Wednesday, November 14, 2018

Psychedelic Babbels

Hi everyone, my name is Vicky, and I’m a pharmacist rotating through mdBriefCase for the next 5 weeks. I’m very excited to learn about the world of medical writing, and content development. This blog will be my baby for the next few weeks, and I will be chatting to you about various topics that I find interesting.

But first, a little bit about me: I’ve been a practicing pharmacist for 5 years. I started out in community pharmacy, working for independent pharmacies that emphasized on patient care. A chance encounter placed me at the outpatient transplant pharmacy in London, Ontario where I was engrossed in all things solid-organ transplant related. That was also where I developed a fondness for nephrology and thrombosis.

A couple years later, I wanted to push myself therapeutically and took on the role of inpatient orthopedic surgery pharmacist. It was a big change for me to go from the fast-paced commercial world filled with patient interaction and drugs in nice packaging, to an equally fast-paced world filled with surgeons with swagger, bleary eyed medical residents, intravenous drugs, and patients so sick that code blues were called on the regular. It was like Greys Anatomy with none of the sexiness. I loved every minute of it.

Fast forward another couple of years when I met my husband in Toronto, and we decided that long-distance was not the key to happiness and longevity. I moved back to Toronto, taking on the position of float pharmacist at Humber River Hospital. As a float pharmacist, I covered everything from ICU/emergency/ nephrology/cardiology, to rehabilitation/ internal medicine. Humber was where I started writing policies and procedures for the hospital, and developing hospital specific guidelines. While I loved working at Humber, I couldn’t quite shake the feeling that there’s more for me to learn and to take on in this world. I heard about Medical Science Liaison (MSL) through a good friend of mine, and thought it would be something I could potentially be very good at. A chance encounter placed me in contact with Paladin pharmaceuticals, which was looking for someone to be the MSL for a new transplant medication. The world came in full circle, and I’m happy to say that I will be starting a new career as a MSL with Paladin.
It’s hard to believe that 5 years went by so fast, and I’m so grateful for the opportunities that have awarded me with such rich experiences. If there are interesting tidbits and experiences that I can share, they would be:
  • Orthopedic surgeries are bloody. Nails, hammers and bone saws are regularly used.
  • On the opposite of the spectrum, open heart surgeries are delicate and long. Patients sometimes have to be chilled slowly to preserve organ function, and warmed up slowly after the surgery.
  • Kidney, heart, and liver transplant patients are very different from one another. Kidney patients are usually healthy-ish except for the fact that they need dialysis or they’ll die. Heart patients are so sick they’re at the precipices of dying by the time they receive their transplant. And liver patients all have some degree of brain damage because of the ammonia that accumulates in their blood.
  • Internal medicine is not sexy. There’s a book called House of God that took a satirical approach at internal medicine. While terms like “gomers” (stand for Get Out of My Emergency Room) and “buff and turf” are mostly tongue-in-cheek, what’s not satirical is how brutal on-call hours can be for the newly initiated. A resident on call can be awake from 6 am of day 1 all the way to 10 am of day 2. Now multiple that by 3 days a week, for 4 - 6 years.
  •   Also not satirical is the emotional toll internal medicine can have on doctors. Dark humor was something we used to get on with our day in spite of the daily tragedies. One of my favourite books, When Breath Becomes Air, written by a late neurosurgery resident who discovered that he had terminal lung cancer, has a brilliant passage on how cynical all medical professionals become. The author, Paul Kalanithi, had just been paged out of his lunch – a diet coke and ice cream sandwich – to help a 22-year-old man with major head injury. He spent an hour trying unsuccessfully to save the patient, and then:
    • “I slipped out of the trauma bay just as the family was brought in to view the body. Then I remembered my Diet Coke, my ice cream sandwich . . . and the sweltering heat of the trauma bay. With one of the ER residents covering for me, I slipped back in, ghostlike, to save the ice cream sandwich in front of the corpse of the son I could not. Thirty minutes in the freezer resuscitated the sandwich. Pretty tasty, I thought, picking chocolate chips out of my teeth as the family said its last goodbyes.”

Outside of work, I’m a prolific reader, and a dancer. Some of the most awesome experiences I’ve had in the world of dance include when I went back to China for their Olympics of Chinese dance - Tao Li Cup, and when I auditioned for So You Think You Can Dance Canada.  Come talk to me about anything anthropology, history, sociology and spirituality related. I’d love to share ideas and learn from you. 

And that’s all for now. Stay tuned for the next issue!

 - Vicky

Monday, November 12, 2018

Staying Relevant in a Digital Age

At its roots, community pharmacy is a customer service field. A patient comes to a pharmacy with a prescription for the product that they need, the pharmacy prepares and packages the product, and the patient pays for the product and services. Although medications to treat or prevent disease are often valued higher than the products at a clothing store or fast food restaurant, buyers are still looking for the same things - convenience and efficiency.

Recent enhancements in automation and technology in the pharmacy field have been aimed to improve the ease of filling prescriptions. PopRx was the first application to make an appearance on the Canadian pharmacy technology scene in 2015.1 It is an app that allows people to send a picture of their prescription or medication vial to their local pharmacy and have the medication delivered to them on the same day. Other technologies have since been developed to improve accessibility. Pharmabox is an automated kiosk that sells personal care items and over-the-counter (OTC) medications that can be found in pharmacies.2

With technology disrupting the pharmacy landscape, pharmacists must come up with ways to stay relevant and avoid becoming overshadowed by the convenience of applications and automated machines. Here are thoughts on how pharmacists can add value to their services in a way that machines can't.

1. Remember our other products
Medications are not the only products sold in the pharmacy. Yes, medication is the first thing that comes to mind when you think of pharmacy, but our products go beyond technical services. Pharmacists can use their clinical knowledge to provide comprehensive medication reviews, disease screening and education, chronic disease management, smoking cessation consultations, and much more. Our cognitive services can never be replaced by technology. Instead we can use technology to grow these services, such as in the case of point-of-care testing or pharmacogenomic testing.

2. Filter information
In 2013, more than 50% of Canadians reported that they used Google searches to research or self-diagnose their symptoms.3 This number is only expected to be higher today with the widespread use of cell phones and social media. Although access to all of this information by means of technology is empowering for the public, it doesn't mean all of the information is true. In the pharmacy, I often field questions from patients asking if the latest health trends in the news or on the internet actually work or if we sell a product that Google recommended they try for their symptoms. Pharmacists shouldn't be discouraging people from using technology to research their health answers, but we should be encouraging them to let us help them decide what's factual and what's inaccurate.

3. Provide a personalized experience
Computers or automated services can't compete with the experience of face-to-face interaction. Pharmacists can provide patients with clinical services that are tailored to their needs, instead of reciting a laundry list of side effects or irrelevant information about a drug or disease that ultimately doesn't help the patient with decision-making. It's not just about having all the information, but it's also about knowing how to apply it to the patient that's in front of you. 

Having the knowledge and expertise to filter information and provide individualized clinical services for our patients is how the pharmacy profession will stay afloat amidst the rise of technology.


1.     Hardy, Ian. (2015, November 24). PopRx, the "Uber of prescriptions" launches in Toronto. Accessed on October 22, 2018:
2.     Harman, Megan. (2018, October 3). Automated Drugstore Concept 'Pharmabox' Aims to Disrupt Canadian Retailing. Accessed on October 22, 2018:
3.     Oliveira, Michael. (2013, July 31). More than half of Canadians use 'doctor Google' to self-diagnose. Accessed on October 22, 2018: