Karen Berger, PharmD

While a great deal of the country was safe at home, pharmacists, pharmacy technicians, and other pharmacy support staff were on the front lines, taking care of patients amid the chaos of coronavirus disease 2019 (COVID-19).

When polled on social media, pharmacists described personally delivering prescriptions, greatly expanding the delivery radius, donating masks to first responders, and bringing food to nurses at hospitals. Pharmacists also discussed the steps taken to keep the pharmacy as clean as possible and create space for social distancing between patients in line and at the register, as well as sealing off the pharmacy when possible.

Considering the nationwide toilet paper shortage, Nancy Peterson, RPh, owner of Clearwater Pharmacy in Clearwater, Kansas, had a great idea. “We are asking each homebound delivery whether they need toilet paper. Our local grocery store donated 12 packs. Our mayor offered to help deliver if needed. Our police officers offered to deliver, as have several patients. I just love my little town!” she shared.

Lisa Hess and Doug Hess, RPh, own Doug’s Family Pharmacy in Elverson, Pennsylvania. Lisa said, “It is amazing the response we have received. People have been so appreciative of our fight to help keep them safe. We spray the cash drawer with Clorox spray, wipe down their credit cards with Clorox wipes, and avoid passing anything unnecessary back and forth. We require our deliveries to be prepaid with a credit card or put on a store charge. Again, we are keeping both parties as safe as possible. All of our employees have made a pact to self-quarantine to keep each other safe. We are surviving both economically and physically, which makes it so important to have each other’s backs. I’m so impressed with the tolerance and patience of our staff and customers during such a drastic change and trying time.”

Trisha Winroth, PharmD, pharmacy manager at Walgreens in Lowell, Massachusetts, stressed the importance of leadership: “Managing a team during the COVID-19 pandemic is no different from managing them through any situation. If they trust in your leadership, the rest falls into place. I give them all the information I have, and I am available to hear their concerns and answer questions. Making my team feel well taken care of is my main goal. We’ve had homemade snacks, plenty of vitamin C, lots of coffee, and a ton of laughs! For us, laughter is really the best medicine, and it keeps us all going throughout any stressful situation. I’m wearing a shirt that says, ‘In a world where you can be anything, be kind.’ I chose it because it’s what we all need through this time. If we all take care of each other and our patients, we’ll come out stronger in the end. Stronger team. Stronger patient relationships. Stronger leaders.”


				Loretta Boesing, a patient advocate, describes ways she has seen pharmacists go above and beyond during the pandemic. “Pharmacy staff are risking their lives to protect their patients. More pharmacists who were silent about the mistreatment of workers and unsafe conditions are breaking their silence about the prioritization of profits before patient safety.” She commended pharmacists who have found creative ways to take care of patients through telemedicine consultations, setting up curbside pickup, demanding proper personal protective equipment, and making hand sanitizer. “Pharmacists and pharmacy staff are there for their communities during this challenging time, checking in on others because they care,” Boesing said.

Articles

Thank you to pharmacy staff on the front lines. 

Social Media and COVID-19

We asked pharmacists from various settings around the country: “Why did you become a pharmacist, and what keeps you motivated?" Their answers are refreshing and motivating, and a reminder of why we all chose pharmacy.

Larry Riggi, PharmD, Pharmacy Manager                                                                                                        

“I chose to pursue a career in pharmacy because the medical field has always interested me. When it came time to decide, I had heard the rumors about a lucrative pharmacy career back in the early 2000s, and had added that as an option. I was really interested in becoming an ER doctor as well, so I decided to shadow a pharmacist for a day. The pharmacist said one thing that really stuck with me: ‘If you want to have a family later in life, choose pharmacy over ER doctor.’ I chose pharmacy after that day and haven’t looked back. Whether or not that still stands true today with the direction pharmacy is going is still to be determined.

There are a few things that keep me motivated on a regular basis–my kids being the biggest thing. Looking. forward to days off with my kids is what can get me through a long stretch of work every time. I also enjoy seeing my store excel with corporate metrics and comparing how we stack up to other stores. I’d be lying if I didn’t say that the desire to be the best in the district wasn’t a motivating factor.”

Laura Dee, PharmD, Clinical Pharmacist                                                                                                                      Crusader Community Health, Rockford, IL

“I started a part-time job at a retail pharmacy and my pharmacy manager’s compassion and enthusiasm inspired me to become a pharmacist.

As an ambulatory care pharmacist, my coworkers and my patients keep me inspired. I manage a hepatitis C clinic, and just hearing my patients’ stories of all the obstacles they’ve overcome, I’m honored that they entrust their medical care to myself and my team.”

Elaine K. Richer, RPh, CEO                                                                                                                                      MyCureAll, Fair Lawn, NJ

“I always knew that I wanted to work in the medical field, and as pharmacy school was shorter than medical school, it was a no brainer.

As a newly licensed pharmacist, I loved working in a retail setting, interacting with people, helping with their questions, advising on interactions with food or medicine. It was a very fulfilling experience, and I looked forward to going to work every morning.

As the years passed, and I had my daughter, I also realized that working as a pharmacist was a great job for a female because I was able to design my schedule around my family’s needs. Pharmacy as a profession is very versatile–you can do research, or work in a hospital, industry, or retail. You are also learning something new everyday–as our society evolves, so does our profession. When I started out as a pharmacist, I would never imagine vaccinating a patient or administering Narcan, but alas, that is what pharmacists are doing now. And I really enjoy it.

Now that I am in the middle of my career and I decided to completely shift my focus and work in a med/tech start up world, everything I’ve learned as a pharmacist is here to support me, and my knowledge leads the way to new and exciting opportunities.”

Arun Tandon, RPh                                                                                                                                                      Advanced Health Pharmacy, Portage, Michigan

“I became a pharmacist as I was very much interested in human health.

What keeps me going is the ability to understand health at a much deeper level and translating it to my patients. Seeing them healthier and happier drives my passion.”

Gunda Siska, PharmD                                                                                                                                              Presbyterian Hospital, Albuquerque, New Mexico

“Even as a kid, I always knew I would work in a hospital. I went to LPN (licensed practical nurse) nursing school concurrently while in high school. Then I automatically went to college to pursue an RN degree, but at the last minute, I decided to pursue pharmacy school. I did retail and mail order work right out of pharmacy school, but felt restless until I got a hospital job. It thrills me to be involved in acute and critical care. I often think of my time as retail pharmacist, and now I write pharmaceutical articles to pass on the knowledge that I acquire in the hospital setting to the retail pharmacists. I think it takes a village to keep the general public safe, and the retail pharmacists are the most accessible. They are on the front lines and I admire their contributions. Iwant to support them the best I can. I think making the world a healthier place is my destiny and life mission.”

Jennifer Gershman, PharmD, CPH
						Fort Lauderdale, Florida

“I’ve always looked up to my father, who is a pharmacist, and wanted to follow in his footsteps and make a positive impact on patient care. Educating pharmacists and patients about vaccines, new drug approvals, and hot topics in health care through writing is a true passion of mine. I enjoy helping pharmacists stay up-to-date with the ever-changing profession through drug information updates.”

Andrea Levin, PharmD, BCACP, Assistant Professor, Department of Pharmacy Practice                                                Nova Southeastern University College of Pharmacy

“I became a pharmacist because of my love and passion for medicine paired with the opportunity to make an impact in patient care. Pairing this with my love of teaching made being a pharmacist faculty the perfect path for me. This is also why I specialized in ambulatory care, as it allows for more longitudinal patient care, often times in an interprofessional setting. Ambulatory care is truly unique since you have the opportunity to interact with both other health care providers and patients equally and work as a team to provide the highest quality of care for a patient.

My motivation as a pharmacist and faculty comes from my students and patients. Seeing how proud and accomplished my students are when they make a difference in a patient’s life reminds me everyday why I love teaching. Also, seeing my patients’ HbA1c or blood pressure or some other laboratory markers either decrease or get to goal and seeing that same sense of accomplishment and knowing that their health will improve keeps me going as a pharmacist.”

We asked pharmacists from various settings around the country: “Why did you become a pharmacist, and what keeps you motivated?"

Why Did You Become A Pharmacist?

Social media posts show that pharmacists are more overworked and stressed out than ever.

Salaries and Stress Stagnate: 2019 Pharmacy Salary Survey Results

Let’s take a look at some of the most common issues pharmacists are facing, as seen recently on Facebook.

Pharmacists are reporting enormous stress due to a hectic daily workload combined with demanding flu shot quotas. On top of filling hundreds of prescriptions daily, pharmacists are constantly being pulled from behind the counter to administer flu shots or other immunizations.

“The stress is unbelievable. I’m actually going to go in today and speak with my PIC. Turns out my suspicions have been correct. Although my cough is instigated by an illness, it is magnified by stress. The biggest culprit is work. There’s just an unbelievable workload. MTM, vaccines, constant training of new staff. High turnover. Good techs don’t stick around because of the low pay and high stress.”

“We get weekly threats on...vaccinations (we have a contract quota to uphold or ‘we’ll lose a million dollars’ lol)”.

“I wish everyone was competent, but that’s not the case anymore. Those of us that are, we’re burning out. The lack of help. The tight job market that makes it hard to get out. All of it. It’s hard to have high expectations when others just don’t get it, so workflow is always different depending on who’s working.”

“I personally don’t understand how some are doing 400 prescriptions plus 40+ vaccines in 1 day. I struggle with breaking 200 with what I have and I’m working every queue. A lot of people turn queues off, but I never feel like I can do that because my techs are usually stuck up front and that’s the only way I can get things moving forward.”

It’s not all bad news though: Some pharmacists seem relatively satisfied with their job.

Stress isn’t the only thing pharmacists are worried about. Pharmacists are worried about job security. The prevailing worry is, “Will I be forced out and replaced with someone younger that will work for less money?” Many pharmacists are seeing this happen in the workplace, and fear for their jobs.

“It seems like a cycle. Increased pay rate with sign on bonuses, pharmacy schools turn out students, the market saturates, they lower the pay rate, less people enter the profession due to pay, time goes by, people retire, competitors open, there’s a demand for pharmacists, they increase the rate, market saturates, then repeat.”

“I got pushed out after 20 years at (my chain) and replaced by a new grad making $18 less an hour.”

“We need provider status, a desk, 1:4 pharmacist to tech ratio, mandatory lunch breaks, and absolutely no more opening of pharmacy schools!"

Given decreased technician hours at a time when they are needed the most, pharmacists are torn between going home at closing time or staying and working off the clock. It’s a catch- 22: those who work off the clock may be helping their team open up to a smooth morning the next day; however, many argue that working off the clock for free shows the companies that they can keep decreasing support staff hours because they see that everything is getting done. 

What Pharmacists Are Saying About Stress

For some motivation in 2020, I turned to Jerrica Dodd, PharmD, MS, Founder and CEO of Your Pharmacy Advocate, for advice on how to build on your pharmacy career in the new year.

Below are 4 pharmacy-related New Year’s resolutions that can help enhance your pharmacy services, according to Dodd.

According to the American College of Clinical Pharmacy (ACCP), a board certification indicates an extra level of skill and expertise and can lead to personal satisfaction, financial reward, and career advancement.

 Not to mention, in this competitive job market, a certification will surely make one stand out from the crowd.			

Patty Taddei-Allen, PharmD, MBA, BCACP, BCGP, Senior Director of Clinical Analytics at WellDyneRx, advises pharmacists to perform self-reflection to “assess where you are in your career and what you hope to achieve in the short term (within 1 year) and long term (in the next 3 to 5 years).”						

Once you identify your goals, Taddei-Allen recommended assessing what skills are necessary to achieve these goals. For example, when she knew she wanted to design and deliver clinical programs, she realized that a Board Certification in Ambulatory Care Pharmacy would be a great certification to achieve, giving her a broad focus on chronic disease management. From there, she went on to obtain her BCGP, knowing that the elderly population was rapidly growing and would need clinical services.							

Taddei-Allen credits her certifications with helping her to develop clinical programs and analytics as well as formulary management. A bonus: “The ongoing board certification education requirements, which are intense and require focus and true understanding of clinical principles, also keep me on my toes and up to date with relevant clinical care.					

According to an article in PBA health, customers prefer shopping from companies committed to the environment.

“We believe it is our responsibility to maintain this planet for future generations,” Courtney McQuade, PharmD, owner of McQuade’s Marketplace pharmacies, said. “We are always looking to improve our environmental impact. As grocery store pharmacies, we always strive to ]provide the best service while helping to maintain the environment for future generations.” 														

McQuade’s deliveries, both prescriptions and groceries, go out in diesel vans that have been retrofitted to use vegetable oil that is a waste product of their kitchens and cafe. They boast a large solar array, converting natural sunlight into energy and have also eliminated plastic bags at the checkouts, using recycled paper bags instead.								

Additionally, McQuade is replacing a large percentage of health and beauty care products with sustainable lines that use minimal packaging. The stores carry many other items that are reef safe and packaged in metal tins. Dr Bronner’s soaps and washes are a hot seller due to the company’s commitment to the environment.

According to ASHP Guidelines on Pharmacist-Conducted Patient Education and Counseling, “pharmacists can contribute to positive outcomes by educating and counseling patients to prepare and motivate them to follow their pharmacotherapeutic regimens and monitoring plans.”																			

A major cause of nonadherence is that patients do not understand their conditions and medications and the importance of adherence to therapy. However, in the daily chaos of being overworked and understaffed while trying to add in dozens of immunizations, how do we find time to fulfill our duty to help patients?																					

Trisha Winroth, PharmD, is the pharmacy manager at Walgreens in Lowell, MA. She acknowledged, “Counseling patients in a busy retail setting is an ongoing challenge as the demands grow to do more with less.” Winroth prioritizes patient-centered tasks and delegates other tasks to her qualified technicians. “Training and engaging technician staff to work at their top capacity frees up valuable minutes for pharmacists to engage with patients.” For example, with vaccinations, her technicians perform data entry, go over paperwork with the patient, and ring up the sale, so that the pharmacist can spend time speaking to the patient while administering the vaccine.																																																																

“A successful pharmacy team will quickly develop methods to ensure the patients who need the pharmacist’s time get it.”																																																																							

Bhavana Mutha, RPh, BCMAS, reminded us that “counseling patients is one of the most important aspects of pharmacy.” Mutha recalled a time when, on just another routine, hectic day at the pharmacy, she noticed a patient who seemed out of sorts. “I immediately stepped out of the pharmacy. This woman was 7 months pregnant, dizzy, and about to fall. I had her sit down and checked her blood pressure. The number was very low. I directed the technician to maintain the pharmacy workflow and had another member of the team grab Gatorade while keeping her in sight.”												

Mutha and her pharmacy team helped the patient, staying with her until she felt better, reached out to her family, and made sure she made it home safe. Feeling gratification from helping this patient out of a risky situation, Mutha proudly said, “We are the face of health care, with so much knowledge, and should abide by counseling in our role.”											

We hear a lot about provider status and pharmacists being reimbursed for clinical services.																											

Ambulatory care pharmacists are already being reimbursed for services such as anticoagulation, behavioral health, and oncology. Some pharmacists are billing for office visits. Often, getting reimbursed involves getting creative, forming collaborative practice agreements with physician offices, offering enhanced services such as medication consultations or managing prior authorizations.														

After completing his community pharmacy rotation, Michael Higbee, PharmD, pharmacy manager and clinical specialist at Buhl Drug in Buhl, Idaho, saw the potential in providing reimbursable clinical services to the community.														

Soon after he graduated pharmacy school, Higbee opened Buhl Drug. “From the start, I focused on MTM services, employer health programs, and physician outreach.” Over the last 9 years, Higbee has built a fee-for-service patient care pharmacy.														

Through marketing his MTM services, he receives patient referrals from local providers who pay cash for clinical services. Higbee goes out into the community to provide on-site flu shot clinics for various clubs, businesses, schools, and municipalities, billing directly for those services.																													

Building on those relationships, he offers smoking cessation treatment and weight loss clinics, charging the employer $40 per employee who enrolls.															

Several years ago, Higbee wrote a collaborative practice agreement with a local physician so he could prescribe smoking cessation therapies. Since then, laws have changed in Idaho and pharmacists are allowed to prescribe for a host of conditions. Because they cannot currently bill insurance for these services, they charge a competitive cash price in line with insurance copays.																																																																		

“Patients are usually happy to pay the small service fee because they can get quick service instead of waiting days to get into an available doctor,” Higbee said.																		

Higbee, who has been recognized for outstanding outcomes and was a regional McKesson Healthmart Pharmacy of the Year winner, also regularly prescribes naloxone (Narcan) to patients on opioids, without charging for that service.																																																																																																				

“I personally feel so much more fulfilled with my career when I am an active participant in my patient’s health care team. Pharmacists learn and train to provide these services, but all too often are stuck just trying to keep their head above water in understaffed pharmacies. There is nothing better than making a real difference for my patients.”

American College of Clinical Pharmacy. Board Certification. ACCP’s website.https://www.accp.com/stunet/compass/certification.aspx.				

How to Make Your Pharmacy Go Green and Wow Patients. PBA Health. Published August 24, 2017. https://www.pbahealth.com/ make-pharmacy-go-green-wow-patients/

ASHP. ASHP guidelines on pharmacist-conducted patient education and counseling. 

Here are 4 pharmacy-related New Year’s resolutions that can help enhance your pharmacy services.

Author | Karen Berger, PharmD

Articles

Social Media and COVID-19

Why Did You Become A Pharmacist?

What Pharmacists Are Saying About Stress

4 Pharmacy New Year’s Resolutions For 2020