When he joined the pharmacy in 1998, Rick Siemens had a vision to transform London Drugs Lethbridge, AB into a patient services-focused practice.
By Talbot Boggs
Photography by Ethan Calvin
“London Drugs enabled me to pursue an advanced practice with the understanding that if they supported me, I would build the business in balance with my patients’ best interests,” says Siemens.
Siemens has developed a highly personalized diabetes program that includes initial intervention, glucose monitoring, management, and lifestyle transformation. He was one of the first 15 pharmacists in the province to have additional prescribing authority and among the first to become an insulin pump fitter and trainer, and worked hard over the years to get to know local physicians and instill confidence in his abilities and program.
In one instance a patient came to him looking for a blood sugar monitor. Siemens ordered a lab test (A1c), which recorded a level of 16.9. “Having my Additional Prescribing Authority from the Alberta College of Pharmacists allowed me to intervene in the patient’s medication therapy (prescribing two medications to control the patient’s blood sugars), and I sent a letter to his doctor telling him what I was doing,” Siemens recalls.
“In three months the level had dropped to 8.9 and to 6.7 three months after that. I take a holistic approach that looks at the entire person, and I am diligent about documenting and communicating everything I do. Physicians have noticed our commitment to advanced practice, which has translated into greater respect for the entire pharmacy team and a lot of patient referrals.”
Siemens has expanded his practice into prescribing, injections, and a travel health clinic, and he works with five area assisted-living facilities numbering almost 400 beds. Two geriatric-trained pharmacists visit the homes, meet with doctors and nurses, and accompany them on their rounds, review patients’ medications, and make recommendations for changes where necessary. As a result, the homes have seen a significant drop in the use of certain medications that had been targeted for reduction.
Before starting his travel clinic about five years ago, Siemens invited nurses from the local health unit to lunch to explain what he could do and how he could help them and their patients. Siemens recently helped out a patient who urgently needed a travel vaccination.
“The local health clinic couldn’t accommodate him, so he gave us a call and we did it for him right away,” says Siemens. “Patients love the convenience and it really helps out the clinic and doctors. It’s important to put in the preparation time and educate other healthcare providers on how you can help them and their patients. This is the way to build a practice and create a tighter circle of care for patients.”
Business has grown steadily over the years. The pharmacy now employs a number of full-time pharmacists, registered technicians and assistants, producing high prescription volumes from a relatively small 1,450 sq. ft. dispensary in a 28,000 sq. ft. store. Diabetes management now accounts for a significant proportion of the business, the travel clinic has grown and now provides vaccinations throughout the day for area doctors.
The improvement in the pharmacy’s business has been a direct result of an expanded scope of practice, developing the trust of other community healthcare providers, and improved convenience and patient care.
“One patient I helped out ended up transferring all their scripts to me and I have subsequently helped treat other conditions,” Siemens says. “Customers love the convenience and level of care and want to see the expanded services continue. The growth of the business has matched the evolution of the pharmacy from a dispensing model to a complete care model.
Rick Siemens is currently involved in all aspects of advanced pharmacy practice including: initial access prescribing, medications administered by injection, travel clinic assessments, CACP and SMMA care plans, diabetes education, insulin pump and continuous glucose monitor training, and pharmacy driven immunization programs.
Rick Siemens recently presented at Pharmacy U Toronto.