Buford Abeldt, Sr., Abeldt's Gaslight Pharmacy (Lufkin)
Growing up in Haskell, TX, Buford Abeldt, Sr. decided to pursue a career in pharmacy early on. He attended pharmacy school at Southwestern State College in Weatherford,Oklahoma, earning a bachelor's degree in pharmacy in 1969.
But then he had a small detour.
"I was drafted during the Viet Nam War,” says Abeldt. "I joined the Navy and ended up in Pensacola, FL. I worked in a Navy pharmacy for four years, and got a Florida license to boot. It worked out well.”
When Abeldt got out of the Navy in 1974, he returned to Texas looking for a job in pharmacy.
"There was just one drug store in Haskell, and it sold, so I took a job in Lufkin,” says Abeldt. "I worked at Memorial Hospital until 1979.”
"At that time, a clinic opened up, headed by three doctors, and I handled the pharmacy operation. They gave me the opportunity to own my own pharmacy,” says Abeldt, who has been a member of TPA for over 35 years.
Abeldt's West Loop Pharmacy opened in Lufkin in 1979, and has soon began attracting local customers.
"I remember we filled 15 scripts the first day, so I had some doubts,” says Abeldt.
But Abeldt steadily built a customer base. He purchased Hendrick’s Pharmacy in Lufkin and incorporated that into Abeldt's West Loop Pharmacy. He then bought Cavanaugh-Peden Pharmacy in Lufkin, and ran it for several years before consolidating.
"I took the inventory and customers and brought them into Abeldt's West Loop Pharmacy,” says Abeldt.
In 2007, he grew again, building a store from the ground up.
"I had a lot on Gaslight Boulevard in Lufkin, says Abeldt. "My business had expanded so much that I needed to move, so I moved to Abeldt's Gaslight Pharmacy, which includes a medical supply store.”
"We currently have four pharmacists on staff at Gaslight (counting me) and nine pharmacy technicians with rotating schedules. Gaslight Pharmacy is thriving—I attribute that to God’s blessing. I’ve stayed in one place and been fortunate.”
Lufkin has a population of around 35,000 and is located between Tyler and Houston. Although Abeldt has a lot of competition, he’s not concerned. Abeldt's Pharmacy was awarded the 2006 Small Business Award from the Angelina County Chamber of Commerce and "Best Pharmacist" by the Lufkin Daily News for 2006-2015.
"We’re the last independent in town, and I think people like independents,” he says. "We have a niche market with our compounding and sterile products.”
Owning and operating an independent pharmacy requires a good business sense and a lot of work, but it has its rewards.
"I come to work and get to interact with folks I’ve known for 30-plus years,” says Abeldt. "We take care of about four different generations.”
At the store, Abeldt is hands-on, filling prescriptions and managing his 26 employees.
"I’ve been fortunate in that most of my staff has been with me for more than 15 years,” he says.
"Independent pharmacy is strong,” adds Abeldt. "PBMs have not helped. And Medicaid managed care certainly has not done us any good. But I think that independent pharmacy is determined to stay alive for the benefit of themselves and their patients. We are a hardy group. I think people like to know their pharmacist. Given a choice, I think people will choose independents. But insurance can be an obstacle to that.”
Abeldt is currently on his second term for the board of directors (he has been Vice President and is currently Treasurer) at the Texas State Board of Pharmacy, and will serve through 2019.
"It’s been very gratifying—I’ve learned a lot and gotten to rub shoulders with some mighty fine people,” says Abeldt of TSBP. "I’ve learned other aspects of pharmacy’s perspective, and to pay close attention to the consumer aspect of it. Being on the board is a major part of my life, but I’m contributing and I’m gaining from it.”
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Kalyn Marie Acker- University of Texas College of Pharmacy
As a Bio-chemistry major at Texas Tech University in Lubbock, Kalyn Marie Acker was on a pre-med track. But by her sophomore year she realized it wasn’t a good fit, and an exploration of other career paths led to pharmacy.
"I knew I wanted to help people,” she said. "I have a friend who is a pharmacy technician, and she suggested that I go for pharmacy.”
Acker received her degree in Bio-chemistry in May of 2011, and began as a P1 at the University of Texas College of Pharmacy that fall. Now a P4, Acker is doing clinical rotations at the UT Health Science Center in San Antonio—specifically an in-patient adult medication rotation.
"Right now I’m following nine patients, monitoring their drug therapies and making recommendations regarding their medications," says Acker. "I love doing it. I’ve had amazing preceptors and and I’m learning a lot, while having a lot of fun.”
Ultimately, Acker is interested in the administration side of pharmacy.
"I’d like to do a pharmacy administration residency,” she says. "In a residency, you apply and rank your choices of jobs, and then you are ranked within a database. It’s post-graduate work, and can lead to a better job offer once you begin your career search,” says Acker. "I’d like to become a pharmacy director—in charge of the entire pharmacy department. Even though I may not be directly involved in patient care, by making sure the pharmacists you are directing have all the resources they need, I too will be impacting patient care.”
Acker, the 2014 Luther and Mary Ann Parker scholarship recipient, has made a point of being involved with student leadership at UT during her pharmacy education, and has set a great example for other pharmacy students.
"At UT, I’ve been privileged to have a lot of different roles,” she says. "I’m on the admissions committee for the College of Pharmacy; I’ve served as social chair, student political advocacy chair, and president (2013-14) for the student American Pharmacists Association (APhA) chapter. I’m also the regional delegate (Region 6) for APhA.”
Provider Initiative has been on her radar, and she’s done "hill” visits in both Texas and Washington, DC.
"In 2013, I met with offices of senatorsTed Cruz and John Cornyn, discussing the importance of pharmacists on the healthcare team, and how provider status is crucial for that,” says Acker. "We also met with Texas state senator Leticia Van de Putte, and we’ve done letter-writing campaigns to local legislators.”
Acker became aware of TPA through APhA, and her first experience with TPA was when she attended the Leadership Symposium in 2012.
"I’ve been to every TPA Leadership Sympoisum and Annual Conference since,” says Acker. "TPA is my favorite of all the pharmacy conferences, including national—because it’s local, and it’s easy to speak with pharmacists and learn about different professional settings. As a student I’m exploring, and at TPA everyone is so friendly…it’s easy to talk to different pharmacists, so it helps with my career choices. It’s an opportunity to learn about the profession from practicing pharmacists.”
Additionally, Acker has taken advantage of the different competitions offered in these settings— she was on the winning 2013 UT Student Self-Care Championship team, and took second in student patient counseling competition that same year.
"I really like the student programming and competitions, because they help you grow professionally and personally,” says Acker. "The competitions helped reinforce my clinical knowledge and my confidence in interacting with patients. You get great feedback on how you did, and you can become better.”
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Reneé Acosta, R.Ph., M.S. Clinical Associate Professor of Health Outcomes & Pharmacy Practice, UT College of Pharmacy
Pharmacy typically requires a high aptitude in math and sciences, and the desire to help people is important as well. Attending high school in Slaton, TX, just outside of Lubbock, TPA member Reneé Acosta fit that profile exactly.
"I was good in math and sciences and I wanted a medical career where I could help people without necessarily dealing with blood and needles,” says Acosta.
That’s when she turned her attention toward pharmacy.
After attending Angelo State University for two years, Acosta transferred to the University of Texas College of Pharmacy, where she first earned her Bachelor of Science in Pharmacy (1987), and then her Master of Science in Pharmacy in 1998.
Along the way, she worked as a pharmacy technician at Walgreens, an experience that would help shape her future career in academia.
"While I was in school, I started working at Walgreens as a pharmacy technician,” says Acosta, who went on to be a staff pharmacist and then pharmacy manager at Walgreens. "Community pharmacy was a perfect fit for me—I liked the patient interaction.”
A Career in Academia
Acosta left Walgreens in 1998 to head up the Pharmacy Technician Program at Austin Community College.
"At the time, ACC was starting their pharmacy technician training program and was looking for a program director. That’s how I ended up in academia,” says Acosta. "That program was designed to prepare people for the certification exam.
"As a community pharmacist, I worked at very high-volume pharmacies, and utilized pharmacy technicians, and I appreciated those who were well trained and could really help—they are an invaluable asset. As pharmacy advances, we need technicians who are trained, educated and put in place to do all the things they were trained for, so that pharmacists can do the things they were trained to do.”
In 2005, Acosta took the post of Clinical Assistant Professor, Division of Pharmacy Practice at The University of Texas at Austin and in 2009 was named Clinical Associate Professor of Health Outcomes & Pharmacy Practice—her current fulltime position.
"I teach nonprescription Pharmacotherapeutics and Self-Care I and II — over the counter drugs (OTC) and Basic Intravenous Admixtures. It’s a skill-based course where students learn about sterile IV preparations,” says Acosta. "It’s really more than just the study of OTC—it’s educating patients on how to care for themselves, and how to use the products. So it ties in with patient counseling.
I love interacting with the students on a daily basis…knowing that you’ve made a difference in someone else’s life. It goes back to why I got into pharmacy to begin with. They are great leaders and really want to change pharmacy. It such a joy to work with them every day and know that they are the future of pharmacy.”
Acosta, who is very active in local, state and national organizations believes that, "now more than ever pharmacists are recognized as the drug information experts. It’s up to the pharmacist to put it all together for the patient. To help lower healthcare costs and to prevent hospital re-admissions, you have to have pharmacists on board. We see patients more than any other healthcare provider. When you look at the future of healthcare, I think it’s important that pharmacists be recognized and utilized.”
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Angela Franklin Aguilar, CPhT, Tarrytown Pharmacy (Austin)
”A native of Gonzales, Angela Franklin Aguilar began her career as a pharmacist technician by chance. In 1996 an independent pharmacy called Kotzebue Drug,Inc. was looking for a clerk who was bilingual. The owner, quickly seeing Aguilar’s aptitude, trained her as a pharmacy technician, a career she’s had since 2,000.
Seeking broader horizons, Aguilar moved to Austin in 2003, and found a great fit with Tarrytown Pharmacy.
"I’ve been a pharmacy technician now for 14 years, and I love it here at Tarrytown Pharmacy—it’s a lot different from a small-town pharmacy. You meet a lot of different, interesting people,” says Aguilar, one of four full-time techs at Tarrytown Pharmacy.”
Aguilar starts her day with a cup of coffee and a smile on her face, and gets ready for whatever the day brings. Then it’s on to getting the pharmacy ready, preparing for the patients who will be coming in, and wrapping up any odds and ends left over from the previous day. Manning the counter, she’ll make sure everything is flowing smoothly, taking in patients’ information concerning allergies, current insurance, and so forth.
"I also look to see if I have any questions about their prescriptions,” she says. For example, if the patient drops off a prescription for amoxicillin and I notice it doesn’t have a strength, I’ll let them know we have to check in with his or her doctor. That way they’ll understand why there’s a hold-up. It’s about communicating with patients, so they’re not frustrated why a prescription may take a while.”
"I think the most important aspect of my job is customer relations. I think it’s important to make customers feel special, and communicate with them, along with the doctors’ office and nurses, to make sure our patients are taken care of properly.”
Additionally, Aguilar notes the role pharmacy techs play in ensuring the accuracy of prescriptions.
"We [pharmacy technicians] see the prescription from the beginning to the end. We check the prescriptions and ask the pharmacist on duty if something doesn’t look right. So we’re certainly involved in that on a daily basis.”
Aguilar finds that the highlight of being a pharmacy technician is the interaction with people.
"Communicating with people, just knowing that I’m helping someone is something I really enjoy,” says Aguilar. "Especially older folks who may be struggling with their medications. I’ll help them clarify things, and get them counseling with a pharmacist to straighten out their meds, so they know what to do, and what the different medications are for.”
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Lydia L. Aguilera
Long before Lydia L. Aguilera became a pharmacist, she had several mentors in her South Texas community. Local pharmacists B.L. Garza, who owned Garza Pharmacy, and Manuel Ruiz of Edinburg Pharmacy served as role models, inspiring a young Aguilera to pursue a similar career path. "My family did business at both pharmacies, and I saw what a difference community pharmacists make in people’s lives,” says Aguilera.
"It’s not just about providing medication, it’s about advice and resources for folks when they get their prescriptions filled. What I really liked was the rapport with the patients. Unlike a mail-order pharmacy, you build relationships. The human touch is important—sometimes people just need to talk with someone and that’s therapy too. Aguilera went to University of Houston, and she did what was called an "externship” with Edinburg Pharmacy after her freshman year, gaining valuable early practice experience. "It confirmed my choice to be a pharmacist,” says Aguilera.
After graduating from the University of Houston, Aguilera worked in a hospital for a while, and later worked for Walmart for 14 years. After leaving Walmart, she went to work for Med-Aid in Edinburg, and in 1999, following their model of having a pharmacy next to a clinic, she opened Mom’s Pharmacy, which was connected to a pediatric clinic.
"Operating Mom’s Pharmacy from 1999-2012 were wonderful years,” says Aguilera, who has two daughters that are pharmacists and a son in medical school. "It was scary opening my own store, but two months later I was in the black. It was great being my own boss, making my own decisions, and getting to know my own customers. It’s what pharmacists dream about—building a rapport and treating your customers like your own family.”
Aguilera had earned a bachelors in Pharmacy in 1980, and in 2000 requirements changed so that new pharmacists entering the profession had to have a Pharm.D. As an existing pharmacist, Aguilera did not need to, but in 2005, she decided wanted to earn a Pharm.D.
Career Change "As part of the curriculum, I had to give some lectures,” says Aguilera. "So I contacted the UT Pan American Cooperative Pharmacy program in Edinburg and started lecturing. I loved it, and liked the interaction with the students. When a position opened, I thought about it long and hard, and applied. I had two pharmacies open, and my husband thought I was crazy to go to academia.” Aguilera got the job, and now serves as Assistant Dean for the University of Texas at Austin College of Pharmacy, and Director for UT Pan American Cooperative Pharmacy program.
"When I came to teach in 2009, I saw so many students who were like I had been, but did not have a role model,” says Aguilera. "So that’s one thing that motivates me to teach pharmacy students and train them. It’s a challenging job—there’s a lot of interaction, and I feel a need to advocate and be a voice for students who do not have one.
When Managed Care rolled out, Aguilera realized that the business model for Mom’s Pharmacy would not be sustainable.
"I did primarily pediatrics, and my customer base was 90% Medicaid, and the reimbursements were cut drastically,” says Aguilera. "We actually lost money on some prescriptions. I closed Mom’s Pharmacy in 2012. It was a hard decision.” Continuing Role Aguilera served on TPA’s board of directors in 2013, and is currently on the Texas Pharmacy Foundation committee.
"I’m an advocate for the entire pharmacy industry—every facet and career is important to me, whether it’s community pharmacies, hospitals, or chains. We really need to get healthcare provider status! We need to learn all we can and talk to our legislators to ensure healthcare provide status. It’s a win-win situation. We need more providers, and pharmacists are the most accessible healthcare providers. Collaboration is the key.”
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Shawn Ahmad, University of Houston College of Pharmacy
Sometimes high school guidance counselors just get it right. For Shawn Ahmad, who will be a P2 at the University of Houston College of Pharmacy next fall, that was the case.
After high school in San Marcos, Ahmad went to Argentina for three years on a mission for his church, and when he returned, he worked for almost a year as a carpenter.
"I didn’t know what I wanted to do for a career,” says Ahmad. "I visited with my old high school guidance counselor who suggested pharmacy. Plus, the mission president in Argentina was very knowledgeable about healthcare and thought it was a good idea, so that was two people telling me I should look into it.”
After briefly attending Brigham Young University in Utah, Ahmad returned to San Antonio and went to University of Texas/San Antonio, where he gained sufficient prerequisites to apply to the University of Houston COP in January 2014.
"I chose the University of Houston College of Pharmacy because I like Houston, and I like the diversity,” says Ahmad. "Also, when talking with advisors and meeting with students, I really liked the environment. I liked the family aspect and how everyone worked together.”
"During my P1 year, we all stuck together,” says Ahmad. "It was a huge step up from my undergraduate workload, and took some getting used to. Fortunately there were a lot of resources and people willing to help out. The study groups were especially helpful, and I took advantage of all of the resources available, and that really helped.”
Ahmad realized that he could develop his leadership skills by getting involved in several organizations.
"I joined the Mexican American Pharmacy Student Association—I was the culture coordinator,” says Ahmad. "I also took an extra night class to learn Spanish for health professionals, and this year I should be getting a certificate for Spanish language health professional skills. When I was in Argentina, I fell in love with the Latin culture. I feel like it’s one of my callings to help out the Hispanic community, whether in Texas or another country.”
Having just completed his P1 year, Ahmad is interning at CVS Health in San Marcos this summer.
"It’s been a great learning experience,” says Ahmad. "I’ve had great preceptors. I think CVS has a terrific program set up for teaching pharmacy students how to become pharmacists. It’s a three-year program, so I’ll continue to work with them throughout the upcoming school years. I’m licensed as an intern—I work under the supervision of my preceptors, doing patient counseling and so forth.”
Ahmad has been getting involved with TPA: He attended the 2015 Leadership Symposium and the recent 2015 TPA Conference & Expo in The Woodlands.
"When I was at the Capitol last April during the Leadership Symposium, and learned about the issues, I realized how important it is for us to advocate for our profession,” says Ahmad, who is currently the junior director for TPA at UTCOP. "It was a lot easier to speak to the staff and legislators than I thought it would be.”
At the conference in July, Ahmad was elected as the TPA education chair for student directors.
”I really enjoyed getting to know a lot of the different leaders at the conference and learning about current issues and possible solutions,” says Ahmad. "It’s exciting to know that there are so many other people who are passionate about pharmacy, and I’m excited to see how we’ll move forward and what we’ll accomplish.”
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Linda Stevens Albrecht, Regional Director of Experiential Programs (UT Austin)
Linda Stevens Albrecht’s pharmacy career has led her from Rhode Island, the smallest state to Texas, the largest (contiguous) state in the country. She currently is a Regional Director for Experiential Programs for the University of Texas, teaches a techniciantraining program at Richland College in Dallas, and is also a consultant with Dembny Pharmacy Consultants.
Albrecht received her BS in Pharmacy from Auburn 1983, and soon started a residency.
“This was before the Pharm.D. program,” says Albrecht. “My last year was the first year that Auburn even offered a ‘post’ BS program. I tracked right into a residency at Rhode Island Hospital in Providence, RI.
“I loved Rhode Island,” says Albrecht. “I met my husband Jon in pharmacy school and he was at Rhode Island Hospital and we got engaged.”
However, Jon was recruited as a nutritional support pharmacist at Methodist Dallas Hospital, which required moving to Dallas.
“I had accepted a job at Rhode Island Hospital, but had to turn it down,” said Albrecht. “We moved to Texas in September 1984.”
Once in Texas, Albrecht knew she didn’t necessarily want to work at a chain setting, and was more interested in an independent or hospital setting.
“I was looking at Dallas’ Parkland Health and Hospital System,” says Albrecht. “I walked into the door on a Friday and met a fellow named Toby Clark. He knew I had done a residency at Rhode Island Hospital, and told me I was hired. It was probably the best thing that ever happened to me!”
Albrecht went on to take a number of different roles at Parkland, building her experience along the way.
“Pharmacy practice in Texas hospitals was not what it is now. I got to do a lot of great things. The goal was to become Education Coordinator, which is what I wanted to do,” says Albrecht.
Albrecht worked at Parkland for 10 years, and did become Education Coordinator.
“As Education Coordinator, I was in charge of CE, and orienting new employees,” says Albrecht. “We had an in-house pharmacy technician training program, and we had a residency program, which I got going. I liked hospital pharmacy, because you worked closely not only with patients, but with physicians and nurses. Plus your job is varied—you don’t do the same thing every day.”
These days, Albrecht divides her time between UT, Richland College, and Dembny Pharmacy Consultants. As a consultant for ambulatory care, Albrecht has 14 centers that she visits on a weekly basis, making sure they are compliant, and that records are maintained.
At UT Austin, she’s in charge of students in the Dallas/Fort Worth area who are doing rotations.
“I currently oversee 17 students,” says Albrecht, “I am in charge of site placement and following up in the sites, making sure everything is going OK. I have three people who work under me at UT.”
At Richland College she teaches students of all ages. “I love to see those folks get a job and re-tool at an older age,” says Albrecht. “I love to see them get jobs in pharmacy. Some of the techs return to go to pharmacy school, and that’s really rewarding. I had one young lady whose entire family had been on welfare, and when she got a job, it was just great.”
Custom building her own career has allowed Albrecht to create a good work/life balance.
“I’m able to juggle it all,” she says. “It’s very flexible I get to do what I want to do, which is very rewarding. When Jon and I adopted three children, I needed that flexibility. It would have been a lot harder if I had stayed at Parkland or worked in a retail pharmacy.”
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Yasmine Alhasan- Texas Tech Health Sciences Center School of Pharmacy
As Yasmine Alhasan heads into her senior year at Texas Tech University Health Sciences Center School of Pharmacy, she’s exploring her career possibilities, and staying involved.
From an early age, Alhasan, who grew up in the Dallas area, observed how pharmacists were always available to answer questions and saw that they helped a lot of people.
"I saw that pharmacists were very accessible to people in their communities,” says Alhasan.
At the University of Texas (Dallas) while majoring in biology, Alhasan learned more about pharmacy.
"I liked that there were so many areas in pharmacy to go into,” says Alhasan, who chose Texas Tech after finishing at UT Dallas.
"When I learned about the different curricula, I noticed that Tech’s was very clinically focused, and I liked that they had rotations for both third and fourth-year students,” she says.
Alhasan attended classes at Tech’s Amarillo campus for her P1 and P2 years, and is finishing up in Dallas.
"I’ve learned a ton,” says Alhasan. "I feel that doing rotations during my third year has helped me preview what I’m interested in. We have four rotations that we do: inpatient (adult-med); community (this can be any kind of retail); hospital; and ambulatory care.”
"I’ve always known I didn’t want to go down a strictly clinical path,” says Alhasan. "Right now, I like the patient perspective, but I may specialize in some other area that involves business and industry. There are so many possibilities. Having all the rotations—and being part of TPA—has exposed me to a lot of areas. Going to TPA meetings and being involved with the organization has helped me understand what I might want to do.”
Dr. Roland Patry, Professor, Chair, Clinical Practice & Management, Head, Pharmacy Practice Management Division serves as the Dallas regional dean, and has been a mentor to Alhasan.
"He’s practiced in most areas of pharmacy, and is very involved in advocacy,” says Alhasan. "He taught one of the first non-traditional courses in pharmacy school,Pharmaceutical Care Systems, which was centered on health policy and business, allowing me to better grasp what political involvement really means.”
Alhasan, who began working at CVS Health as a pharmacy technician in 2008, is currently a pharmacy intern there, and is getting practice counseling patients (with preceptor supervision) on medications, immunizing, dispensing medications, interpreting prescriptions, and communicating with doctors and nurses.
Alhasan, who is currently the TPA Chair of the Student Board, took over for Jeffrey Van Liew earlier than planned, when he left to fulfill his APhA obligation after being elected as the National Member-at-Large.
"I’ve always been involved in APhA throughout my first year of pharmacy school, but I really didn’t know much about TPA,” says Alhasan. "After attending my first TPA conference during the summer of my P1 year, I realized that TPA was an incredibly helpful source for student pharmacists and was also politically involved—and I really like politics, so I knew that TPA was a good fit for me.”
Alhasan visited the Capitol for the first time in April, during TPA’s Pharmacy Day at the Capitol.
"It was very hands-on, and very cool to see how much influence you can have as a student,” she says. "We met with our Texas Representative, (Morgan Meyer)and let him know our concerns,” added Alhasan, who will be attending the 2015 TPA Conference & Expo at The Woodlands. "It’s good to know that my voice really does make a difference, and that it is up to me as student to help shape the future of my profession.”
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Stephanie Alvarado, CVS Health (San Antonio)
Stephanie Alvarado had a retail job at Drug Emporium in San Antonio in the early 90s,and she took advantage of a clerk opening in the pharmacy to receive training as a pharmacy technician.
"When I first started, certification for pharmacy technicians was not necessary,”says Alvarado. "So the pharmacist taught me everything. Later on, I got certified by the state. Every two years, you renew the certification. You have to have 22 hours of CE to do so. For the most part, you can learn a lot from the CE—it’s very informative.
In 1993, Alvarado landed a job at a CVS Caremark store in San Antonio, and eventually, through hard work and ambition, was promoted from dispensing technician to pharmacy technician supervisor.
"I’ve been a supervisor now for more than 10 years,” says Alvarado. "I supervise pharmacy technicians, which includes mentoring and job development. We’ll talk about workflow, job skills and so forth. In a retail setting, techs are the frontline of the pharmacy, so they have significant patient interaction. I encourage the technicians to move up in the company.”
A big part of Alvarado’s job concerns managing new clients. "These are big companies,” says Alvarado. "I work in the mail order division of CVS. So I have to look at the new clients’ prescription benefit plans. There are different areas to look at— for example, we may need to contact account managers to resolve any conflicts that we see. My techs are the ones who are handling these orders.
So we may need to contact doctors’ offices if any issues arise regarding prescriptions. Most of the time, that’s straightforward. However sometimes there are challenges. But we get it done!”
And that’s where Alvarado shines.
"I like to problem-solve to find out what is going on so we can get the orders to our members. I find that gratifying,” she says.
Alvarado, a TPA member since 2010, has been to several TPA conferences, and enjoys the live events.
"I like the continuing education—I’ve gotten some good information, especially regarding law and how it may apply to pharmacy technicians. It’s great meeting the different types of pharmacists and technicians who work in different pharmacy settings. TPA has helped me keep abreast of the legal aspects of my profession”
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Keith Anderson, Advanced Pharmacy
Right from the start, TPA member Keith Anderson knew a career in pharmacy was for him.
“While in high school, I started working at a local independent community pharmacy as a tech/cashier/driver in Birmingham Alabama,” says Anderson. “I kind of went from there. That’s what spurred my interest. Being able to help others is what appealed to me, and that’s what I like about long-term care.”
Anderson received his B.S. in Pharmacy from Auburn University in 1982, and has seen many changes implemented in the profession since that time.
“Of course the biggest changes are in technology,” says Anderson. “We did not have computers when I first started. We were typing labels. New technologies have helped tremendously. For example, we have a system called DocuTrack which allows us to check the prescription queues so we know what is in queue and what needs to be worked.”
Amidst change, one constant has been Anderson’s practice setting—he’s stayed with long-term care throughout.
Anderson, who holds licenses in Alabama and Texas, began his career as a staff pharmacist at Pharmacy Corporation in Birmingham, Alabama, and continued working there in various roles until 2000, when he joined Omnicare. He later served as executive director for Lone Star Pharmacy in Garland, where he helped grow the operation to 15,000 patients in four different states.
In July of 2015, Anderson became director of pharmacy at Advanced Pharmacy in Garland. Even as director, Anderson still retains a lot of patient interaction.
“We work directly with a number of different nursing homes. A large part of my day is spent taking care of operations, but I interact with patients all the time. An example is a local nursing home in Richardson. I normally bring the orders over there so I can interact with the rehab patients,” says Anderson.
One part of his job that he enjoys, and places a lot of importance on, is his staff.
“Building a great team is what’s best,” says Anderson. “Getting the right players in place and training them. I’m very involved in interviewing. I look for honesty and integrity first—it’s kind of gut feel whether a candidate will be a good team member. When you surround yourself with very capable people, they kind of take the lead and go with it. Right now we have a staff of about 25, including pharmacy technicians.”
Anderson also has high praise for the way Advanced Pharmacy operates.
“The technology is phenomenal,” he says. “We have a machine called Passport. It holds about 300 medications. We have drivers/couriers that load the medications into Passport. Prescription accuracy is managed through the technology side. The medications are put in cassettes with labels and barcodes, and pharmacists check every single cassette. The chip in the cassette will match directly up to the patients' records. Every shift, the nurses run their drugs and it puts the medications in a pouch with the patient’s name and instructions. It can then be delivered to the patients. It saves the facility money for Medicare A.”
In addition to his career responsibilities, Anderson is active in professional organizations. A TPA member since 1988, Anderson enjoys the networking and resources.
“The interaction with other pharmacists is one of the best aspect of TPA,” says Anderson. “I was chairman of long-term care for TPA several times, and I’ve attended a number of TPA conferences. I’ve also been a member of the House of Delegates. I like having a voice in pharmacy.”
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Michael Arizpe RPh, Director of Network Oversight, Aetna (San Antonio)
Can playing football in high school lead to a career in pharmacy? Just ask Michael Arizpe, a Pharmacy Director of Network Oversight for Aetna Pharmacy Management(APM).
“I blew out my knee playing high-school football,” says Arizpe. “For volunteer work at a hospital facility in San Antonio, they had me deliver packages from the pharmacy to the upper floors. I took the stairs—that was my rehab. I’d go up and down seven flights of stairs.”
Delivering medications to patients sparked Arizpe’s interest in pharmacy. He enrolled at The University of Texas College of Pharmacy, and worked at MD Pharmacy on Congress Avenue as a pharmacy tech and cashier. Arizpe graduated from the UT in 1981 with a B.S. in Pharmacy, and served his hospital and clinical psychiatric rotations at the San Antonio State Hospital where he gained an appreciation of the impact of appropriate drug utilization within that population.
“I had a strong internship in psychotropic medication,” says Arizpe. “We saw the older anti-depressants give way to the new class of serotonin re-uptake inhibitors like Prozac with the progress of the industry.”
“Having to work as a student helped make me a better pharmacist,” adds Arizpe. “We were challenged as students—we understood that pharmacy was changing—that’s when the emphasis on counseling began. We learned that you have to be able to adapt, because things are changing around you. Nowadays we have to reinvent ourselves time and time again.”
Arizpe initially worked in a retail settings like Skillern’s Drugs, Revco and Eckerd’s in the Dallas/Fort Worth area, before electronics and software became the norm. “I remember using one of the first Honeywell computers as we transitioned from paper to electronic,” says Arizpe.
Following Eckerd’s, Arizpe returned to San Antonio and his career path took a different turn.
“I was doing some claims remediation and was a guest at Humana meetings,” says Arizpe. “When Prudential opened up an opportunity for there to be a city director of pharmacy, I applied for the job and got it. I reported to the medical director.” At Prudential, Arizpe addressed complex claims issues and participated in giving utilization feedback to selected physicians.
“My role was not unlike what the pharmacotherapy specialist does today,” says Arizpe. “Over time, we’ve actually expanded the nature of pharmacotherapy—it now has board certification in different areas for more clinically oriented pharmacists.”
In 1999, the Prudential Healthcare portfolio of medical and pharmacy products was purchased by Aetna, Arizpe was promoted to Regional Pharmacy Director for Aetna, and is now Director of Network Oversight.
“The pharmacy network serves all of the member populations at Aetna,” says Arizpe. “I am one part of a small team in the organization who has oversight and conducts audits and addresses pharmacy network issues. It’s somewhat of a unique role. I assess the viability of various pharmacy networks and look at the availability of clinical products and services in various areas. We have member satisfaction and sponsor surveys which help me understand how we can do our jobs better. I enjoy the people who I work with. There’s a lot of gratification in being able to deliver care from a different perspective.”
(Note: The views and opinions expressed here are that of the interviewee and not attributed in any way to Aetna, Inc.)
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Gloria Arnold, Circle Drug (Waco)
At 73, Gloria Arnold continues to be a life-long learner. “I appreciate the free member continuing education TPA offers,” she says. “I’ve been a member of TPA since 2010.”
Arnold’s dad was a pharmacist, and she remembers looking at his certificates andadmiring his accomplishments. She followed in his footsteps.
“I went to Baylor, thinking I wanted to be a medical technologist, but then I decided I wanted to be a pharmacist,” says Arnold, who graduated from The University of Texas College of Pharmacy in 1965.
Arnold worked briefly in Austin, but later headed to Houston, where she entered the retail setting.
“I worked in a retail pharmacy called Dugan Drugs,” says Arnold. She went on to work for a lot of different retail independent pharmacies in the Houston area. “In 1968, I had a chance to go to the Albert Schweitzer Hospital in Haiti for about six months, so I got some clinical experience. It was interesting—you really know what poverty is after visiting a third-world country. It really made me appreciate Texas,” says Arnold.
In 2000 Arnold tried something a bit different: she took a job at the Cherokee Indian Hospital in North Carolina, and ended up staying there 10 years.
“It was inpatient and outpatient,” says Arnold. “We had counseling rooms where you could talk to the patients, get to know them and counsel them on their medications.”
“I enjoyed it, but decided to return to Texas (Waco) in 2010,” says Arnold, who holds two pharmacy licenses—North Carolina and Texas.
Now semi-retired, Arnold fills in at Circle Drug in Waco.
“I like to keep my hands in pharmacy,” she says. “I also volunteer at Providence Hospital in cardio-pulmonary rehabilitation.”
Looking back on her career, Arnold has some suggestions for emerging practitioners.
“I’d recommend for young folks getting into pharmacy that they get into medication therapy management (MTM),” she says. “In hospital settings, sometimes I’d see discrepancies or duplication in medications. So I recommend seeking out a place where MTM could be used. Focus on areas like Diabetes and anti-coagulation.”
“I’ve enjoyed both retail and hospital settings,” says Arnold. “In retail, you can stop and talk to people, and visit with them and see how their families are. You have to treat the whole patient—their environment and family have to be consider also. At Cherokee Hospital, I always felt comfortable approaching doctors to talk about medications. I’d say that most doctors would embrace that. I feel like we are getting closer to where pharmacists are part of the healthcare team.”
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Lisa Diggs Ashworth, Children’s Medical Center of Dallas
Dotted around the country, you might still find a few nostalgic old pharmacies with soda fountains in them. TPA member Lisa Diggs Ashworth actually started working the sodafountain at a pharmacy when she was 15, back in Pauls Valley, OK where she grew up.
Later on, as a college student studying to be an accountant, she looked back fondly on her time spent in the pharmacy, and realized she didn’t want to be an accountant after all.
"I had always worked around people. After spending a summer at an accounting firm in a cubicle, I decided that was not for me,” says Ashworth.
"I was a senior when I decided I wanted to go to pharmacy school, so I had to go back and take a year and a half of prerequisites before I could start.”
Ashworth wasted no time enrolling in the University of Oklahoma College of Pharmacy, and earned her BS in Pharmacy in 1987. While a student at OU she worked at Norman Regional Hospital in Norman, OK.
Upon graduation she moved to Texas where she worked for a retail chain and met her husband.
"My husband (a nuclear pharmacist) and I were part owners of a couple of retail stores in Irving, Texas. They did well, and we sold our share about 10 years ago,” says Ashworth.
Ashworth was also drawn to the hospital side of pharmacy practice, and began working part time at the Irving Hospital, Irving, TX and later for Texas Health Resources Hospital System in the Dallas and Fort Worth metroplex. In 2001, while still working in hospitals she also began working with Dr. Loyd V. Allen, Jr. as an assistant editor and writer for the International Journal of Pharmaceutical Compounding.
"Dr. Allen helped steer me toward sterile and non-sterile compounding in college and after graduation,” says Ashworth, who is now on the compounding committee for the United States Pharmacopeia Council of Experts—the standard-setting body for the identity, strength, quality, and purity of medicines, food ingredients, and dietary supplements manufactured, distributed and consumed worldwide.
In the 2010-2015 cycle she had the honor of serving as Vice-Chair to the Chair, Gigi Davidson, BS Pharm, RPh, DICVP, a remarkable veterinary pharmacist from North Carolina. The 2015-2020 cycle that just started in July is her third 5 year term to serve the USP.
For almost 8 years, Ashworth has worked fulltime at Children’s Health System of Texas, (Children’s Medical Center of Dallas and Plano), where she is a sterile and non-sterile compounding specialist. "I am a clinical pharmacist, and I also compound,” says Ashworth. "I deal with kids and their medications, researching for information to support our compounding preparations in beyond-use dating, chemical stability, testing, etc. and screening for adverse drug reactions, and proper dosages.”
"We are a teaching hospital affiliated with UT Southwestern Medical School—we teach the medical residents, fellows and students, and pharmacy students from several schools of pharmacy and also have 4 pharmacy residents,” says Ashworth, who is also a preceptor.
"Being a pediatric institution we compound a lot of non-sterile oral liquids for kids that are not available commercially. Seizure medication is an example.”
Ashworth, who has supervised the compounding for kids of sterile and nonsterile preparations, describes her current role as, ”Making life better for children.”
"I’ve been in pharmacy for over 30 years, so I do a bit of everything,” says Ashworth. "Pharmacy has been good to me. I’m very lucky to be able to do the things I do and work with great people whom I learn from every day.”
It’s something she does not take for granted. Having served as a board director for the International Academy of Compounding Pharmacists, and currently as president of the IACP foundation, Ashworth places a high value on involvement.
"Our organizations help us to protect our professions by talking to legislators, providers, and prescribers. We all have to work together as a team,” says Ashworth. "It’s important for pharmacists and pharmacy technicians to be members of their state, local and national organizations, and to be active. You can’t protect your profession unless you are involved.”
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Ramiro Barrera, Richard's Pharmacy (Mission)
Growing up in Mission, Ramiro Barrera used to work for a fellow named David Dovalina, who owned Larsen’s pharmacy.
“I worked there during summers,” says Barrera, “doing a little bit of everything. I was impressed by his operation.”
Barrera was impressed enough to choose pharmacy as his own career. He attended Pan American University, and later transferred to The University of Texas College of Pharmacy, where he earned his BS in Pharmacy in 1972.
“The program was challenging,” recalls Barrera. “It was during the 60’s—that made it interesting. I let my hair grow out but once I got into the pharmacy school, it had to go.”
After graduating and entering the job market, Barrera became interested in retail.
“I like the contact and interaction with people,” says Barrera of retail pharmacy. “I had independent in mind. When I got out of pharmacy school, I worked at a pharmacy owned by my uncle named Palace Drug store in Roma, TX. When he passed away my family asked me to take over the pharmacy—to be the pharmacist in charge. It was challenging, but a lot fun. I was there for about three years.”
Because the pharmacy was situated in a rural area, Barrera found that people really needed a “hands-on” pharmacist.
“We were doing patient counseling way before it was required,” says Barrera. “I had to take patients’ blood pressure and show them how to use medications. We were within walking distance from Mexico. Many folks would bring their medications, and we would do patient management as well. People did not have the medical attention they needed. We had only one doctor in town. He had too many patients—he was overwhelmed, so we helped out.”
Barrera also did veterinary compounding, helping ranchers out in the field with their livestock.
“Back then pharmacy was pharmacy—you didn’t have to worry about being an insurance agent and being an accountant," says Barrera. "It was just practicing pharmacy. I’m glad to see that compounding is coming back.”
Eventually, Barrera opened up his own pharmacy in Roma, which lasted five years—but the devaluation of the Peso made the operation unsustainable. He later moved back to Mission, where he worked for Klink’s Pharmacy, then Wal-Mart before partnering with an old classmate (Richard Martinez) at Richard’s Pharmacy.
“I became partner at Richard’s Pharmacy in the late 90s,” says Barrera. “In 2000 when Richard retired, we brought in my son, Jamie who had just graduated from Texas Southern University College of Pharmacy, so he became my partner. Later on James Olivarez and Vanessa Rawals joined us as partners.”
Barrera now has ownership in three stores: one in Alton, Edinburg, and Mission. The Edinburg store has durable medical equipment, while the Mission store has a compounding lab.
“We’re doing well. I like being a business owner I the sense that I can do what I want,” says Barrera. “As an owner, I feel I have more flexibility to help people. If anyone has a problem getting their medications or finding a doctor, they know they can get their help here at Richard’s. You come to us—you’re family. We’re here to help.”
Michelle Beall originally thought she’d study to be a veterinarian, but as often happens, the attraction to pharmacy began during a part-time job stint.
"I worked part-time in a grocery store pharmacy while I was in college,” says Beall. "I wasn’t so sure about being a veterinarian. I thought maybe pharmacy would be a better fit.”
To pursue that, Beall enrolled at Texas Tech University Health Science Center in Amarillo, where she earned her Pharm.D. in 2005.
"I really enjoyed the program there,” says Beall. "It was similar to their pre-med program—more focused on disease states, the classes of drugs, and the pharmacology behind them as well as how to treat various diseases. It was fascinating.”
Beall, who is the 2014 TPA award winner for "Excellence in Patient Outcomes,” started working for Brookshire Grocery Co. in March of 2005 as an intern, and when a manager position became available that fall at the Brookshire Grocery Co. Super 1 Foods in Marshall, TX, she took it.
There are many routine functions to her job, but what Beall really enjoys are the extra projects like the immunization programs. An example would be the Zostavax shingles immunization.
"If you have had chicken pox, you can get shingles,” says Beall. "There’s a dormant virus that can emerge later as shingles. The whole Brookshire Grocery Co. chain does immunizations in store.”
Beall is also involved with Medication Therapy Management (MTM), and is a strong believer in pharmacists’ role to keep patients on the right track with their medications.
"We set up comprehensive medications reviews (CMRs),” says Beall. "During those, we review patients to see it there are any issues with their medications. At that time we may make recommendations to the patient’s primary care-giver depending on what we are seeing. The goal is to help prevent any side effects from being over or under-medicated.”
Beall would really like to see more of a shift towards MTM in general for pharmacists that are comfortable in that area. "We [pharmacists] are the medication experts,” she says. "That’s what we do and what we’ve always done. Doctors and nurses have their roles, but helping select the most cost-effective and appropriate medications— that’s where the pharmacist’s niche is.”
Beall credits her success in patient outcomes in part to good listening skills.
"Part of it is just taking the time to talk to the patient, using open-ended questions, and filling in any knowledge gaps,” says Beall. "Try to listen to patients and get their feedback. I may even quiz them when I’m done. It helps me understand if they need any further clarification. It’s also good to let them know that you are available, and that they can call you if they need to.”
"Always try to focus on adherence with medications. People don’t always pick up their medications, and if they do, they don’t always follow the directions. The best medications don’t work if patients don’t take them. The important thing is to make patients buy in to why they need them—for example cholesterol or blood pressure medications. They may not feel a need for them, but they do need them.”
For new practitioners, Beall says the most important thing "is to keep the enthusiasm that you have upon starting your career.”
"It's easy to become jaded and go with the status quo to get by. If we aren't working to create the profession we want, no one else will. Your career path and job satisfaction are determined by your own decisions. Be willing to try new things. If they don't work, try something else. When they do work, share them with others so we can all grow as healthcare providers.”
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Stephanie Bishop has always had a lot of ambition. At McNeil High School in Austin, she was in a program called Health Occupation Students of America, and McNeil also offered a pharmacy technician course, which she took.
"My first job was as a pharmacy technician at Walgreens, and then later Eckerd’s,” says Bishop. "I also worked as a pharmacy technician at an HEB in Waco. I have an appreciation for pharmacy technicians. It really helped me understand the systems and processes I’m getting into as a pharmacist.”
Bishop received her undergraduate degree at Baylor University in bio-chemistry in 2008. Following a year off, she then went to Texas A & M Health Science Center Irma Lerma Rangel College of Pharmacy in 2009 and earned her Pharm.D. in 2013.
"I really enjoyed the program there,” says Bishop. "It was pretty challenging. Of course, being interested in the subjects, it was not tedious. The students had a lot of say in the educational process and the development of classes. The mentors were really great there, too. There were several professors who I felt were especially helpful—Dr. Juan Bustamante was a really good mentor. I also learned a lot from Dr. Ladan Panahi.”
When it came time for rotations, Bishop experienced many different types of pharmacy, and gravitated to community pharmacy.
"I felt I fit best in community pharmacy because I like to reach out to people, help them achieve their health goals, and see the impact I have on their lives,” says Bishop.
After graduation, Bishop set her sights on HEB.
"I had been working for HEB as a pharmacy technician for seven years,” says Bishop. "A & M has a job fair in the fall, and I only interviewed with HEB. Luckily, I got a job offer. I work at the Temple location on Adams Street, and I was promoted to pharmacy manager after a year.
"I really couldn’t picture myself working for any other chain—I think it’s a wonderful company to work for. They have great benefits and a supportive culture, and they give you every opportunity you could want. And they give you a lot of freedom. I’ve been able to do a lot of Medication Therapy Management (MTM), which is encouraged.”
A Day in the Life
A typical day consists of arriving at work about an hour early (7:00 a.m.) to take care of paperwork and reports. When the store opens, Bishop goes into pharmacist mode.
"On Wednesdays we have leadership meetings—managers from different departments in the store,” says Bishop. "We review different projects and programs that we’re running. Right now an example would be back-to-school shots. I get a lot of face-to-face interaction with all of my patients. My favorite part is counseling—answering patient questions, and I also help with health screening. We’ll look at patients’ numbers and suggest how to improve them.”
Bishop, who was a student director for TPA (2012-2013), goes to Washington DC every year to lobby, check in with Texas legislators and talk about issues that are current at the time.
"I‘ve always had an interest in politics, and TPA has always encouraged me,” says Bishop. "Last May when I went to Washington, we talked about provider status; preferred pharmacy legislation; and drug distributors. In my area [Temple is not far from Ft. Hood], because of limitations on distribution of certain drugs, it can be challenging to have enough narcotics available for wounded military.”
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Jason J. Beauchamp, Pharm.D., H-E-B (Houston)
Many people find that their career paths stem from situations and experiences they had in high school. Such was the case with TPA member Jason J. Beauchamp.
"My mom has a mild case of myasthenia gravis,” says Beauchamp. "When I was in high school, I used to go pick up her medications and help her out. At the time I knew nothing about pharmacy. I began to ask pharmacists how drugs could help that condition. I met Brian Tuschl, a professor in at the University of Houston, and he got me interested in pharmacy. At the time, Brian was writing a book to help people pass the pharmacy technician test,” says Beauchamp, who later worked as a pharmacy technician in Houston.
Shortly after that, he went to pharmacy school—but not in Texas.
"I traveled to Hungary and went to school at Semmelweis University Pharmacy School in Budapest,” says Beauchamp. "I was dating someone who was from Hungary, and when she went back home, I followed. I learned Hungarian, and I learned a lot about pharmacy. It was the first two years of a five year program.”
When Beauchamp returned to Texas, he started as a P1 at the University of the Incarnate Word Feik School of Pharmacy in 2010.
"I looked at several schools, and in some cases it was difficult to get my credits transferred from Semmelweis, but Feik made it easy,” said Beauchamp.
Feik School of Pharmacy turned out to be a good match for Beauchamp, in more than one way. That’s where he met fellow student and present fiancée Kristen Tharp, now a pharmacy manager at a Target in Huntsville.
"Getting married to a fellow pharmacist will be awesome,” says Beauchamp. "As for the program at Feik, I loved it. It’s a new school, and the professors are fairly young, very progressive and clinically minded. I especially liked the cardiology and oncology-related courses—I did my P4 presentation on head and neck squamous cell carcinoma. While at Feik I was a member of the pharmaceutical fraternity, and I made a lot of connections and enjoyed the camaraderie.”
After graduating in 2014 with a Pharm.D., Beauchamp decided on retail pharmacy, and was able to secure a position at H-E-B.
"I was lucky enough to get an internship with H-E-B,” says Beauchamp, and I had a corporate internship my second year while I was at Feik. By the time I had the actual employment interview, I had already worked at H-E-B for a few years as a pharmacist intern.
"H-E-B is a great place to work. They really allow you to be a pharmacist,” says Beauchamp, who started in San Antonio, and is now in Houston as a floating pharmacist.
As a floating pharmacist, Beauchamp sees a variety of different stores. He’ll check his assignment online and can see his schedule a few months ahead.
"I’ll go in around 8:30 a.m. I’ll do eight, 10 or 12 hour shifts. I have a pretty decent background in nutritional aspects and supplements, and I help people out with that. My favorite part of pharmacy is feeling like I made a difference in people’s lives. I hope to be in a managerial role—I’ll stay in retail as long as I enjoy it,” says Beauchamp, who renewed his membership with TPA and says, "I like the news that I get from TPA. I don’t have a lot of time to surf the web, so it’s a worthwhile resource to keep up with things.”
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Bruce Biundo, Professional Compounding Centers of America (Houston)
Bruce Biundo literally grew up in a pharmacy. His father was a pharmacist who rana small-town pharmacy in Independence, Louisiana, and the Biundo family lived on the second floor above it.
"My father was very active in pharmacy and served in the Louisiana Pharmacy Association—that’s one of the things that taught me about what being a pharmacist meant,” says Biundo, who was TPA Vice President in 2011. "So it seemed natural to be involved. In a sense, my father set an example.”
Everyone in Biundo’s family helped out in his father’s pharmacy, a traditional old-fashioned store with a soda fountain, school supplies, and magazines.
The family business must have rubbed off as Biundo, along with his brother and a sister, all earned pharmacy degrees.
Biundo figured he’d go back to a small-town pharmacy after graduating, but as a senior at the University of Houston School of Pharmacy, he met his future wife (Ann), and began his career in Houston.
"I spent nearly eight years with Walgreens, and I thought maybe I’d make my career in chain pharmacy,” he says. "However, I did not necessarily want to move around to move up. I left Walgreens and started Boone Road Pharmacy in Houston in 1973, and later sold it in 1981.”
In 1991 he joined the Professional Compounding Centers of America (PCCA) as a member. He now serves as a consultant for PCCA, a resource offering training and support for pharmacists and techs.
"What makes us unique is the ongoing service and support we offer pharmacists,” says Biundo.
Biundo served on PharmPAC’s board for about seven years before becoming chair in 2012, and feels strongly about advocacy.
"It’s [PharmPAC] something I’ve supported for quite a while,” he says. "It’s pretty obvious how important the politics and policies of pharmacy are. So PAC was a natural outgrowth—I believe deeply that pharmacists should be part of the process. I learned that you can really, really make a difference if you’re committed.”
Biundo concedes that getting the message out can be challenging because many people still don’t understand that you can make a difference if you advocate for your beliefs.
Biundo notes that other areas of pharmacy advocacy have awakened, and that there are more organizations participating in pharmacy advocacy.
"The challenge for TPA is to remain relevant,” says Biundo, who was TPA Pharmacist of the Year in 2013. "You have to show people that you’re effective in this arena, and to find ways to communicate that to people.”
Find Your Passion
As a preceptor, Biundo sees upcoming students with great skills in patient care. "We try to give students a really good sense of what pharmacists do and what they value,” he says.
"I see people anywhere form their first rotation on,” he says. "I tell them to take full advantage of all rotations and to find out what you are passionate about, and try to work within that framework. Don’t accept a role simply because it’s available. The goal is to find out what you’re passionate about and learn as much as possible in that area. Remember why you’re here, and don’t settle.”
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Lauralee Bogue, Timberland Discount Pharmacy (Lufkin)
Longtime TPA member Lauralee Bogue remembers a time when there was a shortage of pharmacists in Texas.
"When I was growing up in Texarkana, my sister, who is six years older than me, was studying journalism. I remember my dad, reading an article in the Wall Street Journal, and telling us that there would be a shortage of pharmacists. She changed her major, and I followed suit—I always liked science.”
At that time (the late 70’s) there were only a few pharmacy schools in Texas. Bogue attended Stephen F Austin University, where she took two years of pre-pharmacy, and then went on to the University of Texas College of Pharmacy in Austin, and earned her BPharm in 1979.
"I loved the program- I had some excellent professors,” says Bogue. "I stayed in my own little world of studying—I loved gaining the new knowledge and I really enjoyed pharmacy school.”
Since 1982, Bogue has lived in Lufkin, south of Nacogdoches. She currently works at two different jobs.
Bogue started out as a pharmacist at an old-fashioned retail store called Thompson’s Pharmacy. "They had the lunch counter with hamburgers and milkshakes,” she says. "And the owners always worked with me so I could take care of all the things a mom has to do.”
Currently Bogue has a part-time schedule at Timberland Discount Pharmacy, where she’s worked for 20 years.
"I love it because I get to see the same customers I’ve always seen,” says Bogue.
Although there are quite a few pharmacy options in the Lufkin area, Bogue notices that people like the one-on-one customer service of a small-town pharmacy. For example, she always gives her cell phone number to customers, in case of emergencies.
"People like to come to our store,” says Bogue. "I remember one family whose daughter was being treated for cancer. They’d come home after going to MD Anderson in Houston with a prescription that no one else could fill right away. So I’d do the research to get it for her. Or I might get a call on my cell while I’m in church from someone who’s about to take a trip, and they need me to get their prescriptions filled. I’ll go down to the store, unlock the closed door, and fill it for them.”
Timberland Discount Pharmacy fills around 200 prescriptions a day, but, says Bogue, "Times are changing. The way insurance coverage works, it’s hard for small-town pharmacies to make it. I have loved pharmacy forever. It’s more than a job, and always has been. You have to have compassion and empathy for people—it’s a mission, not a job. My career in pharmacy has been a blessing.”
Bogue’s other job is at East Texas Behavioral Health Network, and couldn’t be more different.
"It’s essentially a mental health organization—those are the type of prescriptions we fill,” says Bogue.
"It’s a very busy operation. We mainly fill prescriptions for indigents. It’s not a typical walk-in pharmacy. Clinics from around 70-80 counties send their prescriptions here and we fill them and send them out by UPS.”
According to Bogue, it’s mostly mail order, though she may do some phone counseling—patients can call in and she’ll help them out if they have any questions.
"It’s much different from retail, but it’s referred to as a Class A pharmacy,” she says.
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Sharon Braxton, CVS Health
TPA welcomes new member Sharon Braxton, who moved to Texas from North Carolina earlier this year.
Originally from Jamaica, Braxton went to Campbell University College of Pharmacy & Health Sciences in North Carolina, while working part time as a pharmacy technician at a local grocery store.
Braxton found Campbell’s pharmacy program agreed with her, and earned her Pharm.D. in 2001.
"Campbell is smaller, more personal,” says Braxton. "I liked it- you had the chance to work more closely with the professors. We had maybe 70 class members in the college of pharmacy—that’s one of things that drew me to the program. My P1 year was not too hard, P2 was a little harder, and P3 really hard! It was very rigorous. I’d go through reams of notes every week—you have to learn a lot in a short amount of time.”
Most of Braxton’s rotations were at Duke University Medical Center, where she enjoyed being a part of the healthcare team.
"My favorite was ambulatory care— a clinic setting where patients get personal care for disease management,” says Braxton. "In North Carolina there are certified clinicians—they are responsible for managing certain disease states for certain clinics.”
Braxton’s career started in 2001 managing a clinic, working with doctors and physicians assistants as well as helping the providers with certain disease states, such as diabetes. She moved to retail in 2002, and has stayed in that area of pharmacy.
"I started at an Eckerd’s, and then went to a grocery store chain called Lowe’s Foods in North Carolina in the Raleigh area,” says Braxton. "Unfortunately, around 2010, Lowe’s closed their locations, and I started with Walgreens in 2011.”
Subsequently, Braxton moved to Dallas in 2014 to be closer to family.
"I wanted to get my two children (Caleb and Marley) into school first. So I took part of 2014 off, and applied for my Texas pharmacy license,” says Braxton.
"I like Texas a lot. The weather can be a bit capricious. But it’s been a really good adjustment. If there’s one thing to do in NC, there are 10 to do in Texas! It’s true- everything bigger in Texas.”
Currently with CVS (on Greenville and Lover’s Lane in Dallas), Braxton is finding her new job and Texas quite agreeable.
"The CVS I work in is very neighborhood-oriented, so you get to know customers a bit better,” says Braxton. "We have a lot of young professionals, students and an older population as well.”
"I get a fair amount of patient interaction,” adds Braxton. "Not as much time to talk as when I worked in ambulatory care, but I still get to talk to them about their needs. I really enjoy it. Initially, I was concerned about being the ‘new kid on the block.’ But the pharmacy manager is excellent and the techs are awesome. I floated a lot with Walgreens so this is an opportunity to be more grounded and stay in one place. I’ve been blessed with the opportunity to learn Texas pharmacy law. It’s a bit different from North Carolina.”
"TPA has helped me to adjust to Texas. Being new, I wanted to join an organization that would help me learn more about Texas law. The law review course really helped me to pass the Texas law exam. And I enjoy the CE TPA offers. I like to be with pharmacists and know what’s going on, and TPA helps me to learn more.”
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Joseph Brewster, Pharmacy Manager, H-E-B (Oak Hill)
In 2007, just after graduating high school, an interview with a pharmacy manager changed Joseph Brewster’s career outlook.
“I figured I couldn’t be a pharmacist because I am such a people person, and I thought pharmacists just sat behind computers and hit buttons all day without seeing people,” says Brewster.
But after a five minute talk with Paul Howell, a pharmacy manager at H-E-B in Harker Heights, Brewster changed his mind.
“He said I could have a lot of patient interaction, counseling and would be able to make a difference in patient outcomes,” says Brewster. “That, along with the ability to communicate with doctors, nurses and other pharmacists—not to mention a good work/life balance—changed my whole outlook. I was just entering Central Texas College in Killeen, and from that day forward, I wanted to be a pharmacist.”
Brewster transferred to The University of Texas in 2009, and worked as a tech-in- training at the HEB in Austin at Hancock Center. There, TPA member Mark Comfort, who is the store’s pharmacy manager, served as a mentor to Brewster.
“I think UT has one of the better pharmacy programs in the country,” says Brewster. “Many managers have backed up that feeling. The program well-prepared me for a job in the real world. And it gave me the ability to succeed in patient interaction and people skills. They offer a wide range of opportunities to grow you as a healthcare provider.”
One such opportunity is the “Pharmobility Program,” a P4 rotation option to study abroad.
“I spent several months working at a pharmacy in Portugal,” says Brewster. “I saw differences in over-the-counter processes there, and how they handle patient care and interactions.
“As a community pharmacist, I found it interesting that there was no wait time for medications. I’m talking two to three minutes, tops. They had great technology—everything was pre-packed. They had a huge robot that would gather up the prescriptions and put them on a conveyor belt and drop them into the pharmacists’ hands. They are also into very collaborative practices. For example a dietician and a podiatrist had offices in the bottom floor of the pharmacy. It was very progressive. I think we could incorporate some of these things here. We were also taught that the pharmacist should greet the patient first. It’s a signal that every patient matters.”
Brewster, a member of TPA since 2013, earned his Pharm.D. from UT College of Pharmacy in May 2015, was board certified July 31, and now works as a pharmacy manager at H-E-B in Oak Hill.
“HEB is a great place to work,” he says. “I’m a lifer. They value their ‘partners’ [employees]. It’s an excellent pharmacy to work for. They take good care of us.”
Anna Brozick Texas A&M (Kingsville)
How many pharmacists can say that they are classically trained musicians? Anna Brozick can. Brozick, who is the Assistant Professor of Pharmacy Practice, Director of Introductory Pharmacy Practice Experience (IPPE) at Texas A&M (Kingsville), is a French horn player who still plays publically when she can.
"I’ve had a unique career path towards pharmacy,” says Brozick, a native Houstonian. "I started out bachelors and masters degrees in music— not the most practical career choice.”
After a stint teaching high school geometry for three years, Brozick turned her attention towards healthcare.
"I’ve always had an interest in healthcare, but didn’t know what I wanted,” says Brozick. "When I realized you didn’t have to be knee-deep in blood and guts to be in the field, I began to think that pharmacy would be a good fit. It was an instinctual realization.”
Pharmacist Fast Track
To become a pharmacist, Brozick got on the fast track, taking 48 undergraduate credits in one calendar year at Houston’s Lone Star College so she could start pharmacy school the following fall. In 2003, she started Midwestern University Chicago College of Pharmacy, and as part of an accelerated three-year program, she earned her Pharm.D, in 2006.
For the next five years, Brozick racked up a wide variety of experience, including patient care pharmacist in oncology, home infusion, and hospice; hospice consultant pharmacist; IV clean room supervising pharmacist; emergency room clinical pharmacist, and community pharmacist.
That career path well-prepared Brozick for her role at A&M.
"I’ve always had an interest in teaching,” says Brozick. "It was a perfect moment because I was ready for more opportunities in my career when the job at A&M opened up. I’ve had quite a breadth of exposure, so that was a good match. As director, I recruit preceptors— pharmacists and sites to be actively engaged in a teaching of pharmacy students during their rotation experiences. I was a preceptor myself from 2008-11.”
Brozick teaches a total of five classes, and says, "For me, the best part is working with students and nurturing their professional development. I’m with them on their first day of classes, and the last day of their third year. Bringing them through professional growth—providing them with academic advice, helping them with how to prepare for exams, career guidance, and talking about their career path.”
Brozick has been a TPA member since 2008. And as an active member, she attends meetings, and participated as a presenter at this past summer’s conference.
"For me, TPA is about networking—meeting other pharmacists,” says Brozick. "I believe TPA is essential to really create one voice for our profession, and to understand the needs of pharmacy not only internally, but to listen to what the external organizations are saying to meet the needs of patients. I believe in the power of team-based collaboration to move our profession forward.”
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Donna Burkett, Clinical Associate Professor University of Texas at Austin College of Pharmacy
"My uncle Don Burkett was a pharmacist,” says Donna Burkett, Clinical AssociateProfessor University of Texas at Austin College of Pharmacy. "I thought I wanted to be a medical technologist, but my mom steered me towards pharmacy. I’ve never thanked her enough for it.”
Burkett attended the University of Texas, earning her BS in pharmacy 1972, and a master’s of pharmacy administration in 2000.
Early on in her career path, Burkett chose to work in a hospital setting. In San Antonio, she was director of pharmacy and ancillary services at Warm Springs Rehabilitation Hospital from 1989 to 2000. Following that, she was Director of Pharmacy at the Texsan Heart Hospital-San Antonio for three years, and beginning in late 2006, took a position as Director of Pharmacy at St. David's Round Rock Medical Center.
"I love pharmacy—I’m very proud of our profession, and I loved working in a hospital setting,” says Burkett. "I got hooked on that, and got involved with the Central Texas Society of Health-System Pharmacists (TSHP). In 1996 I was president of TSHP.”
Burkett’s service to the pharmacy profession escalated when President George W. Bush appointed her to the Texas State Board of Pharmacy (TSBP) in 1997.
"It’s a six-year term,” says Burkett. "I was president of TSBP from 2001-2002. After my tenure on the board, Governor Perry appointed me to the Texas Health and Human Services Commission, Medicaid Pharmaceutical and Therapeutics Committee to serve as vice chair. There were six physicians and five pharmacists.”
In 2011, Burkett’s hospital experience proved a good match for an entrance into academia, when a clinical associate professor position opened up.
"I enjoyed working at St. David's Round Rock Medical Center,” says Burkett. "But a friend told me that a position was opening up at the University of Texas College Pharmacy. She said ‘it had my name written all over it.’ The position was coordinating a hospital pharmacy rotation for P2s. I was unsure at first, but I wanted to give it a try—embrace my fear, as DeDe Murcer Moffett would say."
"I applied and got it. My stress level dropped, my blood pressure dropped, and my salary dropped,” says Burkett. "I love working with students. I never thought I’d enjoy it as much as I do.”
Experiencing both sides of UT’s pharmacy program has given Burkett an advantage and a unique perspective.
"It really helps with my teaching,” she says. "My students love all of my stories, and after 30 years of practice, I have quite a few.”
Currently, Burkett coordinates the Institutional Introductory Pharmacy Practice Experience, and is the regional intern director for the Austin/Temple/Waco P4 rotation and the advisor for the APhA Academy of Student Pharmacists. Her teaching responsibilities are hospital pharmacy, pharmacy management and pharmacotherapy lab.
"What’s so rewarding is when students come back and either tell me or email how my classes helped them in their rotation or in their new practice setting,” says Burkett. "That’s what makes it all worthwhile—helping these kids advance and achieve success in the pharmacy setting.”
One of Burkett’s focuses is on pharmacy advocacy. This coming spring (2016) she’ll be teaching a course on pharmacy leadership and advocacy.
"We’ll be offering it every spring including non-legislative years,” says Burkett. "We’ll be taking students to the hill, contacting their legislators, etc. Advocacy has always been a big part of what I’ve done throughout the years.”
In fact, advocacy and leadership play an important role in Burkett’s advice to her students:
- Always keep the patient and patient-safety in mind first.
- Advocate for your profession, because if you don’t someone else is going to.
- Always, always stay involved in your professional association. Whether you advocate and are active, or just pay your dues, you are helping.
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John Russell Carson, Oakdell Pharmacy
You might say pharmacy runs in John Russell Carson’s family. Carson, who just got his 50th year certificate as a pharmacist, owns Oakdell Pharmacy in San Antonio, and has been in business for 35 years.
"Overall, there’ve been nine pharmacists in our family,” says Carson. "I have four uncles on my father’s side who are all pharmacists. My son Jeff is a pharmacist—he’s chief of staff and part owner of one of our stores in San Antonio.”
Carson’s father was a rancher, and he still operates a family ranch which has been in the family for 135 years.
"I was raised on a ranch near Gonzalez, TX and went to school in Cuero,” says Carson. "My dad had four brothers—all pharmacists. One of them—Charles Carson—owned the original Eagle Pass Drug Store. I have a photo of him around the turn of the century.”
My uncles thought maybe I should pursue a career in medicine or dentistry, but they had all been successful, so I chose to follow.
Carson, who graduated from the University of Texas College of Pharmacy back in 1964, currently owns three retail stores, one long-term care and assisted living facility, and one home intensive care pharmacy- mainly offering sterile products (IV sterile solutions).
"We have the only accredited compounding labs in South Texas in our pharmacies,” says Carson.
Things have changed incredibly since Carson studied to be a pharmacist.
"Pharmacy has changed dramatically since I entered the profession in 1964,” says Carson. "Medicare and Medicaid have been a big change over the years for pharmacy. And then of course the arrival on the scene of PBMs has caused drastic changes, not all for the better, I might add.”
"If you had told me in 1964 that I would fill prescriptions below my cost, I would say you were crazy,” he says. "PBMs, and maximum allowable cost (MAC) have put enormous pressure on pharmacies. It’s harder today to make a profit than 10 or 15 years ago. The big chains have the ability to buy drugs at higher volume and lower costs. For example, Walmart can leverage the fact that they own multiple stores and buy medications at a lower cost. Fortunately, independent pharmacies have gotten together in buying groups, and that has helped.
Over the years, Oakdell Pharmacy has grown astronomically. They handle a lot of medical supplies, and hold seminars to educate their customers.
"Oakdell still gives the same great service as always,” says Carson. "We want a doctors to see us like a "one-stop shop.”
Oakdell delivers, and offers personal charge accounts. Additionally, they provide night service.
"Our employees will deliver 24-hour emergency service,” says Carson. "I’ve gotten up at 2:00 in the morning to deliver medications to nursing homes, or call doctors to get prescriptions, fill them and deliver them.”
Looking to the future, Carson cites employee Chris Alvarado as a leader to watch. "He is an exceptional young man,” says Carson. "Chris worked 10 years for me as a tech, and then he decided to go to University of Incarnate Word to get his Pharm.D. degree. I take my hat off to anybody who goes back and get an advanced degree after 10 years. That’s remarkable. I know how difficult that is—you have so many obligations at that point. Chris is good with customers, facts, and management. He’s simply outstanding. And he’s involved politically. He’s an upcoming leader, for sure.”
Carson, who was TPA president (1983-1984), and president of National Community Pharmacy Association NCPA (2000-2001), knows that there are challenges that lie ahead.
"You have to be involved in politics whether you like it or not. If you want to survive, you’ve got to have representation. It’s our job to educate legislators so that they know what our position is,” says Carson. "TPA has a division that handles legislative affairs, but some of the buying groups have taken the lead in this area. They have taken over a large part of the responsibility for legislative affairs. So they have become competition for TPA. And it’s hard to get everyone to work together—not everyone cooperates with each other. Everyone wants to be the primary entity, so there’s been a lot of division in who represents pharmacy. Who’s speaking for pharmacy today? If everyone could get together and pull the same wagon in terms of legislative affairs, it would be the best thing for pharmacy today, and we’d have more clout!”
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Adam Chesler, Director of Strategic Alliances, Pharmacy Technician Certification Board
"I am a great believer in luck, and I find the harder I work, the more I have of it.” So spoke Thomas Jefferson.
TPA member Adam Chesler is certainly a good example of that. Chesler is a registered pharmacist in Arizona, Colorado, Illinois, Florida, California, Texas and Hawaii. He just wanted to cover all the bases to allow himself more choices.
"One thing I learned is that there’s really only one opportunity for everything,” says Chesler, a former Wall Street trader. "Whether it's stock or life decisions. If there’s something that you want, you have to go for it. That’s why I got licenses for every state I wanted to live in—so I could jump on any opportunity that came up. There are a lot of places that would be nice to live. You never know—you might want to live near a beach in Hawaii and work there!”
In addition to his comprehensive pharmacy background, Chesler was a registered NASDAQ representative back in 2000.
"I traded for Trillium Trading—did it all through a computer,” says Chesler. "That helped teach me multi-tasking, time management and decision-making. Plus, it helped me learn to stay focused. Those skills translate well to pharmacy—when you’re working in retail pharmacy, you’re getting hit from all sides, analyzing metrics, supervising pharmacy technicians, and interfacing with customers.”
Originally aiming for a career in medicine, Chesler found he wasn’t happy just making money as a trader.
"I moved to Texas intending to open a trading business, but I missed making a difference in people’s lives on day-to-day basis. I craved the human interaction,” says Chesler, who returned to school, earning his Pharm.D. at the University of Texas College of Pharmacy in 2008.
Before taking his current post as Director of Strategic Alliances for the Pharmacy Technician Certification Board (PTCB), Chesler worked in some big retail outfits like Target and Walgreens. In doing so, he got back into the "people” business.
"I think it’s a good experience for all pharmacists to work at a retail outfit to see what the patient care is like,” he says. "Getting to know patients and making the decisions that affect people’s lives…I remember one patient who described some distressing bowel symptoms, and I told him several times to go to the emergency room. He finally listened—turned out he was bleeding internally and needed emergency surgery. He later told me I saved his life. Working in a retail outfit shows you the impact pharmacists can have on healthcare and the importance of the day-to-day action of pharmacists within their communities.
Before, and now as Director of Strategic Alliances Pharmacy Technician Certification Board, Chesler always places a high value on the role of pharmacy technicians.
"When I first started managing at a larger store, I remember seeing a patient’s prescription that had been inspected the night before by a pharmacist,” said Chesler, who worked as a pharmacy technician himself at an independent store in Florida. "I remember a pharmacy technician catching an error on the dose, potentially saving a life. That really piqued my interest in techs, and I realized how vital their role was. I learned I couldn’t be a good pharmacist without strong techs. If you look behind every pharmacy manager that’s successful, you’ll find a strong core of pharmacy technicians behind them.”
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Ron Cheyne, Ron's Best Value Pharmacy
Ron Cheyne, a pharmacist and multiple pharmacy owner, has a message for students preparing to enter the field of pharmacy, and to those who dream of oneday owning their own store: Be innovative and do whatever it takes.
That’s certainly the path Cheyne followed.
He remembers back in the 50’s when his father worked in drugstores –-a time when rules were more lax than now. Though Ron's father was not a pharmacist, the old chemist in the store even let him fill some prescriptions! Cheyne’s father regretted that he did not have the schooling necessary to become a pharmacist, and instilled in his sons Ron and Royce the desire to pursue a pharmacy education.
"They had great coffee at the local drug store, and he’d go there all the time,” says Ron. "He introduced me to the owner of the drugstore, and told him I’d like a job. Sure enough, I ended up behind the soda fountain at D & S Pharmacy in Amarillo on the east side of town. I made 40 cents an hour, and some of that went to food for my family.”
After graduating from high school 1958, Cheyne scraped up enough money to go to Amarillo Junior College.
"During my first year at Amarillo Junior College, I knew I wanted to go on to pharmacy school, but I needed to learn how to get over the stumbling blocks, like having enough money to rent an apartment and so forth,” says Cheyne. "Back then, you could become a pharmacist after one year of pre-pharmacy school and three years of pharmacy school.”
Cheyne did the math, and realized that if he could share an apartment three ways with Buddy Carr, a fellow employee from D & S, he might be able to afford Southwestern Pharmacy School in Weatherford Oklahoma. Additionally, Carr loaned Cheyne $100 a month to see him through school on the agreement that the debt would be repaid upon graduation.
"We split $45 a month three ways for the apartment,” remembers Cheyne. "But I wanted to earn some extra money. I had a friend in my chemistry class who worked at one of the drugstores in Weatherford, and asked him to tell me when any of the students working at one of the two drugstores in town was ready to quit. One day he came running up to me announcing that someone was quitting. So I went down there right away. The owner had a huge stack of applications, but told me he’d hire me to save the trouble of looking through them. I got the job and my fun money was $5 a weekend.”
Cheyne worked hard and made passing grades. He graduated in 1962 with an R.Ph degree.
"It felt really good to earn that, and pass the board exam,” he said. "My message to current students is to always try to figure out how to do what you think may be impossible.”
When Cheyne was ready to open his own pharmacy, he recalled a conversation with a customer at the counter at D & S Pharmacy in Amarillo.
"Back when I was working at the soda fountain in the drugstore, an old man at the counter told me that ‘a bank can’t take away anything that you don’t owe any money on.’ That made me realize to be careful when taking loans.
My wife and I were frugal enough to save $13,000 and I was ready to open my first store. Back then it took around $50,000 to open a new drugstore in Granbury, so we had to figure out a way to make it happen. We bought the smallest size subscription bottles, so we could at least fill subscriptions. Sometimes we’d receive an order at 9:00 a.m., and my wife would have to drive to the wholesaler in Fort Worth to obtain the prescription and get back by noon so it would not look like we couldn’t fill it.”
So by doing what he could, Cheyne was able to open Ron’s Pharmacy (now called Ron's Best Value Pharmacy) on $13,000 in 1969 without having to borrow any additional money.
In the mid 1980’s Cheyne partnered with fellow pharmacist Wayne West and began expanding.
"He [Wayne] was an A student, a good talker, and church-going. All-in all, a good partner,” says Cheyne. "The owner of a drugstore chain Wayne worked at ended up selling Eckerd’s, and Wayne worked there for a year or so, and that’s when I approached him and struck a deal.”
In exchange for four rental properties West owned, Cheyne gave him 20% ownership of Ron's Best Value Pharmacy.
"We bought a store that had been doing well, and that became our second store,” says Cheyne. "Currently I own 14 stores (my brother Royce is also a pharmacist and part-owner of one store), buying the most recent one in April 2014. Most of them are in the general Fort Worth area. We paid cash for almost all of our stores.”
The Future of Independent/Community Pharmacies
Cheyne believes that there will always be a place for independent/community pharmacies.
"It’s not an easy road, but it’s not too hard,” he says. "Customers prefer to deal with someone they know. So you just have to be friendly with the next customer who walks in, and engage them.”
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Ellen Church, Omnicare
TPA member Ellen Church knows how to make a mean cherry phosphate, and she can make a pretty good milkshake too. What does that have to do with pharmacy?
As a high school student in Vegas, Texas, Church worked at an old-fashioned pharmacy where they still had a soda fountain, and that early exposure to pharmacy helped guide her on a career path.
"My senior year I decided I wanted to pursue either pharmacy or be a medical technician,” says Church. "My counselor directed to me to Southwestern Oklahoma State University School of Pharmacy in Oklahoma to become a pharmacist.”
Church followed her counselor’s advice, doing her my pre-requisites at West Texas State (now called West Texas A & M), and graduating Southwestern in 1974.
"I really enjoyed my studies there. All my classes were on the third floor, so we had three graduating classed all intermingling,” remembers Church. "It was great for getting to know people. For me, it was kind of like being in high school, though the courses were more challenging. In your senior year, the dean would get everyone together and give a pep talk. He said "Pharmacy is going to be good to you. So you should be good to pharmacy. He urged us to get involved professionally. That stuck with me, and is one reason I’m involved with TPA.”
After graduating, and before she passed her board exam, Church, took a job selling magazines and cigarettes in a local drugstore, and later was a typist at Weinstein Drugs in Fort Worth. By the end of the summer she was working about 60 hours a week.
"You had to have so many hours working in a drug store to take the written portion of the exam, and additional hours for taking the practical part of the exam. I ended up being able to take both exams in Texas and Oklahoma, and I keep up both of my pharmacy licenses to this day,” says Church.
In February 1975, she began working as a pharmacist for Weinstein Pharmacy, and continued there for 24 years. Weinstein had both a retail and long-term care business, so Church became familiar with nursing homes. Eventually, Weinstein sold the retail operation. When he sold the long-term care operation to Omnicare, Church followed.
"At that time they [Omnicare] were called American Pharmaceutical Service,” says Church. "They were building up their business (pharmacy-related services to long-term care facilities and to other customers in the health care environment) in each area.
Currently, as a staff pharmacist Church is tasked with checking prescriptions for accuracy, always inspecting the final product that is going out the door.
It’s an important job.
"I don’t think there is a pharmacist anywhere who can say that they are 100% accurate. But something clicks as you are getting ready to hand off medications, and you catch it. That’s why pharmacy tries to have as many checks and balances as possible,” says Church, who also coordinates several different dispensing systems.
"The only patients we deal with are those in nursing homes or assisted living facilities. Omnicare is what’s called a ‘closed-door’ pharmacy. In the assisted living center, folks may order their own medicines.”
Observing trends over the years, Church has seen an increase in the regulatory aspect of prescription drugs in the area of psychopharmacotherapy.
"Some of the earlier drugs of that type had disabling side-effects, and they have now been able to limit those,” says Church. "We have to be careful when dealing with geriatrics with drugs that may make them drowsy. Doctors have to prove that the patient can handle the dosage. I’ve seen a lot of improvement in that area.”
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Lauren Clark, Pharmacy Manager, H-E-B
Lauren Clark got a head start in pharmacy, working as a pharmacy technician for Walgreens when she was still in high school.
"I got my pharmacy technician certification in high school,” says Clark, who is the 2015 TPA Distinguished Young Pharmacist winner. "I really liked my experience at Walgreens—I liked the fast-pace environment.”
Later, as a student at the University of Texas in 2001, Clark witnessed the tech bust, and knew for sure that she wanted a career in healthcare.
"A lot of graduates were having problems finding jobs,” says Clark. "I had a role model who was in pharmacy school himself at the time, and he gave me the idea that healthcare would be a good field. I knew it was a stable profession with more opportunities.”
After two years of prerequisites, Clark embarked on the Pharm.D. program, where she excelled.
"I did really well in the program—I was able to handle the workload,” says Clark.
"I especially remember Dean Patrick Davis of the College of Pharmacy,” says Clark. "He had a great teaching style, and was really passionate about teaching pharmacy. His courses included basic principles of drug metabolism and the medicinal chemistry and pharmacology of antimicrobial agents.”
As a member of the Christian Pharmacists Association, Clark found out about a volunteer health clinic in Cedar Park—just north of Austin, where she gained some early experience helping patients get prescription drug assistance.
After earning her Pharm.D. in 2007, Clark worked briefly as a consultant at a company called Asista, but found that she wanted to get back to patient interaction. She subsequently started as a part-time pharmacist at HEB, and that led to full-time position.
"I went from staff pharmacist at the H-E-B in Elgin, to pharmacy manager in Pflugerville in 2009, and then to the Bee Cave H-E-B,” says Clark. "In July of 2013, I helped open the new Mueller store in Austin (as pharmacy manager).”
"I am never bored, adds Clark. " Every day in pharmacy is an adventure and I enjoy the ride! Counseling, immunizing, hugging my favorite patients, sharing a cry with someone who is experiencing loss or pain, dealing with a difficult customer.... you never know how your day will turn out! Yet, every night when I walk out the door, I feel satisfied and fulfilled.
At the Mueller H-E-B, Clark is part of a residency team in collaboration with UT College of Pharmacy.
"We and have five spots open every year,” says Clark. "We take first-year pharmacists. They are able to cram a lot of experience into one year: MTM, disease states, and research projects. Residents often have an advantage when applying for jobs, and are considered for more clinical positions. For example, one of our residents is now managing our compounding pharmacy in San Antonio.”
Clark feels that most pharmacists embrace the clinical aspect of the job by nature of their profession.
"I get fired up when I hear the words ‘clinical pharmacist,” she says. "Every pharmacist should be a ‘clinical pharmacist,’ regardless of what environment they are working in. As community pharmacists, we have the most exposure to patients, physicians, and our neighbors.”
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Barry Coleman, R.Ph
Like many successful pharmacists, Barry Coleman became interested in pharmacy during high school. Growing up in Chicago, he worked for Walgreens as a clerk during that period. Noting his interest in pursuing pharmacy, Walgreens helped out by giving him a work scholarship, and he left the Windy City and headed south.
"I went to University of Arkansas. They had just opened up their College of Pharmacy, and I was one of the first graduating classes. There were only 15-20 students in each graduating class,” says Coleman.
Coleman was drafted in the Army in 1956, but graduated Arkansas with a Bachelor of Science in Pharmacy in 1957.
"I served as a field medic in the Fifth Army,” says Coleman. "I had taken a course at the YMCA – a Red Cross course in First Aid. I bragged about that, and next thing I knew, I was a medic.”
This was during the end of the Korean War, and Coleman was transferred to William Beaumont Army Medical Center in El Paso, where he became the sole night pharmacist.
"Many American soldiers came back from the Korean conflict with wounds, illnesses and psychological problems,” says Coleman, who notes that the U.S. never actually signed a peace agreement with them.
Success and Action
Coleman liked El Paso and decided to stay. It was a good move, as he was very successful there.
"I lived there until 2005 when I retired,” says Coleman, who now lives in Dallas. "I bought or opened 10 stores in El Paso from 1960-87: five Coleman Pharmacies and five Sun Drugs. El Paso was going through tremendous growth. At that time- about the late 60s, there was a transformation going on among drug stores. They were dropping their fountains and turning into retail stores, and most did not sell tobacco. TPA and APhA successfully lobbied to get pharmacy stores to discontinue selling tobacco— I was president of the American Cancer Society at the time. This was passed in 1971, and I was the author of the resolution. Those pharmacies that stopped were all small chains or independents.”
Coleman served as TPA president in ‘94 and ’95, and saw several ground-breaking efforts to completion.
"I had a wonderful board of directors –all very capable—including Dick Dill; James Paul Miears who became president after me; Jim Yates; and Harold Pieratt, to name just a few,” says Coleman.
"We (TPA) set up the first compounding section in the country with the help of Bill Letendre of Professional Compounding Centers of America (PCCA). Bill helped sign up enough members so that financially, we were able to get the thing off the ground. We also helped get the United States-Mexico Border Health Commission formed. TPA played a leadership role in that.”
Coleman, along with his wife, set up an endowment for a professorship at the University of Texas, El Paso. The endowment helps fund a professor who will work on Texas border public health issues from a pharmacist’s viewpoint.
"His legacy includes so much more,” noted Joe DaSilva, TPA’s CEO. "The first time I met this man known as ‘Your Older Buddy Barry,’ I felt his dedication and passion for pharmacy as his profession and for TPA as his professional organization. Texas pharmacists truly have been blessed by Barry’s leadership and his efforts to strengthen pharmacy through effective public policy action,” DaSilva continued. "As for me, I am honored to have become his friend and grateful for his continued guidance and advice.”
Change and Influence
"A lot of areas in the economy want to influence pharmacy,” says Coleman. "I saw that the insurance companies; drug manufacturers; the State Board of Health; the Department of Public Safety; the Welfare Department and so forth all wanted to control pharmacy practice and operations. Many pharmacists were not sensitive to what was happening and didn’t get involved. As pharmacists, we still have less political influence and market power because we have traditionally failed to advocate for what’s in our best interest. More membership and ACTIVE membership in TPA is the antidote.”
A Parting Note
As Coleman reflects back on a life spent in the pharmacy profession, he wants people to know how much he personally appreciates the opportunities he’s had.
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"Pharmacy: how enjoyable,” says Coleman. "Helping people every day—from the greatest to the least among us. Working with interesting, well-educated folks, working in a good surroundings and environment, and using your knowledge and education. And being well paid. It’s been wonderful.”
Mark D. Comfort, H-E-B Pharmacy (Austin)
Mark Comfort’s job as a pharmacy manager for the H-E-B at Hancock Shopping Center in Austin has its roots in his student days at the University of Texas, which is just a few blocks away.
"I started working at H-E-B in 1998,” says Comfort. "I was looking to get into pharmacy school, and wanted to see if I’d like it. I started as a cashier and trained to be a technician."
Turns out he did like it. Comfort studied to be a pharmacist at the University of Texas School of Pharmacy, and graduated with his Pharm.D. in 2003, the first all-Pharm.D. class.
Comfort worked as an intern at an H-E-B pharmacy during school, and did a fair amount of patient counseling for three years.
"The [pharmacy] program itself was challenging, and is more demanding today,” says Comfort. "When I was a student, I worked 20 hours a week and applied what I was learning while working as an intern at H-E-B pharmacy. Interns today can do a lot more now than we did in the 90s—they get more exposure to professional services.”
With more than 10 years of experience managing a busy H-E-B pharmacy under his belt, Comfort is giving back to students, serving as a mentor to students from UT.
"I usually have quite a few interns, and hire pre-pharmacy students,” he says. "It’s good to hire people who are interested in applying to pharmacy school. That way I can follow up with them later. We’ve helped quite a few students to get admitted to UT School of Pharmacy (and other schools). I really enjoy helping them along that path.”
When I was in school, I was not very involved in organizations—I mainly studied and worked. If I did it all over again, I would be more involved. So I advocate that to current students.
Although most current students are Medication Therapy Management (MTM)-certified, that was not the case a decade ago. But Comfort quickly realized the value of MTM, and got certified.
"I was trained in both Immunization and MTM about four or five years after I graduated,” says Comfort.”
As pharmacy services started moving towards ‘anytime’ flu shots, and as customers’ needs were changing, I knew it was time for me to step up and get certified.”
With MTM, Comfort sees pharmacy evolving more toward offering and getting reimbursed for professional services (services outside of just dispensing).
"I wanted to be involved in MTM to help push that along, and being certified helps with my credibility,” he says.
Currently Comfort spends much of his time filling prescriptions, along with staff management, administration, scheduling, and budgeting.
Comfort notes that increasing use of technology—helping to fill prescriptions offsite, automated dispensing, etc.—is changing the role of pharmacists.
"I don’t have dedicated time to do too much else. So automation is actually coming at a great time, giving pharmacists more time to explore other roles. I think we’re at a tipping point,” he says.
Involved and Engaged for Change
Comfort joined TPA in 2009 because he "wanted to know more about what’s happening in the profession, and to give input moving forward.” He’s also involved with Capital Area Pharmacists Association (CAPA), where he’s currently President- Elect. Additionally, he served on the Texas State Board of Pharmacy (TSBP) Pharmacy Technician Task Force this past year.
"Id’ like to see the duties of technicians expanded, because I feel that will help pharmacists have more time to provide healthcare services,” says Comfort.
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Since we are not yet considered healthcare providers, we can’t directly bill Medicare or other insurances for professional services. That’s why we hope to see the status of pharmacists as healthcare providers change."
Royce G. Cook Jr. Kerrville Drug Company
Royce G. Cook Jr. literally grew up in a pharmacy. His father, Royce Sr., was a pharmacist and owned the Crystal Drug Company in Crystal City, TX. There Royce Jr. worked as a teenager—stocking, sweeping floors, and jerking sodas.
Cook went on to the University of Texas College of Pharmacy and graduated in 1975. He spent five years working as a pharmacist for his father in Crystal City before going into business for himself.
After scouting out various prospects, Cook bought Kerrville Drug Company in June of 1980, which he co-owns with his brother Mike, who runs a medical equipment company.
Though Kerrville Drug Company stays busy, Cook says it can be challenging from a business standpoint.
"We are constantly looking at ways to stay profitable. How to generate enough margin is a big challenge. Managed care and pharmacy benefit managers, as well as Medicare Part D impact our profit margins,” says Cook. "So we look for alternate sources of revenue. The traditional role of just filling prescriptions is not going to fly anymore. In order to generate income we do things like medication therapy management (MTM). We also started up a medical equipment division called Hill Country Medical equipment. We offer durable medical equipment like oxygen, hospital beds, and walkers.”
"When I first started as a pharmacist,” says Cook, "almost all my time was spent filling prescriptions, taking prescriptions from doctors and dealing with patients. Now I spend a lot of time dealing with pharmacy benefit managers and paperwork—there are a lot of compliance issues to deal with. As the federal government gets more involved in healthcare, more documentation is required.”
But Cook knows what really matters. He’s a big believer in patient service, or as he says, "Taking care of people the way we would want to be taken care of ourselves.” Despite the challenges, Cook believes that as long as there is a demand for personal service, independent pharmacy will be fine.
"People will pay for the service. You may need more staffing to provide better service,” says Cook. "Counting myself we have two pharmacists and four technicians at the Kerrville Drug Company. We stay busy all the time, and we get our prescriptions out quickly. It’s still about customer service- taking care of people.”
Cook believes that empathy and understanding patients’ needs is probably the most important aspect of being a pharmacist.
"People want to be treated like people, not numbers,” he says. "That’s still the biggest thing. It’s the most rewarding part of the job. If you don’t like people, you’re not going to be a very good independent pharmacist. The bottom line is finding a happy balance—staying profitable and taking care of people. I’m a healthcare provider—it’s what I do. We should be able to do it and do it at a rate that we can live off of.”
That’s where advocacy comes in to play. Cook has been a member of TPA since pharmacy school, and tries to be active and support PharmPAC.
"If you’re not advocating for independent pharmacy, were not going to have independent pharmacy,” he says.
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Daniel Cruz, Pharmacist Technician at UTSW Medical Center Campus Retail Pharmacy
Daniel Cruz’s career as a pharmacy technician and his service to his country have overlapped through the last decade, but Cruz has always found time to give his bestefforts.
He was the DFW Hospital Council Outstanding Employee of the Year in 2011, received the Strauss Award from Zale-Lipshy Hospital for Quarterly Outstanding Employee, and in 2014-15, received the UT Southwestern Pharmacy Department Meritorious Award.
Right out of high school in Dallas, Cruz joined the Army.
"It was a good opportunity to get help with my education,” says Cruz, who is the 2015 TPA Distinguished Pharmacy Technician. "I did two years of active duty from ’91 to ‘93 and then came back home.”
By ’95, Cruz was married and seeking employment in the Dallas area.
"I ended up interviewing with a pharmacist at Parkland Hospital. At the time, they were creating a new satellite pharmacy. She liked me and took me under her wing, and trained me to be a pharmacy technician,” says Cruz, who later received his official certification.
Cruz prepared for the pharmacy technician exam by studying the related laws, reviewing his math skills, and learning the top 100 drugs.
"The math comes into play for compounding,” he says. "As a technician, we have formulas which have been created by physicians—we have to make sure we weigh out everything and prepare the compound. Then it gets checked by a pharmacist. For example we make a drug called ‘Miracle Mouthwash’ (Maalox, Benadryl and Lidocaine) that creates a lot # and I have to match that with the compound. I also do IV preparation.
When duty called again as the situation in the Middle East changed, Cruz was deployed.
"I toured Iraq in 2005 and 2007—Operation Enduring Freedom & Operation Iraqi Freedom,” says Cruz, who was able to take a leave of absence from his pharmacy technician job for those tours."
As a staff sergeant in the Army, Cruz learned a lot—taking nothing for granted.
"Initially, I was in training for security detail for a general. You have to be very detailed, aware of everything around you to make sure everyone gets back safely. I was team leader for the security detail,” says Cruz. "We did a lot of recon—much of it at night. That made it easier to spot locals. We’d go out two to three days prior to an engagement.”
"It’s so much different there than it is here at home. You work with a group of guys who are complete strangers and who are willing to take a bullet for you. Danger was ever present.”
Cruz recalled one incident that occurred at his camp while his crew was loading a truck with supplies.
"In Baghdad, there were 12-foot barriers surrounding our camp. On my first day, a threat threw a grenade into my truck and blew it up. Fortunately, it was parked, and no one was on it!
Cruz, who retired from the army in 2009, is currently Lead Pharmacist Technician at UT Southwestern Medical Center Campus Retail Pharmacy.
"I love it,” he says. "I’m really enjoying the retail side. "
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Though Christopher M. Dembny R.Ph., was born in Osawatomie, Kansas andreceived his Bachelor of Science in Pharmacy degree from the University of Kansas School of Pharmacy, it didn’t take him long to get to Texas. Once in the Lone Star state, his varied career led to a successful consulting business.
Initially, Dembny took a job in chain retail, spending eight years at an Eckerd’s in Dallas.
"It was a busy, profitable store,” says Dembny. "It was a great learning experience. I got to see the financials. I learned a lot about pharmacy and how money was made and how to run a pharmacy. It was a good foundation.”
In 1991, Dembny moved to Presbyterian Apothecary (Dallas), a smaller operation.
"It was not nearly as busy, and was much more patient-care focused—a more clinical environment. It was enjoyable,” says Dembny.
While at Presbyterian Apothecary, part of Dembny’s job was to consult for their surgery center, an experience that would later shape his career path.
Dembny gained even more experience working as a clinical pharmacist at Methodist Hospital in Dallas, where he spent six years after leaving Presbyterian Apothecary.
Dembny wanted to experience a hospital setting and because Methodist is a medium sized hospital, he worked everywhere: neuro-trauma; neo-natal intensive care; and renal transplants.
"It was very interesting. We had babies born that were less than a pound, and they survived. Often it was touch-and-go. The protocols were well-set—the doses were so tiny, we’d dilute the drugs down to very low concentrations. We’d make a drug up in a 500 milliliter bag, and the dose would be less than a milliliter—in order to measure it accurately.”
Eventually, people started calling Dembny, asking him to consult for their surgery centers. That’s how Dembny Pharmacy Consultants came to be.
"My practice grew out of the fact that people kept calling me—seeking out my services,” says Dembny. "I was consulting for about 15 surgery centers, and just did not have time to work a full time job. So I quit Methodist in 2,000 and started full-time consulting as Dembny Pharmacy Consultants. I had enough facilities to make a living and it just kept growing. Currently, I have about 75 surgery centers—all in Texas, and I have about 25 contract labor pharmacists who help consult.
Most of Dembny’s consulting concerns regulations—every surgery center is required to have a consultant pharmacist. As Dembny explains, a pharmacist is required to visit a center once a week.
"The regulations describe exactly what you have to do—handling drugs, documentation; legal and licensing requirements,” he says. "You have to keep up with the rules, so I stay current. I’m responsible for keeping the surgery centers in compliance with the rules.”
In 2011, a law took effect requiring the emergency care centers to have a consultant. The same rules for the surgery centers apply, so Dembny had a ready-made market and now has about 40 emergency care centers that he consults.
In addition to his consulting business, Dembny, who served on TPA’s Board of Directors for five years, is currently on the Board of Texas State Board of Pharmacy.
"TPA helped me get on the TSBP board. It’s very interesting keeping up with what’s going on, and I get to interact with a lot of very intelligent people from different areas of pharmacy,” he says. "Last legislative session, a group of doctors attempted to push through a law making it legal for doctors to dispense drugs, but Governor Perry vetoed it. And of course, there was the technician ratio issue, which resulted in a compromise--1:4 ratio.
In recognition for his diverse career, Dembny received the TPA Education Excellence award in 1995 and the Innovative Pharmacy Practice award in 2004.
"I got the Education Excellence award because I helped start up Richland College pharmacy technician training program—one of the first accredited pharmacy technician programs in the state,” says Dembny. "It was a lot of work, but it was interesting, and I enjoyed it. I basically taught pharmacology and pharmaceutics.”
His the Innovative Pharmacy Practice award was the result of his consulting for surgery centers. "Consulting of that type is not so common,” he says. "There are probably only around 10 people in the state who do what I do.”
Gay Dodson, Executive Director, Texas State Board of Pharmacy
If you grew up in the Dallas area in the 70’s or 80’s you may remember the Texas chain of drug stores called Skillern’s. And if you were a customer there, you might have been helped by Gay Dodson. Although the Skillern’s Pharmacy chain is long gone, Dodson has moved on to one of the most prominent positions in Texas
"I worked as a pharmacist at the Skillern’s in Lancaster,” says Dodson. "We built it up to be a really busy store.”
Eventually, Dodson grew interested in management, and started looking around. Around that time there was an ad in the Texas State Board of Pharmacy (TSBP) newsletter for a compliance officer in the Houston area, and she decided to investigate.
"I didn’t really want to go to Houston,” says Dodson, "but I thought I’d look into it.”
This was when compliance officers were initially put into the field by TSBP, and it turned out to be a good move. Beginning in 1982, Dodson served two years as a compliance officer in Austin, three years as the senior compliance officer, 10 years as Director of Compliance and began as Executive Director in 1997.
"It’s something I really enjoy doing,” says Dodson of her position at TSBP. "No two days are alike. Every time I think I’ve heard it all, I hear something new! It’s constantly a challenge to see what people are proposing. When we are looking at changing the rules to accommodate changes in practice, we always have to look at how the rule will protect the public first, since that’s the mission of the Board.
Dodson has seen considerable change during her career, especially in the area of technology.
"Change seems to be the norm,” she says. "Technology has changed the way pharmacy is practiced. Also, there has been a continuing emphasis on pharmaceutical care—taking care of a patient beyond just dispensing drugs. We are continuing to find ways to help pharmacists do a better job in that area. I’ve always said that the most important factor in good patient counseling is whether or not pharmacists want to counsel.
Pharmacists as Healthcare Providers
With California leading the way, it seems like only a matter of time before other states pass legislation recognizing pharmacists as healthcare providers.
"I think it’s crucial to the profession moving forward for pharmacists to be recognized as providers federally by Medicare/Medicaid. That’s when compensation will follow, and that’s when you’ll see it really take off.”
Looking at the job market in Texas, Dodson points out that things have tightened up a bit for pharmacists, but opportunities exist.
"Right now, it appears there are still jobs,” she says. "We’ve had a great influx of pharmacists coming into the state—largely due to the number of colleges of pharmacy in Texas and nationwide. We’ve had many more people graduating—the number of pharmacists we’ve licensed has increased by 26% since 2006. Folks entering the profession may not get their first choice as to where they want to work, but they should be able to find a job.”
Concerning pharmacy technicians, Dodson observes that there’s still a strong demand.
"There are currently 56,500 pharmacy technicians in Texas, and that’s been growing every year,” she says. "Of course, the number of pharmacies is also growing. At the end of FY13, we’d licensed 7,350 active pharmacies, that’s a 19% increase since 2006. We currently have about 29,500 pharmacists with an active license.”
Don’t miss Dodson’s Texas State Board of Pharmacy Update at the 2014 TPA Conference & Expo (1:30-3:00 p.m. Friday, August 1). Attendees can expect to hear about any changes in the laws and rules over the last year.
"We’ll have a number of TSBP board members at the conference, and attendees will be able to ask us questions,” says Dodson.
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Abimbola Farinde, Pharm.D., HCA Hospital Corporation of America (Pasadena)
After graduating from Texas Southern University College of Pharmacy and Health Sciences in 2007 with a Pharm.D., Abimbola Farinde went on to complete a generalist residency with an emphasis in primary care.
"One rotation that I was on was an inpatient psychiatry program at the Waco Veterans Hospital in Waco,” says Farinde. "This experience allowed me to be exposed to the dosing and administration of psychotropic agents such as antidepressants, mood stabilizers, antipsychotics, and anxiolytic medications—anything that impacts your mental health.”
"During my second year training in psychopharmacology, I had the opportunity to train at the North Texas Veterans Administration in Dallas, Texas. It was at this location that I saw diagnoses of posttraumatic stress disorder stress disorder (PTSD),” says Farinde. "From this experience, I learned that pharmacists play an integral role in helping veterans to cope. I had a lot of one-on-one interactions with a number of veterans, and had the opportunity to recommend medication replacements or substitutions to my preceptor and/or prescribing psychiatrist.”
Farinde later worked as a clinical specialist for the Carl R. Darnall Army Medical Center in Fort Hood, as one of the first clinical pharmacists to provide clinical pharmacy services in their traumatic brain injury clinic.
"In some respects, what I was doing was similar to Medication Therapy Management (MTM),” says Farinde.
After her time at Carl R. Darnall Army Medical Center, Farinde took an opportunity as a clinical pharmacist at the Lufkin State Supported Living Center, where she worked from 2010 to 2012.
"As part of my specialty residency program, my preceptor directed me towards the identification and treatment of neurological and psychiatric disorders in the elderly veteran population,” says Farinde.
Currently she is a clinical pharmacy supervisor at a dual campus Hospital Corporation of America (HCA) in Pasadena, Texas.
"I enjoy clinical pharmacy because it is ever-changing,” says Farinde. "You have a lot of options. For instance, the VA can be viewed as a great place for pharmacists to have a lot of autonomy. It’s very specific and defined.”
TPA Information Highway
"I think being a member of TPA is great opportunity to network with other pharmacists and to see what they are doing within their own practices,” says Farinde, who has served on the TPA Association Affairs Council since 2013. "TPA keeps me abreast of all the legislative activity affecting pharmacists in the state of Texas. The information that comes from TPA is amazing—it gives an inside view of what’s going within the practice of pharmacy.”
Jennifer Fix, a former TPA president, has always been interested in health care. Her father was a doctor, and his family practice was connected to anindependently owned pharmacy next door.
"There was a breezeway doorway between the two,” says Fix. "I observed the pharmacist, and I saw how my dad worked. I decided to go to pharmacy school.”
Fix went to Drake University in Des Moines Iowa, earned a BS and an MBA in 1985, and later received a Pharm.D. from University of Colorado in 2009.
"I was one of four people who took the combination BS/MBA degree program,” says Fix. "They had a combination where you could do the pharmacy program and the MBA program at the same time. The pharmacy program was five years, and you stayed on an extra year for the MBA. We took accounting, statistics, business management and math along the way. It was a six-year program.”
Fix was president of TPA from 2003-2004, and that’s when she decided to get her Pharm.D. Her first pharmacy job in Texas was with a chain pharmacy, and she later opened her own Medicine Shoppe franchise in 1990, with a 20-year contract through 2009.
"I knew I was going to be trying something new—maybe opening my own shop. I felt like it would be in my best interests going forward,” says Fix.
Her education and experience allowed Fix to open her own store—Jen Care Pharmacy, which she’s run since 2009.
Jen Care, just north of downtown Fort Worth, offers a number of services, including immunizations, compounding, a cholesterol consultation service that yields total cholesterol- HDL, LDL, and Triglycerides; and A1C testing, a specialized finger stick that shows a 12-week average for a glycoprotein—a more comprehensive way of looking at blood glucose.
"We follow the cholesterol and glycoprotein consultations up with a counseling session,” says Fix. "The most rewarding thing about pharmacy is sharing our education with people, and helping them get smarter about helping themselves.”
"Having a successful practice in Haltom City for 25 years, and serving patients has been a great experience,” says Fix. "One of the neat things is you develop relationships with patients, and you see their children grow up and meet that generation’s children.”
Fix knew that she one day might sell to a chain pharmacy, and the question was when.
"Right now is the best time,” she says. "It’s likely in the near future that Jen Care will be sold to a local chain pharmacy. There are some industry changes which are making it complicated for us to go forward. There has been a shift of consumers from independent pharmacies to chain pharmacies or mail order. Independents have been losing patients to mail order for a long time. In the last two years, PBMs made changes in the way contracts were offered. PBM contracts allowed for "preferred pharmacies” which were generally large chain pharmacies or mail order, and independents were not included. What this means is that patients with prescription coverage would have better pricing at the big chain stores.”
Although unsure what comes next, Fix remains optimistic about her future and with her multiple degrees and experience, she has every reason to be.
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Eric H. Frankel, West Texas Clinical Pharmacy Associates (Lubbock)
You could say longtime TPA member Eric H. Frankel is well-educated. He earned his Bachelor's degree in Psychology and a Master’s of Science degree in Education from The City College of New York and received his Bachelor of Pharmacy degree fromArnold and Marie Schwartz College of Pharmacy in Brooklyn.
But Frankel, at a time when pharmacy doctorate programs were in their infancy, looked to the future.
“I looked around and got a sense of where the profession was heading,” says Frankel. “I sensed that clinical practice would be the future of pharmacy. Knowing that I would be a pharmacist for life, I decided to go further.”
In 1979 Frankel earned his Pharm.D. from Mercer University in Atlanta, Georgia. In choosing a practice focus, he decided on nutrition support.
“I liked nuclear pharmacy and pharmacokinetics as well,” says Frankel. “My wife steered me towards the nutrition specialty and I never looked back or regretted my decision.”
While networking in pharmacy associations in Atlanta, GA, Frankel met the assistant director of pharmacy for Crawford Long Memorial Hospital of Emory University (now called Emory University Hospital Midtown) at an association meeting.
“He learned that I was studying nutrition and that dovetailed with his plans to start a nutrition support service at Crawford Long Memorial Hospital. I got the job and was there for eight-plus years. Being an association member was a major positive influence on my career,” says Frankel.
In 1988, Frankel was recruited by St. Mary of the Plains Hospital (now Covenant Health System) in Lubbock and headed west. He became their nutrition support service coordinator.
“I stayed there until 2007,”says Frankel. “In 1997 I also started West Texas Clinical Pharmacy Associates, a consultant business still going strong today. My business is supported by home infusion pharmacies—they see me as the perfect intermediary. I have collaborative practice agreements for delegated prescriptive authority with over 50 physicians. These agreements enable me to work as a physician extender, aka “health care provider” or advanced pharmacy practitioner (APP).”
Networking within the TPA resulted in being appointed the TPA’s representative to the United States Pharmacopeial Convention (USP), a direct benefit of his TPA membership and participation.
“Basically, nutrition support is about feeding people who have difficulty receiving nourishment the normal way by eating,” says Frankel. “We extend life for this population. This is very rewarding when the quality of life is otherwise good.
“I design parenteral nutrition regimens — feeding a person intravenously, bypassing the usual processes of eating and digestion,” says Frankel. “This can be done in an institutional setting or with a home infusion pharmacy. I currently consult for home infusion in the State of Texas. Typically physicians are not trained in parenteral nutrition. It’s an area where pharmacists have an opportunity. I can help keep patients at home and decrease re-hospitalization. This benefits the patient and the home infusion pharmacy.”
“I’ve spent my entire career in the area of nutrition support. There’s been a lot of change in the landscape. For one thing, the expertise and academic focus on this area of practice has diminished. The other thing is that economics have discouraged the utilization of highly-focused specialists in pharmacy.”
Speaking to new practitioners, Frankel has some advice.
“There are two areas where I see the most opportunities for emerging pharmacists,” says Frankel. “Anti-microbial stewardship—a practice using pharmacists’ knowledge to optimize the use of antibiotics and antiviral medications—is one such area and emergency department pharmacy practice—where pharmacists coordinate the transition from community to acute care and optimize medication use—is another. I think the key is finding an area of practice that is not a physician focus and capitalizing on that.”
“I have been a pioneer in the use of collaborative practice agreements to help patients, to support physicians and to expand the practice of pharmacy. Opportunities exist where a pharmacist can save time for physicians without costing the physician money. One example would be obtaining delegated authority to renew expired prescriptions based on a protocol that is developed jointly with a physician. This would be a win-win. Be creative and you can think of areas where a pharmacist could really help optimize care and do not hesitate to step in.”
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Yaser M. Gadit, Walgreens (Austin)
Yaser M Gadit is back in Austin, and he’s happy to be here.
Gadit, who earned his Pharm.D. at The University of Texas College of Pharmacy, initially relocated to Houston after graduating, but found he missed Austin.
“I did my undergraduate courses and pharmacy school at UT Austin,” says Gadit. “I really liked my experience at UT. The professors were really open and accessible. And they expressed the importance of being involved politically, so being in Austin I was able to take part in lobbying for our profession.
Now that I’m back in Austin, I feel like I can be more involved with UT, and have more interaction with pharmacy students. I’m a preceptor and I want to mentor students in the way I was mentored when I was a student, and to be more involved in alumni events.”
“I’ve been a TPA member since I was a first-year pharmacy student,” adds Gadit. “I’ve attended many TPA conferences, as well as conferences throughout the country. That has helped me to be able to see how other pharmacy leaders around the country lead and what they advocate for and where pharmacy is heading.”
Like many young pharmacists, Gadit is well aware of the increasing role pharmacists must play in healthcare.
“In my observation, it seems like pharmacists are being relied on to take a more clinical role, such as medication therapy management (MTM) and immunizations,” says Gadit. “Personally, I became MTM, Lipid and Diabetes certified. If we can achieve provider status that would really accelerate the process of healthcare team involvement. There’s a lot of work to do, but I believe pharmacy is headed for more clinical roles and ambulatory care. As pharmacists, we are often underutilized. So provider status would help with that, as well as healthcare costs."
Gadit, who worked at Kroger in Houston for three years—and was pharmacy manager for two—says he learned valuable skills in that role.
“Being a pharmacy manager means you need to handle certain situations,” he says. “You learn to be accountable and responsible, especially regarding to patients. It’s extremely important to communicate with patients. As pharmacy manager, I definitely had situations where I had to go the extra mile to help patients. That helped me learn to be a good leader—especially for the technicians.
They are so essential for the operation. You really want to have a strong team and motivate them. I’m definitely open to managing again at some point.”
For Gadit, now a floating staff pharmacist for Walgreens, the community chain setting is a good fit.
“In a community chain setting, I feel like I can help the most people on a daily basis,” he says. “I like interacting with people and coaching students and interns on what it takes to be a pharmacist, and how to utilize core principles such as empathy and listening. I really like the patient interaction and being an accessible healthcare professional that patients can reach out to for advice.”
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Stephanie Garza- University of Texas at Austin College of Pharmacy
High school is said to be one of the best times of life, and sometimes, it can set the course for the future. That’s what happened with TPA student member
Stephanie Garza of Laredo.
"I got into a health-science magnet program in high school, and they let us dip our toes into everything,” says Garza. "We got to do ‘clinical rotations’ and tried many different areas. When I tried pharmacy, I fell in love with it. I liked how it was team effort—everyone working together for the same goal.”
Garza is currently enrolled in the University of Texas – Pan American (UTPA) / University of Texas at Austin (UT Austin) College of Pharmacy Cooperative Pharmacy Program, where she’ll be a P3 next fall.
Organizations and Mentors
Initially, arriving in Austin and attending one of the biggest universities in the country was somewhat of a shock for Garza.
"My first year I was terrified,” she says. "It was a huge transition for me, and I didn’t really focus on any organizations. By my second year, I felt better, and dove headfirst into various organizations like American Pharmacists Association (APhA).”
Garza was especially interested in drug addiction and prevention of abuse, and visited with TPA’s Courtney Hulbert, LCSW and got an idea about forming a student personal recovery network.
"Courtney has been really supportive of everything we’ve been doing,” says Garza. "She’s helped us get our student PRN off the ground. She came and talked to us at UT, and told us how PRN works.
The idea was to show students what resources were available. And it also helps show how to treat future recovery patients. Also, at APhA I’m involved in Generation RX- a national program to prevent drug abuse in middle school.”
At UT’s College of Pharmacy, Garza likes getting out in the field, and enjoyed a counseling program where students went into Walgreens and got to counsel patients on how to use over-the-counter products.
And she’s highly appreciative of the professors at UT’s College of Pharmacy, and all they have to offer.
"Dr. Erickson, our advisor for the student PRN is a great mentor,” says Garza. "And Dr. Lydia Aguilera - she’s been rooting for me the whole time. I met her right out of high school when I got accepted at the UT Pan American Cooperative Pharmacy Program. I wouldn’t be in pharmacy right now if not for her.”
Garza has been having a productive summer, continuing to build on her interest in drug addiction and abuse prevention. Recently, she attended a conference at the University of Utah School on Alcoholism and other Drug Dependencies, where she was named student ambassador for the conference.
This fall, Garza will leave Austin and head to the Rio Grande Valley.
"I’ll be doing my P3 and P4 years in the Rio Grande Valley to complete the University of Texas – Pan American (UTPA) / University of Texas at Austin (UT Austin) College of Pharmacy Cooperative Pharmacy Program (CPP). P3 year is distance learning while P4 year is rotations in different facilities around the Rio Grande Valley. It’s part of a program to help underserved areas,” says Garza.
Garza wants to get into patient education in a community pharmacy setting where she can help protect patients from potential addictions. "I know the job market is going to be competitive—it’s pretty saturated in some areas,” she says. "But I’m optimistic. UT College of Pharmacy is ranked number four in the country, so we’re doing something right!
Marshall A. George, TPA Student Executive Committee and Pharm.D. Candidate Class of 2016
The seeds to become a pharmacist were planted when Marshall A. George was just 12 years old. His mother was in a very severe car accident—so severe in fact that she expired and was revived on the operating table several times. When she came home, his father could not take care of her, so George began managing her medications and feeding her through IV, essentially becoming her primary caregiver.
When George later moved from California to Texas, some opportunities came his way. He took a professional career development course to become a Pharmacy Technician and earned a certificate when he was a senior at Leander High School. In 2008, when the economy was bad, George noticed that pharmacy techs were not being hired as readily, and made the decision to become a pharmacist, and enrolled at the University of Texas College of Pharmacy. Now scheduled to graduate in 2016, he’s finding he made the right choice.
"I really enjoy the College of Pharmacy,” said George. "The program can be fairly rigorous, but overall, it’s very rewarding. There are a lot of areas for students to get involved in- especially community service. This is great because it ties into building people skills. As a pharmacist, you want to be a blend of scientific-minded and people-minded.”
As Director, TPA Student Executive Committee, George pays a lot of attention to current issues facing pharmacists, noting that "provider status is huge.”
"We [pharmacists] are being expected to carry more and more of the patient care workload,” he said.
"So if pharmacist are going to be expected to interact with patients, they should be compensated for that. The crux of the issue is that pharmacists need to be compensated appropriately to provide the kind of care that patients need. The main concern is to get them the care they need. In California, pharmacists are now legally recognized by the state as healthcare providers. So because of that, they have the right to perform additional healthcare functions. It may look like pharmacists are simply seeking more cash, but the reality is that once recognized, employers will feel more comfortable allowing pharmacists to increase their role as healthcare providers.”
As someone about to enter a changing profession, George has noticed that pharmacists often tend to be very passive when it comes to speaking up on issues. "We can’t do that anymore because of the way healthcare laws are changing,” he said.
George feels that dispensing drugs alone is no longer the way pharmacists will be able to stay in practice, and that dispensing as a be-all and end-all is going away. "We have an advanced degree and are capable of making healthcare decisions. Our profession is evolving along with others like nurse practitioners. I believe that recognition should be taken more seriously.
George believes that we must evolve towards a "team-based” system of healthcare providers, and that in an ideal situation, you’d have one member of every professional involved in patient care set up to interact with all the other members of the team.
"The patient is seen by the doctor, and from there, they may be discharged with medications,” he said. "Next, they’ll talk with nurses and pharmacists. The idea is that patients should not leave until they understand how to take their meds to achieve the best outcome. So in the future, pharmacists, nurses, doctors, and social workers will network in a more robust fashion.”
As George sees it, reaching that point involves advocacy thought organizations such as TPA. "We need to show that advocacy works. It’s hard to supply people with something tangible. So it’s important for associations like TPA to make members aware of accomplishments. The key is to make sure the memberships knows that their support is achieving results.”
"If nobody is speaking up, no one knows what is good for the profession. TPA represents the unified front of individuals in the pharmacy profession, when they may not have the ability or resources to speak up. And by being involved with TPA, pharmacists play a role in shaping their future.”
Isaac Gomez, University of North Texas • UNT Health System College of Pharmacy
Isaac Gomez will be part of UNT’s first College of Pharmacy graduating class in 2017, but right now he’s got a lot on his "to-do” list. Gomez, who will be a P3 next fall, is just wrapping up finals before starting a busy summer.
Before coming to UNT, Gomez earned a BS in Biology (2012) at the University of Texas, El Paso. Then, after talking with a few pharmacists friends, he set up a shadow session with a pharmacist at a Walgreens in El Paso.
"I worked as a pharmacy technician at Walgreens for about a year before entering pharmacy school,” says Gomez. "It was awesome. The pharmacy manager, along with the rest of the staff, was really on top of things. I got a good sense of what it would be like to be a pharmacist.”
Gomez enrolled in UNT Health System College of Pharmacy in the fall of 2013, and has been tackling the challenges that all new pharmacy students face.
"My first year (P1) was a lot of studying—it was a whirlwind. At UNT we have what are called ‘block exams’— three on Friday and two on Monday. That was a challenge. The only thing I could compare it to was finals week as an undergraduate, but the block exams are every week. I felt like I was behind as a P1. I used to try to cram things, but learned that that does not work. My P1 was a year of adjusting and learning new study habits, and learning about pharmacy advocacy involvement. The second semester we started joining organizations like APhA and TPA. It was great to be part of those.”
Gomez’s second year, (P2) has been somewhat easier. UNT changed the exam schedule to two exams every two weeks, allowing for more preparation and recovery.
"This year I helped to kick-start two pharmacy fraternities. Kappa Psiand Phi Delta…so that’s taken some work,” says Gomez.
"Now that we are getting into therapeutics, I’ve found the diabetes block to be very applicable to what we’re going to be using in a practice setting. The course has been taught really well, and we reviewed real-world case scenarios. That’s when you put everything together.”
Looking to the future, Gomez is keeping the door open for retail pharmacy, but is also looking at clinical services.
"I took a class on community care, learning how to bring clinical services into a retail community—really using everything in a pharmacist’s toolbox in a pharmacy. So that area is an option. Another area I’m interested in is transitional care—when patients leave hospital care.
At UNT we have the Seniors Assisting in Geriatric Education (SAGE) program. Student teams are paired in groups of three to four inter-professional healthcare students. The student teams are then matched with a community-dwelling adult, over 60 years of age. Pharmacy students do an audit on the person’s medications to make sure nothing is amiss. Other members of the team would look to me as the medication expert.”
As Gomez wraps up finals, he can see the light at the end of the academic tunnel, but will be very active this summer.
"I plan to work as a pharmacist intern at Walgreens this summer. I also plan to set up some ‘shadowing’ with a specialty pharmacy and a transitional care team, working with other healthcare providers. Additionally, I’ll be doing a hospital rotation this summer in Lewisville,” says Gomez, who also plans to catch up on sleep, and try out a new bicycle he bought as well.
An Advocate is Born
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"The Leadership Symposium really sparked a great interest for me,” says Gomez, who joined TPA last year. "The college of pharmacy deans, and Mark Riley’s sessions were really informative. When we were at the Capitol opposing the Physician Dispensing Bill—Senate Bill 588 (Huffman) and its House companion House Bill 1483 (Zerwas), I knew that we really need to get involved to have an effect. Too small a percentage of pharmacists are involved as advocates for the profession.”
John Heal, Governmental Affairs Director for PBA Health/Texas TrueCare Pharmacies (Austin)
John Heal has represented independent pharmacy in Texas for over 15 years. As Governmental Affairs Director for PBA Health/Texas TrueCare Pharmacies, this role has provided him an opportunity to join a cause that is close to his heart.
"My family owned and operated a small business in Dallas,” says Heal. His father had been a successful restaurant executive, and his mother is Italian. So when the opportunity presented itself, they opened their own restaurant—PJ’s Ristorante on Mockingbird - across from the old Dr. Pepper plant.
"While immensely challenging, the restaurant alsobrought many blessings,” said Heal. "It’s where I learned how to cook and that’s how I won the heart of my lovely bride Jennifer – surprising her with a pan-seared strip steak with linguine, olive oil and garlic.”
The restaurant is where state Senator "Ike” Harris offered Heal a job at the Capitol in Austin and suggested he finish his college degree at the University of Texas.
"I owe a great deal to that restaurant,” said Heal, "it helped prepare me for the work I do today in representing independent pharmacy.”
Texas TrueCare Pharmacies provides legislative and governmental affairs support for all of Texas independent pharmacy. Through their predecessor, Legend Pharmacy, they are the oldest independent pharmacy group in Texas. "We are proud to stand with all groups in protecting the viability and the future success of pharmacy in Texas,” said Heal.
"Allowing pharmacists to practice to the full extent of their knowledge and skill is vital and we must embrace change that allows for an increased role in improving patient care,” he said. "A new day has arrived, and we must be vigilant in laying claim to the positive results that pharmacists can provide to the delivery of quality healthcare in Texas.”
The 84th Texas Legislative Session
"I believe that pharmacy is poised to have one of its best legislative sessions in many years,” says Heal. Last week during the Senate Finance Committee hearing concerning the HHSC budget, several senators voiced their concern about pharmacy reimbursement. "Independent Pharmacists have been taken out to the woodshed for the past several years and we hope to change that," said Sen. Charles Schwertner. Sen. Juan "Chuy" Hinojosa acknowledged that reimbursements many times don't even cover costs and that pharmacy should be able to turn a profit. Sen. Lois Kolkhorst likened the propriety aspects of pharmacy benefit managers ("PBMs”) to a "black box”, lacking transparency.
"We tinkered with your levers, I understand, your dispensing fee, and the PBMs, we’re going to end up with a mess here pretty soon,” she said.
The concern demonstrated by these senators underscores the importance of grassroots advocacy in educating our elected officials of the challenges facing our profession. "I believe that the hard work done by the many Texas pharmacists who have taken an active role in advocating for your profession is paying huge dividends,” said Heal, "Our message is being heard.”
"The transition of the Medicaid pharmacy benefit to managed care has resulted in an inequitable reimbursement structure for Texas pharmacies,” says Heal. "More and more frequently, prescriptions are being dispensed below the cost of the actual medication. Equity and transparency must be brought into this process to ensure patients have access to their vital medications, and pharmacists are adequately compensated.”
Heal understands that pharmacies cannot remain viable in a payment system that does not allow for the recoupment of their operating costs plus a return on their investment. Therefore, payment methodologies have to ensure a reimbursement structure that affords pharmacies the ability to recoup the cost of their medications, plus overhead and a reasonable return of investment, just like any other business.
The problem is not just isolated to Medicaid. The Maximum Allowable Cost ("MAC”) structure applicable to commercial plans poses the same inequitable problems for pharmacy as the Medicaid PBMs. "What other profession can be expected to provide a good or service at or below their acquisition cost and remain viable?” he asked. "True economics have to be introduced into the pharmacy payment system rather than a payment methodology left to the whim of the PBM.”
In addition, Texas pharmacies should be able to participate in any patient network where the pharmacy is willing to accept the reasonable terms of the network. "Patient outcomes improve with better access to medication and the other valuable services pharmacists provide,” said Heal. "It just makes good sense to have those patients as close to their treatments and medication as possible.”
Other important legislation is likely to surface this session that will look to pharmacists to play an increased role in the delivery of healthcare.
"As more pressure is put on the overall healthcare system to contain costs while improving patient outcomes, the more pharmacists can be relied on in the delivery of quality patient care,” he said. "Pharmacists play an important role on the healthcare team, and that role is growing.”
"There have been recent developments as to what the role of pharmacy may look like moving forward,” says Heal. "And those developments provide opportunity. The goal is not only to align pharmacists with expanded opportunity to serve patients, but to make sure that those opportunities are appropriately compensated.”
The excellent work that TPA has done regarding the MTM Pilot project is a prime example. We owe a debt of gratitude to TPA CEO Joe DaSilva and Senior Director of Pharmacy Practice Kim Roberson for their diligent work in this area. The results of this study confirm what pharmacists have known for a long time: that their expertise and involvement with patients result in better outcomes and lower healthcare costs.
Stand Together for the Future of Pharmacy
Texas TrueCare fully supports TPA and its mission to protect, advance and unify the practice of pharmacy. Heal believes that our adversaries are too formidable not to stand together and we share TPA’s goal of unifying the profession.
"I would like to salute TPA CEO Joe DaSilva and his leadership for all of Texas pharmacy,” says Heal. "We are grateful to be a part of the team, and we appreciate the opportunity to participate and provide input into the weekly pharmacy advocacy meetings.”
Moving forward, Heal believes that pharmacists are well positioned to increase their role in the delivery of healthcare. "Without exception, pharmacists continually rank at the top of Gallup polls for honesty and ethics,” says Heal. "The public’s trust in the profession coupled with pharmacists’ increased expertise should yield additional opportunities to provide compensable healthcare services in the future.”
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Brittany Hermes- DeTar Hospital (Victoria)
Like many pharmacists, Brittany Hermes had a family member in the healthcare field to spark her interest. Not only that, but she had the advantage of getting a sneak peek at how a pharmacist’s day would be.
"My mom is a surgical nurse,” says Hermes. "She encouraged me to go into pharmacy—or any healthcare field, including nursing. I looked into options like nurse practitioner and physical therapy. She was able to allow me to shadow the nurses and pharmacists at the hospital. That’s when I realized that pharmacy was intriguing—an ever-changing career path. I thought that learning about a multitude of drugs would come naturally, and be very interesting, plus I wanted to help patients.”
Hermes did two years of pre-pharmacy study at the University of the Incarnate Word in San Antonio, and in 2010 enrolled in UIW’s Feik School of Pharmacy.
"The way it’s structured at Feik—the block schedule helps alleviate some of the burden of overlapping class work,” says Hermes. "It seemed to work for most of the students. The students and faculty alike make it a great environment to learn in—that’s what I really enjoyed about it.
"All the classes worked well together. I had a particular interest in oncology. It was very rewarding learning how to treat cancer patients, and the evolving research pertaining to cancer is fascinating,” says Hermes, who graduated with her Pharm.D. in 2014.
Seeking employment in the slightly smaller market of Victoria, Hermes was able to get several immediate job offers.
"I applied to a number of retail stores, and I had an offer in Victoria, my home town,” says Hermes, who worked as a pharmacy technician at Walgreens while a student. "I also applied to DeTar Hospital in Victoria, because I felt a hospital setting would further my knowledge. I did have some retail experience, but I knew that the hospital would offer a different practice setting. It was not difficult for me to find a job in the Victoria area. I think the bigger cities are more bombarded by recent pharmacy graduates.”
As one of five clinical pharmacists at DeTar, Hermes works closely with physicians and nurse practitioners to ensure the best patient outcomes.
"In a typical day, we’ll review the efficacy of patients’ drug profiles, look at dosing, etc.,” says Hermes. "We also have an antibiotic stewardship program. By zeroing in on just the right antibiotic, were trying to minimize resistance to antibiotics to prevent super bugs. We may start on Vancomycin,
and then run cultures and try to pinpoint the precise antibiotic to use.”
We also have a program for automatic renal dosing that helps patients with kidney problems. There is quite a bit that we do that enables us to have a strong communication with physicians and nurse practitioners. And that helps build the trust to take our recommendations.”
"I’ve really enjoyed my first year at DeTar. I love the people who I work with. They’ve all been really helpful, and there is always something new to learn. They’ve supported me and helped to build my confidence,” says Hermes, who plans to remain a member of TPA.
"I plan to keep my TPA membership current,” she says. "I take advantage of the communications—the legislative updates are helpful. It helps me stay informed.”
Eric Ho got his first taste of pharmacy while working as a pharmacy technician at the MBS Pharmacy in Round Rock. That got him interested in the field, and in 2008, he enrolled at the University of Texas College of Pharmacy.
Ho found UT’s program to his liking, and enjoyed the challenge of learning new concepts and ideas. During that time, he became involved with TPA. He earned his Pharm.D. in 2012, and now sits on TPA’s Board of Directors.
"The pharmacy program [at UT] is very robust—you come out with a very strong understanding of how drugs work,” says Ho, who is TPA’s 2014 Distinguished Young Pharmacist award winner.
"I view pharmacy as a young field. Drugs are getting complicated, and drug therapy is getting more complicated,” says Ho. I was just very interested in seeing what I could do in a field that would be changing quite a bit over the course of my career.”
Always interested in technology, Ho created a system called JunoRX in 2010- a kiosk interface that allowed patients to scan a barcode to visit with a pharmacist through the kiosk for counselling.
He then went on to RxWiki- a high-tech company whose mission is to "create, expand and share the world’s medication knowledge in an understandable language for patients and consumers alike.”
"RxWiki is a digital media company that is looking to push pharmacy into the 21 century,” says Ho. "They specialize in content creation; distribution; mobile apps, website building and social media.”
Though Ho recently left RxWiki for Paragon Healthcare, Inc. in Dallas, he still serves as a business consultant for them. Paragon Healthcare is a specialty pharmacy, with a focus on infusion and specialty drugs. Paragon’s infusion therapy allows patients to receive IV at home instead of having to stay longer in a hospital. At Paragon, Ho works in corporate compliance, developing policies and making sure that pharmacies are in line with ACHC.
Ho’s rapidly evolving career reflects his view of pharmacy in general.
"There is so much left to do to bring healthcare into the 21st century but at the same time, this challenge represents a unique opportunity for pharmacists to take the reins and blaze new trails,” says Ho. "My passion is to develop expertise with leadership, innovation, and entrepreneurship to create disruption within the healthcare space.”
"There’s a lot of flexibility in pharmacy,” he adds. "You have a chance to make your career match your needs. I’ve met so many pharmacists who do so many different things. The sky is the limit. It’s very rewarding.”
To new practitioners entering the field, Ho has a number of suggestions.
"I think many of the more traditional pharmacy concepts are changing,” he says. "A lot of students come out of school and may not want to work for chains, but they [chains] are actually very innovative. The job market may not be as wide open as it was 10 years ago, but I think there are two sides to that coin. I think the market is making way for more an innovative kinds of practice. New practitioners will need to stay valuable and set themselves apart. Don’t get complacent. Don’t get tied up in a routine schedule with blinders on. Keep learning, stay involved, and grow as much as you can.”
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Caroline Nicole Hogg, The Woodlands Compounding Pharmacy
TPA welcomes new member Caroline Nicole Hogg! A native Texan who grew up in The Woodlands, Hogg had a taste of California before coming back home to work as a pharmacist.
Anxious to begin working as a pharmacist and seeking a fast track to her Pharm.D. degree, Hogg learned that the University of the Pacific’s Thomas J. Long School of Pharmacy and Health Sciences
offered an accelerated six-year program.
"It’s called ‘pre-pharmacy advantage’,” says Hogg. "It’s a unique program that allows you to get your prerequisites in three years, and then get your Pharm.D. in another three years. You must take certain prerequisites, maintain a certain GPA and then complete an interview and turn in a writing sample. Based on that, you’re pretty much assured entrance into the pharmacy school.
"In that program, you go to school in the summer. It was pretty difficult—you had to put in a number of hours interning in pharmacies and hospitals while taking your classes at the same time.”
In 2011, Hogg also started working at the Woodlands Compounding Pharmacy, first as a pharmacy technician, and later as an intern.
"I got my Pharm.D. in May 2014, as well as my R.Ph.,” says Hogg, who returned to The Woodlands and began working as a pharmacist.
"At one point I was also interested in ambulatory care. One of my rotations dealt with HIV patients, and I was interested in that because it had a lot of pharmacist-doctor-patient interaction.”
Fortunately, Hogg still enjoys that type of interaction at the Woodlands Compounding Pharmacy, where she’s a staff pharmacist.
"I have a lot of friends from school in California, but the job market is more saturated there, and I wanted to be back in Texas,” she says. "I got hired at the Woodlands Compounding Pharmacy in September 2014. I like it a lot—I know all the techs and pharmacists—we’re pretty close.
"I really, like the interaction with the patients. They’re very grateful for the time we spend with them and the service we provide. Sometimes, they are in a situation where nothing else works, but as a compounding pharmacy, we can often find a solution. We’ll contact their physicians and make suggestions. That kind of interaction is unique to compounding.
"We get to problem-solve a lot more. If a specific drug is not available, we have the ability to come up with patient-specific medications. As an independent pharmacy, we have a lot of patient interaction. Many times we have patients with questions. We talk to them about how the drug(s) they are prescribed work, and what results to expect.”
An Advocate at Heart
"I joined TPA after becoming a pharmacist last fall,” says Hogg. "My school engrained the idea of advocating for the profession. I recently e-mailed our state representatives in opposition of HB 1483! Also, I felt by joining TPA, I’d get to know more pharmacists. I’m definitely attending the conference in the Woodlands.”
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Clint Hopkins, Trilogy Pharmacy
When the practice of pharmacy began, the only way to obtain a medication was to have a pharmacist compound it.
That’s the setting Clint Hopkins, a Dallas-based pharmacist now works in, though he has experience in a number of other settings.
Hopkins started out attending Transylvania University in Lexington, KY, taking pre-med courses before transferring to the University of Kentucky to complete his undergraduate work. He later attended the University of Tennessee Health Science Center College of Pharmacy in Memphis, earning his Pharm.D. in 2007.
"I now have pharmacy licenses in 13 states” says Hopkins. "I did my rotations in Nashville and then worked at Target as a pharmacy manager and a district scheduler in Nashville. Target is a great place to work—I had a great patient population and I was part of the community. Nashville is still small enough so that everyone says, ‘Hey, that’s my pharmacist!’
But Hopkins’ career path took a "technology turn” when a preceptor from his P4 year recruited him for a position at Centennial Medical Center, the flagship hospital for Healthcare Corporation of America.
Like all practices of pharmacy, the "IT” or technology area affects patients—it’s just not as apparent.
"I was the Pharmacist Informatics Coordinator. I handled everything related to pharmacy in the computer for the hospital—all of the drug entries have to be built into the dictionary—making it compatible with E-Mar (where the nurses record meds) and other automation,” says Hopkins.
"It was very much an IT job. I had done some of that in pharmacy school, and I knew how automation and medication accuracy helped with patient safety. It also increases adherence. I wanted to expand my skill set, and I knew the experience would lead to consulting.”
Hopkins followed that with a staff pharmacist position at Walmart for two years, but that was not the career path he really wanted, so when an opportunity from Leidos Health arose in 2012, he took it.
"I worked with a hospital information health record system called Meditech,” says Hopkins. "My first contract was with a hospital in North Carolina. I was a senior consultant project manager, and I installed all of their automation. I also served as a trainer, getting pharmacists, physicians and nurses up to speed on Meditech and Omnicell (the dispensing cabinet). From there, I went to Toledo, Ohio where we installed McKesson Anesthesia Care and McKesson Horizon Surgery Manager (HSM). I then went back to Covenant Health in Tennessee, doing IT work as a consultant there for 2 years working with McKesson products.”
The experience was great, but Hopkins continued his search for the perfect practice setting, and found it when he was offered a position at Trilogy Pharmacy in Dallas in March of 2015.
"It’s a compounding pharmacy, and I’m the pharmacist in charge, handling all of the administrative tasks,” says Hopkins. "We are in the process of getting licensed in all 50 states—we’re up to 35 now. I supervise—the other pharmacists and the pharmacy technicians do most of the compounding.”
Compounding is wonderful—it’s a great thing for patients. For example, a patient can apply a transdermal pain cream and not have to take systemic medications like hydrocodone. In my opinion, Independent pharmacy is, bar-none, the best place to be for the best patient care and the best place for a pharmacist to work as far as working conditions and quality of life.”
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Jayme Johnston, who will be a P3 this fall at the University of Texas College of Pharmacy, did his undergraduate work at Baylor University, majoring in chemistry. But he wasn’t really sure that the lab life was for him, and after graduating a goodfriend of his who worked at a pharmacy said they had a need for a compounding technician.
"I knew nothing about pharmacy,” says Johnston. "So I went in and spoke with the owner. In 2006, he hired me on as a pharmacy technician with the understanding that I’d become a compounding technician. I worked there (the Glenview Professional Pharmacy in Fort Worth) for six years. I really loved it. I loved how I got to do something that not many people knew about and I could apply my chemistry education.”
Most of all, Johnston loved the problem-solving aspect of it. Patients would come in with unique needs, and he had a chance to look into how to best treat them.
"For example, a patient with allergies might require a medication without an inactive ingredient because they were allergic to it,” says Johnston. "The owner (Larry Cowan) was a mentor, and encouraged me to go to pharmacy school to further develop my potential.”
Johnston began as a P1 at the University of Texas College of Pharmacy in the fall of 2012.
"I’m learning so much more about pharmacy than I ever thought,” he says.
"I really enjoy the classes about drug-information and evidence-based practice, because they focus on how to find the answers to the problem that you’re facing—it teaches how to find the answer,” says Johnston. "We do exercises where they give you a mock-scenario where a patient comes in with a suspected overdose. So you have to research whether what they took could cause those symptoms, and analyzing it from the perspective of whether the medication could have caused the problem. You’re working with limited information— you research it, break it down analytically, and arrive at an informed professional opinion. Dr. Veronica Young, the course instructor, helps us to learn how to reach those informed opinions, rather than guess-work.”
In addition to being a member of TPA, Johnston is a member of APHA-ASP (Academy of Student Pharmacists), and is also the student affairs representative at UT.
Johnston, who is also President elect RHO CHI Honor Society, is optimistic about his job prospects when he graduates in 2016.
"Pharmacy advocates have done an excellent job of carving out areas for us to work in,” he says. "There are so many different varied opportunities that I’m excited about. I’m currently leaning towards infectious diseases. There are a plethora of new drugs that work in novel ways and they have different efficacies and side-effects.”
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Anne Jones, P3 at University of Texas School of Pharmacy
It’s not especially common to like organic chemistry—one of the more difficult premed courses—but Anne Jones, a P3 at the University of Texas College ofPharmacy does. In fact, organic chemistry played a role in her decision to pursue pharmacy.
"I was always interested in healthcare,” says Jones. "When I was pursuing premed as a junior I was taking organic chemistry, and I really liked it. I knew that was part of pharmacy, and that’s what got me thinking about pharmacy.”
One Fast Pharmacist
While earning a Bachelor of Arts in Biology (2012), and as a P1 at UT’s College of Pharmacy, Jones competed for the Longhorns in track and cross country. In fact, you may recognize Jones in the magazine rack at your local H-E-B, CVS, or Walgreens this month. A competitive runner, Jones made the cover of the April 2015 issue of Runner’s World magazine (see picture at right). Runner's World did a piece on Austin this month, and chose Anne for the cover.
As a P1 she competed at the national cross country championships in Louisville, Kentucky. On the track, she’s most proud of her 1,500 time—a 4:32, which equates to around a 4:49 mile!
Jones went on to join Rogue Athletic Club in Austin, where she’s keeping her running career alive.
"If you apply the concepts I’ve learned in running training to patient care, you see some similarities. Each athlete does not respond the same to the same stimuli mentally and physically, just as patients vary in their responses,” says Jones. "Overall, competing for UT and being part of the track and cross country teams was a great experience. You learn a lot of things you don’t even realize you’re learning: time management; teamwork; performing under pressure; and communication with a variety of people. It was challenging, and at times I felt like I was a little behind the curve. But I’m happy I took the path I did—those intangible skills are harder to come by.”
Currently a P3, Jones enjoys pharmacotherapeutics, and is looking to a future in infectious diseases.
"It (pharmacotherapeutics) focuses on the disease states, and how pharmacy applies to each one—here’s the disease state, and here are the options,” says Jones. "It’s really the core of pharmacy. And because different professors teach different areas within pharmacotherapy you have a variety of perspectives. During our P2 year in pharmacotherapeutics, we focused on infectious diseases. I thought that was really fascinating. You’d examine different disease states and learn the most common causes, and what drug classes might apply in treatment.”
When Jones enters her P4 next year she plans to do her rotations in Houston.
"As a pharmacist, I’m looking to get into clinical pharmacy and infectious diseases,” says Jones. "I‘m particularly interested in the rise of resistance to anti-microbial agents—a growing threat to the U.S. healthcare system. When anti-biotics are used indiscriminately, various bacteria develop resistances. We’re seeing more and more of this, so there’s a growing role for pharmacy in that area, both to help counsel patients on how to take drugs appropriately, and to help doctors make clinical decisions on which drugs to choose in the first place. I feel like that will have a big impact on patients and healthcare in general.”
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Lisa Killam-Worrall, PharmD, BCPS (Denton)
Lisa Killam-Worrall began her career in pharmacy as a pharmacy technician. After earning her biology degree at the University of North Texas, she decided to go to pharmacy school and enrolled in the College of Pharmacy at the University ofTexas.
"I originally went to pharmacy school thinking that I would become a community pharmacist,” says Killam-Worrall. "But during my first week, I changed my mind and decided to see what other career paths were open.”
Killam-Worrall sensed that healthcare was going to change, and decided to pursue pharmacy from a patient-care perspective. To be more involved in the decisions of patient care rather than just dispensing, she did her residency at Scott and White Memorial in Temple, specializing in drug information—answering questions about diseases and medication therapy.
Her first position involved helping with drug information at a large hospital in Omaha, Nebraska.
"I had an opportunity to serve as a preceptor and as an adjunct professor at the University of Nebraska. I liked it a lot and wanted to teach more, but working for the hospital curtailed that,” says Killam-Worrall.
Seeking a job where she could teach more, Killam-Worrall took a position at Texas A&M as the Assistant Professor of Pharmacy Practice and Director of Drug Information, and in June 2012 began working for UNT, where she’s now Assistant Dean for Experiential Education and Associate Professor, University of North Texas System.
"It was a growth opportunity,” says Killam-Worrall. "I always hoped that UNT would start a pharmacy school and that I could be involved.
Killam-Worrall is responsible for the experiential component of the program, and as such, plans what experiences P1-P4 students will have. Additionally, she makes the contacts for the volunteer preceptor faculty.
As a preceptor, her role is to see what students have learned and how they are going to apply that information in the experience.
"At times, I’ll go through the process with students step-by-step and they will observe me,” says Killam-Worrall. "As a drug information specialist, that would involve talking to the person who requested the information, and getting to the heart of the question. Sometimes you’ll need to ask a patient more questions to get to bottom of what they want to know.”
"I encourage students to keep an open mind, to study hard, and to be able to use the information that they learned in class for patient care. I think students need to be willing to take charge of their education and not rely solely on the preceptor to provide all of the instruction—it’s different being in a practice setting versus the class-room setting.”
Catch Lisa Killam-Worrall at the 2014 TPA Conference & Expo. She’ll be one of the presenters for the "Preceptor: TCEP Nuts & Bolts, Student Assessment, Case Scenarios, & the Rubric & TCEP Preceptor Toolkit” session, which begins at 8:00 a.m., Saturday, August 2.
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Jason Kurien, University of the Incarnate Word Feik School of Pharmacy
Jason Kurien, who will be a P2 student at the University of the Incarnate Word Feik School of Pharmacy next fall, already has his sights set on opening up an independent pharmacy someday. But first things first, as in earning his Pharm.D.
As a high school student at RL Turner High School in Carrolton, Kurien became interested in pharmacy because he liked the idea of helping people.
"Medicine can change people’s lives,” says Kurien. "My mom is a nurse—that may have played a role in my choosing pharmacy. I worked hard in science and math. It took a lot to get to where I am right now.”
Kurien double-majored in biology and biomedical science at Texas A&M in Kingsville, and minored in chemistry and psychology.
"I considered going to Texas A&M University Health Science Center Rangel College of Pharmacy, but wanted to move to a bigger city, so I chose the University of the Incarnate Word Feik School of Pharmacy in San Antonio.”
"My P1 year was pretty intense,” says Kurien. "Bio-chemistry was challenging, as was pharmaceutics—calculating how drugs work and how they are developed. I had to get used to the whole structure of the school, but it was a good experience.”
"The ‘block schedule’ also took some getting used to,” adds Kurien. "You have to learn to prioritize your time. The classes are very in depth—much more so than undergraduate classes. You can’t be afraid to ask professors for help. Part of the whole experience is learning how to handle the workload. It’s all about dedication: If it’s what you want, you’ll put the work into it. I’m enjoying it a lot now and I have a better grasp and know who to study with. Feik has a good community—everyone helps each other. It’s a relatively small group, which I think is better.”
Kurien, who is the recipient of the 2015 James Gee Memorial Scholarship, has also been working as a pharmacy technician at Walmart while attending school.
"I got my pharmacy technician certification in 2009,” he says. "I feel like working as a technician builds your responsibility. They throw a lot at you. We have to handle the drive-through and ring up customers inside—there’s a lot to keep up with or you’ll fall behind. Like being a P1 student, you have to learn to manage your time.”
"It’s [being a pharmacy technician] a great experience to have while going to pharmacy school,” says Kurien. "You become more acquainted with the drugs on the market. Additionally, it helps your ability to communicate with patients. I feel like every experience you have in the field can contribute to your skill as a pharmacist, and increase your confidence.”
Two summer ago, Kurien volunteered at an independent store in Carrollton called Express Pharmacy, and knew he’d found his area of practice.
"I was able to see how the pharmacist who owned the store built one-on one relationships,” says Kurien. "He had just opened up the pharmacy. That’s what I really want to do in the future—open up my own independent pharmacy, and see how I can better help patients.”
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Not many people know what they want to choose for a career before middle school, but Sydney Kutter did.
"I made up my mind to be a pharmacist in 6th grade,” says Kutter, a 2014 TPFScholarship winner. "I knew I liked math and science, and did not want to be a doctor. I wanted something with more flexibility. I wanted something where you deal with people all the time, but not necessarily at a ‘bodily’ level.”
Kutter developed a good foundation in math, chemistry and the sciences at Harding University in Arkansas, and after graduating in the spring of 2013 with a Pharmaceutical Management degree, enrolled at Texas Tech University Health Sciences Center School of Pharmacy in Abilene.
"I did a project in college—kind of a term paper comparing community, independent and chain pharmacies,” says Kutter. "I talked to a lot of pharmacists in the community. It was great talking with people in so many different aspects of pharmacy.”
Kutter, who will be a P2 this fall, couldn’t be happier with her choice of schools.
"I love Texas Tech,” she says. "One of the reasons I chose it is because it’s very clinically-based and you get so much experience compared to other schools. We start rotations in our third year (P3). You learn so much actually being on rotation and encountering what you are going to experience the rest of your life. I can’t imagine graduating without that experience.”
Another aspect of campus life Kutter enjoys is the camaraderie.
"It’s [the pharmacy class] a very close-knit group,” she says. "The class is about 160, with only about 40 in Abilene. I can go to classrooms any time I want and ask for help. I like that it’s so small.”
Like many pharmacy students, Kutter finds the program rigorous, but fascinating.
"The hardest classes so far have been anatomy and physiology. The cardiology section was super interesting,” she says.
Building relationships, and looking to mentors is an important part of the developmental experience, and Kutter has found a number of great professors at Texas Tech.
"There are a couple teachers I know I can go to any time with questions,” she says. "Dr. Miller is like the ‘dad’ of our class, because he had a daughter go through pharmacy school at TTUHSC. He’s challenging, but never too much so. He knows that not only are we studying pharmacy, but we need a social life as well. I recall being disappointed about one test grade, and he comforted me, saying that it was only one test, and that I’d be OK. He know it’s important not to be stressed out. He’s really good at helping us cope with everything.”
Looking to the future, Kutter sees herself taking on a role in independent pharmacy.
"I’ve always been interested in independent pharmacy,” she says. "I’ve always kind of had a business mind. I like the idea of pharmacists knowing their patients, and caring about people. I hope to do something like that. In independent pharmacy I think you have more time to get to know people.”
"I absolutely plan on being a member of TPA after graduating. I’m so glad I attended the conference. The way pharmacy is headed there are so many more opportunities than 20 years ago. I loved getting to know all the different pharmacists and learning more about the profession, and about being a leader. And I’m excited to watch how provider status progresses.”
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Scott Lason grew up in Norman, Oklahoma, and worked at a Treasury Drug store during high school. After high school, Lason earned a BS in math from theUniversity of Oklahoma, and from there, went on to the University of Oklahoma Health Science Center College of Pharmacy where he earned a BS in Pharmacy in 1990.
"At Treasury Drug [during high school], I became a pharmacy technician, and progressed through different positions,” says Lason. "At that point I realized I was leaning towards pharmacy as a career. But I needed to mature a bit. That’s why I earned a BS in math first. Now you have more and more students who get a full four-year degree first. It’s very rigorous to get into pharmacy school.”
Lason later became an intern at Treasury Drug, which at the time was owned by JC Penny, and later Eckerd’s. In 2004, CVS purchased Eckerd’s.
After graduating Oklahoma Health Science Center College of Pharmacy with a BS in Pharmacy in 1990, Lason moved to Kansas City where he took a district support role.
"At that time, there were probably about 34 stores in the Kansas City market,” says Lason. "In 1991, the store manager/pharmacy manager position became available at the highest volume pharmacy store in Kansas City, and I took it. I loved it—it was challenging, but a lot of fun.”
From there, Lason’s career continued to move ahead. In 1998 he was offered a district pharmacy supervisor position in the DFW area with Eckerd’s, and in 2002 was promoted to District Manager. When CVS purchased Eckerd’s in 2004, Lason became Manager, Professional and College Relations at CVS Caremark in 2005.
"There are 12 people in the company who do what I do,” says Lason. "I work very closely with the college of pharmacy deans, and I’m involved with preceptor development, as well as developing interns into future pharmacy managers. I work with the pharmacy schools in the five-state region (Texas, Oklahoma, Louisiana Mississippi and Arkansas). There are a total of 15 colleges of pharmacy and 24 campuses in those states. Additionally, I work with 40 District Pharmacy Supervisors helping to support them in their recruiting and intern responsibilities. I’m also the ambassador for the Texas State Board of Pharmacy.”
Lason’s career path did a great job preparing him for his current role—he’s one of the most knowledgeable people in Texas concerning the pharmacy job market.
"From 1998-2010, there was quite a pharmacist shortage, so as a result I was very involved in recruiting and being engaged with interns,” says Lason. "I remember early on, pharmacists had to take the MPJE law review test in a live setting (now it’s offered online). I’d hand out my business card to folks as they went in to take their test. That worked out quite well—I was very successful in staffing positions.”
Lason notes that in Texas, the arrival of new pharmacy schools like Texas Tech (Abilene campus), Texas A&M and University of the Incarnate Word helped alleviate the pharmacist shortage.
"There have probably been about 30 pharmacy schools that have opened up nation-wide in the past 10 years,” says Lason. "The pharmacist shortage started to subside about four to five years ago. Currently, I’d say the supply is equaling the demand in general.”
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Kelley Lavallais, Strawberry Family Drug & Pharmacy (Pasadena)
While most pharmacy students don’t do any rotations until their P3 or P4 years, Kelley Lavallais had a special opportunity in high school.
“I attended Michael E. DeBakey High School for Health Professions. During 10th grade we had a rotation where we could learn about different health careers,” says Lavallais. “I did a pharmacy rotation at Memorial Hermann Hospital. I found I liked the interaction between the different health professionals, being knowledgeable and helping the patients. And of course I was proud to have a job at the hospital versus a fast food place!”
Following high school, Lavallais initially studied mortuary sciences at Commonwealth College for Funeral Services. Not surprisingly, she found she wanted something with a little more social aspect.
“I spent a year there, but I wanted more interaction with people,” says Lavallais, who then enrolled in Texas Southern University College of Pharmacy and Health Sciences.
Lavallais received her BS in Pharmacy from TSU College of Pharmacy and Health Sciences in 1993.
“At that time I was working at Spring Branch Hospital and Houston Methodist Hospital as a pharmacy technician.
The hospital practice setting appealed to me,” says Lavallais.
However, around 1998, after having her first child, Lavallais’ career path took a different turn.
“I had started filling in Eckerd’s, and around that time, a fellow named James 'Bricky' Hills from an independent pharmacy named Lava Rock Pharmacy called and asked if I could fill in. I was on maternity leave, but he said, ‘bring the baby with you!’ The pharmacy was inside a clinic.”
At Lava Rock, Lavallais was able to use her clinical expertise, and enjoyed the position. Hills had another pharmacy location, and when it became available for sale in 2002, Lavallais went for it.
“Back then, TPA had a credit card program for members, and I used mine for the initial down payment,” says Lavallais.
“The business was about $400,000 and I maxed out the credit card to $100,000. I could have just bought the pharmacy, but I bought the building and the pharmacy.”
Although Lavallais did not know that much about running a pharmacy,” she knew she wanted to make it work. Naming it Strawberry Family Drug & Pharmacy, Lavallais completely renovated the building.
“It was trial by fire, but the community was very receptive,” says Lavallais. “I treated people right, and I did a lot of marketing. I had signs made up for my SUV and delivered prescriptions. And we offered flu shots.”
Lavallais saw her customer base grow, but around 2009-10 the industry started changing.
“It got more competitive,” she says. “The large chains began offering vaccinations, and incentives. I had to do aggressive marketing and improve my skills. I began offering other products like diabetic shoes and durable medical equipment—I diversified. The market is forever changing, but with change comes opportunity. Currently,
I’m considering offering home infusion as a specialty service.”
Never one to rest on her laurels, Lavallais continues to build on her skills and education.
“Buying Strawberry Family Drug & Pharmacy was the right decision,” she says. “I’ll graduate this year from Texas Women’s University with an Executive Masters in Business Administration. I think that it will solidify my business sense, and enable me to do the best I can.”
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Debra Lopez, Pharm.D., CDE, BCACP, BCPS
After briefly considering a career as a chiropractor, Debra Lopez chose pharmacy, a choice that offered her a variety of possible settings.
"Growing up in Corpus Christi, my uncle was an independent pharmacy owner. He was actually very active with TPA,” says Lopez, a longtime TPA member herself. "I knew I wanted to get into healthcare, but did not know what area. My uncle highly recommended I give pharmacy a shot.”
After graduating from Texas A & M, with a degree (BS) in bio-medical science in 1994, Lopez enrolled in the University of Texas College of Pharmacy, and earned her Pharm.D. in May of 1999.
Lopez first got the inclination to teach while doing her residency in ambulatory care at Blackstock Family Practice where she ran a pharmacist-managed clinic.
"That had teaching components in it, so that’s where I first starting thinking about academia,” says Lopez.
In 2,000, Lopez began as Clinical Assistant Professor in the division of Health Outcomes and Pharmacy Practice at UT, and also continued working at the Blackstock Family Practice.
"I was at the practice site for two days a week running a residency and rotation program, and three days a week I was teaching at the UT College of Pharmacy,” she says.
Most recently Lopez taught Non-Prescription Therapeutics where she focused on diabetes maintenance and smoking cessation, as well as Pharmacotherapy in Special Populations, where she taught genomics.
"Pharmacogenomics looks at genetics and drug responses in patients,” says Lopez. "For example with Warfarin, an anticoagulant drug, doses vary with different populations depending on their genetic background. Doses can be tailored to a person’s genetic makeup.”
As the residency director/preceptor at Blackstock, she provided a post graduate-year 2 residency in ambulatory care and a rotational site for Pharm.D. students.
"It’s been great—I like to teach, and as a preceptor, you get to do it in a practice setting,” says Lopez. "You show students how to apply their clinical skills in an outpatient setting.”
"Working at both Blackstock and UT simultaneously required a lot of organization and planning,” she says. "But it worked. I liked the variety of the two different settings—healthcare providers and academia. Plus, the real-world examples were helpful in my teaching.”
This past January, Lopez started a new career— she is now a Regional Medical Liaison for the cardiovascular team for Sanofi, a global pharmaceutical company.
"I’ve always been kind of curious about the industry side of pharmacy,” says Lopez, who retains her relationship with UT with an "adjunct” title and still helps with student rotations. "I’d been in academia for a long time and was ready for a new adventure.”
In her new role, Lopez is covering Austin and San Antonio, working with physicians on pre-clinical drug trials.
"Right now I’m working on pre-clinical trials for a drug in the cardiovascular area. I have research sites in physicians’ office, and I can help them with questions about the drug. Many of these physicians are involved in research.”
As the medical liaison, Lopez gives physicians a thorough background on the new drugs, and helps them as they perform the trials.
"These are what’s known as "stage 3” trials,” says Lopez. "At this point, they are getting fairly close to FDA approval. It’s pretty exciting really; you’re still helping with the patients indirectly by giving knowledge to the physicians.”
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Cindy Luu grew up in Midland, where she attended Midland Lee High School. There, she developed a budding interest in healthcare, and shadowed her older sister Lan, who was already working as a pharmacist at a hospital.
"Watching pharmacists in their jobs, I got to see how everything actually worked,” says Luu.
Luu’s journey toward becoming a pharmacist began with courses at the University of North Texas, where she was able to get a lot of her prerequisites checked off, and by the time she enrolled at the University of Texas (Austin) in 2003, she only needed one year of undergraduate work before starting as a P1 at the UT College of Pharmacy in 2004.
"I really liked UT,” says Luu. "The professors are very distinguished. It was challenging, but in a good way. The pharmacy classes are not that large, so I was able to form study groups, join professional organizations, and network. That’s how I became involved in TPA.
While at UT, Luu joined the APhA Academy of Student Pharmacists, which included TPA, and has been a member since then.
"I went to my first TPA conference as a P2,” says Luu, who was on TPA’s public policy council from 2012 to 2014. "It was really good. As a student, it’s great meeting students from other schools.”
During fourth-year rotations, Luu was able to experience all types of pharmacy and became interested in ambulatory care. She graduated early, earning her Pharm.D. in 2008, and followed that with a year of residency at Kelsey Seybold Clinic in Houston.
Following her instincts, she landed a job as a pharmacist specializing in ambulatory care and clinical pharmacy at CommUnity Care in Austin in 2009.
"I worked for CommUnity Care for five years,” says Luu. "It’s a federally funded clinic. We did disease state management, focusing on diabetes. The physicians at Community Care would see the patients, and then we (pharmacists) had 30-minute educational time slots to help counsel them—charting and adjusting medications. It was a good experience. We also worked with Debbie Lopez (Clinical Associate Professor in the division of Health Outcomes and Pharmacy Practice at UT), placing residency students from UT.”
At that time, Luu was also involved in administration. "We had a lot going on in terms of different projects,” she says. "So I also helped manage the formularies.” (A drug formulary is a list of prescription drugs, both generic and brand name, that are preferred by consumers’ health plans.)
Last April, that experience led Luu to her current position as clinical pharmacist at US Script in Houston, a pharmacy benefit manager (PBM) dedicated to providing better health outcomes at lower costs.
"After five years, I was interested in the formulary side of things,” she says. "My interests were changing and I felt I need to grow.”
As a clinical pharmacist at US Script, Luu conducts reviews on various drugs and makes a decision on whether she can approve them so they can be covered by various health plans.
"There are now seven pharmacists at the Houston location, and we’re growing quickly,” says Luu. "Our clients are health plan companies. They are ultimately the ones deciding what gets covered and what does not. I feel that we help facilitate the healthcare system. The goal is to deliver effective care in a cost-effective way. In my role, I’m able to see a lot of different types of drugs, so there’s a lot of research and information. It’s fascinating to see what types of drugs are coming out.”
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David Maize, Associate Dean, Academic Affairs and Professor, Pharmaceutical Sciences - University of the Incarnate Word Feik School of Pharmacy
It’s not surprising that Dr. David Maize chose a career teaching pharmacy. Maize, the Associate Dean, Academic Affairs and Professor, Pharmaceutical Sciences at the University of the Incarnate Word’s Feik School of Pharmacy, has a background tailor-made for a future in healthcare academia.
"I always loved chemistry and I come from a family of teachers,” says Maize. "Originally, I wanted to become a high school chemistry teacher, but ultimately decided to pursue pharmacy.
Maize, originally from Stoystown, Pennsylvania, received his bachelor’s in pharmacy from Duquesne University (Pittsburgh, PA) in 1991. He then went on to West Virginia University and received his PhD. in Pharmacology/Toxicology in 1996.
"I really enjoyed my time at Duquesne,” says Maize. "And West Virginia has a huge medical center—I had lots of opportunities there.”
At West Virginia, Maizefocused on pulmonary pharmacology, and earned his doctorate studying how ozone affects people’s breathing capacity.
"I did my dissertation on the effects of ozone on the lungs,” says Maize. "One thing I saw was that there were higher incidences of emergency room asthma visits on sunny days (where ozone levels are higher). "That’s why now you hear the term "Ozone Action” day. In simple terms, I learned that that we have an enzyme in our lungs that protects us from "over-contraction,” and that ozone inactivates the enzyme that breaks down acetylcholine, thus rendering people more vulnerable to breathing problems.”
Before coming to San Antonio to teach at Feik, Maize worked in a community pharmacy, two grocery chains, and also worked for CVS for close to 15 years.
Maize joined the staff at Feik School of Pharmacy 10 years ago, and continued to work at CVS on a part-time basis for about seven years after starting at Incarnate Word.
"I really love practicing pharmacy,” he says. "The increase in prescription volume took some of the fun out of it, and not practicing full-time, it became more difficult to keep up with the drugs. In today’s reality, you need specialists keeping up with all of the new drugs, and pharmacists are those specialists.”
At Feik School of Pharmacy, Maize’s teaching duties include pharmacology, anatomy and physiology. Additionally, he is a brother of Kappa Psi Pharmaceutical Fraternity and is the co-advisor for the school’s chapter—in 2011 he was named the top advisor in the country.
"The thing that I try to stress to my students is that pharmacy school is not about grades,” says Maize. "It’s about acquiring the knowledge to treat and help people. So my students should have the moral obligation to learn as much as they can in order to treat patients effectively. If that earns them an "A”, then great. Being a pharmacist is a life-long process in education. Every patient encounter could be something new.”
Maize has also offered numerous continuing education programs in HIV prevention, and considers HIV education an important priority in today’s environment.
"Certainly we’ve come a long way in HIV drug therapy,” says Maize. "Today, you can look at HIV as a long term condition. While the number of deaths is dropping, sadly, the rates of new infections are not. This is because treatment has gone from multiple drugs in multiple pills to multiples drugs is a single pill. This has made treatment much easier for a patient. The idea of a once-a-day drug with long term survival has caused people to lower their guard concerning HIV transmission.”
As a specialist in pulmonary pharmacology, Maize is also an expert on smoking cessation, and offers us a brief primer on the nature of tobacco addiction.
"Nicotine is a very lethal poison that was once used to kill people during medieval times,” he says. "High doses cause respiratory paralysis. But it’s highly nauseating, so that in some ways helps prevent toxic doses while smoking. When I teach smoking cessation, I let people know that nicotine is as addictive as heroin or cocaine. The body clears it out rapidly, but builds up a tolerance during the course of the day. So when a person wakes up, the craving is full force. That’s why the morning hours are the most difficult for folks who are trying to quit. Unlike alcohol addiction, you can stop nicotine addiction cold turkey, and I believe that’s the best way, Becoming cognizant of the triggers is the key. To make the cravings a little easier, pharmacists are a source of good advice on nicotine replacement therapy.”
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Dorinda R. Martin-Dripping Springs Pharmacy, Lamar Plaza Pharmacy,
and Lake Hills Pharmacy
As a senior in high school, Dorinda R. Martin took a part-time job at Gibson’s Pharmacy in Denison, TX. It was a job that would change her life’s career path.
She kept the job while attending nearby Grayson College, and listened to some advice from the pharmacy’s owner.
"I was going to be an English teacher,” says Martin. "The owner recognized that I loved pharmacy and told me I should go to pharmacy school. I realized he was right, and basically started over—it was a lot of work to catch up.”
Martin was subsequently accepted at Southwestern Oklahoma State University School of Pharmacy in Weatherford, Oklahoma and earned her Bachelor’s degree in pharmacy.
After a brief stint at a K-Mart Pharmacy, she ended up buying the two Gibson stores in Sherman and Denison with business partner Milton Chapman.
"We ran those for 12 years, and then sold the stores to a company that merged with Omnicare,” says Martin.
"I became a branch manager with Omnicare, and later director of clinical services. I was there for another 12 years.”
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Martin’s husband Jim, who was CEO of TPA from 2000 to 2009, is also a pharmacist, and they wanted to get back in to independent pharmacy. The Martins now own three Austin-area stores: Dripping Springs Pharmacy, which they bought in 2005, Lamar Plaza Pharmacy (2009), and the recently opened Lake Hills Pharmacy. All three are part of Martins Compounding and Wellness Pharmacy group.
Members of the Lake Hills Pharmacy team (l-r) Marvin Mead, Jobby John, Pharm.D., Tracy Strandhagen, MD, and Carl Schmidt, ND
From our first store (Dripping Springs), it’s been very successful,” says Martin. "There now is a Walgreens, CVS and HEB in Dripping Springs, but we offer delivery, compounding, diabetic education and shoe fitting, and immunizations (at all three stores).”
Additionally, each store has a wellness department that is staffed with certified nutritionists, naturopaths, and acupuncturist. The Lake Hills store also has an MD focusing on integrative medicine.
"Most pharmacists have not been trained to know about herbals or supplements,” says Martin. "We have a huge line of supplements. We’ve found it really helps if a patient comes in with a disease state and a naturopath can show them a supplement that may address the underlying cause instead of masking symptoms. To get the word out, we have a radio show called the Wellness Connection every Sunday on Austin’s 1370 Talk radio. Two of our wellness consultants host that show.”
Martin notes that women are often not given all the options for hormone therapy, and she has taken steps at her pharmacies to offer choices.
"We like to take a bio-identical approach,” she says. "For example, recommending a non-synthetic form of estrogen—one that can be applied topically. We also offer therapy for men. It’s better to supplement with products that match what our bodies endogenously produce.”
Looking to the future, Martin, who served as TPA president from 2011-2012, sees many challenges for pharmacy, but many opportunities as well.
"We [pharmacy] are just coming into our own,” says Martin. Three things I see: 1. "I think that obtaining healthcare provider status will be a huge shot in the arm (no pun intended). 2. I think that as America realizes what benefits of treatment and prevention that customized medicine (compounding) can do, they will demand that these benefits be provided by their insurance. And lastly, there is the opportunity to shine with the CMS STAR Ratings. Every pharmacist should know their STAR ratings and take every opportunity to improve it. Our future is bright!
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Bradley Miller, Pharmacy Technician Operations Supervisor, UMCB (Austin)
Bradley Miller has been a pharmacy technician with the University Medical Center at Brackenridge (UMCB) in Austin, TX for 34 years, and it’s a career he takes great pride in.
"When I was in high school in Austin (Austin High School), I knew I wanted to get into something in the medical field, but I just wasn’t sure what. An ad for volunteers for Brackenridge Hospital caught my eye," says Miller.
That ad changed Miller’s life. He headed down to the hospital that weekend, initially interested in volunteering for the dentist branch.
"When I visited Brackenridge, the dentist was not available, so I checked out the pharmacy," says Miller. "The rest, as they say, is history. The pharmacists showed me the ropes and I really enjoyed it so I kept going back on Saturdays. As a volunteer, I learned a variety of things, including how to package medication. Karen Maxwell, the assistant director, called me the next year, and asked me if I’d like to work at the pharmacy as a paid employee that summer (1979). The following summer (1980) I came back, and have been here ever since. Initially I worked only weekends.”
As the Pharmacy Technician Operations Supervisor at Brackenridge, Miller is the go-to-guy when pharmacists and pharmacy techs have questions about running the pharmacy, "in part because I’ve been there so long,” he says. "We have a great working environment here.”
Miller especially enjoys the "people” part of his job—interviewing new pharmacy technicians looking into getting hired.
"I ask a variety of "situational” questions,” he says. "Some places hire based solely on experience, but I look at things like attention to detail, and how long they’ve stayed at jobs. I get 50-100 applicants for every fulltime position that’s open, so I conduct phone interviews to screen first. Once a person comes in for an interview, I size them up by their dress, and their character: Are they energetic? Do they communicate well? When they respond to me, where do they look? I look for eagerness, and I expect them to ask questions.”
Once hired, on-the-job hands-on training is an important aspect of preparing a pharmacy technician.
"We have 26 techs here, and I have a handful of techs who are good instructors, so I have those help new techs learn a particular area,” says Miller. "Some are going to pharmacy school at the University of Texas, and three of those are currently part of an intern program with UT.
Texas State Board of Pharmacy
Miller, the first pharmacy technician to serve on the Texas State Board of Pharmacy, just finished serving his first year of a six-year term.
"Senator Leticia Van de Putte helped push the legislation through allowing pharmacy techs to serve on the state board,” says Miller. "It’s an honor to have been appointed. The other members of the board are exceptional in their fields.”
Miller commented that there will be changes regarding pharmacy technicians going forward. "By September 2015, any pharmacy technician involved in preparing IVs has to be ACPE-accredited in IV’s,” he says. "We’ve also been talking about the pharmacist-to-pharmacy technician ratio again. There was a lot of discussion as to whether to raise it, lower it, or keep it the same. The bottom line is that we want to ensure that every prescription is filled correctly.”
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Harriet Monsell, The Medicine Shoppe
TPA may not offer a dating service for pharmacists, but you never know who you may meet at a TPA event. Just ask Harriet Monsell.
She was moderating a TPA seminar in 1993 in Waco, and Toby Young (a former Bowl of Hygeia award winner) was attending. They started dating shortly after the seminar and were married in 1995, and now own and operate the Medicine Shoppe in Belton.
"Toby has had the Medicine Shoppe location in Belton since 1984, so were coming up on our 30th anniversary,” says Monsell. "He was one of the first area pharmacists who would work with AIDs patients.”
Monsell, who graduated from the University of Texas College of Pharmacy in 1977, worked for Eckerd’s until 1991, and later worked for nursing homes, filling & consulting.
Her desire to be a pharmacist stems from the sincerest of motivations.
"I wanted to help people. My mom had a good friend who graduated from pharmacy school in 1945, and it seemed like a secure career,” says Monsell. "I liked the course work—I am still learning. So many people look at it [being a pharmacist] as just a job— but I look at it as a profession.”
The Medicine Shoppe is a franchise, so owners can customize their locations, tailoring them to their own design, and catering to specific niches.
"We do compounding; immunization; hormone counseling; and herbal products,” says Monsell. "I love the herbal products. Herbals will work, but they take time, and they can play a preventative role. We offer counseling on herbal products—focusing on prevention and wellness—that’s what will help the healthcare cost in this country. For example, we had a postman who wanted his cholesterol down. We advised him to try red yeast rice and flaxseed oil, along with diet and exercise. And he got his numbers right. I took a nutrition course in pharmacy school, so I can also recommend vitamins. TPA actually had an herbal-certification course at one point.”
Monsell says that compounding and wellness are the Medicine Shoppe’s strength.
"You’d think it would be harder for us to be profitable in Belton, but we are completely different from any other pharmacy. Prevention and wellness are what make us different. We know our customers’ names and we try to solve problems—not just getting the data, but looking at our patients. It’s that one-on-one that makes us different.”
And that’s where Monsell’s job satisfaction comes in. Knowing the people, helping them and having them thank you.
"Pharmacists, by nature, are problem solvers,” she says. "We want to help people, and we want to find out what works for them, because everyone is very different. You can’t take a cookie-cutter approach, especially concerning geriatric patients. We’re able to help the patients assess what’s going on and give them a game plan. We get paid in cash for our consulting.”
Like many in the profession, her favorite aspect of pharmacy is "Being able to help people. Knowing you made a difference.”
"That gives me job satisfaction,” says Monsell. "We hear about how patients benefited, and you get to know people in the community.”
With the Fort Hood Army base nearby, the Medicine Shoppe does a lot of prescriptions for military.
"So we help the troops,” says Monsell. "Belton is a nice community. You’re three hours from Houston, one form Austin, and three from Dallas.”
Although Medicine Shoppe is successful Monsell is an active political advocate, and observes that there’s very little support from most pharmacists today.
Advocacy is Key
"We really need to stick together,” she says. "There are a lot of forces who don’t think we are important. Reimbursement fees have gone down, and I’m sure there are insurance companies that want it all to be automated.”
"So many doctors’ offices and nurse practitioners rely just on computers for proper drug dosages and medications, when pharmacists should be involved. Computers don’t know the nuances. I’d like to see a network of pharmacists who can do in-depth counseling, so we can position ourselves with accountable care organizations (ACOs). Then we would establish our clinical expertise and get paid for our services. We have a lot to do. It’s going to take all of us working together.
I’m talking about advocacy— using pharmacists for their proper roles—talking to the patients, making sure they are taking their medicine properly—you know, the five ‘rights’: Right medication; right dose, right patient, right time, and right route.”
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Warren Moody, Jr., Kroger Pharmacy (Houston)
Warren Moody remembers getting interested in pharmacy back when he was in high school in Marshall.
"I was working in a drug store called Jack Kerr’s Pharmacy doing delivery,” recallsMoody. "I had asthma, and when I told the pharmacist, he offered me Tedral, an over-the-counter medication, which worked well for me. His practice was interesting—and I enjoyed making deliveries in his [the owner’s] Jeep. He encouraged me to pursue pharmacy as a career.”
Moody took the advice to heart, and applied to Texas Southern University College of Pharmacy and Health Sciences.
"My parents were very excited—I was the first in our family to attend college,” says Moody.
"It was a five-year program to earn your BS in pharmacy. I enjoyed the prestige of being in the program—other students at TSU looked up to us.”
At that time, TSU pharmacy students were required to accumulate 1,000 hours of student practice. Moody initially tried a retail setting, but when an opportunity at St. Joseph’s Hospital (Houston) opened up, he decided to try that.
"I did what was called an apprenticeship at St. Joseph’s—on the job training,” says Moody. "It was a paid position. That was in 1964. I ended working there until I graduated. It was really beneficial—it gave me a broad medication knowledgebase.”
After graduating TSU in 1967, Moody was offered a retail staff pharmacist position at Ward’s in the DFW area, and though he liked the hospital setting at St. Joseph’s, he took it.
"Opportunities were limited,” explains Moody. "Some of my other classmates took positions as far away as Chicago."
However, Moody only stayed at Ward’s for a year. When a position opened up at a Kroger Pharmacy in Houston, he jumped on it, and never looked back.
"I started with Kroger in Houston in 1968, and spent 45 years there. In December of 2013, I retired and now serve as a relief pharmacist. I’ve loved it,” says Moody, whose son graduated in 2000 with a Pharm.D. from TSU and now also works for Kroger.
"When I first started, drugs were set on the pharmacy shelves by brand—Abbott, Lilly, Pfizer and so forth—so you could easily check your inventory,” says Moody. "Now it’s all automated. Prescriptions were way cheaper, too. For example, thyroid medication was $1.29! It’s sad that it’s escalated to the point where people of lesser means cannot afford medications, even with co-pays.”
"Pharmacy has always been regarded as one of the most trusted professions, and that is a source of pride for me. We (pharmacy professionals) like to provide that extra ounce of service to the public. I enjoy the fact that as an individual, you can help people by offering guidance and empathy. It’s very gratifying.”
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Bill Moore, Moore's Pharmacy (Sinton; Corpus Christi)
At 79, Bill Moore is a man in motion, and always has been. Currently an active pharmacist, the former TPA president (2008-2009) worked his way through high schoolin Edna TX in the 1950s and went on to study chemical engineering at Victoria Junior College.
"During that time, I also worked as a janitor at Lee’s Drugs in Edna,” says Moore. "I’d clean up the store after hours. I got to thinking that as a chemical engineer I’d be sitting most of the time, and I don’t like to sit. Looking around at the pharmacy, I decided to go to pharmacy school."
Moore took a job working construction and saved enough money to go to The University of Texas College of Pharmacy in 1956.
"While I was a student, I had a full-time job for the state doing night watch for the Texas Department of Public Safety. That’s how I earned my money to go to school. I’d sleep from 7:00-11:00 p.m. at night, and I’d study on the job. Then I’d go to school 9:00 a.m. to 5:00 p.m. every day. I’d only sleep four hours a night, and then sleep 15 hours Saturday to Sunday.”
Moore and his wife Barbara (now deceased) have one daughter and two sons, some of who are following in the healthcare tradition.
"My daughter is a nurse, and one son is a pharmacist,” says Moore. "And my grandson Robert Joel
Moore is on his way to becoming a pharmacist. He was just elected president of the Pharmacy Council at The University of Texas at Austin College of Pharmacy.”
Moore graduated from the UT College of Pharmacy in 1960 with a BS in Pharmacy and went to work in an independent pharmacy called Ratliff’s in Ganado, TX before working for Harding and Parker Drugs in Victoria.
That gave me a background in independent pharmacy,” says Moore. "In ’65 I bought a store in Sinton. It’s called Moore’s Pharmacy and we’ll celebrate our 50th anniversary on August 30th,” says Moore, who was mayor of Sinton in 2014.
"It cost me $51,000 for the inventory and the fixtures. I rented the building from the owner,” says Moore. "I opened a Beeville location, which closed in 2013 when I moved my compounding operation and consolidated. Now I have two stores— the one in Sinton, and Moore’s Compounding Pharmacy in Corpus Christi which opened in 2003.
Despite rumors of struggling independents, Moore says both stores are doing excellent.
"I attribute that to customer service, and being willing to change our pharmacy practices to keep our businesses going in the current environment,” says Moore. "There were three stores in Sinton when I started, and now there’s just Moore’s Pharmacy. I’m on my sixth generation of customers, and have a very loyal customer base. In Corpus, we’re unique in that we’re a compounding-only pharmacy. We have a full wellness center, and we host free monthly seminars in our 70-seat classroom on public health issues. For example, we’ll cover topics like breast cancer, diabetes, or heart disease, as well as nutrition and supplements. The seminars are always well-attended. Sometimes outside companies ask us to put on special wellness seminars for their employees,” he says.
Counting himself, Moore employs five full-time pharmacists for his two stores and seven pharmacy technicians – two compounding, and five regular, while the Corpus Christi location has an additional four compounding technicians. Savvy business skills and a solid work ethic have kept his businesses thriving.
"Because of pricing issues, you need a high volume to stay in business,” says Moore. "You build on your different services, and incorporate them into your business model.”
Moore has taken a lesson from his own wellness classes, and now follows healthy habits- as does his wife Linda.
"I used to eat things like cheeseburgers and fries routinely, until I learned about heart issues the hard way,” says Moore. "I had open heart surgery 17 years ago and had four bypasses. Since then, I’ve embraced the wellness that we teach. I only eat meat once or twice a week, and stick with low-fat proteins and have some nuts or a nutrition bar at lunch. I keep my weight down and stay active. Also,
I take about 20 supplements a day. I recently thought I was going to need additional heart surgery for arterial blockages, but the doctor said my heart had built paths around the blockages, so I don’t need it. We teach wellness, but I also live it. That’s the only way to beat these things!”
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Mark Newberry, Tarrytown Pharmacy (Austin)
Mark Newberry has a framed time sheet in his office stating that he worked 3.47 hours for Tarrytown Pharmacy and earned $1.78.
That document dates back to when Newberry started working in his dad’s pharmacy (Tarrytown Pharmacy) when he was just five years old.
"It reminds me that this didn’t happen overnight—we’ve been doing it for a generation and have worked very hard for it,” says Newberry, who now owns the pharmacy.
"I helped with the shelves and stocking merchandise. In our early teens we helped with cashier duties, and later in the pharmacy.”
Newberry graduated with a Pharm.D. from the University of Texas School of Pharmacy in 2003. After graduating, his father (Brian Newberry) felt that he should work for someone else at least for a few a years, to get a feel for how things are operated in a different setting.
Newberry moved to Vail, CO, and took a job in a Walmart Supercenter, but in November of 2003, his father was diagnosed with pancreatic cancer, so he returned to Texas and in April 2004, became the owner of Tarrytown Pharmacy.
In the past 10 years, Tarrytown Pharmacy has experienced significant growth, now offering compounding and long-term care.
"Mass-merchant pharmacies typically don’t do that [compounding]” says Newberry. "Traditional pharmacy is not going to be the same as it was 25 years ago, so you need to branch out.
Our long-term care (Tarrytown Expocare) is very detail-oriented. We service Medicaid, and developmentally disabled youth. We’ve been able to expand to other cities in Texas. It’s a closed-door pharmacy, similar to larger chains, and we provide a lot of service—for example we overnight meds to patients, and offer onsite pharmacist consulting.”
When he first took over, Newberry was learning how to manage 20-25 employees, a number that has now grown to 50. They’ve also moved to a new 7,200 square-foot building and branched out to include long-term care, and a large high-end gift boutique which his wife Leslie runs.
If you visit Tarrytown Pharmacy, you’ll find a classy website telling the story about the business and its services.
"We are very different from mass retailers,” says Newberry. "We are truly an independent pharmacy, so we want to show how we are different. That’s why our website shows how we looked in the 40s—people can see who we are and where we came from. My feeling on advertising and marketing is to take a long-term approach to our message and how people see us. So we have newspaper, radio, web—all those things reinforce our image, and help us come to mind when people think of pharmacy.”
Of course Tarrytown Pharmacy faces the same challenges as all independent pharmacies: Mail order and chain drug store have changed the prescriptions into a commodity.
"We’ve seen where this is headed, so we’ve diversified our revenue stream,” says Newberry, referring to the gift boutique and long-term care. "And we’re twice as efficient—we have a dispensing robot.
In the past, pharmacies used to be able to counsel patients and spend more face time. We still strive for that. We want our pharmacists out their counseling and spending as much face-to-face time as possible.”
As a pharmacist, but also an owner, Newberry spends much of his time managing the business. His daily task is to think ahead of where the business is, and come up with new ideas for what can they
do better to secure their line of business long-term.
Like many independent pharmacies, Newberry recognizes that mail-order prescriptions are his
number one competitor.
"When a patient has a mandatory mail-order plan built into their insurance, there’s nothing we can do about it,” he says.
"My belief is that there is a downside to mail-order prescriptions—there’s a disconnect in patient care. Everyone knows that there’s a tremendous amount of value that pharmacists offer, and it’s obvious we should be recognized as healthcare providers. We can’t sit on the sidelines!”
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Tina Nguyen, Texas Southern University College of Pharmacy and Health Sciences
After graduating Klein Collins High School (outside of Houston) in 2009, Tina Nguyen got her pharmacy technician license and starting working at H-E-B. It was there that she saw the type of interaction pharmacists have with patients.
"I had a really good mentorship with a pharmacist there,” says Nguyen. "I really got a feel for what pharmacy was like. All the pharmacists were very interactive with their patients—all the patients asked questions of their pharmacists.”
While an undergraduate at the University of Houston, Nguyen’s mother became ill, and she had to handle the medications, which further got her interested in becoming a pharmacist.
Now a P4 at Texas Southern University College of Pharmacy and Health Sciences,
Nguyen is well on her way to achieving that goal.
"I’m currently doing rotations,” says Nguyen. "I’ll be doing them the whole year. Right now, I’m at
Memorial Hermann doing an ‘Advanced Hospital’ rotation. You get a look at how the whole operation works, from pharmacy to critical care. One of my responsibilities is a discharge counseling program. I communicate with the nurses and look up patients’ information and review their medication list and go up to their floors and counsel them. I’m really enjoying it—I’m learning more about pharmacy each day.”
Nguyen is the kind of student pharmacist who thrives on being involved in organizations. This past year, she was Chapter President of the TSU APhA Academy of Student Pharmacists, and she was Student-Patient Counseling Competition Coordinator for TPA.
"My second year I was president-elect for APhA,” says Nguyen. "I made connections and became very involved with TPA. By my third year I was the APhA student president. That’s how I became involved with TPA. Every pharmacy student in Texas should be involved with TPA!”
"Last July I became the coordinator for the TPA counseling competition, which was held during the 2015 TPA Conference & Expo," says Nguyen. "Patient counseling has always been a passion of mine. It’s really an art to be able to counsel patients and to be able to communicate with them as to how they should be taking their medications. As part of the healthcare team, it’s important for pharmacists to be able to be that last line of support for getting the patients the information they need.”
Nguyen is passionate about fully embracing the role pharmacists can play moving forward.
"From what I’ve seen in pharmacy, it’s not just a job. We really want to treat patients like family members. It’s a wonderful profession to be in because we’re involved in so much more than just patients’ medications. We can make a difference by just talking and interacting.
"Provider status is a term that has been at the forefront for my entire education. Now that I am on my rotations and I see clinical and community pharmacists play a role – I can see how much they can do to help manage patients’ medications. There’s always more that we can do. It’s all about showing people what we are capable of. Pharmacy is more than just vaccines or flu shots; it’s about stepping in and helping to manage our patients’ health.”
Frank North- Select Specialty Hospital
As a science major at Texas Southern University, Frank North knew he wanted to get into the medical field and help people.
Many of those North was studying with were interested in pharmacy, so after receiving his BS in biology and completing a business entrepreneurshipfellowship he continued for a Pharm.D. degree, which he received from Texas Southern University College of Pharmacy and Health Sciences in 2011.
While attending school, North worked at a chain drugstore as a pharmacy
"It helped me to understand their [techs] role,” says North. "I value everyone’s role. I value their aid and support to me and the profession. I think that their presence in the pharmacy is greatly needed for both new and experienced pharmacists as well as the patients we serve. As a new practitioner, this was valuable. Community pharmacy was a great experience.”
After graduating, North applied and interviewed for several residencies, was unsuccessful in the match, and got his first experience with a chain drugstore.
"I used that time to learn and grow, to gain knowledge to move on to the next level. From there, I asked myself, ’how can I learn from that experience‘?” says North, who joined TPA right after graduating.
"Once I graduated and started working, I saw how challenging pharmacy could be as a profession. TPA has created an environment for assessment and growth as the voice for pharmacy, and that makes it important to me and the profession. I know that TPA is there for me—but we need more people [members and experiences] involved so TPA can continue to best represent all stake holders in the profession of pharmacy.”
North realized that he wanted to challenge himself in a different area of pharmacy. He had experienced community pharmacy, and wanted to see a different area of profession.
"I’m passionate about teaching and learning more, whether it’s through CE or work experience, or live events,” says North.
North’s career exploration led him to Select Specialty Hospital, where he is currently employed as a clinical pharmacist. Additionally, North created Frank North and Associates, LLC—a consulting company which helps independent pharmacies better engage their communities and target audiences.
"Select Specialty Hospital is a long-term acute care hospital. We care for a lot of geriatric patients,” says North. "It’s a constant learning process. Each patient requires different levels of care and different approaches regarding medication therapy. I have been able to use TPA experiences and CE’s to build on my knowledge and help with day-to-day challenges.”
"Clinical pharmacy is a different world from community [retail]. You’re responsible for individual on-site patients on a daily basis, and you engage on a team with other healthcare providers like nurses and physicians. I like the ability to interact with them because it helps, me help them understand pharmacists’ roles and what we offer.”
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Roseline N. Okwura, Pharm.D.
New TPA member Roseline N. Okwurais a problem solver who enjoys helping people.
As a high school student in the West African town of Akure, in Ondo, Nigeria, Okwura loved science, and recalls keeping a first-aid kit handy for fellow students. Ultimately, she realized pharmacy would be a good career choice for her, and came to the UnitedStates to earn her doctorate of pharmacy at the University of Maryland School of Pharmacy.
"I’ve always been good in sciences, and I was always the one with the first-aid kit in high school,” says Okwura. "Looking at where to get my Pharm.D.,Maryland was one of the top schools for pharmacy, and was very diverse.”
"I really liked it there— they have a very good pharmacy program,” says Okwura, who was active as a student leader and worked in the dean’s office and also as a pharmacy technician.
Okwura received her Pharm.D. in 2000. After graduating, she worked at the Greater Baltimore Medical Center in Towson, MD, where she served as a rotational lead pharmacist, supervising a staff of up to 60 professionals in all pharmaceutical practices and protocols.
Over the past 15 years, she’s had experience in quite a few areas of pharmacy practice.
"I’ve worked in a number of different pharmacy settings, including retail, hospital, and managed care,” says Okwura. "I like dealing with patients. I’m able to empower them and help them take better care of themselves. I enjoy all pharmacy settings, but working directly with patients has more impact. I enjoy counseling and making a difference in peoples’ lives.”
Beginning in 2004, as a clinical staff pharmacist at the George Washington University Hospital, she managed compliance to federal and state laws, quality control and adhered to accreditation and pharmacy practice standards, while supervising a team of 15 pharmacy technicians and managing all aspects associated with compounding and quality assurance of sterile and non-sterile products.
"In any setting that I’m working in, I like to be part of the solution,” saysOkwura. "I like to provide better ways of doing things—make things more efficient. For example, when I was at George Washington University Hospital in Washington, DC. I helped set up an automatic therapeutic substitution program which allows the hospital to maximize the use of their formulary and become more efficient with their inventory. It helped save a substantial amount of money.”
More recently,Okwura was in the retail arena, working as a pharmacist for Shoppers Pharmacy in Bowie, MD. There she managed compliance to federal and state laws, and collaborated with physicians and other healthcare professionals to plan, monitor, review, and evaluate the quality and effectiveness of drugs and drug regimens.
She also analyzed prescribing trends and monitored patient compliance to prevent drug interactions and toxicities, and served as an immunization and patient counselling specialist.
After having her first child (now almost two years old) Okwura moved to Cypress—in the greater Houston area—in 2014 to be closer to her family. She’s currently a floating pharmacist for Life Pharmacy and other independent pharmacies while she seeks full-time employment in a clinical environment.
And as a newly-licensed pharmacist in Texas, she’s taken the next logical step: joining TPA.
"I found out about TPA through the Texas State Board of Pharmacy. I thought it would it would be a good thing to join,” she says.
"Advocating for pharmacy is something we should all be doing. There’s a lot going on right now, and we need a strong united voice representing us!”
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Tony Palmer, Academic and Business Consultant
TPA member Tony Palmer has an impressive career in pharmacy, spanning four decades of business consulting and academia.
“I started out in hospital pharmacy in 1973 in Galveston in the old St. Mary’s Hospital,” says Palmer. “I started out as a staff pharmacist, then worked my way throughmanagement positions. My interest in business and pharmacy management began during that time. Right now I focus on specialty pharmacies—most are independent entities.”
Palmer is an adjunct professor at Richland College in Richardson and recently received the 2015-2016 Excellence in Teaching Award for Adjunct Continuing Education Faculty.
“From an academic perspective, my career takes almost 30 years of teaching into account,” says Palmer. “I was involved with the University of Oklahoma College of Pharmacy at Tulsa as a start-up pharmacy college. I’ve also worked with the University of North Texas Health Science Center College of Pharmacy—I’ve been teaching there the past two years as a vendor contract instructor.
“I teach pharmacy administration. That includes a number of different courses, including Introduction to Pharmacy and Pharmaceutical Policy.”
Palmer earned his BS in Pharmacy back in 1973, but in 2010 returned to school to complete his Doctorate of Business Administration, which he received from the Walden University in Minnesota, in 2014.
As a pharmacy professor, Palmer feels that the seeds of leadership should be planted during pharmacy school.
“From a grassroots standpoint, we can do things to enhance leadership opportunities,” he says. “Academia needs to be a benchmark for promoting students into leadership areas. We’re now starting to see a shift towards management leadership skills to compliment the strong clinical skills that our students are receiving.
“There are so many things people can do with a pharmacy degree. As the health system continues to maturate, we’re seeing more and more skills needed for pharmacy graduates to be able to function well within the dynamic changing health system.”
In addition to his other duties, Palmer is involved in pharmacy technician training.
“Pharmacy technicians are a part of our profession and their training is beneficial for the future of our profession,” says Palmer. “We’re gearing up for a whole new way of training technicians starting within five years. The American Society of Health-System Pharmacists is now partnering with the Accreditation Council for Pharmacy Education (ACPE) beginning 2020 to rewrite what it takes to become a certified pharmacy technician. This will open a more robust career path and career profession for pharmacy technicians.”
His career has led him down numerous paths, allowing him to experience many areas of pharmacy.
And that’s just the way he likes it.
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Oren Peacock, R.Ph
Growing up in Waco in the 50’s, Oren Peacock got a job as a "soda jerk” and delivery boy for Olsen’s pharmacy while a student at Waco High School. The manager, Charles Olsen was allowed Peacock to help out behind the counter, sparking the beginnings of a life-long career.
Peacock worked at several Waco area pharmacies, and one agreed to help put him through pharmacy school at the University of Texas College of Pharmacy.
"I worked part time at a 7-11 to make enough money to live on during the week,” says Peacock, who also worked at Tarrytown Pharmacy in Austin to help make ends meet. "I really enjoyed pharmacy school. But it was challenging— having to work in order to support myself affected my grades.”
"I rode a motor scooter to class, rain or shine,” he says. "I couldn’t afford the dorms, so I lived in rooming houses and boarding houses."
After graduating with and receiving an R.Ph. in 1962, Peacock went to work for William’s Drug Store in Waco as a pharmacist.
"A guy named Cecil Willis, who happened to be [the late governor] Ann Richard’s father, helped get me the job,” said Peacock. I’ve had five different jobs, but never left the original company. William’s Drug Store was bought by Dallas billionaire Harold Simmons, who bought a number of drug chains. Later it became Eckerd’s.”
Peacock was promoted up the ladder at Eckerd’s and served as a regional manager in Clearwater, Florida, and later a regional vice president. Most (but not all) Eckerd’s stores were subsequently acquired by CVS.
A Storied Career
Over time, Peacock’s career and interests extended even further.
"I was appointed to the Texas State Board of Pharmacy by Governor George W. Bush in 1996,” says Peacock. "That was a fantastic experience. I loved it—learning how the political process works, and how the governmental agencies have to handle the political aspects of it. We had to understand both the professional and the public sides of it. I was serving with TSBP when pharmacy technicians were recognized and began being certified and I saw that transition (1999-2004).
Peacock later became president and chairman of the board (2007-2008) of the National Association of Boards of Pharmacy (NABP).
Peacock recalls working as a pharmacist during the 60’s, and in his experience, spending a good bit of time helping patients, not just dispensing.
"It’s interesting,” he says. "When I worked as a pharmacist, people called me ‘Doc Peacock.’ People looked to me for advice, and we counseled them when they couldn’t reach their doctors. Then it was behind the counter for years, and now it’s evolving back to helping patients. It’s kind of come full circle.”
Peacock, who retired in 2012, has been a TPA member for many years, and was instrumental in establishing the Texas Pharmacy Congress while serving on the Texas Pharmacy foundation board.
"I’ve enjoyed working with TPA,” says Peacock. "I attend TPA’s annual meetings and enjoy the fellowship of other pharmacists throughout the state, along with the continuing education.”
As a note to P4 students, Peacock advises ongoing professional involvement.
"I think it’s critical that new practitioners stay involved in their associations like APhA and TPA, to help with changing the environment for pharmacy, and to understand the legislative process. Their future is dependent on associations like TPA meeting with the legislators to help direct where pharmacy goes.”
Mark Peippo, Family Pharmacy of Pottsboro
When Mark Peippo was studying engineering at LeTourneau University in Longview, TX, he started working for the college ambulance service, and passed a certification to become an EMT as a sophomore. That got him interested in changing his career path. He transferred to Texas A & M and got degree in biology in 1982.
"At that time, I was working as a phlebotomist at a hospital in College Station,” says Peippo. "I didn’t want to be tied to a beeper (remember those?) and decided to pursue a pharmacy degree.”
Peippo subsequently attended the University of Houston School of Pharmacy and graduated in 1988 with his R.Ph. degree.
Working for Eckerd’s right out of school (1989 to 2002), and later Walmart, Peippo came to realize he wanted to be in an independent pharmacy setting.
In 2007, he took a position as pharmacy manager at Family Pharmacy in Pottsboro (population 2,100), an hour north of Dallas, and in 2010, he bought the store with his wife Sue Morrison Peippo, also a pharmacist.
"Initially when I got into pharmacy, owning a store wasn’t even on the radar,” says Peippo. "At Eckerd’s I never really knew what things cost. At Family Pharmacy, I could see how the budget and the insurance companies worked. After I was there for three years, I approached the owner about buying it. He was thinking about selling, but I beat him to the punch. We did financing through the owner at first, and a year later refinanced through Live Oak Bank. I almost have it paid off- I’ve been paying extra on the principle. We’ve never looked back once!”
Though not a large store, Family Pharmacy has been able to capitalize on fast prescription turnarounds.
"We don’t have too much completion in Pottsboro,” says Peippo. "There’s a Walmart in Denison, a CVS about four miles away, and a Brookshire’s opened about a year ago.
We usually fill prescriptions and have people in and out in 5-10 minutes, including counseling,” says Peippo. "We know everyone when they walk through the door. We’re very family oriented. So people in the general area can avoid the wait at bigger stores. We have loyal customers from Oklahoma and nearby major cities like Denison and Sherman. We average about 250 prescriptions a day, which is very good for a small-town store. Also, we do immunizations for the school system.”
Peippo finds that owning an independent pharmacy gives him a lot of freedom to do other things he wants to do.
"I see my son’s baseball games and my daughter’s soccer games,” he says. "And it gives us time to do community events. Sue is on the Chamber of Commerce board of directors, and the Pottsboro Foundation board of directors and we are both involved with the rotary club.”
As part of his marketing plan, Peippo has a company that is helping keep up with his Facebook page. The company—Keep Your Pharmacy Open (KYPO) is a social media outsourcing service for independent pharmacies.
"They post daily,” says Peippo. "We get great feedback from our customers. We like to make everyone feel like they are part of family.”
Though he’s running a profitable operation, Peippo says that staying on top of reimbursement is a constant struggle. Pharmacies contract their own reimbursement rates through a pharmacy service administrator organization (PSAO).
"Good Neighbor Pharmacy Provider Network is mine,” says Peippo. "They negotiate the reimbursement contracts for me. All the different PBMs decide how much they will reimburse pharmacies. And then you have, ‘Maximum Allowable Cost,’ where each insurance company has a list of certain medications and how much they will reimburse the pharmacy for those medications.”
Peippo observes that the cost to purchase drugs keeps going up, while the reimbursement rate often does not keep up with it.
"In January of 2013 I paid $31 for 500 tablets of Doxycycline,” he says. "Now the price is $2016. It took the insurance companies three months to catch up with that rate increase. Fortunately, our high prescription rate acts as somewhat of a buffer to the reimbursement struggle.”
"I’ve been happy to support TPA and PharmPAC, because we have to have a voice,” says Peippo, who has been a TPA member since 2,000. "Nobody’s going to speak for us except ourselves. Fortunately we have TPA to voice our concerns about pharmacy both in the national and state political arena.”
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Scott R. Penzak, UNT Health Science Center College of Pharmacy
As a high school student working at an independent pharmacy in Sterling Heights, Michigan, Scott Penzak was struck by how knowledgeable pharmacists were.
"I saw how pharmacists interacted with patients,” says Penzak. "They seemed ‘all-knowing.’ It looked to me like it would be a fulfilling career.”
Penzak earned his BS in Pharmacy in 1990 at Ferris State University in Big Rapids, Michigan, and after a stint working as a staff pharmacist at Kmart for four years, he got his Pharm.D from Wayne State University (Detroit, MI) in 1996. Following that, Penzak did a two-year fellowship in infectious diseases pharmacology at the University of Arkansas for Medical Sciences (UAMS).
Penzak found that academia agreed with him, and signed on as a professor of pharmacotherapy with the University of North Texas Health Science Center College of Pharmacy (located on the Fort Worth Campus) in 2014.
"The thirst for knowledge and being able to research is what attracted me to academia,” says Penzak. "And I really like the interaction with students—it’s great to see them grasp concepts and to know that you had a role in making that happen.”
"It’s very exciting to see our first 2017 graduating class on the horizon,” adds Penzak. "It’s kind of a landmark for UNT to see that inaugural pharmacy class finish up. I think they will make a big contribution to pharmacy and I’m excited to see it.”
Quite a bit goes in to creating a college of pharmacy, not the least of which is the curriculum.
"It’s been a lot of work—we’ve continued to hire faculty,” says Penzak. "I’m currently chair of the curriculum committee. We’ve looked at curriculum from top pharmacy schools, and we’ve put together a very rigorous curriculum that will benefit students.”
To UNT P1s who just started this past week, Penzak has this to say: "Being a student is your job right now. Focus your attention. Delay gratification. There’ll be plenty of time later to do fun things. Don’t let a bad test grade define you. Have confidence in yourself, and don’t give up and don’t accept any limitations on yourself.”
As a professor, Penzak has been involved in pharmacokinetics (what the body does with the drugs over time, and how drugs interact with each other) and pharmacogenetic research, with a particular focus on antiretroviral agents. He has lectured extensively to healthcare practitioners and trainees on drug-drug, and drug-herb interactions and has routinely assisted clinicians with therapeutic drug monitoring and drug interaction management in HIV-infected patients.
"An HIV vaccine is a definite possibility in our lifetimes,” says Penzak. "There’s been a lot of research. I think it will happen.”
Nathan Pope, University of Texas College of Pharmacy (Austin)
As a high school student in Branchburg, New Jersey, Nathan Pope excelled at science and math. His father, a pharmacist involved in research and development suggested applying to nearby Rutgers University in the hopes that Nathan might also pursue a career in pharmacy.
"I got accepted [to Rutgers], and one of the first courses I took was ‘Intro to Pharmacy,’” says Pope. "I was stoked from then on. Once I saw what pharmacy is about and where you could go with it, I loved it. I still find it amazing that something as simple as taking a pill can change body functions—making you better, changing how you feel.”
After graduating from Ernest Mario School of Pharmacy at Rutgers University in May of 2002 with a Pharm.D., Pope began his career at Walgreens.
"I had worked as a pharmacy technician as a freshman while at Rutgers, and I did a community pharmacy residency with Walgreens in collaboration with the University of Houston from 2002-2003,” says Pope, who subsequently took a pharmacist position at a Walgreens in Austin.
In 2008, Pope saw an opportunity open up at the University of Texas College of Pharmacy for the Clinical Assistant Professor of Health Outcomes & Pharmacy Practice.
"Ever since my residency, I wanted to get into academia,” says Pope, who jumped at the chance and landed the job. "My job is teaching-focused, dealing with community pharmacy practice—covering areas like compounding and supplements. A big part of my job is my role as Director, HEB/UT Community PharmacyResidency Program.
Pope oversees all aspects of the HEB/UT program and makes sure that it follows the accreditation standards, and that it’s the best educational experience possible. Additionally, he supports and develops preceptors.
"I love teaching because the students are so energetic and excited, and I feed off of that. It makes you excited about the profession,” says Pope. "When they [students] see the impact they have on patients—that’s just great.”
Currently, Pope’s practice site is UT’s Forty Acres Pharmacy, where he has increased educational offerings and patient care initiatives. The site serves as the Advanced Community Pharmacy
Experience for The University of Texas at Austin College of Pharmacy.
"When I first started, we only had P2 students going through Forty Acres Pharmacy, and now we have P2 through P4 interning there to get experience. It used to be strictly focused on dispensing, and now we have medication therapy management (MTM) and immunizations,” says Pope, who also provides pharmacy-based educational services to the physicians and nurses of health services.
A Belief in MTM
"MTM first started when I was beginning as a pharmacist,” says Pope. "I remember taking an MTM CE course through TPA. I’ve always been involved in it since.”
Pope recently participated as an MTM expert with TPA’s Director of Pharmacy Practices Kim Roberson, and also served on a TPA committee for MTM.
"It’s important because it’s been proven that pharmacists providing MTM make positive changes in patients’ outcomes: decreased hospital visits; stronger adherence to medication; and lower overall healthcare costs. I think it’s [MTM] where the profession needs to go so that we’re more respected for cognitive services, and so that we can be reimbursed accordingly. Community pharmacists are on the frontlines of pharmacy, and have the most interaction with patients, so it’s a chance to positively affect patient outcomes. Pharmacy has an opportunity— you can’t sustain a pharmacy on dispensing alone. So MTM is a viable option on many levels.”
Be the Best Pharmacist
To pharmacy students getting ready to enter the profession, Pope has this to offer:
"Be the best pharmacist that you can be so that you can help patients the best you can. That encompasses professionalism, maturity, expertise, knowledge, and continuing learning, as well as being empathetic and understanding.”
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Anne Marie Powers, Walgreens (Conroe)
After spending some time with two family members who happen to be pharmacists (one in a hospital setting, one in retail), new practitioner Anne Marie Powers decided pharmacy just might be the right choice for her, too.
She got her prerequisites taken care of as a chemistry major at the University of Texas at Austin, and in 2009, enrolled at Texas Tech Health Sciences Center School of Pharmacy.
"The main campus is in Amarillo, but I studied at the Abilene campus,” says Powers.
"It was nice in that it is a small town. There were only around 40 pharmacy students in my class, with a total of 120 on campus, so it was a tight-knit group and we stayed involved. We were able to reach out to the community. For example, we worked with the nearby hospital and helped out with charity events like Meals on Wheels and coordinated with other programs like March of Dimes and so forth..
When choosing rotations, most pharmacy students stick with the typical settings: retail, hospital, etc. But Powers opted for a very unusual rotation.
"I was able to do a rotation at a maximum security prison,” she says. "I remember that quite well. I saw a lot of chronic obstructive pulmonary disease; diabetes, and asthma. I learned a lot about asthma and COPD diseases.”
"For safety’ sake, prison guards were always on hand. One thing I noticed is that you had to be careful about trusting what inmates said. They [convicts] could be very manipulative. Many had been in for a long time. You definitely learn that you can’t trust everybody. Often you have to probe to get true answers.”
Powers completed her Pharm.D. in 2013, and decided to pursue a career in retail, landing a job at a Walgreens in Conroe.
"I knew I wanted to get into a retail practice—a hospital setting is not really for me,” she says. "I’d interned with Walgreens for a few years, and I did a rotation with my pharmacy supervisor, so I had ties to Walgreens in the Houston area. I was placed as a pharmacist in Conroe in 2013. When the previous pharmacy manager went to The Woodlands, I was asked to step up as pharmacy manager.
Former TPA president Carole Hardin Oliver is now my pharmacy supervisor.”
The Walgreens Powers works at is a 24-hour location, so there are specific challenges to keep up with.
"Our late shift works 10:00 p.m. to -8:00 a.m. seven days on and seven days off. My shift is 2:00 p.m.-10:00p.m. one week, and the next week 8:00 a.m.-4:30 p.m. We try to manage workflow as effectively as possible, helping with any customers’ issues, keeping an eye on techs, and keeping in line with Walgreens mission,” says Powers. "Sometimes you get pulled in different directions. You have techs up front, you’re trying to verify prescriptions, fill, and deal with insurance issues. So time management is the main challenge. Along with immunizations and MTM, pharmacy managers have a lot on their plates, and must be experts at managing their time. It’s all about revenue, and being able to spend time on what’s important.”
Powers has five staff pharmacists working for her, and seven or so pharmacy technicians on staff.
"Typically there are four pharmacy technicians working throughout the day. You can’t run a pharmacy without techs. They are the heart and soul of a successful pharmacy. Walgreens does a good job of making sure that their techs are high quality.”
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Dana Radman, Director of Pharmacy Services at Baylor Scott & White Health
TPA welcomes new member Dana Radman! Originally from Los Angeles, Dana Radman studied pre-med at the University of California at San Diego, where she double majored in Animal Physiology/Neuroscience and Psychology.
"Like most premed students, I was interested in biology. Animal Physiology/Neuroscience is a sub- specialty of biology,” says Radman, who also served as a coxswain on UCSD’s crew team.
When Radman realized she did not want to go on to med school, she sought other options. She took a few years to figure things out, working for a pharmaceutical-related company in San Diego as a research associate.
There she became more familiar with the pharmacy industry, and in 2002 applied to University of Southern California School of Pharmacy.
While interning with Keck Hospital of USC during pharmacy school, Radman realized she didn’t want to work in retail or research.
"Once I was in the hospital setting I enjoyed the patient care aspect and the cutting edge technology,” she says.
After earning her Pharm.D. in 2006, she went on to become Manager of Clinical Effectiveness at Stanford Healthcare. In that role, Radman oversaw a number of components, including quality, medication safety, regulatory, and operations before being promoted to Assistant Director of Pharmacy, where she led a larger team.
While pursuing her executive masters in Health Administration, Radman made a decision to leave California for Texas.
"My decision was both personal and professional,” she says. "I met my significant other at that program, who happened to live in Texas, and it made more sense for me to relocate.”
Radman moved to the Dallas area last November and started her new position as Director of Pharmacy Services for Baylor Scott & White Health in Garland a month later.
"Looking at the opportunities here in Texas, I zeroed in on Baylor Scott & White Health," says Radman. "It’s a health-system made up of more than 40 hospitals. The director position has allowed me to apply the experience I gained at Stanford in a new setting and expand my skills and grow as a leader in a new organization."
The TPA Connection
Seeking help preparing for her MPJE exam, Radman became a TPA member last January after signing up for the Law webinar.
"I highly recommend that webinar for anyone preparing for the Texas pharmacy law exam,” she says. "I did the self-study version, and the live recorded session really allowed me to listen at my own pace. I could review things and ‘rewind’ if I needed to check key areas of emphasis.
"Being new to Texas, joining TPA in January was a good way to find out what was happening in pharmacy in Texas. It’s a chance for me to better understand Texas pharmacy from a hospital setting. And it’s certainly a networking opportunity for getting to know the leaders in a new state.”
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Lauren Ragan, MTM Clinical Pharmacist, Brookshire Grocery Company
Lauren Ragan was always interested in a career in healthcare; the question was which field was the best fit. While an undergrad studying biology at Baylor University, she realized that pharmacy just might be the answer.
In 2007, I got a job at Walgreens as a pharmacy technician,” says Ragan. "That got me interested and helped me see what opportunities there are within pharmacy. There are lots of options: big chain stores; grocery chains; hospital settings.”
After graduating with a degree in biology in 2008, Ragan enrolled at University of Louisiana at Monroe School of Pharmacy.
"I applied to 10 different pharmacy schools in Texas, Oklahoma Arkansas and Louisiana,” says Ragan. "I liked ULM—I grew up in Paris, TX, and it’s close to my east Texas roots. It has a small-town feeling—very community based. My class only had 40 people in it, so we had small classes and got a lot of attention. I built great relationships with my professors. Of course, the pharmacy program required a lot of studying—they wanted to make sure we were successful!
After graduating, Ragan worked briefly at the LSU Health hospital in Shreveport, LA, but was interested in a path that offered more patient interaction.
"The part I enjoy most about pharmacy is patient education, l and I was not doing a lot of that at the hospital,” says Ragan. I was not necessarily interested in being a "big box” pharmacist, and a grocery chain seemed like a good fit for me. I find you can interact with patients better in a grocery setting. I think that’s because in the "box” pharmacy, people are mainly there to pick up prescriptions, whereas in a grocery setting, they are there for different reasons, so the environment is a lot more relaxed. Brookshire has a lot of customers who have been with us a long time. The patients/customers are very friendly and enjoy talking.”
In 2013, Ragan met with Lisa Glorioso, vice president of pharmacy operations for Brookshire Grocery Company, and expressed her interest in working for the chain.
"I told her I was interested in patient education, and that I had a background in medication therapy management (MTM) through APhA,” says Ragan.
Brookshire, which has 116 pharmacies, was looking at involvement in that kind of program, and Ragan was hired on to help implement MTM company-wide.
"I was part of the Brookshire Pilot MTM program,” says Ragan, who currently works closely with TPA president Charlotte Weller. "Brookshire decided after a year that the program was successful enough to start an MTM team. We now have seven MTM pharmacists, and I’m in charge of Shreveport and parts of east Texas.
Ragan talks to patients every day, typically dealing with those who may have high blood pressure; asthma, diabetes, high cholesterol, or chronic obstructive pulmonary disease (COPD).
"I do a lot of educating on things they may have missed, looking for side effects, adherence, and so forth,” says Ragan. "It’s rewarding, and our patients are very excited about the program: they like being contacted and asked how they are doing. Having a pharmacist call them and find out how things are going is much appreciated.”
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Steve L. Rodriguez, Pharm.D.- MedPro Pharmacy and Wellness
As a kid growing up in Austin, Steve L. Rodriguez was always intrigued by what went on behind the pharmacy counter. Now, as the owner of two MedPro Pharmacies—one in Melissa, TX and one in Plano, TX—Rodriguez knows a whole lot more than just what goes on behind the counter.
"In high school, I wanted to be a fighter pilot. Before I went off to college, I wasready to join the Navy. But all along I knew I wanted to be an independent pharmacist owner,” says Rodriguez.
Rodriguez, the first in his family to receive a college education, went to Angelo State where he did his pre-pharmacy studies, and played two years of college football, before going on to earn his Pharm.D. at Texas Tech University Health Science Center School of Pharmacy.
As Rodriguez recalls, his senior year internship really helped pave the way for future endeavors. "It was a great experience,” he says. "My last year of rotations really prepared me to be a well-rounded pharmacist. I worked at an independent pharmacy in Dallas, and they hired me after I graduated. I later worked at the chains and hospital pharmacies, but I knew I wanted to be an independent owner. I had worked for some successful and some not-so successful pharmacies. So learned what to do and what NOT to do!”
One situation in particular stands out to Rodriguez. He saw one owner lose a great historic pharmacy to bankruptcy. For Rodriguez, it was an eye-opener.
"One lesson I learned was that you have to embrace technology,” says Rodriguez. "In today’s world, you have to automate as much as possible in order to be efficient. I have state-of-the-art computers and ScriptPro software—it’s a dispensing tool for dispensing our top 200 medications. You have to make it as easy as possible for patients to call in prescriptions— through your website, a mobile app, etc. The real lesson I learned was that you have to work smarter, not harder. And you need to think about strategy, business development, and marketing.”
Rodriguez is passionate about advocacy, and has deep concerns about the direction managed care is going.
"The other lesson I’ve learned is that you must get involved politically,” says Rodriguez, who employs about 15-20 people. "There are many interest groups out there taking a piece of the pie. Pharmacists need to get involved with the legal process and be in tune with what’s happening in the political arena. Our profession is under attack by non-pharmacist interest groups. If you don’t get involved, you’re not going to be able to maintain a good income. Many pharmacists don’t get it. I’d guess there are 20,000 in Texas, and the participation rate in state association or advocacy groups is probably only 5%. I’m on TPA’s PharmPAC, and I’ve been to Washington to help advocate. It’s absolutely essential to be involved, and I can’t stress that enough.”
Rodriguez believes that by protecting the interests of independent pharmacists, you are protecting the interests of all pharmacists.
"Studies have proven time and time again that pharmacists are an effective entity for managing healthcare costs,” he says. "We have the opportunity to provide a huge savings to tax payers. We are the most accessible healthcare providers available. We can take blood glucose, blood pressure, check cholesterol, and so forth. And we can provide those services at a cost that our customers can handle,” he says.
Rodriguez points out that Pharmacy Benefit Managers have now become the middlemen, and they will manage what’s in their best interests, not the patients’. And he feels that this trend could potentially put independent pharmacies—and other pharmacies as well—out of business and put a burden on the healthcare system.
"With the advent of managed care, pharmacists have been restricted in their abilities to help manage healthcare costs,” he says. "It comes down to the patients’ right to choose.”
"And I believe that taking care of patients is first and foremost. You’ve got to focus on the patients. Even though I talk about business, politics and management, ultimately it all leads to patients.”
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Bruce Rogers, Rogers Pharmacy, Medicine Man (Victoria)
"Fair prices, friendly service and a pharmacist you know.” That’s the slogan Bruce Rogers came up with for Roger’s Pharmacy, and it’s a fitting one for Rogers, who opened his first pharmacy at age 28.
That was back in 1979, and he had beenworking as a pharmacy manager at Skillern's Drugstore. When Skillern’s closed its Victoria location, Rogers decided to go into business for himself.
Good call. He now owns seven stores—along with Rogers Home Medical Equipment and Services, with locations in Victoria, Port Lavaca, and Santa Fe, TX.
Rogers’s wife Elizabeth manages the gift department for Rogers Pharmacy, and has helped expand the business while Wilson and Stephen, two of his three sons, are on staff as well, overseeing the books and the home medical equipment portion of the business.
Rogers, who attended the University of Texas at Austin College of Pharmacy back in the 70s, is quick to point out that the model for those interested in starting their own businesses is not what it once was.
"On the economic side, we’ve lost control,” he says. "Pharmacy is no longer considered to be a model of capitalism. We are no longer free to establish the pricing of our products and services. When I graduated in the 70s, if a person wanted to open a business—whether medical, hardware, or a pharmacy, it was a lot easier.
"Now the business model has changed. A few weeks ago I read an article about the guy who cofounded Home Depot. He said that there was no way he could create Home Depot in today’s business climate because of the red-tape, roadblocks, and federal oversight. We’ve allowed our freedom to get out of our grasp by allowing government and other entities too much control. That’s why I’m involved in the legislative process—working to get the system to respond to the individual in America.”
Rogers, who is currently the chairman for the Texas Pharmacy Business Council and is on the board of the American Pharmacies group, has been involved with TPA for some time.
"I was involved very heavily with TPA back in the 90s, specifically with the vendor drug program and reimbursement. I was on a committee that met with the Health and Human Services Commission, representing TPA. As a community pharmacist I made a choice to enter this profession, and unless we stand up for pharmacy economically, financially and professionally, we’re not going to get very far.”
"We’re on a battlefield, and you can’t have two generals trying to run that battlefield,” says Rogers, who recently rejoined TPA. "One will go right, one will, go left. If you’re united you’ll succeed. We have a better chance of succeeding if we unite. It’s time to come together.”
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Kevin Rosenblatt, M.D., Ph.D. CompanionDx™
You may have heard that "personalized” medicine is the wave of the future, but the reality is, we’re already making significant steps in that direction.
New TPA member Kevin Rosenblatt, M.D.,Ph.D. has been helping patients with pharmacogenomic counseling since 2012. Rosenblatt, a renowned molecular pathologist who is recognized internationally for his pioneering work in the fields of proteomics and genomics, founded a Houston-based company called CompanionDx™ (Companion Diagnostics) in 2011. The company specializes in pharmacogenomics testing, companion diagnostics for cancer treatment and therapeutic drug monitoring.
According to their website, "it was the vision of Dr. Rosenblatt that led to the formation of Companion Diagnostics, a leader in personalized medicine. His passion for developing and commercializing cutting edge pharmacogenomic technologies has allowed him the opportunity to become a leading authority in this new era of testing.”
"I was doing proteomics—looking at the proteins in the blood or patients’ tissue. It became clear to me that pharmacogenomics and proteomics were going to be big players in the medical field,” says Rosenblatt. "So I took a risk and dedicated my career to that area. CompanionDx™ helps doctors wade through the many drugs to find the appropriate match. We provide feedback to physicians regarding the best match in drugs for individual patients.”
CompanionDx™, which includes 14 pharmacists on its staff, performs pharmacogenomics testing and evaluation, and assesses results and offers recommendations from their staff of doctors and pharmacists. Additionally, the operation has a pharmacy called Genovations, which provides consultative services.
"Pharmacogenomic technologies has become second nature to me,” says Rosenblatt, who is adjunct Associate Professor of Molecular Medicine and has served as Director of the Center for Clinical Proteomics in the Centers for Proteomics and Systems Biology at the Brown Foundation Institute of Molecular Medicine/UTHealth. He is also adjunct Associate Professor in The Division of Oncology, Department of Internal Medicine, and Co-Director of the Proteomics Core for the Center for Clinical and Translational Sciences at UT Health.
The CompanionDx™ website states that, "Anywhere from 40 percent to 75 percent of drugs are ineffective for individual patients depending on drug class. In fact, research shows that 90 percent of drugs work in only 30 percent to 50 percent of individuals.”
At CompanionDx™, we do genetic testing (ordered by physicians) to help match patients with the best types of drug therapy,” says Rosenblatt. "We look at the patient’s DNA. Based on the samples, we run evaluations to match the best drugs. For example, we can determine which genes will affect drug absorption. Genes play a significant role in how drugs are delivered. Our future growth will be in pharmacogenomicly compounded medicines.”
Dr. Rosenblatt clearly recognizes the role of pharmacists as drugs experts, and uses that expertise wisely within his company.
I’ve built a pharmacy program,” says Rosenblatt. "The pharmacists put it all in context—they are the ones interpreting the clinical pharmacology aspect. Every report is looked at by a pharmacist and a physician.
"Clinically, I’m trained as a pathologist,” he says. "Pathologists are not pharmacists. I knew that it [CompanionDx™] would be a multidisciplinary endeavor, and that’s why we need pharmacists. In some ways, I feel a kinship to pharmacists—we’re both about medications.”
"My view is that the future standard of healthcare will involve rapid genetic testing,” adds Rosenblatt. "The patients, physicians and pharmacists will all know the patients’ profile. Twenty years from now, we’re going to have a very good handle on pharmacogenomics.”
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Roderick Sanchez, Walgreens (San Antonio)
A San Antonio native, Roderick Sanchez got interested in pharmacy as a sophomore at St. Mary’s University while studying biology. At the time, Sanchez was working at an allergy clinic and a medical assistant at the clinic noticed he liked dealing with patients.
"She recommended that I become a pharmacy technician,” said Sanchez. "I took the test the next summer (2005) and got my technician license.”
Sanchez got a job at the Walgreens at West Avenue and Lockhill-Selma (San Antonio) in 2007, working full time as a pharmacy technician while pursuing a master’s degree in biology.
"I basically fell in love with pharmacy at that point, and that’s when I knew I needed to apply to pharmacy school,” says Sanchez.
"I fell in love with the science behind pharmacy, and with the patient interaction—to me, pharmacy is the perfect combination of patient interaction and science.”
Wanting to stay in San Antonio, Sanchez chose the University of the Incarnate Word Feik School of Pharmacy to earn his Pharm.D.
"It's a very good program,” says Sanchez. "They [UIW] are still in their infancy, so there are still a lot of things that are evolving. They’ve given me the tools and the skills to become the best pharmacist that I can be. The staff and faculty are fantastic—they are both supportive and absolutely professional.”
Sanchez found UIW’s "block scheduling” to be an asset. Each semester is broken down into three blocks. Students take approximately 18 hours a semester but only six to eight hours in each block.
"You’re bombarded with information intensely over each five-week block, so that helps reinforce the material,” says Sanchez.
"Everyone knows everyone at UIW—we’re all there for each other,” Sanchez adds. "The student life is unmatched—there are plenty of organizations you can join that are pharmacy-related: American Pharmacists Association (APhA); Texas Pharmacy Association (TPA); Student Societies of Health-System Pharmacy (SSHP); National Community Pharmacists Association (NCPA); etc.
A TPA member since 2011, Sanchez is a two-time Student Patient Counseling Competition winner (2012-13), and served as TPA student president while at UIW.
"If you are going to practice pharmacy in Texas, you should be part of the premier Texas Association that looks out for the profession,” says Sanchez, who is engaged to fellow UIW graduate Rachael Wiles, also a pharmacist at Walgreens.
Career Takes Off
After graduating in May of 2014 with a Pharm.D., Sanchez got licensed in July, and started as a pharmacist at the Walgreens on Rigsby Avenue in San Antonio in August.
In just four weeks, he was promoted to pharmacy manager.
"My time with Walgreens and my experience as a pharmacy technician, helped pave the way,” says Sanchez. "I have a lot of respect for pharmacy technicians—they really are the life-blood of community pharmacy.”
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Dahlia Solomon- Walgreens, College Station
TPA member Dahlia Solomon knew what she wanted early on, and let nothing slow her down as she pursued a career in pharmacy.
"I was disciplined as a kid, and my parents encouraged me into pharmacy. I’m very science-oriented,” says Solomon, who was in the international baccalaureate program while at Miramar High School in South Florida. "It’s structured to get you ahead in terms of undergraduate requirements.”
Solomon was accepted at Florida Agricultural and Mechanical University, and earned her Pharm.D. in 2010.
"FAMU is a historically black college with high standards and a rigorous curriculum. I’m very grateful for the College of Pharmacy and Pharmaceutical Sciences program. They have a six-year pharmacy program, and I loved it—I took to the discipline,” says Solomon.
Looking at the South Florida job market in 2010, Solomon began to consider alternative locations.
"In 2010, the recession was still a big factor,” says Solomon. "There were not a lot of positions in South Florida at that time. I had worked for Walgreens during school, and wanted to stick with them. A recruiter I worked with suggested Texas. You always think about moving west!
Given the choice of relocating to a Walgreens in Midland/Odessa or College Station, Solomon chose College Station.
"I packed up a U-Haul in June, trained for several months, and got my Texas pharmacy license in November 2010,” says Solomon. "I’ve been working fulltime ever since. I was a staff pharmacist until 2012, then promoted to pharmacy manager in March of 2012,” says Solomon.
"I like managing the store. You hear that managing a store can be hard, but I have a loyal team, and that really helps. I work a 12-hour shift one day a week, and the rest are eight-hour shifts. I work about 45-50 hours a week.”
Solomon’s managerial responsibilities include recruiting, hiring and training of pharmacy technicians.
"Often we get pharmacy students as techs—typically from Texas A&M Kingsville,” says Solomon.
"As a manager, I’m basically responsible for operating the business, scheduling and so forth,” Solomon adds. "There’s lots of stuff to keep up with—vaccinations, immunizations. Back-to-school vaccinations were a big thing in July and August. Now we’ll be moving towards flu shots.”
Like many practitioners, Solomon finds that one of the most rewarding aspects of being a pharmacist is when patients express their appreciation.
"I recall one patient who kept refilling an antibiotic for a chronic sinus infection, and I consulted with her and pointed out that when something is not responding to antibiotics, you have to take a look at the structural side.
She ended up being able to address a problem with her sinuses that resolved the
"My advice to upcoming pharmacists choosing their pharmacy setting is to really look into what they want to do. Do some due diligence and you’ll find where you want to commit. It takes special people to be pharmacists!”
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While working as a pharmacist at Tom Thumb, and later Randall’s, former TPA president Dennis Song (2011) developed an interest in diet, nutrition and plant-based medicine.
"I enjoyed working in the grocery store setting,” says Song. "In fact that’s what got me more interested in nutrition. I worked closely with the store directors, and they allowed me to expand the offerings. We created a weight-loss program—we’d use the different food departments and teach basic nutrition. The dietician I worked with was Kathy King-Helm- former dietician for the Denver Broncos. That’s how I got started with the herbs and the vitamins.”
That interest eventually led Song to start his own business—that, and TPA.
At the time, TPA offered a "pharmaceutical care” toolkit, and that’s what started Song on his pharmacy ownership. TPA also had a course which offered certification on phytomedicinals and alternative medicines taught by renowned experts Wendell Combest and Constance Graud. Song took advantage of both.
In 1998, after 15 years working in a chain setting, Song bought a small independent pharmacy in Flower Mound, now called Flower Mound Pharmacy.
In addition to traditional dispensing, Song began to add alternative offerings.
"We stared with herbal teas, candles, and a few supplements. And we developed relationships with chiropractors, nutritionists, and conventional doctors,” says Song.
It wasn’t long before Song expanded the pharmacy’s features to include a wide range of supplements and specialty foods to support a healthy lifestyle. And Song, who is careful about what he stocks, points out that all supplements are not created equal.
"Everyone and anyone sells supplements,” he says. "We sell a 'nutriceutical' grade of supplement.
Flower Mound Pharmacy has a strong emphasis on patient care, and is "prevention and education based, featuring a complete diabetes education program that includes nutritional education, fitness and lifestyle modification training.” Additionally, they are a compounding pharmacy that specializes in bio-identical hormone replacement.
As Song explains, more and more people are seeking natural approaches to treating health issues.
"When people come in with a prescription, they may ask: ‘Is there anything natural I could use instead?’” says Song. "For example, we might recommend fish oil to help with cholesterol levels. Whatever we do, we record and get the information to the patients’ doctors. Most doctors are really good about letting patients try this approach. We like to treat the condition, not just the symptoms. Hopefully, natural medicine will become more used by the public,” says Song, who was TPA’s Innovative Pharmacist of the Year in 2003.
"The award came about because of my ‘novel’ practice- integrating supplements and lifestyle changes. So far insurance does not pay for this approach. Eventually, I think pharmacists will be covered [reimbursed] for that.”
"I attribute my business and professional success to TPA,” Song says. "From a business perspective, it makes good sense.”
Jonathan Spinks, University of Texas College of Pharmacy
Jonathan Spinks worked as a pharmacy technician at CVS Health while a student at Texas A&M in Bryan, College Station. Ironically, he didn’t know his future career was right in front of him.
"I was interested in healthcare, but didn’t know what area,” says Spinks. "I took an EMS class at A&M—I thought maybe I’d get into that, or maybe go to med school”
After graduating A&M in 2009 with a degree in biology, Spinks moved back to his native Fort Worth and took a position at Walmart, again as a pharmacy technician. All the while, he was still considering what area of healthcare he might further pursue.
"A pharmacist at the Walmart in Fort Worth said, ‘Why not pharmacy?’ That’s when it hit me— what a great idea. I took the Pharmacy College Admission Test (PCAT) as early as possible, and it went really well,” says Spinks. "I applied to a number of schools, and it came down to the University of Texas College of Pharmacy and Texas Tech University Health Sciences Center School of Pharmacy. I was attracted to Austin, and that sealed the deal.”
Spinks, who started at UT in 2013, joined TPA as a P1, to "gain exposure, network, and see what companies were hiring.”
"I loved the conference,” he says. "I thought it was really fun, and I really enjoyed the seminars. I enjoyed hearing Texas State Board of Pharmacy’s Gay Dodson—it was very interesting.”
Currently a P2, Spinks is certainly finding that he made the right choice to pursue his Pharm.D. at UT College of Pharmacy.
"I’m loving the program—it’s top rated. I definitely think that it paid off to complete my undergrad at A&M—and spend time working in the field before coming back to it,” says Spinks, 28. "I wasn’t as surprised at how difficult the program is—it’s rigorous. But that’s good—you want to get as much as you can out of it.”
Without a doubt, a serious amount of studying is required, especially headed into the second year.
"This year we had our first pharmacotherapy course—it was a six-hour credit course requiring a lot of study,” says Spinks. "We covered chronic disease states such as hypertension, congestive heart failure, and chronic kidney disease. I think it’s important to have a fundamental understanding as to how these chronic diseases manifest—they are often intertwined and pharmacists are in a position to offer input towards prevention. I like that pharmacy is headed towards a team process. There’ so much to know. Doctors can’t be experts in all areas of medication therapy, and that’s where pharmacists come in. For example, I attended a workshop last week that dealt with minor variations in drug responses in individuals, and the upshot is that one drug may work better for one person, but not another.”
While all courses are challenging, Spinks thoroughly enjoyed his pharmaceutics course, taught by Dr. Robert O. Williams III.
"It’s really interesting,” he says. "The lecture style is a ‘split’ classroom. You do the reading ahead of time, and discuss during class. We talked about drug delivery systems, and ran case scenarios.”
Like many P2s, Spinks is not drawn to any one area of pharmacy yet, and figures he’ll know after doing his rotations.
"That’s where I’ll get hands-on experiences,” he says. "I am starting to like the clinical aspect of pharmacy and intend to look into it further.”
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Nicholas Stark, Walgreens (El Paso)
New TPA member Nicholas Stark has traveled a long way to be a pharmacist in Texas. Originally from Whitehall, NY, which is just an hour or two from the Canadian border, Stark studied at New York’s Albany College of Pharmacy and Health Sciences.
"I was originally considering medical school,” says Stark. "But I had a friend whose parents and grandparents were all pharmacists, and I liked that there were a lot of career options. They pointed me to Albany College of Pharmacy and Health Sciences, telling me what a good program they had.”
Stark found that Albany College of Pharmacy and Health Sciences has a unique six-year Pharm.D. program that features "built-in prerequisites" the first two years, followed by the traditional P1-P4 years.
"It was a rigorous program,” says Stark. "There were a lot of opportunities for community outreach and joining pharmacy organizations. Along with a few others, I started up student chapters for Academy of Managed Care Pharmacy (AMCP), and American College of Clinical Pharmacy (ACCP) chapter. We had a lot of networking events and did community outreach events. For example we held senior events at the YMCA, like ‘Know your Medications: Brand vs Generic.’ And we were very active in APhA.”
Another strong point at Albany College of Pharmacy and Health Sciences was the leadership opportunities and staff.
"We had a lot of mentors,” says Stark. "Dr. Leon Cosler was are our chapter advisor for AMCP and was a great role model. He pushed us to be open-minded and look into our careers.”
Stark graduated with his Pharm.D. in 2014, and interned at a popular northeastern food chain called Hannaford where he did patient counseling, some compounding, and took verbal orders. But if you’ve spent any time in upper New England, you know the winters are very harsh. Stark had warm weather in mind when he did his rotations.
"I did all of my rotations away from the Northeast,” he says. "I wanted to get away from the cold. I did rotations in Miami and Dallas.”
One of Stark’s rotations was at the Medical Center of Plano, and while he was there, Walgreens reached out to him concerning a pharmacist staff position in El Paso.
"I flew out to El Paso and checked it out,” says Stark, who liked it right away.
"El Paso has hiking, mountains, and the people are very friendly and welcoming,” says Stark, who took the offer. "You can wear summer clothes year round, and you don’t have to check the weather.
There’s a lot more socializing—you spend a lot more time with people. For me, it was about meeting new people, and taking on a whole new set of challenges.”
Stark works the night shift at the 24-hours Walgreens at El Paso’s Doniphan and Mesa, clocking in at 10:00 p.m. and finishing at 8:00 a.m. He speaks decent Spanish, and it’s helped him tremendously in El Paso. "Local folks are very appreciative of that—many don’t speak English,” he says.
"I work 10 hours a day from Monday to Monday, and then I have a week off,” says Stark. So it’s seven on, seven off. You can become a bit of a zombie in that you sleep during the day. I’ll sleep from 10 in the morning to five in the evening. On my seven days off, I convert back to normal. It can be a bit disorienting! But believe it or not, I prefer the night schedule.”
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Before heading to Trinity University in San Antonio, Allyson Thrall went to high school in Phoenix, AZ. There, her mother was a nurse, and she always knew shewanted to do something in the medical field as well. Classes at Trinity furthered that ambition.
"I really liked my biology and chemistry professors at Trinity,” says Thrall. "I knew I did not want to be a doctor, and pharmacy seemed like a great choice. My mom instilled in me the desire to care for and help people. I really want to be there for people who need somebody.”
Thrall graduated Trinity in 2012, and decided the University of Houston College of Pharmacy was the right fit for her to continue her studies to be a pharmacist.
"When I interviewed at UH COP, I really liked how open and welcoming they were,” says Thrall.
Living in Houston was a big change, coming from Trinity in San Antonio. But Thrall says the College of Pharmacy is very close knit.
"I feel like I’ve found a family here,” she says.
Thrall, who will be a P3 this fall, says that the University of Houston College of Pharmacy is bit different in that the P1s, P2s, and so on are split up when they take classes.
Though the program is not easy, Thrall, a 2014 TPA Scholarship recipient, is up to the task.
"The most challenging class I’ve had so far is medicinal chemistry,” she says. "But I got a B, so it was OK.”
"Everyone at University of Houston College of Pharmacy is involved in student organizations,” she says. "It’s really great to have all these students who are involved and passionate about their interests. I’m really happy with my decision to go to UH, and I’ve had so many great opportunities to learn outside of the classroom.”
"One of the faculty members I really look up to is Dr. Lynn Simpson—she was one of the first faculty members to speak with our class. She’s involved with APhA NCPA, and TPA. "I feel fortunate to be able to build those relationships with professors.”
This past year Thrall was UH student chapter president of NCPA, and helped with community outreach pharmacy advocate events. As Thrall learns more about pharmacy and the various aspects of it, she’s been changing her mind concerning potential career paths.
"Initially, I was interested in independent pharmacy,” she says. "Now I am considering other options such as a residency or going into academia. I took an infectious diseases class this summer, and that has piqued my interest.”
"I think the job market is looking a little tough, especially here in Houston,” says Thrall. "That’s another reason why I’m interested in a residency. The field is getting more competitive, and the extra knowledge you gain from a residency can help you.”
"I definitely plan on being a member of TPA after graduating. One thing I’ve learned is that organizations can’t accomplish things without members.”
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Lanh Tran, H.E.B. Pharmacy (Houston)
For new practitioner Lanh Tran, becoming a pharmacist grew out a need to know more about medications and how to care for people.
"My grandmother is the reason I wanted to become a pharmacist,” says Tran, who graduated from Xavier University College of Pharmacy in New Orleans with a Pharm.D. in May of 2014.
"She had a blood clot, diabetes and high blood pressure, and I was taking care of her,” says Tran. "I remember her asking me, ‘what do those medication do?’ and I realized I was clueless. That’s when I knew that healthcare was what I wanted to learn more about—that was my magic moment.”
At that time Tran was attending Lamar University in Beaumont, near her native Port Arthur. She graduated in 2009, earning a bachelor’s degree in biology, with a minor in chemistry.
Realizing she wanted to know more about pharmacy and medications, Tran enrolled in Xavier University College of Pharmacy (New Orleans) in 2010.
"Xavier’s pharmacy program appealed to me, and I have a sister in New Orleans,” says Tran. "It was a hard transition at first, being away from home and all. But after I got acclimated, things started to go better. One of the courses that I really enjoyed was pharmacology— the mechanism of various drugs. Pathophysiology was a tough course. It involved anatomy and how disease states affect various body systems. It was a hard course, but I earned a B.”
Ultimately, Tran found Xavier’s program to be very rewarding.
"I really loved Xavier by the time I finished,” she says. "I feel like what you put in to it is what you get out it. During rotations, I was very involved, and my preceptor really helped. I did not have a problem passing my board exam.”
Tran found that she liked ambulatory care, which could include working with diabetes or Coumadin clinics.
"You get more time with patients, and you see how medications and diet affect them,” she says. "Diet is very important. For example, with patients on Coumadin too many green, leafy vegetables can throw off your International Normalized Ratio (INR) levels. The goal is to keep blood levels in the therapeutic range.”
Tran, who had worked for H.E.B. as a pharmacy technician while taking her undergraduate courses, is now working as a pharmacist for H.E.B. in Houston.
"It feels very accomplished to be a Pharm.D.,” says Tran. "I wanted to stay with H.E.B., because they have a lot to offer. Their environment offers a balanced workload, which helps reduce stress.”
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Anjanette Wyatt believes in hard work. She attended the University of Texas College of Pharmacy on a full scholarship and graduated with a degree in biology in
1987. She then attended Texas Southern University in Houston and got her R.Ph. in 1991.
While working at Eli Lilly in Los Angeles, Wyatt decided to go back to TSU again, this time to earn a Pharm.D.
"At Lilly, most folks had their Pharm.D., and I wanted to be proactive about learning more clinical information so I could integrate into a healthcare team. I was looking toward the future,” says Wyatt.
In 2003 when Wyatt earned her Pharm.D., she was working, raising a family, and attending school at the same time.
"It was hard. It was difficult, yet rewarding,” says Wyatt. "It opened a new world of pharmacy for me. I did the ‘traditional’ Pharm.D, and did rounds with doctors, learning the same things medical residents learned. It was certainly a good decision to earn it.”
The most interesting class I had was pathophysiology & pharmacology—it was very thought-provoking, and helped me tie everything together insofar as how drugs interact with the body.”
Wyatt taught Therapeutics, Patient Assessment, and Substance Abuse at TSU College of Pharmacy, and also started working for St. Luke’s Episcopal Hospital in Houston in 2003 as a clinical pharmacist.
"It was my first time in a hospital setting, and it was a challenge,” she says. "It was a busy time. I became aware of the level of clinical decisions that are made by pharmacists, and the importance of pharmacists in the treatment modalities. We are a very integral part of that. That’s one reason I’m a big advocate for provider status.”
In 2004, while working at St. Luke’s, Wyatt started Clinical Care Pharmacy—her own business—from scratch with no loans or partners. She continued at St. Luke’s while building her Clinical Care Pharmacy business through 2009.
"I love what I do with Clinical Care and wanted to see how I could impact the community,” says Wyatt. "I built the store from the ground up, and now it’s very productive. We just celebrated 10 years. My vision was to integrate clinical care into a retail setting. We help monitor drugs for patients—narrow therapeutic index drugs such as Coumadin, Warfarin, and epilepsy-related drugs. I think that’s the model we’re moving towards."
"It’s been a very busy time of my life,” says Wyatt. "I was going 24/7. I now have 10 employees at Clinical Care Pharmacy, including three to four on-call pharmacists and four technicians.”
Wyatt still maintains an incredibly busy schedule. She recently started a radio talk show in the Houston area. And she fields dozens of phone calls and e-mails on a daily basis.
"Everyone asks me how I get it all done,” she says. "I’ve been going like this from a young age. My parents instilled a hard work ethic in me, and the understanding that nothing comes easy—everything must be earned. People call me the energizer bunny.”
As if her work schedule were not enough, Wyatt is extremely active on the advocacy front.
"I founded Texas Association of Independent Pharmacy Owners (www.taipounite.com
), and we meet every other month and talk about advocacy and what’s going on in pharmacy. Communication is key in pharmacy,” says Wyatt.
Additionally, Wyatt is on the TPA Public Policy Council committee and on the board of Texas Pharmacy Foundation. She is also President-Elect for the Alliance of Independent Pharmacists of Texas.
"I’m very involved, and encourage others to get involved. It’s our profession, and because of the rapid changes that are challenging our relevance in healthcare, it is imperative what all pharmacists become involved.”
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Stephen Wyatt, M&S Pharmacy (Nacogdoches)
A career in forestry or pharmacy? Although Stephen Wyatt earned a degree in forestry from Stephen F. Austin University in 2001, he decided to get into pharmacy.
“The job market changed after I got my degree in forestry. I was always interested in chemistry,” says Wyatt. “I was interested in pharmacy as well. So I continued on to get the rest of the prerequisites."
Wyatt started working at Wal-Mart as a pharmacy technician while earning prerequisites, and then set to work on his Pharm.D.
“I went to University of Houston College of Pharmacy—I was able to work at Krogers as a technician, and then pharmacist intern. I earned my Pharm.D. in 2007,” he says.
Looking back on pharmacy school, Wyatt admits that it wasn’t actually what he thought it would be.
“I was interested in mixing chemicals and compounding, but it was more of a multi-disciplinary patient-care program. That was kind of a surprise, but I benefited from taking all the courses like anatomy and therapeutics. I left the University of Houston College of Pharmacy with a solid knowledge base. You couldn’t do this job without courses relating to how drugs act in the body.”
After rotations focusing on compounding, infectious diseases and geriatrics, Wyatt went to work for Abeldt's Pharmacy in Lufkin.
“Buford (Abeldt) was one of my preceptors, and I had done a community rotation at his store,” says Wyatt, who worked there from 2007-12.
“He (Buford) instilled in me the concept of becoming involved in the profession, adds Wyatt. “He told me to look at it as an investment. I was part of a task-force to review pharmacy technician practice for the Texas State Board of Pharmacy. Working for Buford opened up opportunities. When he became a director for the State Board, I got involved in TPA’s PharmPAC because he had to surrender his PharmPAC post. I’m currently on the board of PharmPAC. It’s a great way to get your feet in the political arena, and understand what’s going on.”
“Working for Abeldt’s was great, says Wyatt. “But I had the opportunity to move to M&S Pharmacy in Nacogdoches and keep my compounding position—my family is in Nacogdoches, so I felt a pull to work there.”
According to Wyatt, M&S is one of the top five independent pharmacies in the state.
“At any given time there are three to four pharmacists working at M&S, and about 30 technicians are on the payroll,” says Wyatt. “I spend almost half my time in the lab (non-sterile compounding), and the other half filling prescriptions.
Compounding is my passion. It’s part art, part science. It’s not just counting pills and telling someone what to take. You’re making something specifically for an individual. You tinker with various percentages. It’s a way for the physician to work with the pharmacist to fine-tune medications.”
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Ed Walsh, Fry’s Prescription Pharmacy (San Benito)
Looking back on his education at the University of Texas College of Pharmacy, Ed Walsh recalls that the school’s program was beginning to expose pharmacists to a strong background in medicine as well as drugs.
"I was one of the "Guinea pigs,” says Walsh, who graduated in 1977 with a BS and R.Ph. "I did six semesters in two years. The last year, half the class did the traditional program, and half went to UTSA Health Science center and did rotations at the University Hospital with the medical students, focusing on the clinical aspect of pharmacy. I liked it—I gained a lot of working knowledge of medicine that has really helped me in the community pharmacy setting. That was the early introduction of that program—we may have been the first class. At that point, it was almost like an experiment. And it underscores the fact that in many ways, pharmacists are the experts in understanding the treatment once the diagnosis is given.
Walsh worked in San Antonio for a company called Sommers Drugs—which later sold to Eckerd’s. By 1983, he had experience managing a pharmacy, and had familiarity with the Rio Grande valley—an area he would later settle in.
"Their [Eckerd’s] model was changing as the big-box stores started having pharmacies,” says Walsh. "That was part of the evolution—Walgreens and CVS are the survivors of the stand-alone convenience store model.
I saw that happening, and decided to go into business for myself. In 1984, I started Island Pharmacy in South Padre, TX.”
Walsh operated that store for 19 years, and in 2003 jumped at the chance to buy Fry’s Prescription Pharmacy in San Benito, TX, a store which is currently thriving.
"Fry’s is in the top five percent for single store volume in the state,” says Walsh. "We do about 180,000 prescriptions a year, approximately 500 a day.”
Part of Fry’s success lies in their wide offering of services, which includes long-term care; compounding for hospice needs; and home infusion.
"These are needed services, and we’re the only provider for them in the three-county area,” says Walsh. "We offer the community services folks know are not available in any other way, whether it’s home delivery of alternative dosage forms, or timely service to area nursing homes and assisted living patients.
Giving Back to Pharmacy
Walsh’s advocacy efforts began as a way of paying back his profession.
"Pharmacy has been good to me,” he says. "It’s time to start giving some of my time and effort back. I’ve been involved with the legislature and with the Texas Pharmacy Association for the past 10 years. I’ve come to realize over the last few years that pharmacy in general may have worked well for stakeholders, but the advocacy at the legislative end of it has fallen way short.”
"In seeing that, I’ve become very passionate about trying to improve not only how we’re doing as stakeholders, but as legislation advocates,” says Walsh.
Walsh is on the board of directors for Texas Independent Pharmacies Association (TIPA), and serves as their legislative chair. Additionally, he’s on the Texas Health and Human Services Commission (HHSC) Medical Care Advisory Committee.
"Currently there is a project underway called the ‘Texas Dual eligible Integrated Care project,” says Walsh. "It’s a project between Centers for Medicaid and Medicare Services (CMS) and Texas Medicaid.”
HHSC’s website states that, "The Texas Health and Human Services Commission (HHSC) is proposing a new way to serve people who are eligible for both Medicare and Medicaid, known as dual eligibles. The goal of the project is to better coordinate the care those individuals receive. The Texas plan involves a three-party agreement between a Medicare-Medicaid health plan, the state and the federal Centers for Medicare and Medicaid Services (CMS) to provide the person with the full array of Medicaid and Medicare services. The project will test an innovative payment and service delivery model to improve coordination of services for dual eligibles, enhance quality of care and reduce costs for both the state and the federal government. The project is scheduled to begin March 1, 2015.”
"For pharmacy, these patients will be enrolled in a Medicare Part D Program provided by the Managed Care Organization and will be under the auspice of CMS rules," says Walsh. "The project will look very similar to a Medicare Advantage program where Medicare will be the main source of income and the MCOs will be coordinating the care. Pharmacy has to worry that though these patients will continue to be under Medicare Part D, this does not guarantee that reimbursements will be better than Medicaid Managed Care.”
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William Yeager, Palacios Presciption Shoppe (Palacios)
Longtime TPA member William Yeager graduated from the University of Texas College of Pharmacy with a BS in Pharmacy back in 1961 and went to work in Dallas for Meyers and Rosser Pharmacy shortly thereafter.
"It was across from the Baylor Hospital,” says Yeager. "I worked there for two years, and then at Walgreens for two years. Later I helped open a new pharmacy in Waxahachie.”
In 1965, Yeager struck out on his own, purchasing a store called Long’s Drug and renamed it Frankston Pharmacy.
"My ambition all along was to own a pharmacy. I paid $35,000 for it.” Yeager recalls. "And I rented the building for $50 a month. I had a lot of compounding experience, and I had pharmacist-in-charge experience, and I knew how to open a store. We were the only pharmacy in town—my nearest competition was 20 miles away.”
Yeager remembers it as a challenging time. For starters, there was only one doctor in town, and he moved three months after they opened.
Another doctor did come along, and not long after that, there was an epidemic of the Hong Kong flu, and prescriptions started to flow.
"I paid for my store and bought land for my house as a result of the flu epidemic. We worked day and night trying to stay ahead of the customers' demand. There was a combination of medications being prescribed,” says Yeager, who also found a niche compounding medications for veterinary use. "From then on, it was smooth sailing.”
Yeager, who joined TPA while a student at UT, served on TPA’s board for 12 years, including a year as vice president. "I think TPA is a way to band together and do more legislatively than you could do individually,” says Yeager. "Pharmacists have gotten so busy with their jobs and families, and everything is so much more fast-paced now. We didn’t used to have to fight the insurance companies and third parties. Drugs were not that expensive back then [in the 60s] and they cost more to develop now. Healthcare was much more affordable. I believe the key for independent pharmacies to survive is to find a niche.”
Yeager sold Frankston Pharmacy in April of 1985, and continued working as a relief pharmacist for a variety of pharmacies through 2004. Today he is retired from full-time work and lives in Palacios, a coastal town of about 5,000 between Point Lavaca and Bay City.
"I love it here,” says Yeager. I live right on the water and remodeled my house so I walk right out onto a pier and onto my boat to go fishing.
But he’s not ready to give up his pharmacy license just yet.
"Today I fill in at Palacios Rx Shoppe about two days a week,” says Yeager. "It’s nice to stay in the business.”
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Kathaleya Yindeemark, University of Houston College of Pharmacy
Growing up in Humble, Kathaleya Yindeemark (or Kay, as she likes it), came from a family that emphasized hard work and education. And when she was challenged with helping her dad with his diabetes, she rose to the occasion.
“My parents are from Thailand and they worked hard to raise four children in a place that was new to them. They worked long hours to provide for their family and taught me strong work ethics and caring for others,” says Yindeemark.
“I remember spending my 11th birthday in the hospital with my dad. This was his first experience with diabetic ketoacidosis, where the doctors later diagnosed him with Diabetes Type 1. I helped him manage his condition as a young girl by administering his insulin injections and getting him accustomed to his new lifestyle routine. Since then, I knew that I wanted to find a career that allowed me to help people manage their health and make their day to day lives easier.”
Now a P4 at the University of Houston College of Pharmacy, Yindeemark has high praise for the school.
“The reputation that this program has is upheld by the people who continue to be active members of our profession. Students and faculty members are constantly engaged in community events as well as competitive activities against other programs. Our efforts are recognized through awards from the local level to the national level.
“With the Texas Medical Center in our backyard, students have many opportunities to collaborate with highly-skilled healthcare professionals and take part in cutting-edge research. The program at the University of Houston College of Pharmacy provides us with the skill set to become confident and competent pharmacists in the field.
“Dr. Lynn Simpson, one of my professors, is one of the most active pharmacists I know. During my P2 and P3 year I held positions as Operation Heart chair for APhA-ASP and President of PLS, to name only two of the organizations that she is the advisor for at our college. She’s supported us through and through and helped PLS become nationally recognized as Chapter of the Year during the meeting in San Diego earlier this year. Her dedication to the students and the school is very inspirational and I can’t express how much I appreciate her continued efforts.”
Currently, Yindeemark is doing rotations: the first, a hospital rotation with Harris Health Ben Taubs; second was internal med- St. Luke’s Woodlands; and the third one was Ambulatory Care with Harris Health.
“Being on rotations has allowed me to dive into diverse experiences in the field of pharmacy,” says Yindeemark.
“I’m now on my fourth rotation—a pharmacy management rotation with Walgreens at Buffalo Speedway and Bissonette and I’ve had the pleasure of working closely with Junaid Chowdhury and Carole Hardin-Oliver, both Heath Care Supervisors for different areas in Houston and the surrounding areas. Their expertise in being able to manage over 75 pharmacies has given them the insight and skill set to be successful in their careers, which they then impart to their pharmacy interns through mentorship. I also gained experience in MTM.”
I’ve had such great experiences during each rotation. The pharmacists whom I’ve worked with provided me with support while challenging me to become the best healthcare professional I can be. I’ve had the opportunity to meet and work with various healthcare providers, and I’ve enjoyed seeing the value that pharmacists bring to the healthcare team.”
A people-person who really enjoys interactions with patients, Yindeemark hopes to find a position that allows her to see smiling faces every day.
“I’m fortunate because there are many fields in pharmacy that will allow me to carry out my passion to make a direct impact on peoples’ health,” says Yindeemark. “A community position with an emphasis on ambulatory care would be ideal. I’ve worked on a few pilot programs with Carole. The hope is that I might do a residency like that.”
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Mark Zamutt, R.Ph. H-E-B (Austin)
Longtime TPA member Mark Zamutt remembers starting to get interested in pharmacy when his father was a pharmaceutical sales rep back in the 60s.
"All we heard about was drugs at the dinner table,” says Zamutt, a Chicago native. "That was what initially got me interested in it.”
But first he had to get to Texas.
A Texan is Born
Zamutt started out in pre-med at Northwestern University outside of Chicago, majoring in biology and chemistry. But when his father got a job as a medical research associate that brought him to Texas, Zamutt transferred to the University of Texas.
Once at UT, Zamutt met with folks at the pharmacy school, and decided that it was a good fit, and enrolled in the College of Pharmacy.
"My first year at UT, I lived at Dobie (dormitory) and believe it or not, my hair was pretty long at the time. On a more serious note, I’d say it’s harder to get in to the pharmacy program now. I think the current program is more clinically-oriented, and offers better preparation for retail pharmacy, working in a hospital and communicating with patients,” says Zamutt who worked full time during school before graduating with a BS in Pharmacy in 1980.
Zamutt began his career at Safeway where he was pharmacy manager, and later worked at Brackenridge Hospital and Seton Healthcare Network (Seton Family of Hospitals) as well as a number of chain settings including H-E-B, Tom Thumb, Albertson’s, Wal-Mart, and Phar-Mor. Currently a staff pharmacist at H-E-B in Austin, he maintains a busy schedule.
"I think H-E-B is changing and evolving towards more patient-focused services. For example, our second Saturday health screenings offer a great service to customers. There’s never a dull moment,” says Zamutt. "The retail pharmacy is so open, and there is a lot of patient interaction. I think the reason we get so much patient counseling is because people don’t necessarily want to see a doctor.
Also, people ask about drugs they saw on TV, which causes doctors to be in a position they didn’t find themselves in prior to TV advertising. We have to explain the same things as doctors do. When I counsel a patient, we do address side effects—usually you just talk about the most common ones.”
A UT preceptor for more than 22 years, Zamutt loves working with students. "At the retail level, I have not had a chance do that as much. But the 12 years I was at Seton and Brackenridge, I did it a lot,” he says.
Zamutt observed that P4s doing six six-week rotations have a lot more opportunities to get a better feel for what area of pharmacy they want to get into than when he was in school, but notes that the job market may be tightening up some.
“They [students] are having a harder time finding jobs right now in Texas,” says Zamutt. “With all the schools, the graduating classes are all looking at once. It used to be that if you wanted a job as a pharmacists, you could drive up to Dallas and have one that same day.”
Then Versus Now
When Zamutt first started practicing, pharmacists used manual typewriters, and later IBM electric typewriters.
“We had a manual filing system,” he says. “If someone did not have the prescription RX number, you could not refill their prescription. We had no pharmacy technicians back then—we were by ourselves all day. The pharmacy technician concept was just getting started back in 1980. Also, although people could ask you questions, counseling was not required. And there were no print-outs of drugs to tell people about them. Back then, if doctors did not request that you put the name of the drug on the label, you did not have to,” recalls Zamutt.
Zamutt originally got involved with TPA in 1980, has served on a number of committees, and was named pharmacist of the year in 2010. He also served on the TPA board as a chain representative.
Zamutt has been a real champion for TPA’s PharmPAC, serving as Vice Chair of the PharmPAC board from 2008-2011, and as Golf Tournament chair he raised close to $27,000 in 2010—a high watermark for the event.
An all-around strong advocate for the profession, Zamutt, who served as president of the Capital Area Pharmacy Association twice, is also an ardent Longhorn fan. As his UT bio says, “He truly bleeds orange and is known for his loyalty and support of his alma mater and its students.”