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Press Start: Lead an Empowered Life as a Clinical Laboratorian

What We Could Learn from Pharmacists

Published June 25, 2016 8:34 PM by Glen McDaniel
 

I know our profession is unique and cannot be identically modeled off any other profession. However in both my personal and professional lives I often try to learn lessons and draw parallels from observations around me.

 

I have been in this profession for more years than many of my readers have been alive. I have practiced in several countries. Although there are differences, some nagging challenges are universal and also have persisted for years. One such bugaboo is the dissatisfaction with how we are perceived, given our education, training and abilities. We also compare unfavorably with others in the healthcare fields who have somehow managed to overcome barriers similar to those we cannot seem to overcome.

 

So that’s where the comparison with pharmacists comes in.  They did not like the name “druggist” so they universally adopted the more professionals sounding moniker  of “pharmacist.”  Yet, we still struggle as to whether we are “just technicians,” “medical technologists,”  “medical lab scientists”  - or something else. We argue among ourselves as to even whether choosing a descriptive name is mere elitism and fanciful thinking.

 

Pharmacists decided to limit entry to the profession. They control their own profession,  have a rigorous entry exam, and allow only a certain number of entrants per year. That practice creates demand from employers and also helps to select the best candidates.

 

They have crafted  their program specifically to fit their body of knowledge. They won’t accept a bachelor's in basket weaving, plus 2 years’ experience working in a pharmacy as an acceptable pathway to enter the profession. Biology and chemistry are essential foundational sciences, but they are distinct from pharmacy.They are not substitutes for a degree in pharmacy. The training is also standardized. I certainly do not want to disenfranchise any current laboratory practitioners, but we ought to have a cutoff date after which we offer (and accept) only a very specific entry level degree. Every one practicing the profession should possess a medical laboratory science degree.

 

Then there is the hot button issue of licensure. Seen by some as just another fee to pay, or a devious plot by government to take more money from the working citizen, it is also one way in which the public health is protected. Each hard-working practitioner is also protected because they cannot be legally displaced in the workplace by anyone who is not similarly educated, certified and licensed. What about the need for a separate licensure examination in each state?  Professions like law and nursing have licensure compacts where licenses are essentially transferable from state to state. Once you licensed, there is no need to sit a different licensure exam if you relocate. Accepting national certification for licensure is also not without precedence. So that barrier is very easy to leap.

 

In recent years pharmacists have deliberately crafted practice routes for themselves without waiting for others to offer them, and without asking for permission to do so. There are clinical pharmacists who make patient rounds and order labs, they manage therapeutic drugs from antibiotics to anticoagulants, they adjust dosages; and they create algorithms and develop best practices. Now it is common for pharmacists to administer immunizations and vaccinations and manage diabetes. They are also the specialialists for medication administration and storage wherever such functions occur in the institution.

 

Pharmacists have gradually (without disrupting the status quo) made the PharmD the entry level professional degree and thereby greatly enhanced their image, demand and earning capacity. Those practicing pharmacists with other degrees were offered creative routes to the PharmD so no one was disenfranchised. See any parallels there?

 

In many states like Georgia, pharmacists have crafted and carefully developed political power as well. Through colleagues in public office and lobbyists they ensure laws are not just pharmacist-friendly, but constantly expand their scope of practice. They can perform some lab tests,  and directly order several tests. They ensure physicians use certain secure mechanisms for writing prescriptions; without which they do not have to fill those prescriptions. All those requirements are prescribed by laws pharmacists helped to create.

 

It’s easy to say we are different. But it is worth drawing parallels and learning from others as well. I think we have a real viable model here.

7 comments

Holden:

This is what US Bureau of Labor Statistics (BLS) says about pharmacists. Retail jobs will decrease by 0.8% (less than 1%) by 2024. However there will be lots of opportunities elsewhere. Here is a direct excerpt:

So where should pharmacists look for jobs? BLS projects that over the next 10 years, physician offices, outpatient clinics, home healthcare, and hospitals will collectively add 9,300 pharmacist jobs (+11%). Here’s what the BLS says about the job outlook:

"Demand is projected to increase for pharmacists in a variety of healthcare settings, including hospitals and clinics. These facilities will need more pharmacists to oversee the medications given to patients and to provide patient care, performing tasks such as testing a patient’s blood sugar or cholesterol…Employment of pharmacists in traditional retail settings is projected to decline slightly as mail order and online pharmacy sales increase."

Maria, Core Lab - MLS July 4, 2016 11:01 PM
Orlando FL

This is an interesting concept. But first I have to say I disagree with Holden McGroin 100% First my husband is a pharmacist who makes 6 figures. Sure he works overtime, but I don't know many of my colleagues who make that much.

His second job is retail and it is grueling and can be stressful sometimes and boring sometimes. But that  is why his main job is a clinical pharmacist in a hospital where he is respected, makes good money and helps patients and doctors directly.

I don't want to speak for Mr McDaniel but I read the article to say you look around you and adopt something that works. If I want to lose weight I look at others and adopt their diet and exercise program. I don't just say, "That's just the way it is-the grass will always be greener on their side" or "what they did will never work for me." I don't understand that sort of mentality. I don't want to BE anyone else, but I do adopt the successful habits of others all the time. That is how we get better.

We cant relax and say "that's the way it is." We push buttons, employers wont pay us any more, payers just want cheap lab tests and we have to accept it all without doing anything. THA attitude is THE problem.

Misty S. July 4, 2016 10:46 PM
Miami FL

I am coming close to retirement and I love my job. I still love my profession deeply. The one thing I am regretful of is that I did not get to use all my knowledge. I left school with a lot of theory having to do with diseases, anatomy, physiology etc. I never used it.

Over the years I learned a lot technically. I also developed almost a 2nd sense like most of my colleagues. We got a  result and we knew what else was wrong, what other results would be off, what the diagnosis was.

I wished pathologists and doctors used our knowledge more. I wished they tapped into our skills more. I would feel more fulfilled and I think patients would be much better served.

I must say one thing that saddens me is the thought that no change in role will ever happen or make our profession better. Some of us prefer to whine but never come up with solutions. It is a shame that people just sit back and accept the status quo. We are unhappy but will do nothing.

They see other professions progressing, but say that is THEM, that has nothing to do with us.

They say a doctorate wont help, CEUs wont help, licensure wont help, speaking out wont make  a difference, membership in professional organizations is a waste of money. They agree that other professions are really professions, but we are button pushers. Why do more than load an instrument with specimens? Why even TRY for recognition they say?

That is really the sad, disappointing thing about our profession. That is the one thing that frustrates me. That is the ONE thing I will not miss  when I retire.

I pray those coming up in the profession ill have the guts and the pride  to change what they don't like.

Angela T. July 2, 2016 4:18 PM
Chicago IL

So this happened to me just last week. I am having trouble keeping my blood sugar stable as a diabetic. I am able to email my doctor for simple problems.

I emailed him and he made an appointment to come in. I saw his nurse practitioner (a nurse with expanded scope, another profession with broad scope). Then she referred me to a clinical pharmacist who called me a few days later. The pharmacist asked about my glucose numbers for the past 3 weeks, asked about exercise, diet, any stress in my life etc. These are things I'd normally discuss with my doctor.

Then on the phone she changed both my medication and dosage (she increased 1, added a second and discontinued my nightly insulin). She also ordered a HbA1c. I went to the lab a day later and the order was there waiting for me.  When I looked at the result in the medical record portal it was shown that my primary care doctor was Dr ABC, but the order was by Dr... XYZ, PharmD.

I am saying this to agree with you. I am used to seeing my doctor personally, but this is the new trend and it might in fact improve care if we don't have to wait to see the doctor for everything.

April July 2, 2016 12:34 PM
DC

Am I missing something? Holden how did you get the idea a doctorate is required or a doctorate was being pushed?

John Taylor, MT2 July 2, 2016 12:26 PM
New York NY

Holden:

I think this is what's wrong with the profession: whine and do nothing. First off there is no where this blog said anything about grass greener on the other side. It does not even mention retail pharmacy. If you re-read it you will see it is talking about options. It talks about options in pharmacy and also says MLS COULD have options too.

Merceded July 2, 2016 12:24 PM
Atlanta GA

Gee, another grass is greener on the other side commentary.

Try working Pharmacy retail. It's a miserable existence. Many low quality pharmacy schools exist and they continue to open more, flooding the market. Their job prospects are not as rosy as this commentary suggests.

The lab is a commodity business. Patients and physicians want lab work done as cheaply as possible. That doesn't bode well for lab worker salary or recognition. A doctorate degree will not fix this.

Holden McGroin June 30, 2016 2:11 PM

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