Cassandra Shields knew she wanted a career in the medical field. She ruled out getting an M.D. or D.O. on account of the long hours and the very real threat of malpractice that medical doctors can face.
She had also considered nursing, the same occupation as her mother. Her path changed when, as an undergrad studying biology at Bethany College in Lindsborg, Kansas, she interned at Apotek Pharmacy.
It was there that she discovered that the pharmacy profession provided opportunities to develop lasting relationships that led to healthier lives for patients. “It was obvious that the patients trusted their pharmacists, and that the pharmacists sincerely wanted to help them,” said the former PBA Health intern. “That’s when I knew pharmacy was the profession for me.”
Reaching the counter
As a student at the University of Missouri-Kansas City (UMKC) School of Pharmacy, Shields enjoyed her studies. Four years of classes, such as medicinal chemistry and pharmacotherapy, provided her with a strong foundation to understand why pharmacists are considered one of the most trusted professions in healthcare. “The first two years can be overwhelming. Everyone is saying ‘How do I retain all of this knowledge?!’ Internships and hands-on experience really showed us how much we already knew and how much we did retain from the classroom,” she said.
“Pharmacists are almost considered to be a little obsessive compulsive, because if we do not perform our job to the best of our ability, we are putting our patients at great risk. Our job as pharmacists is to put the pieces of the puzzle together to see the bigger picture,” she said. “To this day, I use those ideas to motivate me to better understand, and further help, my patients.”
“Leaving school doesn’t mean your education is finished. It’s important to stay up-to-date on what’s happening in medicine and in your community. Utilize the Internet, conferences and communicate with your peers. You’ll be amazed at what happens when people come together to help others,” the 2010 graduate said.
Starting out
Shields worked as a technician at the Olathe Medical Center Pharmacy in Olathe, Kansas throughout her graduate studies. “I actually worked in hospital and compounding settings before considering retail,” she said. “It was a valuable experience; working closely with the doctors and seeing the immediate impact of my work was great.” But, she reflected on what initially drew her interest to pharmacy—the ability to give continual care to patients by getting to know them well.
Independent pharmacy was a better fit for her. Shields said that many national chain pharmacies have a different perspective on the pharmacist-patient relationship. Many national chain pharmacies have incorporated strict time limitations on their pharmacists—such as the infamous promise of ‘Prescriptions in 15 Minutes or Less’—that seriously endanger patient care. A 2011 study released by the Mayo Clinic reported that more than 50 percent of people take medications improperly. Rushing patients out of the pharmacy does not serve to improve these statistics.
Entering community pharmacy
Regional chain and independent pharmacies do not enforce these kind of stringent guidelines on pharmacists. “It’s really important that patients understand the significance of adherence and that we’re able to make time for patient questions and concerns,” Shields said. “The patients here at Key Rexall Health Mart in Salina, Kansas know that they can call or come see us with almost any health-related question.”
But not all patients realize this, and nor do their doctors. “One of the biggest surprises for me as a community pharmacist was the disconnect between the doctors and the pharmacists,” she said. “For example, MTM (Medication Therapy Management) is a requirement of Medicare Part D, and it helps reduce costs. MTM is proven to be effective and it has a positive impact on the ‘big picture’ for our patients,” Shields said. “I’ve had to explain this development to some physicians and make it clear to them why their involvement is so critical for the success of the patient.”
The future of pharmacy
All levels and specialties of pharmacy are changing. According to the 2011 Advanced Pharmacy Practice Report to the U.S. Surgeon General: “Current pharmacy practice is considerably more diverse than what has been previously reported in terms of scope of practice and practice setting. Traditional roles of the pharmacist tied solely to medication product and delivery have been greatly expanded.”
Shields agrees. “The days of making a living strictly with dispensing are over. Eventually, we may even see a flat rate for drugs, with reimbursements based on adherence rates or other services instead,” she said. “In the meantime, the move toward outcome-based care is inevitable, and I believe pharmacists should gladly embrace this change.”
“Pharmacists have a responsibility to their profession,” she said. “We’re often the most approachable and accessible members of our patient’s healthcare team, and we need to let our patients, and their doctors, know this. By working together—with each other, doctors, nurses and other medical staff—our patients can have happier and healthier lives.”
Cassie Shields, Pharm.D., lives in Salina, Kansas with her husband Brad Shields and their two Cavalier Spaniels, Max and Asher.
