The Life as a Pain Management Pharmacist

Hey there 👋🏻

Before I jump in, we just released our Bup Phast Facts Pocket Guide. You can check it out here.

Last week, I had a conversation with my friend about what I do as a pain management pharmacist. We talked about the struggles I face dosing opioids, the bittersweet moments with patients, and all kinds of things I see and do day to day. And he said,

“SP, why don’t you share what you do as a pain management pharmacist? Do people even know pharmacists like you exist?”

Well, he has a point.

I’ve personally asked many students and first-year residents what they aspire to pursue in PGY2. Most of them say ambulatory care, infectious diseases, oncology, or psychiatry. I rarely hear anybody rise to the top and say,

To give you more perspective, there are currently 214 ambulatory care programs, 143 in infectious diseases, 133 in oncology, and 86 in psychiatry.

Pain and palliative care? 30.

The number doesn’t sound right, does it? You’d think there are so many people in the US in pain who need specialists to care for them, and that pain management pharmacists are everywhere helping guide better clinical decisions. Sadly, we’re not there yet.

So by now, we probably agree how rare a pain pharmacist is. And yes, we do exist. But there are so many things about us that are unheard of considering how rare we are, and almost no one on LinkedIn is talking about it. So I figured I’d write about this:

What is it like to be a pain management pharmacist?

To really answer that, I have to share the types of patients I see, and really the types of pain I manage. With pain management, it isn’t just about making someone feel better when they hurt their back or twist an ankle. There are so many kinds of pain that aren’t just painful, but also deeply distressing.

It could be the pain from a newly diagnosed terminal cancer, and the patient has a hard time accepting the new status quo. Or the pain from a fractured spine, and the patient has to face the fact that a family member is sending him or her to a nursing home permanently. I vividly remember when I started my career, a patient who got a terminal cancer diagnosis asked me, right after I introduced myself,

“Am I dying?”

So being a pain management pharmacist is never just about managing pain. I am managing emotions at the same time — both the patient’s and mine. I have to keep my emotions and composure in check because active listening affects my own emotions to some degree, and showing negativity in front of someone who is already struggling doesn’t help the situation.

And because I’ve had so many emotional conversations, I’ve learned a few lessons over the years. If you ever find yourself needing to ground yourself because your emotions feel off, try asking yourself these questions:

1. What is causing me to feel this way?

2. Am I trying to win a fight or prove a point?

3. If I react now, will I regret my decision?

   
   

I hope this gives you a glimpse into what it’s like to be a pain management pharmacist this week.

See you next time.

SP