Posted by Nina Cimino at Wednesday, November 09, 2011

After two and half weeks of ambulatory care, I'm learning what a broad field it is! This rotation is different from some of my other rotations because rather than being very involved with one specific activity, I have had the opportunity to see a wide range of ambulatory care practices in action.

One area I've been exposed to is pain management. I was able to shadow a clinical ambulatory care pharmacist who practices in a pain management clinic. Patients with chronic pain issues can be referred to this clinic by their primary care provider if their pain is not well controlled. The pharmacist then schedules visits with these patients and works to optimize to their medication regimen and control pain. This area is one in which I have been particularly interested, so it was a great experience to be able to shadow a pharmacist practicing in this area!

Today, I shadowed a clinical ambulatory care pharmacist in a geriatrics clinic. This clinic focuses on elderly patients, many of whom are frail and have multiple medical issues. In this clinic, the pharmacist works with a team of physicians, fellows, medical students, and social workers to optimize the care of elderly patients. The goals for a geriatric population are not always the same as the general patient population. For example, while optimal management of a medical condition may require 3 or 4 medications, that regimen may be completely unmanageable for an elderly patient suffering from alzheimer's among other medical conditions. The goal of the clinic then, is to provide the best care for the patient possible while minimizing the burden of medications and adverse reactions.

I'm really enjoying experiencing the broad range of ambulatory care practice areas available at the VA! Tomorrow I head back to the pain clinic, and next week I get to participate in a cardiac risk reduction patient care group! More details to come...