In my relatively short career so far as a hospitalist, I’ve gotten my share of calls from pharmacists concerned about our mutual patients. A short thread on how these calls are helpful and why I appreciate pharmacists:

I have very little knowledge about what drugs a particular insurance plan wants to pay for. I might prescribe Eliquis that turns out to be hundreds of dollars. A quick call from a pharmacist to ask to switch to Xarelto can save the patient so much money.

I often need to prescribe medications that interact and have serious side effects. QT prolongation, for example. When a pharmacist calls, we go over these and discuss the risk/benefit ratio. Sometimes there is no better regimen. Sometimes we can mitigate risk.

Missouri, though improving, is the worst state for prescription tracking. And many STL patients get mediations from neighboring states. Pharmacists can see this better than I can, and they often call to notify me of suspicious or concerning patterns.

When I discharge a patient from the hospital, I don’t always have easy access to their entire prescription history. This results in a lot of questions/corrections about dosages that the pharmacist catches, not me.

On the inpatient side, I’d be totally useless dosing some medications on my own without looking things up. Any weight-based or renally restricted dosing is quickly caught or fixed by pharmacy. This happens with most antibiotics and anticoagulants.

At some places I’ve worked, clinical pharmacists are direct team members that round with the physicians, nurses, social workers, therapy, and clergy. They do everything I’ve mentioned so far in this thread in real-time collaboration with us.

I’ve had pharmacists initiate applications for restricted-use medications that lower costs, shorten hospital stays, and limit drug-drug interactions. They are the leaders in antibiotic stewardship.

I’ve seen a lot of animosity between pharmacists (and pharmacy staff) and prescribers on here lately. In my actual experience, I’ve done nothing but benefit from their work, knowledge, and expertise.