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Ambulatory Care

Kimberly Lewis, Pharm.D.

The family medicine/ambulatory care rotation is a collaborative practice designed to provide the resident with experience and training in the clinical care of patients in an outpatient setting.  It serves as a valuable learning environment that will provide the resident with the opportunity to broaden their knowledge of asthma, diabetes, and warfarin therapy, in addition to other disease states that are commonly encountered in primary care.  Improved management of chronic disease states and appropriate medication therapy is expected to help improve the patient’s health status and reduce complications that lead to emergency room visits and hospital admissions.  The resident will develop skills and techniques necessary to properly educate patients through patient interviews and obtaining medication histories.

Resident Learning Activities

  1. Retrieve and evaluate appropriate clinical and scientific publications as they apply to:
      1. patient treatment and
      2. providing drug information to patients and other healthcare professionals or
      3. in evaluating activities specific to the clerkship.
  2. Collect, interpret, and integrate information in problem-solving activities.
  3. Discuss ethical pharmacy practice decisions and experiences with preceptor.
  4. Evaluate and develop therapeutic plans to ensure outcomes, endpoints, and cost-effectiveness; and display a willingness to contact and refer to other healthcare professionals, if necessary.
  5. Actively participate in providing pharmaceutical services and assessing therapeutic regimens including allergies, adherence, duplications, interactions, adverse drug reactions, effectiveness, and appropriate dosing, according to practice standards/guidelines/primary literature in the clinic at least 2 half-days a week.
  6. Evaluate laboratory test data as it pertains to specific disease states and its pharmacotherapeutic management (i.e. PT/INR for anticoagulation, liver function tests for lipid management, A1C for diabetes).
  7. Provide and present comprehensive organized written information, including journal club presentations, disease state discussions, and pharmacy practice education to pharmacy and medical students, physician assistants, family practice residents, faculty and other healthcare professionals.
  8. Communicate effectively and professionally with patients, nurses, pharmacists, physicians, and other healthcare professionals.
  9. Establish rapport with healthcare professionals at the site and work together for the benefit of the patients; specifically, assisting with medication histories, answering drug information questions, identifying and solving drug-related problems, and/or providing patient education.
  10. Maintain confidentiality and an awareness of ethical and legal standards.
  11. Participate in activities associated with the development and management of patient enrolled in ongoing family medicine disease state management programs (i.e. anticoagulation, asthma, diabetes).
  12. Gain experience in the provision of services to a wide range of patients with common chronic and acute disease states found in the primary care setting.  Specific disease states may include, but not be limited to, the following:
    1. Acute
      1. Acne
      2. Allergic rhinitis
      3. Diarrhea and constipation
      4. Headaches
      5. Otitis media
      6. Sexually transmitted diseases
      7. Upper respiratory infections (viral and bacterial)
      8. Urinary tract infections
    1. Chronic
      1. Congestive Heart Failure  
      2. Depression  
      3. HIV  
      4. Hyperlipidemia  
      5. Hypertension
      6. Myocardial Infarction   
      7. Pain management    
      8. Peptic ulcer disease

It is suggested that you review guidelines for management of the above disease states.


Required Rotations
  Internal Medicine
  Ambulatory Care
  Drug Information
  Administration/Informatics
  Pharmacy Operations
 
Elective Rotations
  Nephrology
  Infectious Diseases
  Oncology
  Critical Care
  Pediatrics
  Emergency Medicine
  Endocrinology/Diabetes
  Psychiatry (Fayetteville VA)
  Geriatrics (Fayetteville VA)