Opportunities for Pharmacists in Public Health

William R. Vincent; Kelly M. Smith; Douglas Steinke

Disclosures

Am J Health Syst Pharm. 2007;64(19):2002-2007. 

In This Article

Free Clinics Offer Free Experience

Pharmacy students in the preprofessional and professional years have much to gain by participating in free clinics and other public health outreach programs. For students, especially before professional year 4 clerkships, free clinics offer unique learning opportunities to develop knowledge and skills in medication reconciliation and patient education. Community-based volunteering at free clinics may meet increased demands for pharmacy students to achieve competencies related to public health and cultural awareness.

A free clinic is a private, community-based health care center for the families of the uninsured employed and for the retired that does not charge for services. In 2001, 365 free clinics across the United States were surveyed to characterize the breadth of services provided.[10] About 30% had licensed pharmacies, and 3% had pharmacist volunteers. Clinics with higher volumes of patient visits were more likely to have paid health care practitioners, including pharmacists. Overall, 0.1% of clinics responding to the survey had paid pharmacists. Only 10% of clinics with licensed pharmacies had pharmacist volunteers. These findings demonstrate a demand for increased pharmacy services in free clinics in the United States. There are nearly 550 free clinics in the United States, representing a 50% increase since the data reported in 2001, indicating a growing need for free clinic health care services for the uninsured. The Free Clinic Foundation of America offers valuable references, including a directory of all registered free clinics in the United States and a "Starting Out" how-to-guide with the first steps in planning a clinic.[11]

Approximately 14% of all clinics had health-profession student volunteers.[10] However, the survey did not specifically capture pharmacy student volunteers. For the pharmacy student, volunteering at a free clinic provides an opportunity to gain direct patient care experience early in the curriculum before experiential rotations of the fourth professional year. Increased efforts by colleges of pharmacy to incorporate similar experiences into their curricula should be encouraged, and pharmacist preceptors must accept the responsibility to facilitate this effort.

Recently, Brown et al.[12] described a service-learning elective course at the University of Cincinnati College of Pharmacy. Students completed 20-60 hours of service at a charitable pharmacy, with responsibilities including medication reconciliation, patient education, and medication dispensing. Students also interviewed patients to determine qualification for assistance programs and traveled to rural communities to deliver medications and provide patient education as a part of an outreach program. The investigators surveyed students before and after course completion and compared the results. The postservice survey showed participating students felt more strongly that health care professionals should be required to participate in community service, felt more comfortable providing services to people of different racial or ethnic groups, and felt more strongly that they would like to work in settings where health care professionals are underrepresented, compared with responses on the preservice survey. Overall, significant improvements in knowledge and understanding of civic, cultural, and social issues and health disparities were shown in the postservice survey.

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