
5 Questions with Ann Philbrick, PharmD
Ann Philbrick, PharmD, FCCP, BCACP, is an associate professor at the College of Pharmacy and the Department of Family Medicine and Community Health at the University of Minnesota. She is on the faculty of Woodwinds Hospital Family Medicine Residency Program and maintains her pharmacy practice at M Health Fairview Clinic - Bethesda. She is a 2006 graduate of the University of Nebraska Medical Center and completed a combined PGY1 and PGY2 ambulatory care residency at the University of Iowa Hospitals and Clinics in 2008.
How did you come to decide on a career in pharmacy?
I ended up in pharmacy because in high school I knew that I liked health care. I liked science. So I did some exploration of different careers. I decided against physician pathways and nursing pathways early on because I don't really like blood. That didn't appeal to me. So I was looking at things like physical therapy, occupational therapy, pharmacy, and it just clicked. I like science and chemistry in general, and I like understanding why things do what.
As a junior or senior in high school, I latched on to certain questions: Why do drugs do what they do in the body? How does a blood pressure medication actually lower your blood pressure? How does Tylenol act on pain receptors to decrease pain?
Early on I decided on pharmacy and this career that I'm in now, which is ambulatory care. I liked the idea of connecting with patients and seeing them over time, getting to know them and helping them with their medications over a long period of time. I like making connections with people, getting to know their story, and being able to help them.
I did a residency at the University of Iowa. In addition to the practice itself, two things that I really enjoyed at Iowa were teaching students how to be a pharmacist—how to do what I love— all about the patient care experience, and also research. I got a chance to write a case report with one of my preceptors/mentors at Iowa, and I was super excited when it finally got published.
When it came time to find a job, I was looking at different opportunities, and academia was the only experience where I could get this combination of being able to teach students a lot, do research, and practice ambulatory care.
Is there a particular research project that you would like to bring attention to?
Over the past few years, I have concentrated on the refugee experience. M Health Fairview Clinic - Bethesda in Saint Paul, Minnesota, has a very large refugee population. I really enjoy the connections I make with these people, and I can see some of the challenges they have. I've been delving into some refugee and immigrant research.
One of the projects that I've been working on more recently that is currently submitted for publication is a scoping project looking specifically at pharmacist interventions for an immigrant and refugee population and seeing what's out there. A lot of educational pieces exist covering things like understanding what a chronic medication is for some of these populations, understanding how to refill a medication in a pharmacy (that's a pretty complex experience for somebody that speaks English, let alone somebody who doesn't speak English natively), and understanding chronic disease states and what it means to have something like hepatitis B or latent tuberculosis.
My research team and I delved into 10 articles that talked about those pharmacy experiences. One thing we found when we were doing our article review was probably about 30 articles that were published only in abstract form. They were presented at some type of conference but never came to fruition as an actual paper. Why did those papers not come to fruition? Was there no time to publish? Were there some publication biases because they were smaller studies with maybe not a big impact?
The other thing that came to the forefront of these 10 studies that were included in the scoping review was that a lot of them were student pharmacist-run. That is amazing because it shows that maybe we can be doing more with our pharmacy students. They have the passion to help these populations. They oftentimes might share some of their lived experience with these populations. So they can really make that connection. That is something worth exploring.
What role does pharmacy play in family medicine?
We are the medication experts on the team. Family medicine does a really good job in recognizing team members for what they can bring to the team—and creating expertise pairings. The physician knows the medicine, the diagnosis, the intricacies of diseases; the pharmacist is the expert with medications.
Together we make a good pairing. It’s a collaboration to best help the patient for whatever ails them.
How do you see pharmacy evolving in the future as it relates to primary care?
I see us taking on a little bit more of that chronic disease state management. I see that with my patients right now. A physician might see a patient with diabetes every three months. But I could see that patient at months one and two in between that every-three-months physician visit and continue to do steps along the care plan. We can get a patient closer to blood sugar goals, blood pressure goals, you name it, with more frequent visits.
A physician doesn't have time to do that when you think about their patient panel. They have a finite time to be able to see those patients in a family medicine setting. So I see those of us in pharmacy taking on even more of that chronic disease state management in collaboration with the physician.
Is there anything else you would like to share?
I've done some research in the past with blood pressure and how best to obtain it in a family medicine environment. I’m hoping to get back into that more in the future, both at Bethesda Clinic and maybe at some other family medicine clinics, to try to get our patients’ blood pressure down to goal, which will help improve cardiovascular outcomes in the future.
That's my next step. I'm always looking for different ideas out there to improve refugee health. So if anybody wants to collaborate, I'm very much up for it.