Bethesda Family Medicine Clinic - St. Paul, MN

APPE Experience Type
Ambulatory Care

Address
580 Rice St.
St. Paul, MN 55103

Phone
651-227-6551

Bethesda Family Medicine Clinic

Region
Twin Cities

Main Contact
Ann M. Philbrick, Pharm.D.
Assistant Professor
University of Minnesota College of Pharmacy
420 Delaware St. SE
MMC 387, C-205 Mayo
p: 612.625.6843 - Mon, Tues, Wed
f: 612.626.4613
philb020@umn.edu

Bethesda Family Medicine Clinic
580 Rice Street
Saint Paul, MN 55103
p. 651.223.7224, opt. 1 - Thurs, Fri

Teaching Philosophy
“When I hear, I forget, when I see, I remember, when I do, I understand”.  Confucius has been attributed to these words, which have been repeated throughout time.  Although they may seem trite, I feel they are a perfect example of my teaching philosophy.    Student pharmacists should be given as many hands-on experiences as possible in order to mold them into the pharmacist that they will become.  Although lectures and small group discussions are important in pharmacy education, passivity is no way to learn pharmacy practice.  Students should be allowed ample opportunity to interview patients, provide recommendations to providers, and educate patients.  A gradual progression towards independence in these tasks will be the goal of education once the student develops proficiency. 

The world of pharmacy is ever changing, and education never ceases.  Education must continue regardless of the amount of ‘credits’ needed for graduation or licensure.  Student pharmacists should also be given the opportunity to critically examine primary literature.  This is an important tool as it facilitates critical thinking, analyzing data, and decision making. 

A basic need of all students is effective and respectful interaction with the instructor in an open and affirming environment.  Having a personal connection allows the instructor to be a more effective advocate for the student’s success.   The instructor-student relationship described fosters mutual respect and encourages free and comfortable sharing of information and feedback.  This ultimately results in better instruction techniques, more self-awareness on the part of all parties, and better educated pharmacists.

Detailed Site Information

Institution
Bethesda Clinic is a family medicine clinic and a training site for University of Minnesota family medicine resident physicians.  Eight residents are in each of three years of the residency program.  This is an academic training program in a strong teaching environment.  Two medical students are also present in the clinic.  Approximately 80 patients are seen a day, which range from prenatal care, OB/GYN, pediatrics, adolescents, adults, geriatrics and basic psychiatry.  There is a diverse patient population, which includes a large percentage of Hmong patients.  Interpreters are available for non-English speaking patients. 

Resources
Resources available include computer workspace in staffing area with internet access, library access with University Of Minnesota x500 password.  There is on site parking and the clinic is close to several bus lines.  A break room with refrigerator, sink, and microwaves is available.  Close to downtown St. Paul.

Patient Care-Ambulatory Care

Primary Preceptor
Ann M. Philbrick, Pharm.D.
Assistant Professor
p: 612.625.6843 - Mon, Tues, Wed
p. 651.223.7224, opt. 1 - Thurs, Fri
philb020@umn.edu
Areas of interest: ambulatory care, pulmonary diseases, geriatrics, smoking cessation, hypertension and socioeconomic barriers to healthcare. 

Preceptors
Ila Harris, Pharm.D., BCPS, FCCP
Associate Professor
Pager #: (651) 864-1474
Direct office number: (651) 223-7324
Office extension (dialed from clinic): 7324
In clinic Mon & Tues; Available by pager Wed afternoon
Areas of interest: ambulatory care, family medicine, women's health, diabetes, asthma, ambulatory cardiology

APPE Structure
Clinic is from 8am-5pm every day.  It is expected that students stay for the entire duration of the clinic and complete their clinic documentation before they leave for the day.  Students will be spending Monday and Tuesday with Dr. Ila Harris and Thursday and Friday with Dr. Ann Philbrick.  Wednesday morning will be spent working close with a physician provider in the morning and then working on required activities in the afternoon. 

With the course of the rotation, students will be expected to complete 1 “Pharmacy Question” per week for distribution to clinic staff and 1 journal club presentation on an article relevant to ambulatory care and published within the past year.  Students will prepare one ‘learning topic’ per week (total of 3 topics) and will lead a case presentation by the end of the rotation.

Student Roles and Responsibilities

I. Provide pharmaceutical care to patients.   This is usually done in a collaborative manner with physicians. This will be accomplished in the following manner:

1. Review charts prior to patient appointments.
2. Look up drugs/diseases you are unfamiliar with.
3. Discuss each patient with pharmacist preceptor
   Present your plan
   Be able to defend your plan and provide the rationale
4. See patients prior to physicians.  Keep this as brief as possible.
5. Discuss any changes in the plan with preceptor.
6. Make recommendations to physicians regarding drug therapy (after several times observing preceptor, once both student and preceptor are comfortable with this)
7. Document the interaction. 
8. Patients are followed at their return visits to clinic and by phone, if necessary.

II. See patients independently (prescribing under protocol)

1. Collaborative practice agreements for anticoagulation and smoking cessation
2. Patient are scheduled to see the pharmacist, OR
3. Patients are seen independently when they come in for their INRs
4. Also, may have patients referred to us for any type of medication management issue

III. See patients as needed for patient education concerning medications

1. Examples are insulin teaching, asthma or inhaler education, contraception education, warfarin education
2. Documentation notes are short and just describe the education that occurred.

IV. Serve as a consultant to other health care providers

1. May be “curbside” consultations regarding patients they are seeing, or
2. Complete chart review with recommendations
3. Provide complete answers and recommendations for medication questions from physicians
4. May require literature search, reviewing several references, and providing documentation
   

Educational Opportunities
Noon conferences occur daily and it is strongly encouraged that students attend.  Certain presentations may be required at the discretion of the rotation coordinator.    

Other Requirements
There are no current ‘other’ requirements for this rotation.