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Student Profile: Derrick Chan '15

Vision of a PharmacyDerrick Chan
I have worked in a compounding pharmacy in the heart of the Sunset district of San Francisco for a few years. The pharmacist that took me under his wings will probably retire in a few years as he is approaching 80 years old. Ideally I would like to purchase his pharmacy with the established patient base. The location is ideal because the neighborhood is a great supporter of local businesses and receives patients from UCSF and local practices. The pharmacy is also on a busy intersection with multiple bus lines, restaurants, banks, and schools. The pros of the pharmacy is apparent, but there is also a large area of potential improvements. The building is old, with poor lightings which casts a slightly uninviting vibe. With ownership, I will renovate the pharmacy to attract more customers and build a clean room for the compounding aspect of the pharmacy. I will also extend my compounding services to veterinary medication.

In addition to compounding, I will also incorporate medication management therapy, immunization, and delivery services. Especially with the increase amount of elderly population, I will target my practice toward geriatric care management also. It is in the best interest for elderly patients maintain their independence for as long as possible. Therefore, my practice will include planning and coordinating care to assist elderly patients and their family members to maintain the patient's quality of life. Medical supplies like wheel chairs, walkers, prosthetics, etc is not widely available to the public. If the calculated risk is ideal for having these available, the service will definitely draw more business and publicity to my pharmacy. Other services that will increase traffic to my pharmacy will include hosting CE events and community health fairs.

Although owning a pharmacy have always been my dream, I have also envisioned myself working in a hospital setting. In order to make both these dreams come true simultaneously, I would need to partner up with four to five colleagues to buy out that pharmacy in San Francisco. I will work at a hospital four day out of the week with ten hour shifts for maintain the full-time status. Similarly my colleagues will do the same with their full time position elsewhere. With proper scheduling we will each work at our pharmacy for one to two days a week. Of course this plan will involve tremendous planning and coordination, but can be plausible with hard work and dedication.

After the end of my career in a hospital setting, I can imagine spending my retirement maintaining my own pharmacy. I would definitely hire a full time pharmacist, but I will also manage the pharmacy with more owner oriented tasks.

An Innovative Pain Management Program
My newly acquired patients, Monson and Raich present a very complex case of seeking the appropriate treatment to alleviate their pain by incorporating alternative measures to replace marijuana usage. As a compounding pharmacy, I will be able to design a drug product that will act locally to treat the area of pain. This should minimize the potential adverse effects that would occur if medication was taken orally or if a large dose is in the systemic circulation. Weighing in fact that these patients are heavily dependent on medically assisted pain relief, I do not envision a complete cure of the patients' conditions. Rather better management of pain, mental health, and physical health can be achieved at my pharmacy.

To aid the patients from their mental dependence on marijuana, my pharmacy will also provide services including psychiatric therapy as well as hypnosis. If withdrawal symptoms are severe, physiological dependence could worsen the patient condition. Therefore tapering off of marijuana may be appropriate after doctor's consent. Once the patients are mentally strong enough to face and combat their condition, physical strengthen through physical therapy, chiropractic therapy, and massage therapy can be attempted. Close assessment and monitoring of the patients progression will help determine appropriate long term therapy. Not only do their painful conditions hamper their everyday lifestyle, but it also affects their family members. For benefit of the patients as well as the family's own understanding of the intricate situation, it would be ideally to get family members more involved with the treatment plan. My pharmacy will host family workshops to educate them with things that they can do to assist the patient including simple massages, application of medicated cream/ointments, and especially the patient's nutritional plan. Because of the complexity of Monson and Raich's cases, extreme and uncommon measures should be considered if other methods have failed. Other treatments that can be facilitated by my pharmacy include acupuncture, spinal cord stimulation, herbal supplement, and music therapy.

Due the intricacy of the patient's condition and the limitations controlled by the federal law, all possible treatments will be exhausted until the proper regimen is fitting for the patient. Unfortunately, there is a chance that absolutely none of the alternative treatment plans will control the patient's condition. At that point the ultimate risk and benefit outcome must be considered for resorting back to the use of cannabis. A possible option is to get the approval of allowing the patient to use a controlled amount of cannabis only at the pharmacy. The drawback of the proposal is inconvenience and pain flares when the pharmacy is closed. To combat the inconvenience, my pharmacy can develop a separate department that specifically performs in home services with on call needs.