What is ambulatory care pharmacy? Read about how alumnus Forrest Beck ('18) serves as an ambulatory care pharmacist.
Beck’s path toward ambulatory care pharmacy
Forrest Beck, PharmD, is now a Clinical Pharmacist working at the San Francisco VA as a PACT team member. He graduated from the School of Pharmacy in 2018.
Where do pharmacists actually work? The role of a pharmacist has been growing and expanding. Concordia University Wisconsin School of Pharmacy graduate Forrest Beck, PharmD, discovered his passion for working in ambulatory care at a VA hospital. He enjoys working with patients and serving at the outpatient level.
As an aspiring pharmacist, what training did Beck need in order to reach his goal?
Forrest Beck completed his undergraduate degree at the University of Iowa. He then applied to Concordia’s School of Pharmacy for his PharmD degree. Beck’s path is a traditional route to pharmacy school, while others pursue a combined undergraduate + PharmD dual degree program.
For Beck, Concordia University Wisconsin offered him what he was looking for in terms of research and experience opportunities. He worked in a research lab with professor Dr. Uvi Castillo as a student and also interned at Aurora.
After graduating with his PharmD, Beck opted to continue his training by applying to a residency at a VA in San Francisco. Applying to a residency program can be competitive, but Beck felt prepared for the search. “There are many different pathways to residency,” said Beck, “there’s no right or wrong way to do things and everyone’s path is different.”
Getting involved is the best way to succeed
There are things a student can do to make it easier. “Get involved. And that’s worth repeating. I encourage all pharmacy students, if you haven’t already started to get involved now. One way could be working as a pharm tech, or working in the labs at CUW. Get an internship at a healthcare facility, or get involved through organizations.” said Beck, “Concordia offers students a lot of opportunities to get involved with pharmacy organizations locally and nationally, so be a member and an active participating member and taking on a leadership role.”
Beck also participated in the Interprofessional Education (IPE) at Concordia, ranked one of the best in the nation. “Concordia University Wisconsin School of Pharmacy students should take advantage of all of Concordia’s opportunities. I was involved with IPE. It helped me gain experience in a wide variety of areas. Concordia has case studies, competitions, and many other options,” said Beck.
Deciding to become an ambulatory care pharmacist
There are other so many pharmacy career decisions available to graduating pharmacists. Beck recommends aspiring pharmacists explore as many experiences as possible. “Find something that you’re interested in and you’re passionate about and find opportunities in that,” said Beck. His involvement in the IPE program, internship through Aurora, and research involvement with the lab helped solidify his interests.
“It was through IPE and my internship that I learned I wanted to be an ambulatory care pharmacist.” said Beck, “I enjoyed patient care a lot.” Some pharmacists in clinical pharmacy work in mental health, pain clinics, and anticoagulation clinics, but Beck’s focus is unique within the VA.
Career as a VA clinical pharmacist
Beck is now a clinical pharmacist and works at the San Francisco VA as a PACT team member. He works with nutrition fellows, psych fellows, works on case presentations, and meets with a team huddle every week. With the VA outpatient model, a team of practitioners works with a patient aligned care team. Each provider adds expertise in their respective areas.
Beck works in primary care and manages diabetes, hypertension, tobacco succession, and is expanding into health failure work. “As a pharmacist at the VA, I work under a scope of practice and prescribe medications, adjust them, order labs, and provide consults,” said Beck, “I enjoy the variety of working with hypertension, diabetes, hyperlipidemia, tobacco cessation. I have a sense of independence in those clinics.”
Pharmacy during a pandemic
The pandemic has shifted the model in which Beck works, but has not changed the level of excellent care he provides. “We work together with patients on video – it’s a unique care model to see a specialist team in San Francisco, without involving a painful 3-5 hour commute,” said Beck. In some ways it has provided easier access for veterans to receive care.
“During the pandemic, telephone and video visits have become even more prevalent. Most of them are via telephone and many during video,” said Beck, “In the beginning I would have liked to see patients in person because that is what i was used to, but I tried to remain flexible with adapting to changes. Now, I truly feel that video visits have become a good way to connect with patients. I was used to in-person appointments and enjoyed establishing rapport that way during visits.
I was worried about using the telephone and video clinic, but I do find their are some real efficiencies. The whole check in process of getting a patient in, checked in, etc, is removed. Telephone doesn’t have that check in process. You call them, and they pick up. I also think it helps us reach a broader audience, especially for those veterans who have difficulty getting to the clinic. One other perk is that hopefully here are less no shows and we keep our rates up of reaching patients.”
Working as a team to support patients is critical
Beck noted that rapport building may take longer over the phone or video. This may be especially true if patients are hesitant to change, adjust medications, or they may have not heard of pharmacists in the clinic. However, he is conscious of hesitancy, understands their reasoning, and gives patients time to warm up to the idea. He also sees the benefit of working with a supportive healthcare team. “It’s necessary now more than ever, because we’re virtual, to connect with other healthcare members,” said Beck.
Other CUW School of Pharmacy graduates, Andrew Russell and Matt Pivec, have also had to adjust the way they provide pharmacy care during the pandemic. They opened their own pharmacy in Minnesota in 2020.
Concordia prepared Beck for his career
Concordia’s School of Pharmacy offers a variety of career workshops and employer meet and greets. Beck found them useful in preparing for his career. “I would encourage anyone to take advantage of all the opportunities for resume-building at Concordia. There are so many at Concordia offered for residency preparation. I took advantage of interview prep, letter of recommendation workshops, mock interviews, and more.”
Concordia brings employers to students at on-campus pharmacy career fairs. Beck took full advantage while a student at CUW. His advice to students still working toward a PharmD? “Take advantage of all those opportunities and be intentional with your interests and your career interests. Also be intentional during residency interviews. Highlight all the great things you’ve been doing over the past few years. Highlight your experiences and advocate for yourself. For example, I expressed and was vocal that my goal was to be in primary care and I wanted to work in clinics.”
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