I would say you didn't have "staff pharmacists" at that place. This is mostly the hybrid model with a couple of specialists added in. I have been at hospitals that are very effective at this. Places that still have a divided model often have pharmacists in the staffing role who don't want to, for one reason or another, practice their clinical skills. It doesn't take long for those pharmacists to loose those skills entirely.
As for university-paid specialists, you have to realize that these pharmacists are mostly professors who spend something like 0.3-0.4 FTE in a practice site in order to develop a clinical experience. They are mostly teaching and don't really count as full-time specialists.
The hybrid model really does work. It can even work in big AMC's. The problem is how to get there. Very few institutions started that way long enough ago. Most still have a divided model. You can spend years only hiring hybrid pharmacists every time either a staff or specialist quits, or you can immediately give all staff clinical responsibilities and all specialists staffing responsibilities (and then fire anyone who can't or won't do it). The former can take forever to do. I have seen the second one work but it also causes a couple of years of hell (and probably only works if you are an AMC who won't loose a bunch of specialists to somewhere else).
1. I disagree. They were not really specialists because they didn’t have a residency in a particular area. They just had 5 to 30 years of hospital experience. Their first hospital pharmacy experience was working night shift staff pharmacy before working the satellite floors.
2. They are not loosing the skills of verifying medications. Even when you work the floors, you still have to verify orders specific to the floors and performing clinical tasks- Heparin protocols, TOC consults, and counseling etc and TPNs.
3. I know a ER pharmacist who can work night shift staff, ER, CCU, CVICU, OR, and MICU. No residency and started out as a staff pharmacist and just had a interest in the ER.
In the past, a pharmacist could tell the manager what area he or she had a particular area of interest without the need of residency or certification.
4. I know another pharmacist in this hospital, who started his career at CVS, then switched to LTC, and then started as night shift staff pharmacist in this hospital. Now, this pharmacist can work staff, OR, CCU, MICU, CVICU, and help the ID clinical specialist with kinetics. No residency at all.
The only specialist is the ID pharmacist and this pharmacist did a residency, a general PGY-1 residency back when residency was rare or not even needed to work in a hospital. Back in 2000- 2008.
Three other pharmacists did the general PGy-1 residency during the 2010-2014 era, when residency started to make one competitive. One pharmacist is specific to ER and only does ER, the other does staff and CCU, and the third just does night shift staff.
The rest of the 12 pharmacists are staff pharmacists who can also perform clinical roles as well. So as you can see, very few have done a residency in this hospital I am describing. And not to mention the RPD and the Pharmacy Manager are not residency trained either.
I have no doubt a staff pharmacist with years of hospital experience can also work the satellite floors and perform clinical tasks in addition to staff duties.
I think all hospital pharmacy should implement this clinical hybrid model. it would make hospital pharmacy much more versatile.
Fair enough the clinical pharmacists from the school don’t count.
Now hiring is different story. We both can agree that hospitals including this hospital now are only hiring residency trained grads due to the the surplus of new grads.
However, I still think the medical model does not work and this COVID-19 has shown that it does not work for pharmacy. And Now we see a saturation of resident trained pharmacists as well as new grads. We hear resident trained pharmacist working at a community college telling future residents to go work for a bank. How many medical residents are working for a bank or credit union?
Guess what ASHP’s solution is after this mess: creating PGY-3s to be implemented in hospitals. Do you really think your average hospital has enough money to fund for a PGY-3. I think the pharmacy residency program needs a huge change drastic change before hospital pharmacy becomes extinct.
Retail is in the process of becoming extinct. Clinical pharmacy/ staff pharmacy will soon follow.
If a clinical hybrid model existed in all hospitals, big and small, there would not be as many furloughs. The staff pharmacists with clinical skills and no residency can go right back to verifying orders.