Jeff Maxon
Serving
Indian People
Jeff
Maxon, PharmD, is an enrolled member of the Cheyenne
River Sioux Nation. He grew up on the Standing Rock
Reservation. Maxon has been a pharmacist at Parker
Indian Health Service Hospital in Arizona, since he
received his PharmD from North Dakota State University
in 2003.
At Parker, a facility that primarily serves Hopi,
Chemehuevi, Mojave, and Navajo people, Maxon and the other
four pharmacists spend most of their time providing
outpatient care. “When the patients’ charts are brought to
us, we make sure that the appropriate drugs have been
prescribed and that the dosage is correct. We check for
side effects as well drug interactions. Also, if the
patients medications needs monitoring, we make sure there
is an appropriate way to do this.”
Maxon enjoys interacting with patients. After providing
information to them about their drugs, he often asks them
to tell him in their own words about their medications and
how they should be used. “That way we can help them if they
have any misunderstandings,” he explains.
Parker is one of the growing number of health care
facilities that offers pharmacy-based clinics for people
with conditions that need to be monitored. “These clinics
not only are convenient for patients, but they also provide
opportunities for patients to become better educated about
their condition and their drug therapies,” says Maxon. “Dr.
Lori Evans, [PharmD] started an anticoagulant clinic for
people with blood clotting disorders who have already been
started on therapy by their physician. If their physician
feels their situation is under control and Lori feels they
can be accepted into her clinic, then instead of seeing
their physician at each visit, they can come directly to
the pharmacy to be monitored.
“Typically she first does a simple blood test by a poke of
their finger and obtains results within a few minutes. Then
based on the blood test results she follows a protocol that
helps her with dosage adjustments if required. If patients
are progressing well, they can get their refills and
whatever else they need and be quickly on their way. If we
need to adjust the dosage, we counsel the patients, making
sure they understand the change. Regardless of their
situation, we’re always ready to answer patients’ questions
and give them needed information.”
Most patients come to Parker for the anticoagulant clinic.
Dr. Evans, however, sometimes travels to smaller clinics to
monitor the care of patients who live in more remote areas.
Once a week, Maxon and his colleagues participate in a
diabetes clinic that involves other health professionals at
Parker. “When patients arrive, depending on what they need,
they see their physician, the eye doctor, the dentist, the
foot doctor or others,” says Maxon. “It can take a couple
of hours, but in the outside world, patients would have to
have separate visits to multiple facilities. The pharmacy
is the last place that the patients come. We make sure they
know what their meds are called and what they are used for.
We make sure they know about important side effects. We
always ask them if they have any other questions regarding
their meds or their visit to the clinic that day. Basically
we try to tie things together.
“At the end of the morning after the clinic, the diabetic
team gets together. There is one person from each
department – a nurse, podiatrist, dietician, social worker,
dentist, optometrist, and physician. We discuss problems
that patients or we may have had in the diabetic clinic.
For example, maybe the chart didn’t get to someone quickly
enough. This is a time to voice complaints and concerns so
we can provide better patient care.”
Besides doing outpatient care, Maxon and the other
pharmacists share responsibilities for emergency and
inpatient care. Every morning begins with one or more
pharmacists visiting the emergency department where they
check the charts of patients who were seen overnight. Then
they input relevant information into the record keeping
system. The pharmacists also need to make sure that the
emergency department is well stocked with medications and
that the use of the medications is monitored and recorded.
About every 5 weeks, Maxon spends one week in the 15-bed
inpatient unit. Pharmacists are important members of the
health team that includes physicians and other health
professions, so at 8am, the pharmacist who is to cover the
in-patient service, “rounds” (reviews the status of
patients) with the team. As in outpatient care, the
pharmacists check for the appropriateness of the
medications, side effects and drug interactions “In
outpatient care, if we want to make a change in the
medications we have to track down the doctor,” says Maxon.
“Inpatient care is nice because you are working
face-to-face with doctors, so you can address issues right
way.”
Recently Maxon attended a continuing education conference
for pharmacists. Pharmacists have to work hard to keep
abreast of all of the new developments in pharmacy. That’s
fine with Maxon. He is glad to be in a profession where he
can continue to learn and be of help to others.
From
Football to Pharmacy
Being a
pharmacist was not Maxon’s goal when he was in high school.
“I chose North Dakota State University because it had a
good football program. I was young and thought that I was
going to play sports the rest of my life. My first couple
of years of college were rough. Looking back, I can’t
believe that I made it through.”
“My best support was my family,” Maxon continues. “Without
your family it’s hard to stay focused and see how all the
hard work will benefit you further down the road.” Maxon’s
friends who went on to college also supported him.
The Native Americans in Pharmacy Program was yet another
source of support for staying in school. He learned that
there was a shortage of pharmacists and that the work was
rewarding. For 3 summers he worked at McLaughlin Indian
Health Service Clinic on Standing Rock Reservation. The
next two summers, he again worked on the Standing Rock
Reservation, this time at the Indian Health Service
Hospital at Fort Yates. “Working with the pharmacists was a
lot of fun,” Maxon remembers. “I worked almost like a
pharmacy tech. I’d type the prescription labels, enter
information into the computers, and put orders away. I even
filled some orders with a pharmacist backing me up. I began
to get used to the drug names and strengths.
“When I finished pre-pharmacy and got into the professional
program, I thought it was going to be clear sailing. But
the classes get harder each year. I think that’s why I
slipped up and didn’t make it through my one class the
first semester. You have to study every day. It’s grueling,
hard, and challenging, but it will make you a very smart
professional person.
“My mom and dad both continued to support me. It was kind
of hard for my mom in the end though because she was going
to school herself. Also she had to go through treatment for
breast cancer. I didn’t tell a lot of my professors about
that. It was tough the last semester.”
Despite challenges, Maxon’s mother, Carol Gaurreau Maxon,
also made it through school, with a degree in elementary
education. She is now teaching at McLaughlin Elementary
School. She is a role model for her son, who, in turn, is
likely to be a role model for others.
This
article was originally published in the Autumn 2004 issue
of
Winds of Change. (The cover
artist is Clarrisa Hudson, Tlingit.)
Update
2007
Jeff is still based at Parker Indian Health Service
Hospital in Arizona where he was recently promoted to
Lieutenant Commander and Deputy Chief. As Deputy Chief he
supervises employees and has other administrative
responsibilities. Jeff is also manager of the pharmacy
anticoagulation clinic. Patients, who have been referred by
their physician to this pharmacy operated clinic, are
taking the blood thinning medication,
coumadin®
(warfarin).
Jeff, who is certified in the care of these patients,
monitors his patients’ blood by a simple finger stick and
makes sure they are taking the appropriate dose of
coumadin®
(warfarin).
This kind of direct care of patients is a growing trend in
clinical pharmacy.
In addition to his work at IHS, Maxon has had several
invitations to speak on healthy living topics. Recently, he
appeared on a local television program called “Healthy for
Life” where he talked about about healthy eating habits and
how to prevent obesity. He also talked about his career as
a pharmacist.