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The Ambulatory Care Pharmacist: What They Do and How to Become One

Published on: Apr 22, 2023
By: Jim Herbst, PharmD, BCPPS
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Pharmacists play a crucial role in patient care, and at the most basic level, they are responsible for ensuring that patients receive the right medications and the correct dosages. Pharmacists, however, can further leverage their skills and expertise to counsel and educate patients and can play a critical role in managing chronic diseases.  While pharmacists are commonly thought to only exist in a retail pharmacy filling prescriptions or in a hospital setting caring for acutely ill patients, many pharmacists practice in community settings alongside physicians, nurse practitioners, and physician assistance acting as the medication experts.  

Many of these pharmacists have specific advanced education through a 1 or 2 year residency experience and have obtained board certification. Board certification is an important way for pharmacists to demonstrate their expertise in a specific area of practice. 

In this article, we will explore how a pharmacist can become board certified as an ambulatory care pharmacist, where ambulatory care pharmacists work, and what they do.

Becoming a Board Certified Ambulatory Care Pharmacist

The Board of Pharmacy Specialties (BPS) oversees the certification process. To become a board-certified ambulatory care pharmacist, pharmacists must first obtain a Doctor of Pharmacy (Pharm.D.) degree from an accredited college or university.

After graduation, they must have a current and active license to practice pharmacy in the United States, have completed a minimum of 4 years of practice experience in an ambulatory care pharmacy setting, specializing in direct patient care, or a general 1 year pharmacy residency with of 2 years of practice experience in an ambulatory care pharmacy setting, or a general 1 year pharmacy residency with a second 1 year pharmacy residency specializing in ambulatory care pharmacy.  

While graduation from a pharmacy residency program is not required, such a residency provides advanced training in the management of common chronic diseases frequently seen in the outpatient (ambulatory) setting, and includes specialized education, training, and intensive experience in the ambulatory care setting. After meeting the eligibility requirements, pharmacists must then pass a rigorous exam to obtain board certification.

There are currently nearly 6,000 practicing pharmacists board certified in ambulatory care pharmacy. These pharmacists commonly practice in a variety of settings, including, clinics, hospital-associated outpatient care centers, physician offices, and community health centers. Many positions specialize in serving those patients with lower socioeconomic status.

Where Ambulatory Care Pharmacists Work

Ambulatory care pharmacists work in a variety of settings, including hospitals, clinics, and community health centers. These clinic health centers are often associated with major or regional health systems. They work closely with other healthcare providers, such as physicians and nurse practitioners, to ensure that patients receive the right medications and dosages. They also work with patients directly, providing education and counseling on medication use, managing chronic conditions, and promoting healthy lifestyles.

Ambulatory care pharmacists often work in outpatient settings, which means that patients are not admitted to the hospital. They may work in specialized clinics, such as those that focus on diabetes management or anticoagulation therapy. They may also work in primary care settings, providing medication management and monitoring for patients with chronic conditions.  These pharmacists often manage patients with one or more chronic diseases, such as diabetes mellitus, hypertension (high blood pressure), high cholesterol, congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), coronary artery disease (CAD), and obesity.

Many pharmacist also work in more specialized clinics, which may manage patients with HIV/AIDS, hepatitis, chronic kidney disease, and anticoagulation. While most ambulatory pharmacists work with adults, there are some that work with children as well.  These pediatric ambulatory care pharmacists may work in pediatric primary care or adolescent medicine collaborative practice centers.

What Ambulatory Care Pharmacists Do

Ambulatory care pharmacists provide a range of services to patients, including medication management, patient education, and disease management. They work closely with other healthcare providers to develop treatment plans that are tailored to each patient's individual needs.

Some of the services provided by ambulatory care pharmacists include:

Medication management: Ambulatory care pharmacists help patients manage their medications by reviewing prescriptions, checking for potential drug interactions, providing education on how to use medication properly, and making recommendations to optimize drug therapy.

Chronic disease management: Ambulatory care pharmacists work with patients who have chronic conditions such as diabetes, hypertension, or asthma, to help manage their conditions and prevent complications. They may also provide support for patients who are undergoing treatment for cancer or other complex medical conditions.

Immunizations: Ambulatory care pharmacists are often authorized to provide immunizations, such as the flu and COVID vaccines, to patients in outpatient settings. This helps to increase access to important preventive care services. These pharmacist can also assess the need for additional vaccines for travel or for those that are immunocompromised. 

Medication reconciliation: Ambulatory care pharmacists help patients reconcile their medications by reviewing their medication history and ensuring that all medications are being used safely and effectively.

Patient education: Ambulatory care pharmacists provide education to patients on a variety of health topics, including how to use medications properly, lifestyle changes to improve health, and strategies for managing chronic conditions.

Collaborative practice: Ambulatory care pharmacists work collaboratively with other healthcare providers, such as physicians, nurses, and other pharmacists, to optimize patient care and improve patient outcomes.

Ambulatory care pharmacists play a critical role in patient care, and board certification is one way for them to demonstrate their expertise in this area and to improve patient outcomes and ensure that patients receive high-quality, evidence-based care in outpatient settings.

References:

Board of Pharmacy Specialties. Ambulatory Care Pharmacy. Available at: https://www.bpsweb.org/bps-specialties/ambulatory-care-pharmacy/

American Society of Health-System Pharmacists. Ambulatory Care Pharmacy Practice. Available at: https://www.ashp.org/Pharmacy-Practice/Residency-Information/Residents-and-Fellows/Residency-Program-Directory/Residency-Programs-by-Specialty/Ambulatory-Care

portrait of Jim Herbst PharmD

Jim Herbst, PharmD, BCPPS is an advanced patient care pharmacist at a nationally ranked pediatric acute care teaching hospital.  Dr Herbst received his Doctor of Pharmacy degree from the Ohio State University in 2012.  He started his clinical career as an inpatient patient care pharmacist covering the neurology and complex care services, before transitioning to a pediatric neurology ambulatory care clinic in 2019. 

Dr Herbst's areas of interest in pediatric neurology include treatment-resistant pediatric epilepsy, infantile spasms, the ketogenic diet, and neuroimmunology.  He has published numerous articles in peer-reviewed pharmacy and neurology journals, including Neurology, Epilepsia, and the Journal of the American Pharmacists Association.  Dr Herbst is board certified as a pediatric pharmacy specialist.

Opinions and information published by the author here on PharmDDegree.com are of my own and do not necessarily represent the views or opinions of my employer.


Education: Doctor of Pharmacy (PharmD), The Ohio State University
Knowledge: Advanced Patient Care Pharmacy, Neurology, Epilepsia