Ambulatory Care Team

Health care is a team business and pharmacists are an integral part of that team. Here is Dr. Brian Cryder, Associate Professor of Pharmacy Practice, describing his team approach to taking care of patients with chronic diseases at his ambulatory care clinic in Chicago. Dr. Cryder is proud to be a pharmacist and is rewarded when patients learn to manage their disease and improve the quality of their life.

To see all that we have going on during American Pharmacists Month, go to our American Pharmacists Month Web page.

I currently practice in an ambulatory clinic with Advocate Medical Group in Chicago. Our team of clinical pharmacists works with outpatients to manage their chronic illnesses, specifically focused on anticoagulant and diabetes pharmacotherapy at the present time. We collaborate extensively with the interdisciplinary internal medicine team of physicians, nurse practitioners, physician assistants, registered nurses, dieticians and support staff to meet the needs of the patients that seek our care.

Our referral service has become very valuable to the internal medicine, cardiology and endocrinology groups whom we collaborate with; especially in light of the ever mounting pressure to increase patient volume and RVU's (relative value units, a measure of resource usage by a particular intervention or service) without compromising patient quality outcomes.

A typical day in our clinic consists of five primary activities: face-to-face office visits with patients, telephone-based follow up, curbside (informal and brief) consultations with other health care providers, assessment of clinical outcomes, and training of students, residents and other practitioners. The office visit schedule averages 18 to 22 anticoagulation assessments and 2 to 4 diabetes medication assessments per day. Visit duration varies based on the complexity of the patient and educational needs, but average about 15 to 20 minutes for anticoagulation and 30 to 45 minutes for diabetes management

Over time, the health care providers with whom we collaborate have relied on our medication expertise to help answer complex drug-related questions spanning a variety of topics from infectious disease considerations to drug interaction management. This growing trust provides an excellent opportunity for expansion of pharmacist services and responsibilities in the clinic, including a planned future transition to a patient centered medical home care model.

For me personally, being a pharmacist in the outpatient clinic setting is very rewarding. I have the opportunity to see the success stories unfold of patients who were overwhelmed trying to make sense of their medical situation, but now can have new confidence in their ability to manage their conditions. From my experience working with patients in the southern portion of Chicago, there are numerous misconceptions about medications and other financial or health literacy barriers that prevent people from receiving optimal care. As pharmacists we can serve an important role in the healthcare team addressing these issues, helping the entire team fill their roles better.