HealthPRO Pharmacist Profile Series, Part V: Gord McGreevy
Q: What inspired you to become a hospital pharmacist?
A: When I finished my chemistry degree at the University of Saskatchewan I knew I didn’t want to go on and get my PhD. It seemed a bit dry. On campus, I saw a poster about pharmacy and thought it had an interesting mix of science, math, economics, and business. And, it appeared to be a growing occupation—particularly in hospitals. Then, I discovered I could apply my learning with patients, nurses and physicians. That made it sound even more intriguing.
Q: How has the hospital pharmacy landscape changed since you began your career?
A: The landscape has changed in many ways. We’ve moved from a product-driven profession to an evidence-based, information-based practice. We’ve transitioned from working independently to collaborating more with other hospital professionals. You spend more time with nurses and physicians to arrive at policies, procedures, pre-printed orders and pathways.
We’ve seen an explosion in the number of available drugs, especially monoclonal antibodies (mAbs), that are quite expensive. Consequently, we deal with issues related to economics. Expensive drugs lead to issues like who gets access and who controls access. This gets us into discussions about ethics, economics and the clinical side of these matters. That has altered the landscape.
Q: How has your role evolved?
A: From a clinical pharmacist, to a supervisor, to a manager, to a regional coordinator. I find today that I work on more complicated problems. They are not so much clinical problems but those related to drug availability, policies, shortages, or budget impacts. Even with 30 years of experience, I’m still surprised by how complicated the issues are that cross my desk. It’s fascinating and keeps my day going by quickly.
Q: What is the biggest challenge you face in hospital pharmacy today?
A: The biggest challenge is prioritization. Everything is important, whether dealing with drug safety, the budget or drug delivery. As the work keeps growing, staffing can become more of a challenge. What we do is dynamic in that it is ever-changing.
Meeting new national and provincial standards is also a complex process which can present policy changes and staffing challenges. It also requires significant consultation and collaboration leading up to the change.
Q: What is the most rewarding part of being a hospital pharmacist?
A: Working collaboratively with educated, thoughtful, caring, compassionate colleagues. Working alongside them to identify a problem, consider options, come up with a solution, see it come to fruition and make a difference in, say, patient safety, cost-savings, or patient satisfaction. That’s rewarding. Knowing your solution isn’t just a quick fix but may be in place for years to come is satisfying.
Q: What is the most Interesting or exciting prospect you see on the horizon for hospital pharmacies?
A: The expanded role in drug therapy prescribing changes for in-hospital patients and out patients. Pharmacists graduating today are well equipped to modify prescriptions. I am picturing that in the next five to 20 years this will grow, so after the diagnosis you will see your pharmacist for direct drug therapy.
Your pharmacist will be much more involved in deciding what drugs you need to be on and what dosage. Pharmacists will be given more authority. With better training, they will want to see patients, not just to hand out medications but to figure out appropriate drug therapies. And, they will monitor the patient. Another exciting prospect is an increase in the types of injectable or intravenous drugs patients will be able to administer in the home.
Q: What is the one thing you’d like readers to know about the hospital pharmacy supply chain?
A: We have a lot more hands in the process—all the way from the drug manufacturer to the patient—than most people realize. Many different supply chain models exist across the country. The purchasing, the supply, the packaging and decision-making in managing the supply chain is quite different from one area to another.
Q: How does being part of a national GPO help you strengthen patient safety?