H-IPPE: Central Outpatient Pharmacy

My rotation day with the Central Outpatient Pharmacy marked my first occasion behind a pharmacy counter.  Having never worked in a pharmacy before, I appreciated seeing this opportunity. Outpatient pharmacy is a hybrid, a mixture of retail and hospital pharmacy. In many respects, the COP acts as any retail, community pharmacy, but there remain numerous differences. They require payment, cash or insurance, and they generally have a quick turn around time. But the COP can only fill prescriptions from prescriber affiliated with the hospital and will not accept transfer prescriptions from an outside pharmacy. Most customers are patients being discharged from the hospital on their way out. 

Many of the pharmacists previously worked at CVS or other retailers before coming to the COP.  That was part of the manager's plan to decrease the wait times for the patients.  Apparently a year ago, patients waited for an hour, while now they are in and out in 20 minutes.  The pharmacist that I spoke to was really happy with his choice to leave retail and come to the COP.  There may have been a major pay cut, but greater quality of life - including less weekends and an actual lunch hour.  It is a lot easier to help the patients because they are attached to the hospital network and can view the entire hospital record for a patient and determine the indication.  Knowing the indication can help with verifying a medication's dosage, especially for pediatrics.  For all pediatric prescriptions, they must recalculate the dosage strength.  This requires the child's weight in kilograms and the indication - both readily available in the COP, not at a local retailer.  

As a public hospital devoted to all North Carolina residents, the COP has a pharmacy assistance program for those that cannot pay.  Some have $4 copays or even zero.  Many patients come from 2-4 hours away to receive their heavily discounted drugs, which is why the hospital is pioneering a mail order program.  Before a patient qualifies for the assistance program, the COP will fill any order for 14 days.  When they come back with the forms and are accepted they will fill the remainder of the order.

Even though I may not know what I want to do in the end of the PharmD program, this was one that I definitely felt comfortable with.  I hear the stories about working in retail and the difficulty of getting into a clinical position, but this sits firmly in the middle.  You help patients on their transition from the hospital to home and you get to use more of your clinical knowledge to help.  I would have no problem working in an outpatient pharmacy after this experience.