was too complicated,” she said.

When Robke started her career working as a pharmacist at a chain store, she often felt powerless to assist such patients. “Your hands are tied.”

They’re not tied at MUSC Health, she said, thanks to the new concierge program. “What the program does is help overcome those barriers for patients, whether it be social determinants of health or access to medications. We also do medication reconciliation, provide medication education and work to increase health literacy.” Medication reconciliation involves comparing the patient’s prescription orders with all of the medicine the patient has been taking to make sure the record is accurate and complete.

Concierge pharmacists also follow up with their patients to see how things are going. “We check in with them after their appointments and address dose or medication changes or compliance issues as well as other questions or concerns.”

She said working as a concierge pharmacist is both challenging and rewarding. “I feel like we're such an asset to both the providers and the patients. The providers don't have time to deal with all these things. I really think they appreciate just having somebody else there just to throw the ball to, to make sure these patients are taken care of.”

System pharmacy technician manager

Quinton Irick has a very different role in pharmacy, one that has taken him up the management ladder. Irick, a veteran pharmacy technician, serves as secondary supervisor to almost 300 other pharmacy techs at MUSC Health. He never dreamed he’d end up in such a position when he first thought about working in the field of pharmacy.

“I was a grocery associate at a Kmart, and across from the grocery department was a pharmacy. At the time, I didn't know what I really wanted to do. I thought about pursuing a career as a PA (physician assistant). I thought about becoming a nurse anesthetist. I thought about a host of different professions. Working outside of the Kmart pharmacy made me think, 'Hmm, pharmacy, let me look,' which later led to my conducting some research on the profession."

 

He liked what he found. Irick earned a pharmacy technician diploma from Trident Technical College and an associate of science degree. Then, it was on to MUSC, where he earned a Bachelor of Health Science degree, and Capella University, where he earned a Master of Health Administration.

These days, Irick is busy bringing other pharmacy technicians into MUSC Health. “I basically focus on retention and recruitment. So, onboarding new techs, working on strategies to retain those technicians, mentoring, coaching, advocating for the profession, those types of things.”

He also monitors turnover and vacancy rates, develops partnerships and pipelines to recruit new talent, works with leaders on staffing issues and helps them make decisions about promoting technicians through a career ladder.

Irick encouraged people to consider becoming pharmacy technicians, a job that’s in high demand. While he has a master’s degree, that’s not required. “Within South Carolina, we do not require our pharmacy technicians to be certified. South Carolina technicians just need to have a birth certificate, a high school diploma and a clean criminal record.”

Pharmacy technicians in South Carolina can reach the next level, state certification, by passing a national exam, completing an accredited pharmacy tech training program and working 1,000 hours under a licensed pharmacist.

Either way, there are a lot of opportunities. “There's compounding pharmacy, specialty pharmacy, infusion - which involves chemotherapy - and the list goes on, from inpatient to retail. You can also work in the military setting; you can work in home health. There's a numerous facets of health care where technicians can work. You will even find technicians working for insurance companies,” Irick said.

“Pharmacy is a great profession. I always promote it. And we're always looking for individuals to join the profession.”

Liver failure pharmacist works with critically ill patients

Carolyn Pfeifer, Pharm.D., loves the profession, too – and she’s not afraid to tackle some of its challenges as a critical care pharmacist. “I work in our specialty medical intensive care unit at University Hospital. It's one of the medical ICU teams. And the specialty part of it is that we take care of all of the patients with liver failure. Our group sees these patients frequently, so we've developed expertise in that.”

 

She likes the complexity of those cases. “From a pharmacy perspective, we have to be creative. And you have to think really critically because there are a number of complexities to navigate,” Pfeifer said.

In the most complex cases, specialty lead-trained pharmacists such as Pfeifer review the patients’ records and conditions daily. “We’re looking to optimize all their medications, optimize dosing based on their organ function, based on drug interactions. We have this specialty service that is sort of happening under the radar,” Pfeifer said.

Patients may be unaware of it, but that specialty service is recognized by the medical team the pharmacists work with. “A lot of our physicians, they will do the diagnostic part of it and say, ‘OK, this patient has this condition, and then they'll just say, ‘Pharmacy, what do you want to do?’ – entrusting the details of medication selection and dosing to the pharmacist.”

Specialty pharmacy tech: “I want to make sure that I'm offering the best of the best.”

Like Pfeifer, pharmacy technician Cassandra Whaley works in a specialty area at MUSC Health. “We mostly work with 14 chronic conditions,” she said.

They include multiple sclerosis, epilepsy, amyotrophic lateral sclerosis (also known as Lou Gehrig’s disease), pulmonary disease and hepatitis C. “Our role is we pretty much do everything for the patient,” Whaley said.

“We do a prior authorization if the patient needs assistance. If they are uninsured or need help with copayments, our role is to just revolve around everything that we can do at one stop for the patient. That's what our specialty does.”

It’s a profession Whaley has embraced, working at MUSC Health for 27 years so far. “When I first came to MUSC, I had a passion for health care. No matter the area I went in, my goal was to be the best technician that I can be for my department, community and other care team members. I take that role seriously because every day, we have families going through crises. I want to make sure that I'm offering the best of the best.”

While most of Whaley’s interactions with patients are over the phone, she knows they’re important. “We have that rapport. We really develop that relationship with a patient. So sometimes, they'll call back and can call me by my name. And I can have a personal conversation. We have that respect for one another, and we share that across the board, and we give that compassion to individuals.”

For MUSC Health pharmacy information, visit its web page.To learn more about pharmacy technicians, see the Bureau of Labor Statistics’ Occupational Outlook Handbook entry on the profession.