Introduction
Dr. Deanna L. McDanel, PharmD, BCPS, BCACP, is a Clinical Associate Professor at the University of Iowa College of Pharmacy and a Clinical Pharmacy Specialist in Ambulatory Care at UIHC. A 2001 graduate of the University of Iowa, she completed a specialized residency in Primary Care and is board certified in Pharmacotherapy and Ambulatory Care. Her clinical focus includes anticoagulation and drug allergy management. A multiple-time Teacher of the Year awardee, she also directs the PGY2 Ambulatory Care Pharmacy Residency and received the 2015 AACP National Master Preceptor of the Year award. Learn more about her here.
Why Pharmacy
My interest in pharmacy stemmed from my personal life. As a young teenager my grandmother had many medical complications and was on numerous medications. No one in my family had a healthcare background. I remember wanting to understand her shoebox full of medications so that someone in our family could be her advocate and have a deep understanding of her medical regimen. It was at that time when I realized that I could put my passion for chemistry, science and math into a career path in the health sciences. I shadowed a pharmacist in high school and saw how much respect patients had for pharmacy and this led me to apply to pharmacy schools.
Regarding ambulatory care, I just loved being able to get to know my patients, make an individual impact on their care, have a lasting relationship and ultimately gain trust and respect with my patients. It was the aspiration to be involved in academia that led me to pursue a clinical faculty career. My mother was a collegiate professor and in her everyday actions she modeled the personal joy that she got from teaching. I have strategically positioned my career around academia as my career began 23 years ago as a professor at the University of Iowa College of Pharmacy and as a clinician within an academic medical center at the University of Iowa Health Care.
Career Journey
I received my PharmD degree from the University of Iowa in 2001 and completed an ASHP-accredited Specialized Residency in Primary Care at the University of Iowa Hospitals and Clinics in 2002. Then I was hired on as a 75%/25% Clinical Pharmacy Specialist in Ambulatory Care and Assistant Professor, respectively, in 2002. I was promoted to Clinical Associate Professor in 2011.
Current Role and Responsibilities
As an Ambulatory Care Specialist, I spend 20-30 hours per week in clinical pharmacy practice. My patient care areas of practice and the time spent in each area per week include: 8 hours in the Drug Allergy Clinic and 12-20 hours in the Anticoagulation Case Management Service.
Additional time per week is spent in my faculty role at the College of Pharmacy and serving as the PGY2 Ambulatory Care Residency Program Director. I have been in that role since 2007. Drug Allergy is a unique clinical role, and I have been in that specific clinic since 2013, practicing in general allergy/immunology from 2002-2013. At that time a formalized Drug Allergy Clinic was created and in 2016 this was expanded to having pharmacist/physician co-scheduled appointments for patients to see myself along with a board-certified Allergy/Immunologist. Since the inception of the Drug Allergy clinic, our team has seen well over 2,000 patients with a >90% de-labeling rate for beta-lactam and other drug allergies. This program is a value to patients, referring providers and the institution as the clinic works in collaboration with numerous referring services and the antimicrobial stewardship team.
Challenges
The most challenging is maintaining work-life integration. I wear many hats, and while I love the variety and opportunities to engage professionally as a clinician, teacher, residency director and serving the profession with external engagement, at times this can become overwhelming.
While I don’t have a perfect “balance” and strive to achieve a better integration, it is important to only do those things that continue to make you happy in your career. At the end of the day, I live by the mantra “continue to do things that fill your personal and professional cup”. Also, I try to give myself grace as I know that not every day will be perfect and that is ok. Just recognizing and celebrating what I have achieved is the most important. I also have leaned into the idea that “saying no” is ok. Lastly, I could not be as successful in my life without my amazing husband and my two children who constantly support and inspire me!
Rewards
One of the most rewarding parts of my career is providing direct patient care daily. I love being able to develop relationships with my patients and to see how my involvement in their care can positively affect their overall health. The collaboration with other healthcare providers in our practice site is also a very positive approach to patient care. In addition, working closely with student pharmacists, pharmacy residents, and medical trainees in a variety of settings is the most professionally and personally rewarding aspect of my career. Teaching and mentoring enriches me professionally because it challenges me to maintain my therapeutic knowledge, continually sharpen my clinical skills and provide guidance and support to learners. The highest compliment of my teaching is when students thank me for what I have taught them and comment that they would like to walk in my career footsteps. Even more gratifying is when I get to observe a student or resident grow personally and professionally over time and finally reach their career goals.
Recently I was recognized with a “You Make a Difference” award at my institution. It was by the son of a patient that I managed in the Drug Allergy Clinic. The narrative stated “My mom has been struggling with numerous drug allergies for 60 years. She has avoided many medications and scenarios for decades due to past traumatic reactions and fear. Deanna was able to calmly walk through the steps, spent time with her, made her feel comfortable, and didn’t rush her at all. I watched my mom take a penicillin challenge that I thought I would never see. Deanna made a difference, and my mom now has the confidence in her medical care in the future. Thank you for all that you did!” I was very humbled by this award as, honestly, I provided this patient the same level of care that I provide to all my patients. I always treat my patients as though they were my parent, sibling, family member or friend when managing their care. I take the time needed and treat them with compassion and respect. This positive impact is something that I hope I have on all my patients.
Advice for Students and Aspiring Professionals
I think you will find ambulatory care to be an extremely rewarding career path, especially if you are interested in providing direct patient care. If you also are considering a teaching career, I would highly encourage you to seek out advanced training in a PGY1 and then a PGY2 Ambulatory Care pharmacy residency. It is a privilege to give back to the profession by guiding students through the transition from being a classroom learner to a practicing pharmacist. Introducing students into my clinical career helps me achieve my teaching philosophy of promoting life-long learning and has been one of the most satisfying experiences of my professional life.