The 87th Texas Legislature was in full swing as I began my final fourth-year rotation with the Texas Pharmacy Association. The weeks flew by in a whirlwind as I navigated through various Zoom meetings, tried to understand the bills affecting pharmacy, and grappled with the political complexities that are the foundation of our society. Looking back, here are a few key takeaways on policy and advocacy that I learned on this rotation.

The Political Process Is Not as Complicated as It Initially Seems

The political jargon and various processes can be difficult to understand at first. Politics is like a game where you have to understand who the players are, the rules of the game, and what rules can be broken. As you piece things together, it begins to make more sense—just give it time and ask questions. This is why TPA employs a fantastic team of lobbyists to guide us through the process.

Politics Can Be Exciting

Too often, government is termed a “boring” topic, especially among us science-minded folk in the pharmacy world. I have experienced first-hand the excitement that comes with a successful public hearing or watching a bill being debated on the floor of the Texas House or Senate.

During one field trip to the state Capitol, I donned my white coat to show support for pharmacy benefit manager (PBM) reform legislation being heard in the Senate Health and Human Services Committee. In a rare move, the committee unanimously voted the bill out of committee that day. Finally, people were beginning to understand the plight of pharmacists against unfair PBM practices!

The excitement in the Senate chamber and in follow-up meetings with TPA members and lobbyists was a refreshing change of pace. Our bills were moving, and that movement spurred a glimmer of hope. Having legislators so passionate about pharmacy issues because of our advocacy efforts provided a glimmer of hope that our profession is valued and recognized.

Your Voice Matters More than You Think It Does

While I did not testify myself on behalf of TPA’s immunization and test-and-treat bills, I helped write the testimonies and helped prepare pharmacy witnesses for potential questions. Hearing words I wrote spoken in a committee hearing was an empowering and energizing experience. My voice does matter. My words do have impact. I can make a difference.

So can each and every one of you. Show up for hearings to register your support or opposition, call or email your legislators, tell your stories, and share your experiences. Legislators remember this when they are making decisions.

Involvement Is Meaningful

Whether you are a TPA Board member, just pay membership dues, or fall somewhere in between, the importance of being a TPA member is paramount if we want our profession to survive and thrive.

Pharmacy has huge opponents in the insurance and medical industries. We need as many people supportive of TPA as possible to move the profession forward for our practice abilities, for our businesses, and for our patients.

Getting involved in policy and advocacy can seem complicated, messy, and confusing. Don’t let that deter you from fighting for what you believe in or for what your profession needs. It is worth it. Regardless of your practice setting, regardless of your interest (or lack-thereof) in politics, involvement is important, impactful, and meaningful.

I encourage each and every one of you to step outside your comfort zone and go do something to advocate for our profession. Take that one extra step and venture outside the pharmacy bubble. Learn about the issues facing other people and our society. Be open minded and open to hearing new perspectives. Not only will you be better able to relate to your patients, but you may discover something new about yourself as well.

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Humpert completed a six-week rotation with the Texas Pharmacy Association during April and May of 2021.

I joined the Texas Pharmacy Association (TPA) during my first year of pharmacy school but failed to recognize the value of my membership at that time. As a fourth-year pharmacy student, I was able to better appreciate the value of being involved in TPA during my advanced pharmacy practice experiences (APPE) rotations.

Although I have been a TPA member for many years, I was not sure what to expect in my rotation as I had a limited background regarding legislation and advocacy. With the help of my preceptor, Debbie Garza, and the TPA staff, it turned out to be an extraordinary learning experience.

Sadly, it was not until this rotation that I got a glimpse at some of the important issues at hand: low reimbursement rates, lack of federal recognition as providers, difficulty joining provider networks in Texas, and concerns regarding job outlook. Throughout my rotation, I was able to participate in meetings with the TPA Board of Directors and other groups, such as Texas Medicaid, that helped me better understand the issues in pharmacy.

Unfortunately, these issues only become apparent to students once they begin practicing, making it difficult to navigate solutions. There is no doubt that clinical knowledge is important, but it is just as vital to learn and educate ourselves about issues that are affecting Texas pharmacists in real time.

TPA provides a unified platform for all pharmacists, pharmacy students, and pharmacy technicians. They actively support and advocate for issues their members are facing, regardless of their practice area. Joining TPA is free for students, but the wealth of information that comes with the membership is immeasurable. It was only at the beginning of this rotation that I realized all the information that I had at my fingertips, as I began to dive further into the weekly newsletters and quarterly magazines.

As students it is easy to get caught in the whirlwind of pharmacy school, but it only takes a couple seconds to sign up and support TPA. Although many issues may not affect students just yet, that does not mean students cannot play a role in advocacy. During the last legislative session in 2019, more than 400 students from all pharmacy schools showed that their voices mattered, resulting in notable legislative wins for pharmacy.

A unified voice in the profession can have a far greater influence than multiple individual voices. TPA has always provided the support, but the organization can only be as strong as its members. Everything is at our fingertips; it’s what we choose to do with the information that can make a difference for our profession and our future.

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Momin completed a six-week rotation with the Texas Pharmacy Association during October and November of 2020.

When I received my APPE rotation schedule and saw I would be wrapping up my P4 year doing an Association Management rotation with Texas Pharmacy Association CEO Debbie Garza, I never imagined it would be completely virtual.

As a student pharmacist just six weeks shy of completing the Pharm.D. program requirements, the COVID-19 pandemic brought much uncertainty. Would we be able to finish our rotations? Would we be able to graduate? Would we be able to sit for board exams?

Fortunately, TPA was able to help ease my uncertainty by allowing me to complete a virtual rotation while also emphasizing its dedication to the profession of pharmacy amidst a pandemic.

I spent six weeks working with the TPA staff, yet never saw them in person. Because of my involvement as a student member of TPA, I was familiar with the Association’s structure and was quickly able to jump on board with projects. Debbie held virtual meetings via the Zoom platform allowing the staff to utilize video conferencing to meet multiple times a week. Through these meetings, I was able to put names to faces which helped make up for the lack of in-person interactions. From sharing fun facts to hosting themed birthday celebrations, the virtual platform allowed me to build rapport with the staff while still adhering to the work-from-home mandate.

While the staff was not directly on the front lines of the pandemic like many pharmacists were, they still worked tirelessly behind the scenes and greatly contributed on many different levels. They ensured their website and social media platforms had the most up-to-date information from both a public health and clinical perspective. They helped connect local news stations with pharmacists to highlight their efforts in the community. Most importantly, they worked closely with the Texas State Board of Pharmacy and the Governor’s office to advocate for changes that would help pharmacists, interns, and technicians better meet the needs of their patients during the pandemic.

Although the rotation was virtual, I was amazed at how much I learned and grew professionally during the six weeks. The structure of the rotation allowed me to work on skills such as effective telephone communication, email etiquette, and self-discipline. Fine-tuning these qualities helped prepare me to transition into a workforce that has largely shifted to remote work using virtual platforms.

Although the rotation did not look how I expected it to, it was a very unique and valuable learning experience that I will never forget.

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Alvarez completed a six-week rotation with the Texas Pharmacy Association during April and May of 2020.

The Texas Pharmacy Association’s 2019 Women in Pharmacy conference taught me many valuable lessons about self-appreciation. I found myself realizing there are barriers women face in the real world that I may face as a soon-to-be pharmacy school graduate. While hearing that there are disparities between men and women was nothing new, learning that women as a whole also hinder themselves was different.

It was a revelation to hear that there is gender discrimination not only in the workforce but also internally in women, through self-doubt and fraudulence. I had never realized that other women had similar experiences, let alone that the phenomenon had a name: imposter syndrome.

Diane Ginsburg, a clinical professor and dean at The University of Texas at Austin College of Pharmacy (and also a great mentor to TPA CEO Debbie Garza), defined imposter syndrome as the persistent inability to believe that one’s success is deserved or that it has been legitimately achieved as a result of one’s own efforts or skills.

Women who suffer from this phenomenon think their success is based on luck or timing, not their own experiences, skills, or other qualities. Those who typically experience this feeling are those with high level positions, creative people, and students, to name a few.

Hearing this, I felt that someone was reading my mind. As a student in my final year of pharmacy school who subscribed to self-doubt and consented to defeat over the years, it is hard to accept that I’m not here based on my good luck but because of my own skills and merits. There is relief in the discovery that there is a name for my insecurity and that I am not alone. Even successful women have cast a cloud over their shining achievements, making it hard to accept the praise they deserve.

The conference was both motivational and inspirational. Being in a room full of women who not only want to better themselves but also support and uplift the women around them was enlightening. Traditionally, the idea has been for women to adjust to the male-dominated workforce, but I believe our goal should be for society to begin to accept and reveal that the capabilities of women are the same as anyone else’s.

I sat at my conference table with a quote staring at me: “Fix another queen’s crown without telling the world it was crooked.” In a room full of other women in pharmacy, it was a reminder that this event wasn’t about men versus women in the workforce. It was about recognizing that as a woman, you can and you should.

Being able to have open conversations about our challenges, we can make more people aware that we all face the same barriers within ourselves. Visualizing success, owning your accomplishments and acknowledging that you deserve to be here are a few of many great lessons I learned.

As I venture into the working world, being able to preemptively address thoughts of hesitancy in advancement due to fear of being under-qualified or feeling fraudulent, I can open doors to more opportunities. By preventing your inner narrative from telling you that you can’t, you’ll be surprised how much you can do.

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Le completed a six-week rotation with the Texas Pharmacy Association during September and October of 2019.

On day one of my final rotation, an elective with the Texas Pharmacy Association, I was immediately swept into the whirlwind of the 86th legislative session. I remember my preceptor, TPA CEO Debbie Garza, telling me that we were going down to the Texas Capitol for our weekly Pharmacy Advisory Group meeting, where representatives from all the major pharmacy groups in Texas would meet to brainstorm a game plan for ferrying our profession’s priority legislation across the finish line.

Having had minimal experience with policy-making procedures, my head started spinning with all the legislative jargon being thrown across the table. Despite years of memorizing medical terminology, I was not prepared for understanding phrases like “working the offices” or “Christmas tree bill.” However, with the patience and tutelage of the team, I dare say I now have a fair grasp of the various tactics and timelines it takes to pass a bill in the state legislature.

Advocacy may appear a monumental challenge to the clinical-minded student pharmacist who would much rather read the new hypertension guidelines than read the language of our bills, but we need to step out of our comfort zone and learn the things our curricula cannot teach us.

I have learned that it takes days of research to prepare for a three-minute testimony at the Capitol, and that you might wait five hours until your bill finally gets heard in committee at 11 p.m. I have also learned that these short testimonies do matter. Even though it seems like a huge time investment for such little airtime, the value of sharing your story with the literature to back it up is priceless. TPA actively searches for pharmacists to lend a voice to our bills, so while “advocacy” might seem like it is outside of our scope of practice, it is our duty to ourselves, our profession, and our patients to make sure laws are in place to support us.

Still nervous about getting involved? Does the thought of talking with senators and representatives give you premature ventricular contractions? I will admit, I still get that rush of adrenaline, fearing that they will throw me a curveball question that I was not prepared for and I will look ignorant. However, just like it is fine to tell your patient or preceptor, “I don’t know, but I will get back to you,” we can do the same with our legislators. They are people like us who hope to make a difference in their community.

While the legislative session has come to an end, your advocacy efforts should not. The days when pharmacists can focus only on the drug product are gone, and if you want job security after graduation, you need to start advocating now for laws that will enable pharmacists to be paid for services we perform. During the interim, I highly encourage students to organize visits with their representatives to talk about pharmacy priorities. It’s as easy as googling who your representative is and sending an email to their office. If you need some help getting started, TPA can certainly assist.

My preceptor told me, “Don’t be a wallflower.” Nothing will happen if we don’t make ourselves heard. Instead, let’s be a wildflower, unapologetically showing our colors and leaving a beautiful pharmacy stamp on this world.

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Nguyen completed a six-week rotation with the Texas Pharmacy Association during April and May of 2019.