CAPT Hope:

A Pharmacist with a Sense of Adventure

By LTJG Elaine Hu and LTJG Jeen Min

CAPT Samuel Michael Hope is a Commissioned Corps pharmacist who wears many hats. He is currently the Chief Pharmacist for the Indian Health Service (IHS) and the Regional Pharmacy Consultant for the Oklahoma City Area in IHS. In addition to his responsibilities as the Chief Pharmacy Officer, CAPT Hope also serves as the coordinator for the regional HIV/AIDS Program, and Chairman for the Oklahoma City Area Institutional Review Board (IRB).

CAPT Hope began his pharmacy career as a Commissioned Corps Officer in the United States Public Health Service (USPHS) after graduation from the University of Houston, College of Pharmacy in 1971. He started as a staff pharmacist at Fort Defiance Indian Hospital in Fort Defiance, Arizona. For someone who grew up near Houston, Texas, living on an Indian reservation was a "culture shock" for him. However, the camaraderie among the physicians, nurses, and the rest of the medical staff helped him to assimilate as part of the "community" on the reservation. Thus, IHS became an unforgettable experience, both professionally and personally.

            After two years at Fort Defiance, CAPT Hope decided to return to the world of academia. He pursued a Master's in Administrative and Clinical Pharmacy Practice at the University of Houston, College of Pharmacy, while at the same time, doing a residency program at the Veterans Administration Hospital in Houston, Texas. After completion of his Master's and residency, he accepted a faculty position at the University of Houston as Associate Professor of Clinical Pharmacy for undergraduate and graduate level pharmacy students.

            Yearning for his days at the reservation, CAPT Hope was faced with a career decision to either stay in academia or return to the IHS. Drawn to the challenges and opportunities that IHS provided, he accepted a position on the Navajo Indian reservation at the USPHS Indian Hospital in Tuba City, Arizona. He later became Acting Director for Pharmacy Services and was responsible for all aspects of pharmacy services.

Two years later, CAPT Hope became the Director of the Gallup Indian Medical Center in Gallup, New Mexico. During his years as Director, he became a preceptor for a pharmacy residency program accredited by the American Society of Health-System Pharmacists (ASHP). Being a preceptor was one of the most rewarding experiences in his career. He truly enjoyed mentoring students and providing them guidance in their careers. He then transferred to become Assistant Director of Pharmacy Services at Carl Albert Hospital in Ada, Oklahoma in 1981, where he was responsible for all clinical and inpatient pharmacy services.

In 1985, he became the Chief Pharmacy Officer for the Oklahoma City Area Indian Health Service, which is the largest regional area of the IHS. In this position, he was responsible for planning, directing, and evaluating pharmaceutical care for eligible Native Americans in the Oklahoma City Area. Three years ago, CAPT Hope was appointed the Chief Pharmacy Officer at the Agency level for IHS, where he oversees approximately 500 IHS pharmacists, and 200 pharmacies in IHS hospitals and clinics. He plays an instrumental part in initiating national pharmacy efforts in the recruitment and retention of pharmacists, disease management, drug formularies, reimbursement for pharmacy services, and many other pressing issues that face the pharmacy profession today.

            As Chief Pharmacy Officer, he is excited about the Clinical Pharmacy Specialist (CPS) program, which was implemented within the last year. This program will credential pharmacists to take on a larger role in patient management. Four major specialty areas for credentialing are anticoagulation, lipids, asthma, and diabetes. Pharmacists receive credentials through local training and competency examinations. Successful local credentialing and fulfillment of specific IHS national requirements result in national recognition (National CPS Certificate). CPS practitioners may be credentialed at Level I or Level II. Level I practitioners monitor patients and prescribe medications in a specialty area such as a pharmacy based anticoagulation clinic. Level II practitioners have a broader scope of practice. This includes diagnosis, prescribing, and monitoring of patients with conditions or disease states included in the scope of practice approved by the local medical staff.

            Currently, along with the many responsibilities as Chief Pharmacy Officer, CAPT Hope is the Chairman for the Oklahoma City Area Institutional Review Board (IRB), where he is responsible for exemption, expedited review, and full IRB approval for all research projects. These IRB reviews ensure the safety of all human subjects who are involved in clinical research programs. At the same time, he coordinates the regional HIV/AIDS program. The primary focus of this program is to provide continuing education programs for local HIV/AIDS coordinators and training on reporting requirements.

            CAPT Hope stresses the many unique opportunities in the PHS. For example, he traveled abroad as a Pharmacy Consultant for the Government of Gambia in West Africa for 90 days. This was a project funded by the Pharmaceutical Manufacturer's Association of America and coordinated by Africare. CAPT Hope, along with two other pharmacists from IHS set out with the purpose of assessing and redesigning drug distribution for the country. Their efforts also included assessment of clinical drug usage, drug formularies, and pharmaceutical care. This project was an extreme success. The model developed by the team was adopted by the World Health Organization for use in other third world countries. He also traveled to Bulgaria as a Pharmacy Consultant in 1996 for a short-term project. This project involved an on-site review of health care facilities in Bulgaria to assess the extent of need for emergency pharmaceuticals. Specific recommendations from this project resulted in an airlifted shipment of critically needed drugs to Bulgaria.

For CAPT Hope, working for IHS was not only a job, but also an adventure. IHS offers a variety of unique and challenging opportunities for pharmacists. Some pharmacists perceive IHS to be too much of a cultural shock to handle, but when asked what he would tell other pharmacists about IHS, he said, "Try us (IHS) out. Get an outstanding clinical and professional experience, as well as a free life and cultural experience!"

*          These profiles highlight some of the opportunities available to pharmacists (Commissioned Corps and Civil Service) in the United States Public Health Service.