I can still remember the lectures about the various pharmacy specialties in my Introduction to Pharmacy class. For an hour or so, weekly or biweekly, we were given a brief overview of a specialty. Over the course of the semester we were introduced to almost every area of pharmacy practice. Often a faculty member or guest lecturer who practiced in that specialty would deliver the presentation. Going into pharmacy school, I had no idea that there were so many different practice areas. Prior to applying, I had only been exposed to community (also referred to as “Retail Pharmacy”) and general hospital pharmacy. I knew that clinical pharmacy existed, but I really had no idea what clinical pharmacy practice really entailed.
In my opinion, pharmacy essentially combines multiple disciplines into one dynamic, constantly evolving field. This is one of the primary reasons I chose to apply to pharmacy school. In many cases, pharmacy sits at the intersection of medicine and business. To this day, this is still a major reason why I enjoy my career in pharmacy. There is always something new and exciting to learn. It is extremely important to have vast and deep clinical knowledge, and it is just as important (if not more so in today’s healthcare climate) to possess a sound business acumen.
I always felt that a community pharmacy setting was the best and most interesting way for me to apply both business and pharmacotherapy knowledge simultaneously. As I progressed through pharmacy school, my love for community pharmacy continued to grow.
I loved the patient interaction, the variety and the fast pace. I was fascinated by the opportunities to grow as a leader and be responsible for multiple pharmacies or even entire business units, such as pharmacy operations or clinical services. Owning multiple pharmacies and developing innovative solutions in both pharmacy practice and healthcare overall was, and still is, an important goal for me.
However, learning about all of the different areas of practice was definitely eye-opening, and my experience in that class ultimately ended up adding an additional dimension to my career. I remember being very excited thinking about all of the possible career paths I could take. Many healthcare professionals, pharmacists included, are not aware of the various specialties in the field of pharmacy.
The Board of Pharmacy Specialties currently credentials pharmacists in 11 different specialties: ambulatory care, cardiology, critical care, geriatrics, infectious diseases, nutrition support, oncology, pediatrics, pharmacotherapy, psychiatry, and nuclear pharmacy.
Towards the end of the intro to pharmacy class, we had to choose a specialty that interested us most and share why with the rest of the class. When I was called on, I proudly said, “geriatrics.” I was the only person in the class to choose that specialty. With puzzled expressions on their faces, many of my classmates (and even the professor) asked, “Why geriatrics?”
Growing up my family and I often went to visit my great-grandmother in a nursing home. She was diagnosed with dementia which, in hindsight, was most likely Alzheimer’s disease. I vividly remember seeing her condition deteriorate over the years. I remember how my family would try to go through the medications in her chart and talk with her nurses and physicians. It seemed that some of the medications were doing more harm than good. She would often be very tired and just “out of it” in general. Her diabetes was poorly controlled and after years in the nursing home, she had to have both legs amputated.
None of the healthcare professionals could communicate a clear picture of her condition. My family was often frustrated and confused. We did not have any healthcare professionals in our family and my mother would often ask friends of hers that were nurses or doctors what she could do to help my great-grandmother. Unfortunately, her condition continued to worsen, and she passed away while I was in pharmacy school.
Needless to say, this greatly impacted me. As I learned more about the role of a geriatric pharmacist, I couldn’t help but think about my great-grandmother and how differently things may have been had a geriatric pharmacist been involved and available to my family.
The Geriatric Pharmacy Fact Sheet provided by the Board of Pharmacy Specialties explains that a geriatric pharmacist does the following:
・Applies the pharmacist patient care process to provide person-centered care to older adults with complex medication regimens and multiple comorbidities.
・Provides direct patient care, education of other health care providers, advocacy for appropriate medication use in older adults and collaboration with interprofessional health care teams.
・Improves public health by identifying, preventing, and resolving medication-related problems in older adults, while promoting optimal therapeutic and humanistic outcomes.
Fast forward almost 5 years and I am now both a retail pharmacy manager and a Board Certified Geriatric Pharmacist. The reason I shared with the class back when I was a student was definitely the driving force behind me choosing to pursue board certification in geriatrics. Additionally, many studies are showing that the number of baby boomers over the age of 65 will double by 2025, making them the fastest growing segment of the American population. Currently, there is a significant shortage of healthcare professionals specializing in geriatrics. Geriatric pharmacy then, is not only a field that I am extremely passionate about, but also one that is, and will continue to be, in demand as Americans are living longer and longer.
Being involved in both community and geriatric pharmacy is very rewarding for me both professionally and personally. There are countless instances each day where my knowledge in one area helps me to solve a problem in the other. I feel that I am a much better pharmacist and resource for my geriatric patients in the community setting. In addition, my understanding of retail pharmacy operations, as well as the nuances of health insurance make a huge difference in my ability to help direct the care of patients when I am outside of the community pharmacy setting.
Looking back on my career progression, I would not change a thing. The experiences I have had thus far have been extremely valuable and have helped me to grow tremendously, both as a pharmacist and as a person. I absolutely love the variety and I am very excited to see where my career will take me as I continue to develop as a leader in both pharmacy practice and the overall healthcare field.
About the author:
Bryan Mayfield is a Board Certified Geriatric Pharmacist who spends most of his days practicing as a community pharmacist in Dallas, Texas. He received his Doctor of Pharmacy degree from Xavier University of Louisiana in 2013, and he has additional certifications in Medication Therapy Management and Pharmacy-Based Immunization Delivery from the American Pharmacists Association and Community Pharmacy Based Point of Care Testing from the National Association of Chain Drug Stores.