Pharmacists Fill Care Gaps as Community Health Workers

Community pharmacists routinely work 12-hour shifts, holidays, and late nights and often face frustrated patients. Shantel Upshaw Houston, PharmD, interim executive vice president of the National Pharmaceutical Association (NPhA), said they need to take care of themselves, too. She also wanted the public to understand how much pharmacists do, and she urged midcareer pharmacists to mentor those coming up behind them.

Addressing Burnout

How to manage burnout "depends on what kind of community pharmacist," Houston said, pointing to the practice environment, script count, and patient population. Still, she said the pressures are common across the field. The community pharmacist "who stays late, who goes in on holidays, who works 12 hours at a time" is also "the bearer of bad news and the receiver of unkind words at times."

"A lot of it is outside of our control," she said. "But what you can control is you taking care of yourself and you being in community with others who are also understanding what you might go through."

Houston said burnout can also come from the strain of caring for patients while neglecting home.

"As a provider who's in the pharmacy, my family has the same issues that my patients have," she said. Pharmacists should use their expertise at home too, so they avoid "that guilt of not showing up as a daughter, as a sister, as a brother, as a father for the people that we love."

When working conditions are an issue, Houston encouraged pharmacists to join professional associations and push for better conditions. Until things change, she recommended building predictable routines.

"When the unpredictable does occur, you are better equipped to handle it," she said, and more grounded against an emotional reaction.

More Than Medication

Houston said she wishes the public better understood pharmacists' training.

"We really are scientists, and we are experts, and we are trained in research and medication," she said. Other health professions may get about a semester of medication training, while pharmacists study pharmacology, toxicology, and patient care, including how to recognize certain disease states.

That training puts pharmacists in a position to fill gaps in care. A patient may arrive with 3 or 4 health problems and not see their provider for another 3 months.

"You are the one who they're going to talk to," Houston said. In those moments, pharmacists may serve as "the community health worker, sometimes the social worker, sometimes the translator."

For uninsured patients, pharmacists track down discount cards, manufacturer coupons, and patient assistance programs. "These things exist, but how do patients know about them? And it's because the pharmacist is looking out for them," she said.

Reaching Back to Mentor

Houston called on pharmacists to invest in the profession's future. "We need more pharmacists. We need competent pharmacists. We need culturally competent pharmacists, able to serve every community and every need," she said, adding that NPhA places a high priority on a sustained workforce.

Mentorship also keeps the profession's history alive, she said. Students may take today's progress for granted because "they don't understand what we couldn't do” and sometimes need to be reminded, “Wait, we fought for this."

She said midcareer pharmacists are in a good position to help.

"Find a student, connect with the university, be a guest lecturer, speak at a conference for students," Houston said. "Just show up for the next generation... just like the people who were before us showed up for us."