On being the MHP

I'm the MHP...Market HIV Pharmacist. I head up the company's HIV program in our market, which extends from Florida to Louisiana. But since HIV is prevalent in certain areas only, I really just have 20 stores: two in Baton Rouge, several in Jackson Mississippi, and the rest in the greater New Orleans area.
Before I moved into my shiny new pharmacy, I was a pharmacist at a busy crazy store in a crappy neighborhood. We had lots of HIV patients, and try as I might, we could not encourage medication adherence or get people to pick up their refills on time. Part of the problem was mental illness (highly correlated with HIV), part was lack of transportation, and part was apathy. It was a little frustrating. Once I moved into my new store, I had zero patients, with HIV or otherwise. I had to build up my clientele bit by bit. Word gets around the HIV community, and HIV patients have started coming to me now.
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I'm loving that I have a private counseling room. This week I had two newly-diagnosed patients and neither felt like they fully understood the therapy they were starting. One was a young man; the other a woman in her late 50's. She did not seek medical care for a long time (even though she has Louisiana Medicaid that covers her doctor's visits) and her CD4 count (those are the white blood cells that the HIV virus attacks) was 48 at time of diagnosis - that is quite low. Under 200 classifies you as AIDS; at her level she's at risk for multiple opportunistic infections. We had a long talk and I showed her how to keep track of her lab values to follow her progress, and told her that when she started her medication she'd feel drowsy and dopey at first. She returned today, three days later, to tell me that she had experienced the side effects I told her about, but that since I'd warned her she knew to stick with it until they went away. Her side effects should wain in about 2 weeks, so I have high hopes for her, despite the tell-tail track marks I saw on her arm today.
The young man who came in today has a full time job with insurance, but he's also a part time student and is trying to stay on a budget. He was started on the same medication as the older woman, but the side effects were something he was prepared for. We discussed starting the medication tonight, so he has time to get used to it before he returns to work on Tuesday (he took Monday off). By the time school starts over, he'll be over his loopiness. However, he didn't love his $50 copay. Luckily, I'm the coupon queen and downloaded him a coupon to cover his entire copay.
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Being the MHP usually means dealing from a distance- answering other pharmacists' clinical questions, helping bill insurance or use copay assistance, or reaching out to AIDS service organizations. Now that I'm getting patients here I'm glad to be working on the more personal side. I feel like I can establish a relationship and help them cope with this disease.
The only thing is, I never get used to it. I never get calloused. Each new diagnosis hits me in the pit of the stomach.
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I know I've shared a lot of crazy pharmacy stories in the past, but I wanted to share some more successful stories, too. It's nice when it's not all drug dealers and drama.