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Frequently Asked Questions


Residents attend a "Resident Paint Night" activity

 


Find answers to frequently asked questions about clinic participation and general PGY2 residency at PeaceHealth.

General clinic questions

Which disease states do the pharmacists directly manage?

We see and directly manage medications for patients with diabetes, anticoagulation, hypertension, smoking cessation, hepatitis C, and COPD.

How are pharmacists involved in the other disease states that are listed?

For patients with HIV, we are involved in their intake visit as they transition their care to our clinic. We review their HIV medication history and labs. If they are due for labs, we order these at the visit with us. We also educate patients on changes to their HIV regimen. For patients who see us for polypharmacy visits we typically do not make changes to their medications but will make recommendations to their primary care provider about any changes we feel should be made.

How are patients typically managed? In person or on the phone?

We try to do most of our visits with patients in person. We feel residents are best able to develop their clinical and patient interaction skills through face-to-face visits with patients. The exception to this is the pulmonology clinic smoking cessation visits. Here the initial visit is often in person with follow up over the phone. Pharmacists are not conducting video visits currently.

How many patients do pharmacists see per day on average?

We typically have 2 pharmacists in clinic and between them and the resident, the pharmacists will typically see between 5 to 15 patients total per day.

What is your relationship like with providers in the clinic?

We are so fortunate to be in the clinic where we work! Being part of a family medicine residency training program seems to lend itself to a better feeling of collegiality and respect for the various professions we have at our clinic. Medical residents are eager to learn from and hear the experiences and knowledge of our pharmacy residents. Faculty providers enjoy the collaboration of being able to provide unique patient care through team-based care.

Are there any clinical services you are looking to initiate or expand?

Currently we are working to involve pharmacists more in COPD management and performing spirometry, and we’re excited about the potential expansion opportunities from this. We hope to also get more involved asthma treatment. We have also recently incorporated more pharmacist involvement in ambulatory antimicrobial stewardship and are excited to see if this could be further expanded. We have also considered some expansion into pain management/Medication Assisted Treatment (MAT) and heart failure – there are so many possibilities for expansion!

How has your clinic and/or program responded to the COVID-19 pandemic to ensure the safety of your patients and clinic staff?

Patient and staff safety are our top priority. Early in the pandemic, we transitioned many of our visits to telehealth visits over the phone, even seeing many patients for INR checks at their cars in the parking lot! While we’ve been able to bring most patients safely back into the clinic, we still have some high-risk patients we manage over the phone. Our clinic has changed many workflows to keep staff safe including universal masking of patients and employees, increasing physical distancing, and frequent cleaning.

 

General Residency Information

How is the resident’s major project selected?

We want our resident’s project to be something that pushes the practice of pharmacy forward or evaluates the clinical value of established pharmacy services. To that end, we maintain a list of projects we feel best fit the clinic’s needs and try to tailor this to the incoming resident’s interests as well.

What are the strengths of your residency program?

Our program really seeks to make our residents into “Doers”, pharmacists that can integrate into a variety of different settings. We emphasize the value of getting the resident experience with operating in the “gray areas” of medicine, where they may not necessarily feel answers are clear cut, while still practicing evidence-based medicine. This also includes supporting them as they practice pharmacy independently in ways that push them out of their comfort zone.

What are the weaknesses of your residency program?

Unfortunately, our program does not offer many traditional academic experiences. The resident has opportunities to directly precept pharmacy students, PGY1 residents, and medical residents in addition to 4 didactic presentations to the family medicine residents over the year, but we do not partner with any colleges of pharmacy currently.

What makes the PHSW residency program unique?

Practicing in the Family Medicine specialty is part of what makes our program unique. Family medicine is about providing whole-person care where we work to address as much of the patient’s medical concerns as possible in the context of the primary care setting. We help our providers keep patients’ medical care within in our clinic, serving to address diverse aspects of patient’s care as seen in the diverse range of disease states we manage. As clinical pharmacists in the state of Washington, we are allowed to practice at the top of our license under broad collaborative drug therapy agreements, and Washington is one of the few states where pharmacists can bill as fee for service providers with commercial and state Medicaid plans. We also emphasize projects that advance pharmacy practice or justify the work we do.

How do you provide feedback to residents?

We’re big proponents of self-reflection and providing feedback in the moment. We like to spend time reviewing how a visit went right afterwards and letting the resident identify how to improve. We also do weekly “Feedback Friday” sessions to let the resident do some of that self-reflection on how the week went. A key element of these feedback sessions is to hear from the resident on how we can continue to improve their experience with us!

What are the staffing requirements for pharmacy residents?

We feel a unique part of our program is how we approach resident staffing. We want our resident to feel comfortable in the area where they will work so we use their staffing time to cover the clinics they are rotating through. Starting in January of their residency year, we have the resident cover when their preceptors are out of the clinic for vacation days or other days off, for a total of 20 days. This allows the resident to build up their clinical skills while learning to function independently.

What is work/life balance like for residents in your program?

Residency is a busy year for all, but we strongly encourage residents to find and maintain a healthy balance during their residency year. Social gatherings with residents are commonplace and residents are viewed as a critical part of the department. Residents typically enjoy the benefits of living adjacent to Portland, Oregon and often spend off days exploring the outdoors in the Northwest. Please contact our resident and find out what their residency life is really like.