PHARMACIST + PHYSICIAN POINTERS

February 09, 2018





As a new pharmacist straight out of school with not much working experience, I found my first job absolutely overwhelming. Although, I am much more confident than I started, I believe I am always learning something new.
One of the challenges I faced was communicating with doctors, despite my outgoing personality.  I quickly had to develop a rapport with MDs/PAs in order to get my message across. I learned to be concise and to the point, not telling my whole life story. Communication is imperative to our daily functioning. And with so many different health personnel involved (including nurses, doctors, PAs, and pharmacists), there should be only one goal set in mind, and that is providing a positive outcome for the patient.
I am so grateful to co-author with Dr. Cher to provide insight on successful ways to communicate with colleagues, both from a doctor's and a pharmacist's perspective.
Here are some helpful tips for effective communication:
 
The Pharmacist's POV
Written by Dr. Sandhya Kumar
(@the_modernpharmacist)
 
Be Confident and Concise
Confidence will come with experience and time. As you make initiatives to communicate via phone, you will become more comfortable. The trick is to keep your calls short and sweet. You want to get your message across in a clear fashion.
Investigate
Take initiative and investigate. Sometimes you can do a little digging through the notes and medication history to find out about allergies or other clarifications that might be needed!
Convey trustworthiness
Trustworthiness is another critical factor in collaborative relationships, therefore know what you are talking about and make sure you are conveying the correct information. If you need to look up something, do it before you get on the phone!
 
Call the physician back
Alternatively, if doctors are calling you for information, you can always give a call back if you don't know the answer off the top of your head. It's better to give the correct information than to guess. You will be respected much more!
Respect time
The truth of the matter is, doctors are extremely busy. One thing I found helpful was to go through a comprehensive problem list of orders before making a phone call. If there were multiple issues to be found, you can address them at once rather than making multiple phone calls. It will make life much easier for everyone, trust! Late night calls should be for true emergencies only. If you can get a hold of a in-house PA or MD, try to do so.
 
The Physician’s POV
Written by Dr. Cherilyn Cecchini
(@doctor.cher_c)
 
I absolutely love when pharmacists join the team on family centered rounds. I can field questions to them about dosing of medications and when to time levels of peaks or troughs for certain therapies.
Communication is key to effective delivery of medical therapies and it is crucial for the entire team to communicate clearly. This may seem easy, but it can definitely prove more difficult than expected, especially when a large group of dynamic individuals are placed together. Teams are constantly changing, and this creates an even more difficult situation. Just as you start to learn the style of one team member, another person replaces that individual and takes over the role. I definitely agree that the overall goal, despite these challenges, remains positive patient care outcomes.
 
Additional tips for effective communication:
 
Ask questions
If you are unsure about certain medications, the pharmacist is a wonderful resource to utilize on family centered rounds. If you do not have a pharmacist rounding with you, be sure to jot down your question to ask them later. Organizing all of your questions in one place allows for easy reference.
 
Ask for clarification
Are you confused about the dose of a medication? Ask for help before ordering the drug. Are you worried about possible medication side effects or interactions? These are perfect questions to ask the pharmacist to look into while you continue conducting rounds. The pharmacist serves as a vital resource for these types of inquiries and they are always happy to clarify dosing, dosing schedules, medication side effects and interactions.
 
Redirect the conversation
So, you’ve found yourself completely off topic and rounds are lasting a bit longer than expected. If you’re the senior physician, encourage the members of the team to revisit the conversation after rounds are complete. If the pharmacist has a teaching point, encourage him or her to share it between patient rounds in order to manage time effectively and round efficiently.
 
Respect time
Pharmacists are generally covering as many patients as physicians and may not always have immediate answers to any questions. Allow the pharmacist to consult resources and get back to you. Try to cluster questions together in order to eliminate frequent phone calls. Lastly, always practice closed loop communication to ensure that nothing falls through the cracks while providing excellent patient care.




Study Tips and Tricks

December 06, 2017

I really had to change my study strategies from when I was in undergrad. I quickly came to realize that I had less time to procrastinate and more information to go through. And no matter what, I never felt ready for an exam and almost always felt like I just needed one more day! Therefore, I put something together that may help not just pharmacy students, but it may help just any student.

Here are some helpful tips:

Outlines and Drug Charts


✅One thing that helped me was to outline each topic or disease state, and then highlighting the important information. For example, for each topic I would generally list epidemiology, etiology, clinical presentation, and diagnosis. And when I mean general, I mean general. This was not much of my focus as a pharmacy student.
✅For me, it was all abut the drugs! In which, I would handwrite or type the drug charts, including the mechanism of action, side effects and anything unique that sticks out. I would then go in with different color pens and add in more information if something important was brought to my attention. All of the above information was condensed into 1-2 sheets, and provided me a quick reference. Especially, if you don't have time to go over everything again. I would take these notes everywhere and pull them out randomly and study (my study spot was the NY subway guys, I had a long commute). Example shown below.



Breaks and Coffee

✅Take breaks, especially if you find your self just staring at your notes and not retaining anything. Get some fresh air or have a cup of coffee. Coffee gave me life!
Group studies was always a good break. Teach back to each other, sometimes you will have a better understanding and may learn more that way.
✅ If you have multiple exams (which is always the case), try switching topics. I feel like that helped me when I couldn't take it anymore!


Note to Self

✅Yes, you will have to memorize a lot. But try to understand your material. I feel like you retain much more long-term.
✅ Make sure you get adequate sleep. Trust me, you need it and your brain will function much better. I was NOT a night owl, and called it quits if I realized I wasn't retaining information. In that case, I would just wake up super early and just start again!
✅Sometimes a little confidence goes a long way, so trust yourself. You know more than you think.
✅Do not wait until the last minute. You will get overwhelmed! Grad school is usually information overload. So it's always good to pace yourself and schedule your topics and study outlines.

Hope this helps, and good luck to all you students. I was there not to long ago, so I feel your pain. You will get through this!

What's the 411 on Retnoids and Retinols?

November 28, 2017



As many of you already know, I am really into proper skincare routine and anti-aging products. There are so many products available that claim youthful and clearer skin. Sometimes its worthwhile researching the active ingredients and knowing what you are putting on your face. Therefore, I believe retinoids is a topic worth understanding!

As our skin naturally ages, the skin tends to loose elasticity, developing wrinkles or fine lines. Retnoid based products are shown to reduce wrinkles, increase blood flow in skin, fight acne, increase cellular turnover, boost collagen and even skin tone.

WHAT ARE RETNOIDS?

Retinoids are a class of chemical compounds that are derivatives of vitamin A. It can be dispensed as prescription medications or it is available in a range of over-the counter products. Retinoids work by promoting the skin to rapidly turn over cells. Old cells die and new cell growth is generated.

WHAT IS RETINOL?

Retinol is a form of vitamin A, that naturally occurs in the skin. Over-the-counter skin products contain 0.05-2% of retinol. The mechanism action of retinol is that it is converted to retinoic acid, which is the active ingredient that show improvements in wrinkles and texture of skin. The fact that it has to go through a conversion process, it takes time to notice results (~3-6 months).

Retin- A (Tretinoin)

Tretinoin was the first retinoid approved by the FDA to treat acne. However, dermatologist noticed that patients on Retin-A experienced clear, soft, bright and less-lined skin. Therefore, it's common that Retin-A is used for skin rejuvenation. Retin-A is more potent than retinol, having an immediate effect. There is no conversion required by the body, since it is already formulated as retinoic acid. Therefore, results are seen much sooner than any other retinoid product (~4-8 weeks).


WHICH ONE TO CHOOSE?

What to choose depends on your skin type and reaction. It's a good idea to start with over-the-counter products to see how your skin reacts. If you do not see the results you are looking for, your dermatologist may recommend a prescription based retinoid, such as Retin-A.

TRUST ME, I AM A PHARMACIST

  • Do not use retinoid products if you are pregnant or breastfeeding. These agents are teratogenic, which means it can cause fetal harm.
  • Waxing can cause further irritation and redness; don't use a retinoid for several days before a treatment.
  • Avoid use of benzoyl peroxide and alpha hydroxy acids, these may deactivate retinoids.
  • Side effects include redness, irritation, sun sensitivity (wear your sunblock SPF 30 or higher) and swelling of the skin. 


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