RAM is one of those experiences that define you as a professional. I think this is because you engage a population of people that usually have nowhere else to go, but typically have the most complex disease state management. More often or not, as pharmacy students we live in a bubble of lectures, homework, studying and day-to-day decompression. We forget that the patients who need us most often do not have the resources to come to our workplace’s doorstep. We also forget, trying to get through our schooling, that the most important lecture we can ever have is patient engagement.
It’s very different to study disease states and how to treat people without a face or life’s complicating problems. It’s also completely different to develop therapy plans when you realize that your hesitations, your nonverbal communication and your empathy directly impact how a patient receives the information or recommendations you propose. You can have the best therapy plan on the planet, but if you are callous, cold, unconfident or unsure, your patients will pick up on these things just like we do without any other social interaction.
We become excellent practitioners not because we are expansive in breadth in knowledge alone, but because we learn to be empathetic, relaxed, confident and sensitive to our patient’s needs. Often these qualities become more important. RAM is one of the places I have developed these traits, and I try to hone as sharply as possible. It’s worth every mile, hour of lost sleep and uncomfortable night of hot, sticky sleep. If anything, it gives you an appreciation for everything you have and how lucky we are to be the givers and not the receivers. I also feel like it’s a sad excuse to not spend a little time in such a setting because most of us spend more time watching television, texting/calling/facebooking each other, and doing other nonessential activities than we devote to helping others.
So many more things crash into focus when you treat patients who often cannot afford their medications, have social and cultural barriers that make counseling difficult, and whose situations are almost never ideal. Things are never as simple in practice as they are outlined in a classroom or a book. You almost never run across best-case scenarios or clearcut answers. RAM helps you make sense of this. It is also is one of the most rewarding things I’ve undertaken. I feel it is our duty not just as community members, but as professionals, to take a couple days out of our schedule to go to those who cannot come to us. We cannot have good health care without engaging in free health care.
There will always be economic divides, but we can help close them a bit, even if only for a couple days, if we go outside ourselves and give our time freely. We also talk constantly about team-based therapy in school and how medicine is going to this model. There is no place where this is truer than at community outreach events such as RAM.
At RAM, you have all the health-care professional specialties working together, instead of in bubbles, to form an integrated form of care, because there are no issues of who gets paid what or whose plan is more important. We come together to give the patient as much as possible. We also learn each other’s strengths and weaknesses and rush to fill in those cracks to form a more seamless plan of care. You also hear the gratitude, the tears of happiness and humility from your patients. I even often hear the phrase, “Thank you for everything you do. This is the best care I’ve ever received.” I also hear, unfortunately, “Thank you for actually spending time with me. My doctor, nurse, pharmacist, etc., does not spend this kind of time with me, and they charge so much money.”
This is my second time at RAM, and my role is much different this year. This year I’m learning to lead my peers to this same great opportunity and trying to develop ways to expand our presence at this event. I try and focus on what things went well, what needs work and which things not to continue or repeat so that next year, when I lead RAM, I can make it a little bit better than the year before and leave another scaffold on which my successor can build and make better after me, as well.
I’m incredibly excited by this prospect, but also very nervous. I want this experience to be as rewarding to others as it has been to me over the last two years. I want my peers to become better professionals. I want to show our communities that pharmacists are willing to go outside of their 9-to-5 work schedules to make sure that their health needs are met. So many of these things will worry me, but they will also focus me to ensure that I put everything I can into making RAM more successful. RAM has been one of the biggest honors I have been given because it has given me the chance to take care of my fellow man without the restrictions of insurance, prestige or management.
Thank you, RAM, for making me a stronger practitioner and a better human being.
Editor’s note: Andrew Carmichael was assistant team leader for VCU School of Pharmacy’s trek to Remote Area Medical 2011 in Wise County, Va.