What is Ambulatory Pharmacy? (A Day In The Life)

Ambulatory Pharmacist

Pharmacy is still one of the best career options out there if you would like to spend your time learning and applying everything medicine related. After the completion of pharmacy education and getting the pharmacy licensure, the pharmacist has a choice on many different practice areas. Pharmacists work in various areas, including community pharmacies, hospitals, clinics, extended care facilities, psychiatric hospitals, and regulatory agencies.

Talking about specializations, pharmacists can specialize in different areas, including hematology, infectious diseases, ambulatory care, nutrition support, drug information, critical care, community, industrial, compounding, pediatrics, etc. Apart from these, there are many other areas in which pharmacists can specialize.

One of the specializations we will talk about in this article is ambulatory care.

Now, what is the ambulatory pharmacy?

Ambulatory pharmacy is about the healthcare services of ambulatory patients transitioning from the hospital to home or another care facility. The duty of an ambulatory pharmacist is to educate and help patients in health promotion and wellness.

The ambulatory care pharmacist interacts with patients in an outpatient clinic setting. The ambulatory pharmacist manages patients’ chronic conditions such as diabetes, hypertension, and high cholesterol.

When it comes to ambulatory pharmacist job roles there is many differences to that of pharmacist roles in areas such as retail and in patient as you will see below.

Ambulatory Pharmacy vs Retail

As we have seen, there are different types of pharmacy specialties. People often get confused between an ambulatory and a retail pharmacy.

Community or retail pharmacists focus on tasks like filling and verifying prescriptions, maintaining inventories, providing patient counseling, etc.

Talking about ambulatory pharmacists, their task is to treat chronic diseases. Ambulatory pharmacists work closely with patients and the healthcare team.

The ambulatory pharmacist can provide counseling to the patient about the disease, while this is not the case with a retail pharmacist.

Basically, a retail or community pharmacist specializes in drugs. He/she receives prescriptions, verifies them, and fills them along with dealing with many other tasks at the same time. An ambulatory pharmacist works directly with other health care providers. Basically, ambulatory care pharmacists specialize on a particular disease such as diabetes.

What are some examples of ambulatory care services?

Ambulatory care services are also known as outpatient services. As an ambulatory care pharmacist, you will have many duties. Basically, any healthcare service you get without staying in the hospital is called ambulatory care services.

You may get these services in a doctor’s office, clinic, ambulatory surgery center, emergency room, or outpatient hospital department. Here are some examples of ambulatory care services:

  • Blood tests
  • Biopsy
  • Chemotherapy
  • Colonoscopy
  • CT scan
  • Mammograms
  • Minor surgical procedures
  • Radiation treatments
  • X-rays
  • Ultrasound imaging

These are some services involved in ambulatory care. Apart from these, there are also other services included in this pharmacy specialty. For ambulatory services, patient do not have to go to the hospital as he/she can get these services in a doctor’s office, clinic, emergency room, etc.

Who works in ambulatory care?

Ambulatory care or outpatient care includes the same healthcare professionals as inpatient care. In ambulatory care, you will find doctors, LPNs, registered nurses (RNs), physical therapists, physical therapy assistants, surgical techs, medical lab techs, and medical administration staff.

To get into ambulatory care, any additional training is not required. Still, nurses can specialize to become an ambulatory care nurse (ACN).

If you want less work stress as a nurse, ambulatory care pharmacy specialization could be the right choice. The reason why nurses working in ambulatory care pharmacy have less stress is that they have more predictable schedules as compared to nurses working in hospitals.

Ambulatory Pharmacist Eligibility Requirements

If you want to become an ambulatory pharmacist, make sure to check out its eligibility requirements. To become an ambulatory pharmacist, you need to pass the Ambulatory Care Specialty Certification Examination. These are the minimum requirements for the Ambulatory Care Pharmacy specialty certification:

  • First of all, you need to graduate from a pharmacy program accredited by the Accreditation Council for Pharmacy Education (ACPE).
  • Your current, active license to practice pharmacy in the US.
  • Now, you can demonstrate your experience in three different ways: you can do four years of practice experience or complete PGY1 residency & additional year of practice experience or complete specialty PGY2 residency in ambulatory care pharmacy.
  • After passing all the above steps, you need to get the passing score on the Ambulatory Care Specialty Certification Examination.

These are the steps you need to pass in order to become a certified ambulatory pharmacist.

Ambulatory Pharmacy Salary

Before choosing any career option, knowing the scope and opportunities of that career field is very important. Pharmacy is a vast field. It consists of different types of specialties. Depending on your interest or preference, you can be a retail pharmacist, ambulatory care pharmacist, home care pharmacist, or any other.

The salary will differ based on the pharmacy specialty you have chosen, the knowledge you have, your expertise, etc. such factors. It also varies based on the location.

The average salary of an ambulatory care pharmacist is $120,000 annually in the United States according to Payscale.com. Depending on the knowledge and expertise of the ambulatory pharmacist, it could be less than $100,000, or it could be around $130,000. The average hourly rate an ambulatory care pharmacist gets is about $59.46 in the United States according to Payscale.com. This data is gathered from the Pay Scale official website.

Should You Choose Ambulatory Care? Opinions From Real Pharmacists or Students

We have gathered the opinions of actual Ambulatory Care Pharmacists or students studying to become one so you don’t have to take our word on this subject.

We curated this information from several different Pharmacist Forums and the only thing we changed was spelling or grammar where needed.

Ambulatory Pharmacist Opinions

1. Requiem “Amazing” – Ambulatory care is amazing. As a professional pharmacist in an ambulatory care setting, you get to be a part of the ambulance and ER setting.

Imagine riding in an ambulance with a critical patient and being able to give him meds to treat him? sensational. Then, you get to go into the ER setting and follow-up treatment with ambulatory doctors & nurses.

To Poland, who mentioned he/she was learning about the topic on TLC/Discovery: excellent idea. Discovery does a great job at portraying ER Pharmacists (ambulatory care) in their medical shows, as does TLC. This is basically real life except for a few little details, the acting and precise day-to-day job routine is astonishing similar.

So, to those interested: seriously just check out discovery and tlc a lot. you’ll learn so much about ambulance pharmacy/ er pharmacy (ambulatory).

2. Ultracet “Fast Paced and Exciting” – I had my ambulatory care rotation in feb and it was so high paced and ultimately the most exciting thing i’ve ever done.

They even taught me how to properly use the defibrillator if necessary.

I highly HIGHLY recommend anyone who wants to go into this field to consider also being trained as an EMT

I love discovery and tlc and it always pumps me up to see what i will be doing in a few short months.

3. Caverject “Eye opening” – I had the opportunity to do an amcare rotation not too long ago in a rural area. I was located in Vidalia Georgia where there is a lot of migrant workers as well. (onion farms) I must say the experience was eye opening. I never knew that in a rural area like this that cops ride along with the EMT’s. They can’t ride in cop cars because it would cause mass chaos in the fields. When the emt’s and myself go to attend the patient in need, the cops check work visas and passports to make sure everyone is legal. Quite a few times, I have seen an unfortunate illegal worker get handcuffed to the stretcher, taken to the hospital and then deported. It’s quite sad to watch, even sadder to watch the family as the patient gets cuffed but the law is the law. Like I said, eye opening!

4. Kwizard “Clarifying the facts” – Just a minor clarification. Ambulatory implies that the patient is not bedridden (i.e. capable of walking) and isn’t necessarily exclusive to pharmacists working in the ER. However, funding for pharmacists in ER setting is becoming more popular due to JCAHO initiatives for med reconciliation and minimization of polyphmarmacy; however, if this is a path that interests you, obtaining some critical care training and/or BLS (Basic Life Support) and ACLS (Advanced Cardiac Life Support) certification may be quite advantageous given the potential acuity of the population (i.e. pts coding). Check out the American heart association for a list of classes (http://www.americanheart.org/). Most residencies train you in BLS/ACLS so you obtain certification during residency period.

Ambulatory care tend to be seeing pts in clinic settings (i.e. managing lipids, htn, diabetes, anticoag, etc); however depending on facility may also include some time in the ER as well but depending on the volume of the clinic, the pharmacy may be able to justify an entire separate pharmacist for the ER. It might be worthwhile to check out ASHP (www.ashp.org) and/or ACCP (www.accp.com) to look at potential am care and/or ER positions/residencies in various geographical areas. Off the top of my head Temple’s hospital in Philly is currently looking for an ER pharmacist so it might be a good idea to look into to the position to compare/contrast w/ qualifications for the job w/ other listings.

Both settings are very important and fast paced and really ideal for those who like pt contact and application of clinical skills.

5. Dgroulx “Lots of interaction with patients” – I now have a week of ambulatory care under my belt. The clinic where I work has lots of poor patients. There is a sliding scale for paying the clinic for doctor and dentist visits.

We have a limited formulary. We do not stock any C-II meds at all. Most of the patients are on patient assistance programs sponsored by the drug company. We have certain shelves just for those meds. If they aren’t on the program, we can sign them up. If a doctor writes for a med that is not in the patient assistance program or we have a lower cost alternative, we send a note next door with our recommendation.

We also counsel every patient. The pharmacist knows some Spanish, but one of the nurses comes over to act as an interpreter when we need it. For new diabetic patients, we have the time to show them how to use their glucose meter. We have demo inhalers to show asthma patients proper technique.

It’s been a while since I’ve had pharmacology, so the pharmacist will quiz me while were filling a prescription. It’s a good refresher course. We also have stools, so we can sit during down time which is nice.

It is very close to retail pharmacy, but at a much slower pace with lots of interaction with your patients.

6. RxDawg21 “Don’t need a residency all the time” – I also work in ambulatory care as a pharmacist. I was fortunate enough to get a position without a residency but also work in a smaller town but enjoy the area and what I do. I do DM, CHF, HTN, LIPID management and prescribe for the patients. I also occasionally will do vitamin D deficiency or hypothyroidism. I don’t make $70 an hour but also don’t live in southern California.

I think it is a joke that a residency trained person is considered to have more experience then someone without residency that has been doing the job 6 months to a year. I know plenty of residency trained pharmacists and all have said they learned more in the first 2 months on the job then in residency and they all did ambulatory focused PGY1s. Also many non-residency pharmacists have actually hit the ground running faster then residency trained ones. It has a lot more to do with knowing the guidelines, confidence, and efficiency/time management. The latter is much harder to teach/relearn through a year of residency and really makes a difference between leaving on time and staying late.

7. PumkinSmaher “Worked both inpatient and ambulatory” – I have worked both and think it was useful to start inpatient to get that exposure before transitioning to ambulatory.

I really enjoy ambulatory from clinical and lifestyle perspectives. I work Monday to Friday, no weekends/holidays, flexible start/end times, office (I see patients in my office or in an exam), independence and direct working relationship with nurses and providers.

I have no dispensing duties, the nurses and providers use me solely as a consultant pharmacy provider. It really is a great working relationship, but it can get hectic. Nurses and providers stop by all day or message with questions or referrals to see patients. I enjoy the work and like the challenge. I see 100% undeserved population with complicated psychosocial dynamics and often working with our social workers and peer support folks.

I will say of you don’t enjoy diabetes then stay away from family/internal medicine ambulatory care pharmacy. Most of my collaborative mgmt is for dm and htn but also growing number of copd, asthma, chf and gout.

You will also likely be responsible for regular educational talks or updates to clinical staff, pharmacy talk sessions at pt groups, precept in pharmacy students and depending on your clinic, also medical residents and students. I do some pharmacy education with our medical students and residents who rotate through.

I enjoy going to work most everyday, I have no plans on leaving ambulatory care, I enjoy the work and the time it allows me away from work;)

Final Thoughts

Here we have discussed everything you need to know about ambulatory pharmacy. Ambulatory care services are also known as outpatient care services. An ambulatory care pharmacist specializes in a particular chronic disease. He/she manage chronic disease such as diabetes, hypertension, high cholesterol, etc. of the patient.

If you are confused between ambulatory pharmacy vs retail pharmacy, all you need to know is retail/community pharmacy is about specializing in drugs, while ambulatory pharmacy is about specializing in a particular chronic disease.

Hopefully this information will help you decide on your career path. If you are a current student try to get in and do some volunteer work within different job opportunities you may want to explore in the Pharmacist Field. This will be the best way to know if it is something you will enjoy doing along with committing to a rotation in that area. Do your research and good luck.


Danielle Winner

Hello my name is Danielle Winner. Welcome to my site on Pharmacy School and tips and tricks to hopefully help you get in. It's not easy but hopefully you can learn to not make mistakes that students (myself included) make. Good luck on your journey. I graduated from Albany School of Pharmacy in May 2010 and have had a few different jobs across the east coast of the U.S.

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