Tuesday, December 30, 2014

Welcome to Detroit City

Posted by Unknown at Tuesday, December 30, 2014

On the first day of my community APPE, I hopped in my car and headed to a place as unknown to me as the arctic tundra: Detroit. A city where my grandparents had once found careers and raised my parents, who, like most other Polish-American middle-class families, fled to the suburbs the moment they had the opportunity. Once established in Troy, my parents only visited the Motor City for downtown hockey games and theatrical performances. Before this rotation, I had only known the city for its stretch of I-75, and everything beyond was left to footage seen on the news and the internet. Little did I know, I would be experiencing Detroit first-hand during my third rotation in community pharmacy.

I first arrived at midtown, on the northwest portion of Wayne State University's campus, on a warm September morning. After an hour and 15 minutes of sitting in traffic, the 5 minute walk to the independently-owned pharmacy felt nothing short of amazing. When I stepped inside the small downtown-like shop, I knew I would be walking into the most interesting 5 weeks of my fall semester.

University Pharmacy is an independently-owned pharmacy by an Rph whose main professional goal is getting PharmDs health provider status. While one pharmacist manages the daily duties inside the store such as checking prescriptions and maintaining inventory, the owner, my preceptor, spends her time in the community providing services and advocating for the profession. My first day, while I figured out how to park at Wayne State's campus without being a student, my preceptor quizzed me on my strengths, weaknesses, and future plans for the profession.

While I didn't spend any time during this rotation learning therapeutic concepts, I instead spent my 40 hours per week providing TB tests and flu shots to different sites within the Wayne State Physician group. My preceptor alerted me to the worries some health care workers had regarding the shot and the pharmacists that provided them. While in the clinics, the complaints patients had about pharmacists providing immunizations stung as much as the shot itself. We even had one secretary ask for a nurse to provide the shot instead of me!

In addition to perfecting my flu shot education and technique, I also learned about the unique challenges that independent pharmacies face. For example, during my internship at CVS, I never had to examine the pharmacy reimbursement for each prescription, the inventory and production used scanners for accuracy, and all tasks, including flu shots and other services, were provided right at the pharmacy front counter. At University Pharmacy, I was able to see how little the pharmacy gets reimbursed for selling generic medications, that the pharmacy did not have the funds for scanner-integrated technology, and that all services, including flu shots, were provided in a separate office in back. In order for the pharmacy to stay competitive against the nearby chains, they partnered with Wayne State University to run flu clinics, provide lectures for the medical students, and screen blood pressure, cholesterol, and glucose for Wayne State faculty and staff.

In a brisk day in mid-October, I hopped onto the Lodge freeway and headed from Detroit to Ann Arbor one final time. Even though I was excited to have less of my money spent on gasoline, I was sad to leave University Pharmacy and Midtown Detroit, a place that had very quickly felt like home. Although I did not leave my rotation with new clinical knowledge about certain disease states, I felt invigorated to become a leader in the community pharmacy setting. And I felt excited to once again visit Detroit, a city which now feels a little less unknown.

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