When people think of pharmacists, they think of the person who hands
over medicine at the counter.

Brian Jensen of Two Rivers wants to change that.

"Pills in the bottle don't provide healthcare," said Jensen, a
pharmacist in Manitowoc County for 27 years and owner of the Medicine
Shoppe Pharmacies in Two Rivers.

Jensen said pharmacists are not merely pill pushers, but should be
educators as well.

Pharmacists are "not being utilized to the best of their skills," he said.

Jensen serves as a mentor for resident pharmacist Aisha Ashraf, 24, of
Wakefield, R.I. She began her residency in July after graduating from
the University of Rhode Island with a doctorate in pharmacy in May.

As a resident, Ashraf will learn from Jensen and his partner,
pharmacist Marv Moore, how to interact with patients when they come
into the Medicine Shoppe for new prescriptions or refills.

For patients getting new prescriptions, she will discuss possible side
effects of the medicine, what the medicine does and should do, and
what the patient should do when encountering those side effects.

For patients getting refills, she will ask if the drug is working and
how they are feeling.

Ashraf said she will also monitor patients' blood pressure, blood
sugar and cholesterol if necessary. There may be times when she would
have access to a patient's medical profile to understand a patient's
medical history.

This is the kind of change Jensen is seeking.

After visiting the doctor — and unless there is immediate medical
attention—patients would spend more time consulting with pharmacists
about their medication, Jensen said.

"(Pharmacists) can be predictors of needs in medicine and help
patients," and pharmacists can also "detect and correct drug-related
problems," he said.

Wisconsin law requires pharmacists to counsel patients about new
prescriptions and refills. Wisconsin is "pretty unique," said Joseph
Bonnarens, director of the University of Wisconsin Community Pharmacy
Residency Program (UWCPRP) in Madison, since it's the only state that
requires both. Other states only require counsel for new
prescriptions, Bonnarens said.

Although there is such a law, Jensen wants to go beyond it. Most of
the time, it's not done at all or is not being done effectively,
Jensen said.

So, for the last 15 years, Jensen has been trying to change his
pharmacy's focus from mere distribution of medicines to patients'
overall needs.

Instead of asking patients if they have any questions for the
pharmacist, the pharmacist will be the one asking the patients
questions, Jensen said.

Jensen is a part of the former Wisconsin Center for Pharmaceutical
Care, now the Pharmacy Society of Wisconsin. From 1993-96, they
provided intensive one-week training for about 100 pharmacy
representatives from 60 sites across Wisconsin. The training was to
create a "critical mass" of patient-focused sites, Jensen said.

These training sessions were done about three to four times a year,
and after three years, less than 5 percent maintained that change,
Jensen said. It was realized that such a transition couldn't be
accomplished through a week of intensive training.

Jensen then came across something in Indiana – a yearlong community
pharmacy residency program providing resident pharmacists a chance to
develop skills and services for patient care.

After meeting with the people involved, he was convinced that it was
needed in Wisconsin.

When Jensen returned, he followed the Indiana model and developed a
curriculum for the Medicine Shoppe.

In 1999, he had the first resident at the Medicine Shoppe, and in
2000, Two Rivers Medicine Shoppe Pharmacies received national
accreditation for its program, making it the first pharmacy to
coordinate an accredited Community Practice Residency Program in
Wisconsin.

"It's an honor to be accredited," Jensen said.

They also were reaccredited in 2003.

Jensen said the residency model is best because the residents "are all
doing the things that the program intended them to do."

A past resident pharmacist is a co-owner of a pharmacy in Chicago, and
another is working as a clinical pharmacist in Madison, applying what
they learned during their residency, Moore and Jensen said. Ashraf is
the fourth resident pharmacist at the Medicine Shoppe.

"I'm very, very proud of the residents we've trained," Jensen said.

Moore, who did his residency in Iowa, is also replicating the
patient-focus approach he learned, Jensen said.

The goal of the residency program is to change a resident to be more
interactive with patients, and "we get better and better at this," he
added.

This year, the Medicine Shoppe recently began its first collaboration
with the UWCPRP. Prior to this, the Medicine Shoppe had its own
community pharmacy residency program, directed by Jensen.

Working with the University of Wisconsin strengthens ties and extends
boundaries between the university and the Medicine Shoppe. It'll also
help improve the capacity of care in Manitowoc County with the
university's support in their research, Jensen said.

Ashraf is the only resident in the university's program this year, and
her residency will run until June 30, 2007. In addition to interacting
with patients, she will develop new patient programs for the Medicine
Shoppe and determine how effective they are. Ashraf will also serve as
an adjunct clinical professor at the University of Wisconsin-Madison
three to four times a semester.

Afterwards, she will apply what she learned from the Medicine Shoppe's
focus on patient consultation in future roles.

Jensen was never in a residency program and said what he's doing now
is "a way to give back to the profession."

There are two Medicine Shoppe sites in Two Rivers owned by Jensen and
Moore — a clinic at 2219 Garfield St. and the main pharmacy at 1500
Washington St.

Labels: No Prescription, Online Pharmacy, Prescription Drugs

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