By Arushi Sinha

Martha White‚ RPh‚ at Baylor University Medical Center‚ Dallas‚ Texas‚ didn’t begin her career thinking that she would work as a pharmacist at a blood and bone marrow transplant facility‚ but she knew she wanted to follow her father’s advice to “Find a profession‚ not just a job.”

Today‚ she is an integral part of a critical care team that takes cancer patients through what may be a life-saving process. She says that since training as a registered pharmacist (RPh) over a decade ago‚ she has seen many changes in the profession.

For one thing‚ licensing has changed. When White was going to school‚ PharmD (doctor of pharmacy) programs‚ she says‚ “were just getting started.” According to the American Pharmaceutical Association‚ after 1992 the RPh was replaced by the more popular PharmD degree.

“The main thing is that you should have confidence in your pharmacist regardless of the initials after the name‚” says White.

Perhaps the most dramatic development in WhiteÃs area has been the shift to outpatient treatment for blood and bone marrow transplant patients; White will participate in about 30 treatments this year. The average hospital stay for a transplant patient in the early ’90s averaged around four to six weeks‚ but today transplants can be performed with patients fully mobile and able to go home while undergoing treatment. Outpatient bone marrow transplants have been made possible by new technologies‚ such as bottle-sized disposable medication pumps and new procedures and protocols that White has helped develop at her facility.

A day in the life of an oncology pharmacist can include activities ranging from patient care‚ research‚ and protocol development to patient advocacy. Here‚ White describes a typical day:

8:00am
Check on hospital patients‚ review charts and laboratory results. Prepare for morning rounds.

9:00am - 12:00pm
For the next few hours‚ spend time with physicians and other caregivers reviewing the treatment plan for individual patients. This involves reviewing current treatment recommendations‚ making suggestions or modifications‚ adjusting dosages‚ or initiating discharge orders for those patients leaving the hospital. This might also involve helping patients find ways to pay for their medications‚ either through their insurance carriers or through programs offered by private companies. A few minutes for lunch‚ then back to work.

12:00 - 12:30pm
Meet with a patient who is being discharged to discuss and review all of his or her medications and how they are to be taken at home. Not taking medications correctly after a transplant can have serious consequences.

12:30 - 2:30pm
Meet with another pharmacist to develop new mouthwash treatment for dealing with mucositis (mouth sores) at the outpatient clinic. This requires changing the procedures already established for hospital patients and modifying them so that patients can be more self-sufficient.

2:30 - 4:00pm
Update the infectious disease database with the latest patient outcomes. The database allows physicians to follow trends and develop better therapies for blood and bone marrow transplant patients.

4:00 - 6:00pm
Administrative duties‚ which include working with the oncologist in writing high-dose chemotherapy orders‚ reviewing drug dosages to ensure accuracy and best value for patients‚ and checking drugs for possible unwanted side effects and interactions with other drugs.

White says that it’s a good feeling that physicians “value your input” as an “integral part of the team.”

The best thing about her job‚ says White‚ is that she “learns something new every day.”

American Pharmaceutical Association: www.aphanet.org
202-628-4410