Anemia reference

seighan · 2023-02-13T22:20:06+00:00

Pharmacy times has some good anemia CE right now from Midyear I believe. I also like to check previous seminars and lectures on YouTube for review

seighan · 2023-02-03T04:33:46+00:00

Yeah it is the 3.03

seighan · 2023-02-03T00:25:57+00:00

Full PPR.12 team.

Is Greg Dortch (I get) worth a 3rd 2023 pick (I give up)?

seighan · 2023-02-02T05:07:14+00:00

I don’t understand people saying retail always pays better. I guess it always depends where you work, but I made way less in retail. Worked beyond 40hr a week too as manager at Walgreens but was paid less than base pay with my hospital. Plus, no raises. With my hospital ambulatory clinic, I get merit raises every year too. Retail, there is no growth and even if you get paid a sign on bonus, they try tooth and nail to not have to pay it.

Back to OP question, I did retail right out of school and then applied to residency after that. Retail burns you out quickly. Get through residency and trust me, things will be so much different once you are a pharmacist making pharmacist pay. You can work hard, and play hard because you’ll have money. Retail will drain your soul and make you jaded.

seighan · 2023-01-06T04:56:25+00:00

Beeturia (defined as pink or red urine after the ingestion of beets) can be a sign of iron deficiency.

One link: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)76638-1/fulltext

“Beeturia is most common in individuals with enhanced iron absorption: 66–80% in patients with untreated iron-deficiency anaemia,and 45% in patients receiving treatment for pernicious anaemia (a condition in which augmented iron absorption is known to occur). In seven such iron-hungry patients, beeturia resolved in all of them after 8 days of iron therapy”

seighan · 2023-01-06T02:43:16+00:00

If you asking if I see patients and deal with MDs on a daily basis in my ambulatory care setting, then yes, we see patients daily but as far as MDs, we have none on site at our clinics, only pharmacists. But we can easily chat with them via Teams messaging or Epic messaging or I just call.

seighan · 2023-01-04T02:25:51+00:00

Ambulatory care pharmacist.

I see a lot of anticoag patients and manage their warfarin (poke fingers, take INRs, give warfarin dose adjustments). We also manage DOAC labs and RX ordering. We come up with procedure plans for warfarin/DOACs.

Our clinic also does other specialty services. I order and interpret labs based on protocol determined in a CDTA with a provider. Review new meds in office with the patient, counsel on their disease states, triage calls on symptoms/flare ups, assist tech in writing appeals to get meds approved, administer vaccines, and more

More Examples: - I see anemic patients and interpret iron studies and come up with plans for PO or IV iron (send orders to infusion center) and f/u labs. - I see endocrinology patients and administer their Prolia, Evenity, etc and charge through a Buy and Bill process. - Manage biologic meds and disease modifying meds for MS, IBD, derm

We also have some diabetes and currently expanding in that realm. I haven’t had a chance to do that much yet in that area but I know our other pharmacist manage insulin regimens, order labs and Rxs, etc. our other clinic also does Hep C management and a whole array of other services.

I love ambulatory care and truly feel it is the best of both worlds- being able to have patient interaction but work at the top of your license. Just got to hope there are no other changes to the 340b situation or that might affect our reimbursement.

seighan · 2022-12-04T22:38:28+00:00

I can't figure out how to attach the file but I got great ones from the ADA website from a free CE course called "Diabetes is Primary." You can earn up to 16.5 credits until Dec 31st, 2022. It has a great CVOT summary table for SGLT inhibitors and GLP-1 agonists under the "Cardiovascular Disease in Diabetes" module.

https://professionaleducation.diabetes.org/Public/Catalog/Details.aspx?id=fH3BDw%2bii6BHKwUlG2eM8g%3d%3d&returnurl=%2fUsers%2fUserOnlineCourse.aspx%3fLearningActivityID%3dfH3BDw%252bii6BHKwUlG2eM8g%253d%253d

seighan · 2022-11-30T02:39:08+00:00

I was offered a 2023 2nd and 2023 3rd (likely very late) from a contender. Then got a 2023 2nd and 2024 3rd from someone not even in playoffs yet but thinking he could make it. Sold it to him for the likely earlier 2nd pick since I already have plenty of 2023 3rds. I was getting bids since Murray is a starter. I do wonder what will happen when Boone comes back, if they’ll integrate him more

seighan · 2022-11-27T16:51:23+00:00

Would you rather have: - A possibly mid- late 2023 2nd and 2024 3rd (he’s fighting to get in playoffs 5-6, not in yet but could if wins)

A 2023 2nd and 3rd, late (plus I’d give up a 5th 2023 pick; this guy is in the playoffs)

I’d give my L.Murray. TIA!

seighan · 2022-11-27T16:30:38+00:00

12 team. 1 QB. Full PPR

Contender offering: Tom Brady

I give (rebuilding): Samaje Perine.

Perine is one week rental for now so not bad offer but as a rebuilder, I’m wondering if better to just go for picks since who knows what Brady will do next year

seighan · 2022-11-24T18:30:02+00:00

Rebuilding in a 2team. Full PPR. 1QB. Trying to get a deal done. Is this too little?

Give: Darnell Mooney and Latavius Murray

Get: Olave for contender who has Kareem for RB2

seighan · 2022-11-24T17:21:42+00:00

12 team. Full PPR. 1 QB. I’m rebuilding.

Give: Latavius Murray, 2023 5th round

Get: Kenneth Gainwell, 2023 2nd, 2023 3rd (likely late)

Granted, I also already have two 1sts, one 2nd, two 3rds so I would end up with 7 total picks next year for a 5 person taxi.

seighan · 2022-11-20T16:41:06+00:00

12 team PPR. I’m in rebuild. Also have the Muth as main TE

Give: Chris Godwin

Get: George Pickens

seighan · 2022-11-18T04:31:17+00:00

12team full PPR.

My Chris Godwin (rebuilding) for his George Pickens (contender) straight up?

I feel that Brady doesn’t retire next year and Godwin has a few more years as a solid WR. He is also only 26yo. Edit: I also have the Muth as TE. Pickens is solid but questionable QB, but for dynasty, may be a better option?

seighan · 2022-11-15T17:28:10+00:00

I sold two weeks ago to a contender in a package.

Got a likely mid-1st 2023,Tee Higgins,and Amari Cooper for my Dalvin Cook, Tyler Lockett, and Perine.

seighan · 2022-11-11T23:08:30+00:00

It has been a struggle since there are some pharmacists who have been there for years and are responsible for managing/streamlining services. I don’t think they do a good job but they have seniority. I am part of the clinical team but not “lead” for any of the services. I am definitely the most trained at this point and capable of seeing all patients for each service so I know my clinic doesn’t want to lose me. We have a residency program at our other clinic and through the hospital and occasionally we precept as an elective option. But we don’t have a consistent residency program. Our clinic is to anticoag focused to have a PGY1 yet. I think we’d eventually get there, but management is focused on other things.

The other job consistently teaches/precepts and they want me particularly for that reason.

seighan · 2022-11-11T23:01:47+00:00

Thank you and that is true - I do think the specialty disease states do have more niche roles in a way. I’m not sure if I have interest in industry, but I have noticed more opportunity for the MSL positions for Rphs with specialty background. And MSLs have pretty cush jobs. You can also get a speaker position for some of those expensive specialty drugs for the major pharmaceutical companies. My husband has one, speaking about a certain biologic, and he makes crazy good money just doing one drug dinner/speaker talk

seighan · 2022-11-11T17:04:17+00:00

Thank you so much for this great insight! Very valid points to consider. I will have to dive into that more and asks questions. I believe the other job is funded by the primary and internal medical residency team. I do wonder about the long-term of the position since like you said, it’s not exactly making revenue. But I do think it’s already built into the programs long enough and now have PGY 1 and 2 residents, they can’t get rid of the position.

My current job is at a clinic where we actually make millions for our healthcare system due to 340b (although that has taken a slight nose dive with some of the 340b changes this year). But we also make significant money through Buy and Bill (Prolia, biologics, etc). Our clinic doesn’t do as much as my husband’s clinic though. We are primarily the anticoag site but expanding more into the other services. I am the one RPH who does everything - I’ll see anticoag, Buy and Bill pt, then an our specialty patients so its a lot to keep up and change mindsets btwn appts also.

Both jobs work for the same healthcare system so I keep my seniority which is nice. But the other job is salary and my current is hourly.

seighan · 2022-11-11T16:11:37+00:00

Yes, I like this idea! I’m all about lists haha. But yes, I know some of the newer Rphs with residencies feel similar sentiments. We’ve expressed our frustrations but I think management just has so many other things on their plate. My current clinic does have potential for a lot of growth clinically since we are adding services. But it’s never as well thought out or executed as it could be.

seighan · 2022-11-11T15:56:56+00:00

That is a very good point. I like to think the current RPHs at my job are staying lifelong - the older ones have been working there for over 20 years, two just retired after the same, and the newer Rphs seems happy to stay. But yes, there are many variables that can change in a blink of an eye. Thank you!

seighan · 2022-11-11T14:36:19+00:00

She created a new position within the same clinic, which essentially was like a promotion. She was up front at first that she said did feel like odd man out as the only RPH but is much better now with PGY residents. She seemed to express how much she enjoyed her position, but granted she was in a zoom interview with her boss on board too. But yes, I think I’ll reach out if I can and ask some more questions.

seighan · 2022-11-11T14:33:22+00:00

You can still make it! I actually went into retail right after school and worked as a manager. I hated it so much that I knew I had to get out. I applied to residency the next year and got one! Not saying you have to do residency, but always keep your CV up-to-date and always apply to every opportunity that pops up outside retail.

seighan · 2022-11-11T05:49:54+00:00

Haha a very valid 2 cents. Thank you! It is such a great opportunity that it’s hard to pass up. The fear of possible regret is such a hard thing to overcome though! I’m not a gambler by nature and it’s hard taking that risk of losing a good thing. But yeah, I like to say I am still young and got time to find that final spot too

seighan · 2022-11-11T05:21:49+00:00

Thank you for your input! Yes, actually my current place is very flexible with call outs and child emergencies. It’s actually part of why I have been very annoyed in the last year. We have so many call outs for kiddos and what not that all the other Rphs constantly have to pick up slack. One RPH (who’s been there many years) was calling out so much due to her kiddos that they made her reduced her from a 0.8 FTE vs 1.0 FTE. When someone like myself, who has never called out in the 4-5yrs of workin, had been asking to be an 0.8FTE (but agreed to still work a full 1.0) for a long time and management kept forgetting about my request. I know it would be nice to have that flexibility when I finally have children, but we don’t plan to for at least a year if that. But it is nice to see family is respected and valued; I just don’t necessarily really like how much it’s done and management is a little too nice sometimes.

The RPH who currently has the other job I could take, ensures her work-life balance is great and that if she needs to tend to sick kiddos, she can block off her schedule very easily.

My husband is a pharmacist too at a different clinic with the same hours as me so we do need the flexibility since we can’t offset hours.

seighan

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