We very much adhered to the team based care model. So for all of our patients that are coming in for chronic disease management, it might be treatment resistant hypertension, or depression. Polypharmacy, lots of medications, specifically in elderly patients. Lots of diabetes management, insulin pump management, anticoagulation monitoring and management. Those are the kind of things that that we try to put in farm clinic. And in addition to that, sometimes it's just, we got a patient with two pages of meds, and we just need to spend some time educating the patient on them and making sure that it's the best pharmacotherapy regimen that we can do for that patient. Any of our patients that have been in the hospital, we see them within seven days, and we see them as a team. So that's a social worker and a clinical pharmacist, typically myself or my resident, pharmacy students and medical students, and then certainly a physician, resident and attending physician. Myself, for my pharmacy students or residents will, a lot of times go in first and do a medication history or medication reconciliation and kind of go through all of the meds with the patient. Because we might have a great list, but if it's not what the patient's taking, then then we have some some other things that we need to be dealing with. We're looking at the whole person, we're looking at the whole patient, we're not just thinking about treating each disease independently, but putting it all together and making sure that we're doing the best that we can.

With any general regular patients we see during the day, patients of mine that I have, if I have questions, and she's here, I come out, I'm able to ask her, you know, hey, this patient has this X, Y, and Z problem. These are the medicines I'm thinking about. This is how I'm thinking about adjusting their medication regimen. What do you think about that? And we're able to discuss the problem. Sometimes she goes in with me or even alone and talks to the patient as well. And then we come up with a plan together. She does the same thing with our residents. So when I'm precepting the residents and they come out with a patient issue, they're not sure how to adjust the medication regimen. Someone with diabetes who needs medication adjustments, somebody who has an INR that's too high, and they're not sure when they need to be seen back or how to make adjustments. We talk with her about those things as well.

The pharmacy team has been of great benefit, especially in terms of the recently discharged hospitalized patients. They provided an invaluable service to an augmented patient safety. Especially around medication reconciliation in that crucial immediate post hospital time frame. We've seen a great benefit in terms of patient safety and decrease hospitalizations, readmissions, with our own patients with the integration of the pharmacy team, especially around that critical, crucial immediate post discharge timeframe.

It provides an invaluable experience to our education. Pharmacy team members aside and ask them questions during that encounter. I don't think there's a day that goes by without using them in some way or another towards my education.

Dr. Calhoun and I work very closely, I would say. It works here because I think we have a tremendous amount of mutual respect for each other. I respect Dr. Calhoun's role, what she brings to the table that I can't because she is trained specifically in pharmacy in medications, she knows about the side effects, she knows about the medication interactions far better than I do.

We always function as a physician pharmacist team for all of these patients. And now we're starting to get the evidence to support that patient outcomes are improved relationship building is hands down the most important thing that will make collaborative practice success.

This approach works because the patient only benefits. That's the biggest reason that it is the best way to do things in my opinion, because we are here to provide excellent patient care when we work as a team. That's what we're able to do. It moves things along faster, the patient is better satisfied, they get better care. I think everybody can feel good about that including the patient, which is the most important thing.

And that patients like it better. We're currently studying it to make sure that the outcomes data supports that what we think every single patient is all of our patient. To know especially for those not in an advanced pharmacy practice model or not practicing team based care the way that we do, is that it took a long time for us to get here. The past couple decades for us to really get to where we're place where we very much function as a team and very much function collaboratively hand in hand.