Pharmacists and Physicians Team Up at Clinic

By Kukla Vera on May 22, 2009 7:50 AM

“Patients don’t care how much you know until they know how much you care,” advised USC School of Pharmacy commencement speaker Paul Gregerson at the ceremony held on May 15 at the Health Sciences Campus Quad.

Gregerson, chief medical officer at the JWCH Institute, welcomed the 176 new Doctors of Pharmacy to their chosen career. The school works with Gregerson at the JWCH Clinic at the Weingart Center, located on Skid Row, where faculty, students and residents provide clinical pharmacy services to patients.

Many of the school’s new pharmacists, especially those who chose to practice in clinics, hospitals and other patient-care settings, will provide medication therapy management to patients with chronic diseases, much like the services the School of Pharmacy offers at the JWCH Clinic. These pharmacists, working under protocol, typically treat the most difficult-to-manage patients who are not reaching therapeutic goals. The pharmacist regularly sees these patients, ordering lab tests and changing medications and dosages as necessary.

Gregerson is an avid supporter of using clinical pharmacy services. “Here at JWCH, we’ve created a kind of national model using a health care team approach resulting in improved patient outcomes while saving health care dollars.”

Coming to USC to deliver the commencement address was a return to familiar territory for Gregerson, who completed his medical residency at the Keck School of Medicine and worked about a dozen years in the emergency room at the LAC+USC Medical Center.

After his stint in the emergency room, Gregerson thought he might want to segue to the administrative side of medicine, thinking he’d be able to bring about changes in health care decisions from that perspective. He added an MBA to his academic credentials and eventually landed at JWCH, where he’s able to meld both his medical and business backgrounds in the six clinics he oversees.

Gregerson did not always have an understanding of the clinical pharmacist’s role on the health care team. That came in 2004 when Steven Chen, a faculty member at the School of Pharmacy, arrived at the clinic. “At the beginning, the physicians were not quite comfortable with the autonomy with which pharmacists worked with patients. They didn’t quite understand that the protocols allowed us to order diagnostic tests and change medications,” Chen said.

In time, staff physicians grew to respect and trust Chen with their patients. According to Gregerson, “Dr. Chen is brilliantly successful with his patients because he meets them where they are, generating trust and strengthening the bond between him and his patient. This bond is just as important as the treatment plan.”

The work the two have spearheaded at the clinic has produced stellar results, improving patient outcomes while saving health care dollars. Much of the savings have been realized through Chen’s reorganization of the clinic dispensary as he more efficiently uses available drug-purchasing programs and free drug options while revamping the formulary. Gregerson noted that the clinic has saved several hundreds of thousands of dollars each year since Chen’s arrival.

This savings only reflects the dollars saved by the clinic. Savings grow exponentially when the calculation includes the decrease in both emergency room visits and hospital admissions that result with healthier, more compliant patients.

“Since we’ve instituted the clinical pharmacy service with USC, patients have a better understanding of their care and are more engaged in their own health, resulting in better outcomes,” Gregerson said.

In the crowed clinic hallway, a patient on his way to an examining room affirmed Gregerson’s comment. “This is the best clinic in L.A.,” he said. “I’m diabetic, I’ve had a tumor and they keep me going.”

The JWCH Clinic at the Weingart Center is located at 515 East 6th St. in downtown Los Angeles. To learn more about the clinical pharmacy program at this clinic and other safety net clinics, contact Steve Chen at chens@usc.edu.

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