I was just reading The Angry Pharmacists most recent post where he puts a douche bag clinical pharmacist in his place. This post got me thinking about what really is the difference between pharmacists who practice in different areas.
Everyone's first instinct is to think that the "clinical" pharmacists are the top-of-the-class, nerdy type and that the retail pharmacists settled on retail because they weren't smart enough for a clinical setting. I think the only thing that separates the two is experience... and it goes both ways. You stick a pharmacist who was doing clinical work for 10 years into a retail pharmacy, and he wouldn't have a fucking clue of what to do. Vice versa, if you took a retail pharmacist and threw him into a hospital, he wouldn't have any idea what to do there either.
It's all just experience. I'm sure all of the interns reading this will agree with me: They teach you everything in pharmacy school except how to be a pharmacist. You learn pharmacology, kinetics, and therapeutics. You learn all the pharmacy-related science you could ever need. However, you don't truly learn how to do ANY pharmacist job.
This is easily seen in the newly licensed pharmacists that only spent the bare minimum time in a pharmacy (hospital, retail, or any other setting) required to be licensed. These new PharmD's can quote you statistics from all the major studies and practically know DiPiro's Pharmacotherapy by heart. However, they cannot perform the simplest of tasks. We think they must be stupid because (like in TAP's case) they can't give a transfer or (in the clinical douche bag's case) they don't know you can't give 40 mEq of Potassium as an IV push (although that one is sort of common sense if you ask me). In reality, they probably are just lacking in experience.
I'm a retail guy. I've been a retail pharmacist for 2.5 years now. I don't have the slightest idea what to do in a hospital environment. The drugs you deal with on a daily basis are different. The rules are different. Your responsibilities are different. I don't know how to use pixis. I don't have a clue as to what a "y-site" is. I'd be completely lost if I had to work in a hospital tomorrow.
I assure you that it has nothing to do with my intelligence or capabilities. I graduated in the top 10 in my class, and I can guarantee you that I did so working half as hard as the other 9 students in that group. My good grades had next to nothing to do with whatever job I was going to take though. Retail pharmacy was not easy for me right away. I was one of those students who didn't spend a lot of time in a pharmacy when I was in school. I only worked about 20 hours per week and only during my semester breaks. When I got my license, I was still struggling to understand insurances. I still didn't have a good grasp of pharmacy laws. I found I had a very hard time making decisions (when I needed to call on interactions, what to do when customers get irritated, etc.). There were even a lot of things about our pharmacy software that I had to learn on the fly because I just never got the experience I needed.
My first few months as a pharmacist were rough, but by continually working 40 hours per week and putting forth an honest effort to improve, I developed into a pretty good pharmacist (I still have much to work on though). It would have been the exact same story had I chosen to work in a hospital instead of retail. All that clinical knowledge isn't much help unless you have the experience to back it. It probably would have taken me 6 months to a year to begin to feel comfortable in a hospital environment.
That's why I will never look down upon pharmacists who practice in other areas. I can't do their jobs. They can't do my job. Give me a few months to learn a clinical job, and I'll quickly learn all the little thing that any hospital pharmacist would need to know. Give them the same amount of time to work my job, and they'll do the same thing. It all comes down to experience. No particular group of pharmacists is any better than any other. They're just more experienced in their particular areas.
***One more thing***
I meant to write this somewhere in the actual post, but I forgot. Since I'm too lazy to go back and work it in so that it flows, you're getting it at the end.
A lot of the my pharmacy classmates went on to do residencies and are now working in highly clinical jobs. Most of these people weren't exactly great students. A few of them, I thought were a little dumb actually (judging by the idiotic questions they always seemed to ask and the way they complained after every single exam that the questions weren't fair). I mean, they used to come to me for answers and pointed me out as one of the smartest students. They did their residencies, and now they can be considered experts and know considerably more than I do about their respective fields. It just goes to show you that it's not really the grades or the intellectual power of the pharmacists in a particular area. Keeping with them theme of the post, it's experience.