LEADERSHIP AND ADVENTURE: MAKING A CAREER IN AIR FORCE PHARMACY

Lt Col Scott Sprenger

Not all members of the US AirForce are pilots. In fact, the Air Forceactively supports a thriving pharmacyservice dedicated to caring foractive-duty personnel, military retirees,and their dependents, ensuringa high quality of pharmacy care at AirForce bases across the country andfor troops overseas. Deployment andtravel are significant in the Air Force.To take full advantage of the opportunitiesthe Air Force can offer, pharmacistsshould start with a love oftheir profession, mix in solid leadershipabilities, and finally add a bit ofthe adventurous spirit. That is the lifeof an Air Force pharmacist.

GETTING STARTED

A career in Air Force pharmacy canbegin through a scholarship programwhere the last 1 or 2 years of pharmacyschool are paid for in exchange fora commitment to the Air Force. Recruitersalso may approach a studentin the last year of pharmacy schoolwith an opportunity to work in AirForce pharmacy. Once interestedindividuals are identified, therecruiter connects them with anactive-duty pharmacist who canarrange a visit to an Air Force pharmacywhere they can see everythingfirsthand.

The scholarship program is popular,but the Air Force has only a designatednumber of scholarships toaward each year. Also available is aloan repayment option where a certainpercentage of loans are paid inexchange for a commitment—anattractive option for students withdebt.

Pharmacists also can enter the AirForce after working in civilian practice,perhaps with a desire to changetheir work environment. That is howLt Col Scott Sprenger came to be anAir Force pharmacist.While in pharmacyschool, a classmate was a technicianin the Navy, and Sprenger wasintrigued by his experiences and thebenefits of workingin the military.

After working for4 years at a civilianretail pharmacy,Sprenger decidedto make a careerchange. He has nowbeen with the AirForce for 19 years,which gives him aunique perspective on civilian andmilitary pharmacy. Today, he is theCommander of the 59th PharmacySquadron at Wilford Hall MedicalCenter in San Antonio, Texas.

ENTERING MILITARY SERVICE

An Air Force pharmacist wouldenter the service as a "direct commission"officer, as opposed to a pilot,who requires lengthy officer training.Direct commission officers have anabbreviated officer training school,known as Commissioned OfficerTraining School (COTS), which is 6weeks of training and learning thecustoms and courtesies associatedwith a military career.

"They know you know how to be apharmacist, so they bring you up tospeed on being an officer—learningthe rules and regulations that militaryis based on and what expectationsthe Air Force has," saysSprenger. It is in COTS where AirForce pharmacists begin to learn thebasics of the levels of command,leadership expectations, and leadingthose who work for you. "Really,there is a dual career as a health careprofessional and as an officer."

AIR FORCE–SPONSORED OPPORTUNITIES

When Sprenger worked in a retailpharmacy, he wanted to travel, and hehad a patriotic desire to serve hiscountry. He saw the Air Force as anopportunity to meet those goals andto get good experience in the practiceof pharmacy and perhaps further hiseducation. He had completed a bachelor'sdegree in pharmacy and, oncein the military, applied to the AirForce Institute of Technology—atraining program offered for a widevariety of careers to get graduate degreesand advanced levels of training.

DEPLOYMENT

As for the current state of travel,Sprenger says that many Air Forcepharmacists are being deployed toAfghanistan and Iraq and are playinga big role in the Air ExpeditionaryForce, which he says is just a fancyname for the medical side of deployment,but says it is an important partof how Air Force pharmacists serveand care for the warfighters. "The AirForce is like any spectrum of societywhere [individuals have] differentlevels of desire to go there [to theMiddle East]. I know that every pharmacistI have talked to said it was thebest experience they ever had. It is theultimate in teamwork in that deployedsituation and how that operationworks so efficiently. The AirForce pharmacists recognize theirvalue on that team," Sprenger confirms.

Sprenger further describes how, atWilford Hall, a constant deploymentof pharmacists leave in 4-monthcycles to Iraq or Afghanistan. Henotes, however, that if one looks athow many active-duty pharmacistsare in the Air Force (approximately240), the number deployed at anytime is relatively small—4 to 6 peopledeployed in any given 4-month window."In today's world, you have to beaware that a good likelihood existsthat you will be deployed. They don'tsend new people, however. They definitelywant to make sure you are welltrained, and a lot of training goes intothat.... It takes at least 1 assignmentto get to that level. That is not an environmentto be ill-prepared," he advises.

ADMINISTERING PATIENT CARE: MILITARY VS CIVILIAN

When it comes to direct patientcare, Air Force pharmacy follows thesame federal and state laws regardingpharmacy practice that the civilianpharmacies follow. One main differenceis that the Air Force does notcharge for medication, because it isfree for active-duty men and women,retirees, and dependents, so the moneyaspect of running the pharmacydoes not exist.

Air Force pharmacies run clinicsthe same way a civilian pharmacywould, including offering flu shots,hypertension screening, hyperlipidemiascreening, cough and cold clinics,and warfarin clinics. In addition,pharmacist-run refill clinics coordinatethe refills, counsel patients, andschedule new appointments.

It is true that the Air Force has fewerpharmacists than technicians, but,because they are required to meet thesame standards of care set forthby Joint Commission on Accreditationof Healthcare Organizations(JCAHO), the Air Force is workingdiligently to migrate their ratio ofpharmacists to technicians fromabout 1:3 or 1:4 to 1:2 as seen in thecivilian world.

LIFE IN THE PHARMACY

According to Sprenger, about 3years ago, the Air Force had a hugepush to standardize their automationand equipped all pharmacies toimprove efficiencies and maximizesafety. They wanted the latest technology—bar coding, on-screen prescriptionreview. "We are proud tostandardize and make significantimprovements in safety," he said.

The Air Force also has felt the biteof the pharmacist shortage nationwide.Their recruiting efforts havenot yet been able to meet their goals,as the market for entry-level pharmacistsis highly competitive. "It is difficultto compete with civilian benefits,"says Sprenger. As a result, the AirForce will continue to offer scholarshipprograms. Sprenger believes thatthe key is to get pharmacy studentsinterested, because once they areactually working as an Air Forcepharmacist, they have a high successrate for retention.

Another effort to adapt to theshortage of pharmacists is the AirForce's newly available contract pharmacistpositions. This is where civilianpharmacists are working in militarypharmacies. The Air Force hasfunded 125 contract pharmacists toincrease the number of pharmacistsneeded for JCAHO requirements. Sofar, says Sprenger, that plan has beensuccessful.

WEIGHING THE BENEFITS

The most difficult thing to pointout to pharmacists coming in is thebase pay, because it does not seemcomparable to civilian pharmacy. Itis important to note that it is consideredspecialty pay, however, whichincreases the longer a pharmaciststays in the military, and it is offsetby bonuses, such as those earned bybecoming board certified. Otherbenefits include 30 days of paidvacation, which starts on day 1 andcontinues throughout the entirecareer. Air Force pharmacists alsoget commissary and Base Exchangeprivileges (groceries and other goodsat reduced prices), as well as a housingallowance and income tax benefits.Once these benefits are factoredin, the gap between civilian and militarysalaries closes considerably.

As Sprenger describes, "Say you arein for 5 years—in that time frame,your salary starts to equilibrate, andyou start to live the benefits."Sprenger says he came to that realizationafter his first assignment. "I feltlike I was in such a learning environment.[...] I liked the fact that the militarysets you on a path for success ...you are on a road for always gettingmore responsibility and, in thatregard, more job satisfaction. It helpsyou grow as a pharmacy professionaland as a military leader. Often, peoplefeel their careers becoming stagnant.Each new situation validates whatyou have learned and you can continuouslyapply that knowledge," he said.

From Sprenger's experience, hefeels that to fully take advantage ofwhat the Air Force has to offer, apharmacist would need an adventurousspirit and personality. He or sheshould be dedicated and eager. Forthose individuals, the Air Force providesfertile ground to excel. "From aprofessional perspective, it is best totake advantage of every opportunity.You are pushed to excel—in a goodway." He says that this is another wayin which the Air Force does not differfrom the civilian world—the highestachievers get the advancements.