The Compromise

Posted by Akin at Wednesday, September 02, 2009

My adult heme/onc rotation ended last week, but I thoroughly enjoyed the experience and would like to further comment on my time there.

I worked on a PA service which was composed of an attending physician, four physician assistants (PAs), and a clinical pharmacist. I generally woke up around 6 a.m. and worked on patients' therapeutic plans at home. Other times, I would develop patients' medication therapy plans in the hospital. I would then meet with my preceptor (Shawna Kraft, PharmD'06, PharmRes'07 and '08), at 8:30 a.m. to review any recommendations that I might have thought of before patient rounds at 9 a.m. Approximately half of my recommendations were vetoed or tweaked by my preceptor and the rest were OK'd meaning I could recommend an intervention during rounds, if it hadn’t already been changed, and later on document the change.

Little did I know that my preceptor would be giving me a summary of all the interventions I made on the last day of rotation, during my final evaluation. As it turns out, I made 20 clinical interventions, 26 patient care alerts, and four drug monitoring notes. I also saved the hospital $94.77! So I’m writing a letter to the University of Michigan Health System. This is how it starts. Let me know what you think:

“To whom it may concern,
I am a P4 student who just finished a clinical pharmacy rotation in the hematology/oncology department. As you know, the clinical pharmacist plays a vital role not only in ensuring appropriate medication therapy, but also in various other services including reducing health care costs. With all this being said, I think it’s important that you know that in the month of August, I saved the hospital $94.77. Let’s keep in mind that this is an underestimation as I may have forgotten to document some my interventions. As a poor student, I believe I’m entitled to at least some of this money. I think half is a fair compromise. Please make a check out to me for $47.39...”


But seriously, it feels good to have a summary of all the clinical interventions that I was a part of for the past month. Perhaps I can also say that I helped our clinical team to prolong a few lives or at least helped to make a patient or two (many of whom were terminal) feel a bit more comfortable in their waning days. This was the most rewarding part of my August experience.