Introduction
Dr. Julie Dopheide, PharmD, BCPP, FASHP, is Professor of Clinical Pharmacy, Psychiatry and the Behavioral Sciences at the USC Mann School of Pharmacy and Pharmaceutical Sciences and Keck School of Medicine. Dr. Dopheide provides care for children and adults with mental health and substance use challenges as part of interprofessional teams at Los Angeles General Medical Center. Dr. Dopheide has had leadership roles in the Board of Pharmacy Specialties (BPS), the American Association of Psychiatric Pharmacists (AAPP) and the American Society of Health-System Pharmacists (ASHP). She completed her PharmD at the University of Nebraska and a psychiatric pharmacy residency at the University of Southern California.
Why Pharmacy
As a high school student, I considered many career options including business, marketing and healthcare. In looking at options in healthcare, pharmacy was most attractive to me given that a pharmacy degree opened the door to so many "built-in" career paths in community, hospital, consulting, specialty care. Pharmacy careers come with good salary, benefits and respect for the pharmacist's knowledge and expertise. Pharmacists help their communities stay healthy and serve as a resource of unbiased healthcare access and health information. I continue to enjoy sharing my rewarding career with friends and family.
Career Journey
I completed 2 years of pre-pharmacy requirements, got my PharmD degree at the University of Nebraska and decided to specialize in psychiatric pharmacy. Psychiatric pharmacy appealed to me because of the need to speak to patients directly to assess symptoms and therapeutic effects of medications. I was drawn to the interdisciplinary approach to patient care in psychiatry. The psychiatric treatment team values all contributing members. I completed a residency in psychiatric pharmacy at the University of Southern California and pursued Board certification in psychiatric pharmacy. Board certification shows healthcare administrators and patients that I have the knowledge and skill to advocate for patients and assist them with their mental health journey to recovery.
Current Role and Responsibilities
I arrive at the hospital or clinic, say hello to my treatment team and review charts of the patients I will see that day. In the hospital, I participate in patient care rounds where I contribute recommendations on optimizing medications for persons hospitalized for mental health and/or substance use challenges. In the clinic, I supervise our PGY2 psychiatric pharmacy resident in providing comprehensive medication management for a caseload of patients with depression, anxiety, insomnia, psychosis, substance use and a range of coexisting medical diagnoses. It is rewarding to develop rapport with the patients over time and see their symptoms and quality of life improve with the individualized pharmacotherapy that we provide. In the clinic we have prescriptive authority and work with psychiatry and primary care to coordinate treatment plans for patients. I coordinate the Central Nervous System module for 8 weeks which involves classroom teaching, but my main teaching role is working with students in the practice setting to help them hone knowledge and their clinical skills in pharmacy.
Challenges
Time management is perhaps the most challenging aspect of my career. There are certain times throughout the year when I have a course to coordinate, patients to see and projects to complete all at the same time with tight deadlines. These periods are challenging but workable and I have the support of faculty colleagues and my family to get it all done in time. On the flip side, my academic career also gives me the flexibility to participate in professional organizations and attend pharmacy meetings and pursue passion projects like advocating for youth in foster care.
Rewards
The most rewarding aspects of my career are working with patients and students/residents and the psychiatric treatment team. Each day I have the opportunity to destigmatize mental illness by connecting students with patients who just happen to be experiencing a substance use or mental health challenge. It is rewarding to see my students and residents develop rapport with their patients and help them recover.
In my role as a psychiatric pharmacist on the adolescent psychiatry service at LA General Medical Center, I worked with the treatment team to safely initiate the antipsychotic clozapine for a youth with childhood onset schizophrenia. I guided my students to provide education to the patient and family on the risks and benefits of clozapine. It is the most effective antipsychotic for schizophrenia, but it has some of the most serious potential adverse effects. These include wiping out neutrophils (immune cells), seizures, and inflammation of the cardiac muscle. Prior to clozapine, this teen was tormented by hallucinations and paranoid/persecutory delusions, believing the mafia was after him and his family. As the clozapine began to work over several weeks, I saw the hallucinations/delusions diminish and the patient engaged more socially in groups. The patient was able to talk about his own desire to go back to high school and learn about gene editing with CRISPR.
Work/Life Balance
I work hard during my busy times of the year and am thankful for rewarding work. During these busy times, I may work 10-12 hours per day. I reward myself with a favorite concert or nice meal out to celebrate my accomplishments. During times when my workload is lighter, I schedule time off and travel to recharge my batteries. Regular exercise and making time for friends and family helps me feels balanced.
Advice for Students and Aspiring Professionals
Psychiatric pharmacy is a rewarding career and pharmacists with expertise in mental health are in demand. If a student is interested in how the brain works and how it guides thinking, mood and behavior, I recommend the student pursue a similar career path to myself and become a psychiatric pharmacist. Obtaining and maintaining board certification in psychiatric pharmacy ensures a method for keeping up on the latest advances in psychopharmacology and therapeutics for brain health.