One Down, Nine to Go

One rotation down, nine more to go until I earn my Pharm.D. My first PY4 rotation took place at a small pharmacy located within a large clinic and adjacent to several other medical practices and a hospital. Despite this prime location, this particular pharmacy is *VERY* slow–they only fill around 30 prescriptions per day, compared to some major chains that fill over 500/day. The majority of these scripts are for trials of meds accompanied by coupons, which usually result in the patient going elsewhere in the future. I think this pharmacy has potential to be extremely prosperous and have a great impact on patient care–they just need to figure out how to promote themselves, their convenience, and their professional expertise.

Although this rotation started very slowly, I found plenty of ways to occupy my time and make the most of the rotation. I had the opportunity to participate in a great deal of compounding, everything from progesterone suppositories, to butt balm, to testosterone cream. I was also able to collaborate with physicians on occasion and assist in the care of patients.

One thing that did bother me was the number of drug reps that crowded this clinic. About every 4th person that walked into that clinic was a drug rep. As we all know, prescription drug costs can be astronomical, and therefore I am a huge proponent of generic drugs and make every attempt to save patients money. Don’t get me wrong, I support pharmaceutical research and appreciate the advancements that have been made. However, I can not justify a patient receiving, for example, an antihistamine that costs them $40, simply because it is a new isomer of an older drug, which would have only cost $10. I am especially critical of “me-too” drugs–those that are only slightly different yet cost two or three times the price.

During this rotation, I was able to see the influence that drug reps have over prescribers. The pharmacy and doctors’ offices were littered with pens and notepads and calendars branded with names of new drugs. Not to mention the daily drug rep-sponsored lunch that lured in the entire clinic to feast, only to open the way for the reps to pounce on them, touting why their new $80 blood pressure med was superior to the $4 beta-blocker that has been around (and effective) for decades.

Overall, the rotation was interesting. There was potential for much more, but I wasn’t too disappointed. Tomorrow I start my next rotation–Correctional Pharmacy Management. It is supposed to be a rotation centered around care of patients in the prison population, namely Kentucky’s major medical prison complex. I have already spoken to the student who just finished this rotation, and she seemed to be pleased with the projects that they undertook, and the hours. I would have to say that I am looking forward to this rotation the most–hopefully I won’t be disappointed. I will be sure to post my conclusion at the end of June.

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In other news, I had my stitches removed and I’m almost completely healed up. The final biopsy showed that they had removed all of the abnormal cells. So I am doing well and don’t even have to follow up with the dermatologist. Please take my advice and lather up the sunscreen this summer and try to avoid the tanning salons!