At the conclusion of American Associated Pharmacies (AAP) Annual Meeting, chairman of the board David Dingman, RPh, joined 

to discuss the importance of pharmacy advocacy work, the biggest issues facing independent pharmacists today, and his top takeaways from the recent meeting.

 Thanks for joining today. My name is Dave Dingman. I’m currently serving as chairman of the board for American Associated Pharmacies Cooperative Group. I’m a graduate of Albany College of Pharmacy, 1993, and that date gets farther back every time I do one of these. Thanks for having me.

 Why is it important for pharmacists to get involved in legislative advocacy work?

Traditionally, over the years, pharmacists have not done a good job of grouping themselves together as 1 professional entity, and we've been left grabbing what's left over from the other the other [health care] professions, both in services and in compensation.

Now more than ever, with reimbursements shrinking and the cost of medications going up, our margins are just evaporating; many of [us are] actually losing money on prescriptions. Who would have thought that that would even be possible? I know my accountants scratching their head wondering how this business model works. But now more than ever, it's important to get involved, be active, and have a voice at that table saying, “Hey, enough is enough. We need to be viable; we need to be compensated to continue to do what we do.”

What kind of advocacy work is AAP supporting to improve the practice of independent community pharmacy?

AAP does support advocacy groups and organizations as far as legislation. We don't do it on our own, but a perfect example would be [the National Community Pharmacy Association] NCPA. We support NCPA, we continue to donate, we do membership drives for them in order to advocate their agenda, rather than create one of our own. We're good at what we do, but as far as supporting the profession in general, we support the groups that are good at what they do.

What is the biggest challenge that you think independent pharmacists and pharmacy owners are facing today?

The biggest challenge that pharmacy owners are facing today… That's a big barrel to choose from.

Right off the top of the head, [the answer] is reimbursement. We have these shrinking margins and these big, huge [pharmacy benefit managers] PBMs just kind of push in, bullying us around, with take-it-or-leave-it contracts. Traditionally, pharmacists are pleasers. Everybody who walks through the door, we want to help them out—regardless of what their insurance is, or their background is, or anything like that; we're here to help and we're here to serve our communities. Over the last few years, as a business owner, you have to make some decisions… [such as], “Look, if you take this insurance, every customer that comes walking through the door is a liability to your business and you cannot afford to continue to fill their prescriptions.” It's absurd that it's come to this, and we need to advocate to fix it, sooner rather than later, because more and more of us independents are going by the wayside. [Many of the] seniors in our group are just throwing up their hands and saying “enough is enough.” We don't have any place to turn; It's getting desperate out there.

Pharmacists have been integral to the COVID-19 vaccination effort, and the recent test-to-treat initiative includes pharmacies as a part of the strategy. Are you hopeful that this expanded practice will become standard for pharmacists?

COVID has, without a doubt, expanded the horizons of what the community pharmacy can do for their communities. I think we've been tremendous with the access, the speed with which we can deliver the care, and the affordability of the care. This is this has been a big bailout for pharmacies that have participated in both testing and in [providing] COVID-19 shots. I think it's a shot in the arm; we're all scrambling through the middle of a pandemic to get this thing up on its feet.

Unfortunately, community pharmacies and the independent pharmacist were kind of left out of the first wave in most parts of the country. Once we got involved, we really shined, and I'm super proud of my peers for doing that.

Now, depending on the state you're in, that has a drastic effect on what you can do and how expansive the rules are. I'm excited about the prospects of the future—new revenue streams, obviously—but it's just 1 more step where we can benefit our communities individually, [and for example,] take some of the what the [physician’s] offices would consider to be a menial task and streamline them into our tasks. I think if we if we work together, as opposed struggling with this turf war, our communities will benefit, ultimately.

This year’s AAP Annual Meeting took place at the end of April in Tampa, Florida. Are there any high-level takeaways that you’d like to share?

The AAP [Annual Conference, held this year in Tampa, Florida from April 21 to April 23], it's a very intimate thing to me, being chairman of the board [and being as] involved and as engrossed with AAP as I am. I'm excited to showcase what the executive staff and the board have come up with for the year. I'm excited to see our members; I get much more out of [the meeting] than I can ever bring to those [meetings], just talking to the other owners and operators and [learning] what they're doing and find out what their solutions to the problems have been. It's been tremendous.

The speakers were high energy, very engaging. It wasn't just number crunching [CE sessions] where you’re kind of half nodding off; it was exciting, it was uplifting. I really praise the AAP executive staff for putting such a great program together.

We do things the way we do, whether it's your ordering, how you fill a prescription, the smart sync program… It's not changing the way the business is done, it's just tweaking a little to accommodate how to become more profitable. It’s taking shipping dollars and putting them into health care dollars. Those are the kinds of things that I've taken away [from the meeting].

As far as the conference personally, I've been exposed to it all year long. So, there wasn't really [much that was] new to me, but I got fired up listening to new our members get fired up—they're like, “Oh my lord, you guys found a fantastic solution to this problem.” Or maybe they didn't understand the problem, but in standing around and having a discussion with them, and explaining it to them, [now they do].

It's great to interact; it's been a few years since we've been able to, and we're looking forward to kind of hitting the ground running and moving forward together.

Do you have any final thoughts you’d like to leave with our audience today?

At the conference, we got to meet a couple of gentlemen who are running for office that are some of our own members. One is a local assembly candidate for Florida. Florida is in a big hotbed battle legislatively to help our members down there. We also have a couple of congressional candidates who are pharmacists. I would encourage you to listen to their platform. Obviously, they have very similar interests being pharmacy owners like yourself, and seriously consider supporting them, or at least hearing their platform.

Get involved: call your local guys, call your local legislators at both the state and federal level, and get involved. It's simple to send an email; if you just ping them once a month, it's not hard to do. In New York, I’m a member of PSSNY, the Pharmacists Society of the State of New York. They give you a cookie cutter [template that you can use to] ping your legislators and just let them know you're there. I think the majority of the problem that we're facing as independent pharmacies today is our problems are so complex, and we're going up [against] such a behemoth of an opponent with these PBMs, and there's so much money coming from the other side, that they don't know how to fix it. And that's mainly because they don't know what the problems are; they don't understand the problems. We have to do a better job of explaining our problems, addressing our problems, and getting legislation through to level the playing field and ultimately take care of the customer.

Expert Interviews

In today’s practice landscape, Dingman’s advice for independent pharmacists is simple: “Get involved.”

Conferences

Total Pharmacy Interviews

AAP: Pharmacists Must Band Together and Advocate for a Seat at the Table

Lauren Biscaldi is the Managing Editor of Drug Topics. 

As a part of American Associated Pharmacies' Stories of Success series, Brandon Trull, PharmD, onwer and pharmacist at Trull Family Pharmacy in Waverly, Tennessee, explains how his pharmacy mobilized to provide community support during devestating flash flooding in August 2021.

Videos

Brandon Trull, PharmD, and the Trull Family Pharmacy staff sprang into action during devastating flash flooding in Waverly, Tennessee. 

Total Pharmacy

Stories of Success: Trull Family Pharmacy 

As a part of American Associated Pharmacies' Stories of Success series,Jacqueline Paye, PharmD, head pharmacist at Dokimos' Pharmacy in Nevada City, California, tells the story of how her pharmacy continued to serve its rural community during the pandemic.

Jacqueline Paye, PharmD, shares how her pharmacy continued to serve its rural community during the pandemic.

Stories of Success: Dokimos' Pharmacy

caught up with Paige Clark, RPh, Vice President, Pharmacy Programs & Policy at Prescryptive Health at the American Pharmacists Association 2022 Annual Meeting & Exposition in San Antonio, Texas.  

Clark will be presenting a session at this year's Total Pharmacy Solutions Summit on April 30, 2022, on navigating trends in point-of-care testing to meet growing patient needs. Join us this Saturday from 9 AM to 3 PM EST. Visit the 

 today to pre-register and secure your spot at the event.

Don't miss Prescrpytive Health's Paige Clark, RPh, at the Total Pharmacy Solutions Summit.

Business Strategies

Learn More About Point-of-Care Testing at the Total Pharmacy Solutions Summit

Sean Slovenski Expert Interview Part 3

 That’s awesome, that seems like something that will definitely become even more popular moving forward—[especially] with…social distancing and everything like that.

Can you tell me a little bit about what resources are available to ensure the success of a script center in a pharmacy?

: Yeah, we have an entire training program and a support program that we put into place, so more than just “Here are your brochures and operating procedures.” We have an entire team that works with the pharmacy staff and the store staff to understand the machines, to understand how the service works, [and] to set up the routines that are right for that particular location.

Each lead pharmacist will have a main contact within our organization to help educate them [and] to help be a support person to them. We run monthly reports to see how it's going, [and see] what's working, what's not, and to suggest new or different ways of doing things because even in one community to the next, there are subtle differences. And so you're always tweaking, it’s not cookie cutter. A lot of personal time and attention has to go into the first 6 to 9 months to make sure that things get launched successfully for many years.

 That sounds like a lot of great ongoing support for the pharmacies. Can you tell me any key takeaways or anything overall that you would like our audience to know?

: One, just to know these things exist. Telemedicine was around for 30 years before anyone really knew if it could do anything. Many of the companies in the space, like ours, have been around for 15 or 20 years; they've been serving institutional groups like prisons, the Department of Defense, and [other] people like that. But now, it's starting to come out into the mainstream and into retail. Just knowing that this option exists—an automatic teller machine but for medicines—if that's one thing they remember out of listening to this is “Hey, I gotta go check that out. I didn't even know about it”… That would be lovely. Everything else will come after that. Yeah, it helps save some money. Yes, it generates new revenue and extends your hours. But if you don't know about it, you can't figure those things out. So just knowing about it is important.

Thank you so much for joining me today and talking about this topic. It's really important and I'm excited for people to hear about this.

In part 3 of this 3-part series, Drug Topics® sat down with Asteres® chairman and BioIQ CEO, Sean Slovenski to discuss 24/7 automated pharmacy pickup and the benefits for pharmacists and patients alike.

Part 3: How Prescription Kiosks Can Revolutionize Your Pharmacy

When Drug Topics® sat down with a group of winners of the 

2021 SingleCare Best of the Best Pharmacy Awards

, humbled quickly became the word of the day.

“I’m very honored, very humbled, by this national award,” said Triet “Tony” Nguyen, RPh, pharmacy manager at Safeway in Annandale, Virginia, and winner of the 2021 Above and Beyond Award. “I guess my customers appreciate my service to them, and that’s why they nominated me.”

 held their Best of the Best Pharmacy Awards, recognizing 25 outstanding pharmacy professionals from around the United States. This year’s awards generated thousands of nominations and honored 10 pharmacists, 10 pharmacy technicians, and 5 pharmacy teams who go above and beyond on a daily basis.

“We are honored to be able to celebrate the pharmacists, techs, and teams that continue to go above and beyond to provide exceptional care and support for their customers," said Rick Bates, founder and CEO of SingleCare. "As pharmacy staff across the country have been stretched beyond their limits over the past year, these awards are especially meaningful in recognizing the critical work pharmacists do to support their communities each and every day."

For Jennifer Bourgeois, PharmD, of Market Street Pharmacy in McKinney, Texas, and winner of the 2021 Best Pharmacist Award, the recognition is proof positive that she is serving where she is best fit. “I think being in health care sometimes seems thankless,” she said. “We’ve put in so many hours, and we’re happy to do that, but just to be recognized by the people that we’re actually showing up for means the most. That’s really what we’re all there to do: to take care of our people, our patients.”

Eric Geyer, PharmD, winner of the 2021 Most Influential Pharmacist Award, was also humbled by the recognition. “For the past 2 years, I’ve really leaned in to trying to be a voice for professional pharmacy,” he said. Geyer recently transitioned from a retail pharmacist role to working as pharmacy director for The Centers for Families and Children in Cleveland, Ohio, overseeing operations for 5 outpatient or community-based pharmacies, in addition to managing the operations of pharmacy residents and a clinical team—all while navigating the complexities of the COVID-19 pandemic.

“I had to think about all of the issues of the pandemic, [how to do] things virtually, and how do I keep us at a safe distance,” Geyer explained. “It’s been a pretty interesting challenge.

“It’s exciting for us in community pharmacy to be able to have such an instrumental role in the availability of the vaccine for our communities,” said Bourgeois, who transitioned into a clinical role just as the COVID-19 vaccine rollout began. “But also, the demands on community pharmacy right now are at an all-time high. Our roles and our responsibilities…the list is just getting longer.”

For Sidrah Alam, a pharmacy intern at Wegmans Pharmacy in Leesburg, Virginia, and 2021’s Best Up-and-Coming Pharmacist, these challenges demonstrate the impact that the pharmacy profession has on the wider health care industry.

“It’s amazing to see how we have [an] impact no matter what setting we’re in,” Alam said.“I think a lot of people don’t realize that all of health care is important and that we’re all part of this team to make sure that all of our patients are comfortable and getting the best care.”

Alam is a pharmacy student at Shenandoah University Bernard J. Dunn School of Pharmacy in Fairfax, Virginia, and will be graduating in May 2022 with her doctor of pharmacy degree and a master of science degree in pharmacogenomics

“Pharmacists have been on the front lines, and I hope that we stay that way,” she said. “I hope that everyone realizes the impact that we can have.”

Her advice for student pharmacists who will be joining the profession is simple: keep an open mind. “You never really know where your pharmacy journey will end up,” Alam said.“Follow your heart; you will find what you are passionate about [and] if you’re passionate about it you’ll find away. Stay involved, be active, and continue to advocate for the profession.”

Check out our roundtable conversation below, and don’t miss our one-on-one conversations with 

, where we dive deeper into their pharmacy journeys. 

Hi, everyone. I'm Lauren Biscaldi, and I'm the Managing Editor of 

. I'm here today with 3 of the winners of the third annual SingleCare Best of the Best Pharmacy Awards. This year's awards generated thousands of nominations from SingleCare customers around the country, and resulted in a total of 25 winners, representing the best of the best.

I'd like to kick things off today with some introductions. Can each of you tell us a little bit about yourselves, what award that you won and what it is that you do for work? Jennifer, would you like to get us started?

Yes, thank you. My name is Jennifer Bourgeois. I am in McKinney, Texas, where I practice community pharmacy, and have been in this industry for 12 years. I received my bachelor’s of science in Nutrition and Dietetics and went on to get my doctorate of pharmacy. I’m wife to my college sweetheart, mama to 2 girls, and that keeps me very busy outside of pharmacy. Currently, I practice as a clinical pharmacist for my company; I received that promotion earlier this year, and so that has been a fun change for me, where I now get to oversee some of the clinical programs in the Dallas-Fort Worth area.

Awesome, Thank you. Tony, I'd like to jump over to you.

 I'm a pharmacy manager at Safeway, a supermarket pharmacy. I graduated from The Ohio State University in 1992 with a chemistry degree, and then went back to pharmacy [school] and graduated in 1996. I worked as national pharmacists [in a hospital] for 4 years before I switched to retail, after I got married and I’ve been in retail since then. I love doing retail, as I found out. I enjoy helping customers and interacting with them. I do immunizations and MTM [medication therapy management] so that my customers continue to be healthy. I love what I do, even though big, crazy time of the pandemic.

Great, thank you. And Eric, would you like to wrap it up?

 My name is Eric Geyer. I am the pharmacy director for the Center for Parents and Children up here in Cleveland, Ohio. I oversee 5 pharmacies, our operations, as well as 4 clinical pharmacists and 6 pharmacy residents. I also do my 

 podcast, which I think is how some people started to hear about me a little bit with winning the Most Influential Pharmacist award. It's just something I always kind of follow, the political side of pharmacy

I'm also a parent, I have 1 daughter currently. It's been a wild journey, having a kid in the middle of COVID-19 and the pandemic. It's been a fun ride so far..

It sounds like you all keep very, very busy, in addition to working as a pharmacist. We appreciate everything it is that you guys do.

What does it mean to each of you to be recognized by your communities as winners of the SingleCare Best of the Best Pharmacy Awards this year?

 I feel very honored, very humbled by this national award, and also thankful that my customers nominated me. I guess my customers appreciate my service to them, and that's why they nominated me. I'm very grateful for that.

I wish I could make this a team award, because my partner of 12 years does the same thing to keep this pharmacy growing and running smoothing. We both do a very good job in helping our customers.

 Yeah, I think it's a real honor, and like Tony said, personally humbling. For the past 2 years, I've kind of really leaned into trying to help be a voice for professional pharmacy, and even when my patients come in—when I was working on the retail side last year—fully educating them on issues, when they were saying, “Why is my copay, so high?” I kind of explained to them some of the issues that are going on with drug pricing and some of the other issues and middlemen, and stuff like that.

It's kind of nice just to be recognized, because you spend all this time doing stuff behind the scenes, and you put in, like Tony said, so many hours—and he's been a pharmacist longer than I have—and to finally be recognized for something like that just feels good and kind of lets you know you're doing the right thing, that people are recognizing it.

And like Tony said, this really was a team award, too. I started a really large COVID-19 Facebook group, I couldn’t do that without some of the admins on that group, or my team at the center who really help me push our profession forward and take care of our patients. It’s a little bit of a different setting than what Tony’s in and what Jennifer’s in, but just in a way that really helps take of the patients and do what’s best for them. No one ever wins this award alone when doing something like this.

Yeah, I agree with Tony and Eric, that is such an honor to be recognized. I think being in health care sometimes seems thankless; we put in so many hours—that we're happy to do—but just to be recognized by the people that we're actually showing up for means the most, because that's really why we're all there: to take care of our people, our patients. So that feels good.

And I think it also is just confirmation that we are serving where we're best fit. You know, I think [for] so many of us here that have been recognized for going above and beyond to provide great service in different areas, I think it's just really an affirmation that we're in alignment with our gifts and just serving where we can make the biggest impact.

Absolutely, it definitely sounds like that. And I guess this next question kind of dovetails off of that. I think the impacts that community pharmacies—just pharmacists in general have had—during the COVID-19 pandemic has been incredible. I know I've relied on my own my own pharmacist for vaccinations and all that kind of stuff. But I know that the industry and the profession as a whole has faced a lot of challenges. Does anyone want to share the biggest professional challenge that you faced in the past year?

 Yeah, you know, for me, there was a big transition. I went from working retail at a big chain, similar to what Tony is, to now being a director at a federally qualified health center. They're very different roles, right?

It's really easy to manage somebody when you're there seeing them every day for 40 hours a week. But when you have to step away and kind of make some more executive, higher-level decisions—then figure out how to implement it and things like that—and then think about all the issues of the pandemic… Things like, I want to do this virtually [and] how do I keep us safe distance, has really been a pretty interesting challenge. And I have to give to my team a shout-out because now that I’m a step removed, a lot of times I’ll dream up an idea, I’ll throw it at them, and they’ll be like, “That’s not gonna work.” And I’ll be like, “Well why not?” and we have to go back and forth. It’s a little bit of a different way [of working] that I’m not always used to coming from more of a retail community setting.

It's also very rewarding, because you can actually go and dream up an idea and then see it as finished product at the same time, with a lot of help from your team as well.

The biggest challenge for me is trying to keep up with the demand of COVID-19 immunizations. So many people want to get shots, and I’m just so glad that they are getting immunized. But right now, we’re just short technician help, and we’re really busy trying to get people immunized. It feels great that they're coming in, [it’s] just the paperwork and billing process that’s tedious. That's the biggest challenge.

I’ll jump in. So, for what I've seen in my practice setting—also in community—I transitioned into the clinical role right as the COVID-19 vaccine became available. And so, I was really able to see it both sides, from more of the managerial perspective and then also from the staffing side.

I think it's been exciting for us in community pharmacy to be able to have such an instrumental role in the availability of the vaccine for our communities. I think we would all agree that that has been a really great part for us and how we can serve our community. But also, just like Tony said, the demands on community pharmacy right now are at an all-time high. Our roles and our responsibilities are just really… the list is getting longer. And unfortunately, our staffing—we're short of staff. And so that has really caused some challenges for us in the community setting.

But I do think, just for me, I try to focus on those stories of the patients who are receiving the vaccine, and just seeing how happy and excited that makes them that they can get back to their life. We have so many elderly patients in our community that we serve, and I can't tell you the countless number of stories that these people come in [with]; they get their vaccine and they're just joyful. I've seen people tear up and cry, because they feel like they can actually see their grandkids again, they can go back to church, whatever their community involvement looks like. That has helped me have those moments, [and] get through those challenging moments. So that's a great part [of how] that we can serve our communities right now.

Sure, absolutely. I feel a little emotional hearing you talk about that, you know, having gone through the vaccination process in my own personal life. But you guys see it all day, every day—it's 1 person, multiplied.

I would like to talk a little bit more about your customers and your community and your patients, because so much of pharmacy is customer service. If anyone has a customer story that had a really profound impact on them, we would love to hear it.

Yes, I have a few. But I think the one that stands out the most to me is [from] when I was probably 2 years into practice. I was very new to community pharmacy at the time.

I had a gentleman who approached me at the counter asking a lot of questions about medications. Through the conversation, I learned that he was terminally ill with cancer and was really just looking for a place where he could trust his pharmacist and really build a relationship so that we could have conversations about his medication. I think he was really just looking for someone with compassion and empathy, who really could see his story and learn a little bit about him and then provide that education back.

It was obvious that he had had some bad experiences. And so, he and I really built a relationship over several months. And, unfortunately, he passed away. And at the end of his life, I got to know his parents, because with terminal cancer, obviously, he couldn't come in, so I built a relationship with them. And they also became customers at the pharmacy.

The next year, they came in and we talked about the holiday; it was November and they asked what I was doing. Unfortunately, I live 5 hours away from my family and my husband worked nights then and I was in the retail space, so that meant I was going to be working a lot during the holidays. I didn't have plans for Thanksgiving, and so they invited me to their home for Thanksgiving. It was just a really sweet relationship that started at the pharmacy counter but just transitioned to be something so much more.

I went and had Thanksgiving with this couple at their home. We continue to be friends, they've been great mentors to my husband and I through our marriage, and they love on my girls still. It’s just a really fun story that I think started… I guess I could have not been that person for him, and I would have missed out on so much. And just to be able to hear the impact from his parents—[to hear] the story from his parents about the impact that it had on him and on them, that just means so much.

That's incredible; I thought it was emotional before, but oh man, you really got me right in the heart there. That's incredible, and I'm sure that it means a lot to his family that you're still in touch.

I have one customer I’ve known since I [started at] Safeway. She's a senior, and she has no transportation; she’s living on a budget so sometimes I would deliver medications to her, or pay for her medications. When she shops at the store, she waits for me to close and I’ll drive her home. I also sometimes give her shots at her home to help her out, with the transportation limitation I can help her out by going to her house. And even now, once a month, I will take her to Walmart so she can do all of shopping at one time; she appreciates that a lot.

She gave me a nickname, Tony the Iron Man—that’s a little funny.

One year, she lost her cat, her only companion. And I was able to find her a new kitten who she loves very much. And she appreciates that a lot as well. So, it makes me happy that I can be someone that she can depend on in your life.

Yeah, so I have a lot of random stories in pharmacy that I could share, but one that really [stands out to me] is I was sitting down to do a medication therapy management with a patient. I was going over his meds and reconciling them, and I said, “Hey, is there you don’t take that’s on here?”

[The patient] actually had hearing loss, so I was trying to be mindful of that. But me having [had] hearing loss as a kid and having a fixed through numerous surgeries, I was always really sensitive to that, and it was a little bit of a connection—I understood when you get frustrated because you couldn’t hear people, I know what that’s like. We had built that little bit of trust from just the random hearing issues we have.

He then told me, “Yeah, you know, occasionally I do go by Norco off the street, because I'm actually addicted to opioids and I can't get in to the treatment. I kind of self-medicate a little bit.” And a lot of pharmacists would be like, well, I gotta report this. But I kind of took this moment of, he’s really just trusting me with his health care. And he's like, “Look, I really want treatment, but I can't get connected.”

So, the next 2 days, I think I spent like 3 hours calling every place on God’s green earth up here trying to get him care for MAT [medication assisted therapy], or in some sort of addiction treatment program. I ended up just calling his insurance like, “Look, this guy wants it, he's afraid to speak out, how can we connect him with it?” Eventually, they got him connected to care. It was a tough situation, because he didn't have a lot of money, he didn't have any transportation, and all the places up here in Ohio are generally pretty full and they’re not really taking new patients. Some are, but it’s just tough trying to work it in to get scheduled, and then with transportation issues… I finally worked with his insurance and was able to kind of get that sorted out and it kind of set him on the right path. He started taking…suboxone for treatment.

And he was really appreciative of that. It helped kind of put him on a “morally correct life” as he called it, because, you know, he didn't have to go out there and buy pills off of the streets, which he knew it was wrong, but he also knew he needed it. So it put him in a really bad spot.

That's incredible. I don't want this to trite or anything, just because I’m on a call with you, but those are truly inspiring stories. It's just nice to hear, I think, with everything that's going on in the world and how difficult things have been, that there are still people who care and who want to help and that it matters to you guys. So, thank you for everything that you've been doing.

I think that kind of leads into our next question. I think that pharmacists are considered by many the most accessible health care professional. And for some, pharmacists are the only health care professional that they can see regularly. So how do you work to make a difference in patients’ lives?

I’ll go first on this one. We are, by far away, the most accessible health care provider. I think with COVID-19 it’s really highlighted that; we're doing tests now, and immunizations, and they're looking at like, can pharmacies dispense the pills based off test now with the CMS regulations and things like that.

But we're really at the forefront of everything, because they realize that something like 85%, 90% people live within 5 miles of a pharmacy—not always true of hospitals. I think it's just one of those things that people have overlooked for so long, what the importance of being close to health care is. And now, people are realizing we can do this, right? There are pharmacies that, people need them—especially in the case of a pandemic. When the pandemic hit, a lot of providers were closing their offices and were only doing Zoom and things like that; people didn’t always have access to Zoom because of their means or what have you. But pharmacists were always open, we were carved out of every exception to be open and be accessible, right?

And that is part of what’s causing the burnout now, like Jennifer was saying. It’s the staffing issues at major chains. Which is why…when people come in, when I was previously in retail and community, and they're mad, I would say, “Hey, you know, our staffing is short, and we’re actually staffed to budget. And this is what it looks like.” This is why we need payment reform. And most of those folks have never heard of…what a PBM is. I was trying to make sure they understood what some of that is, by explaining like hey, maybe there's a way to get this cheaper. I tried to just show them how the sausage is made.

Once they started seeing that, they started taking an active role in their own health care, because now they understand the complexity of it, which is not easy to explain—especially with the limited time we have in spaces like community pharmacy. But then, it lets you speak to bigger topics like too, of like, “Hey, we recognize this provider in Ohio, but not with Medicare, so I can't do this certain service for you," or I can't do this certain thing for you.” I have the knowledge and I have the skills, I just need them to lift the restrictions.

That's one of those things that I thought with the pandemic hitting was a huge call out for pharmacists and for our profession, and CMS [Centers for Medicare and Medicaid Services] as well, to really kind of engage us and all we know, since we know that there are going to be provider shortages for the next decade, by the Bureau of Labor Statistics. There's actually a net negative growth in pharmacist jobs…But you know, I think people are seeing it now: Pharmacists can do this, why the heck can’t we let them.

To make a difference in the customers lives, I…listen to them first, and then give them options to that they feel in control. I want them to feel not hopeless, you know? I also give them recommendations or advice in in to help them in their decisions. That’s what I would do.

Seventy percent of Americans take at least 1 prescription medication. I think that just shows the availability for us to have those relationships with millions of Americans. And just like Eric said, we are very accessible in our positioning because pharmacies are… Usually people are live within about 5 miles of a pharmacy. So [we have], I think, just those 2 things in common—that we are accessible, and that so many people are visiting us, that we can build those relationships with people and build that trust, and that we can have an impact on their life, whatever that looks like. Whether that be immunizations, testing, medications, over the counter supplements…but just that we can build those relationships with our patients.

You guys are making this very easy for me, because this leads right into my next question. I really want to leave our audience with some actionable advice. I think you all kind of touched on that a little bit in your responses, but given everything we've discussed and the staffing shortages in the pandemic… I didn't realize, Eric, that there was a projected 10-year shortage of health care professionals. That's not great; it’s definitely something that we need to work through.

But given all of that, what is the best piece of wisdom that you can leave with our audience, that you have for practicing pharmacists today?

I think the biggest thing pharmacists can do is speak up. We've seen numerous times, especially in my state of Ohio, where a pharmacist speaking up helped when the state was overpaying for medications through the Medicaid system. We've seen where led to access to care for people in rural and urban areas who lack transportation.

I think the biggest thing is speaking up. I know sometimes people are afraid to push the limits. It's just not the personality a pharmacist; we like guidelines, we like things that fit in the little box, all nice and neat and very black and white. But we need to start dabbing more, not just in the gray, but in that middle ground and being advocates. We've even seen some pharmacists in Congress recently, and I’m just a little hopeful for some of the fixes we want to see. Just taking a more active approach… I found that a lot of times when I speak up, I’ll be in a room, and it will be all medical doctors, nurses, and then there’s no pharmacists—I'm the only one there. And that's happened with vaccine record programs, even before COVID-19; no one realized that pharmacies weren’t accessing them. So, I was like, “Hey, we probably give as many, if not more, than you guys do, even with flu and everything every year.”…It's just one of those things, that every time I found when I spoke up on something that I knew a little bit about, it opened the floodgates on a lot of stuff. That’s kind of how I've just been able to get into so many different avenues with this.

Sometimes you're sitting there talking, and you don't realize the person next to you could be your state representative, or your congressman, or things like that. Going to those events… people don't realize that you can talk to someone like that. And you probably know more than they do in some of those cases; you might not, but you are you're the subject matter expert. Speak up, be heard. They’ll usually listen to you, especially if you’re speaking on something you’re a professional in.

Being a retail pharmacist, I believe that customers like to have a personal connection with their pharmacist. I do this by creating conversation with them that can relate to, like their children, or their work, or school, or sports, or passion. And I do this when giving them immunizations [and] when I counsel them on their medications. I think they're happy after they leave, feeling that I took an interest in our lives.

I'll piggyback on what Tony said: I just want to challenge the community pharmacists out there to find ways to go above and beyond in the service that you provide every day. Maybe that looks like a conversation with your patient, getting to know them. Maybe that means stepping out from behind the counter to assist with an over-the-counter selection, Whatever that looks like, I think that that is such an opportunity, because people want great service. And unfortunately, in today's world, it's really hard to find great service. I think that is one way that you, as a community pharmacist, can really set yourself apart and grow your business. People are going to return if you give great service, and if you are interested in them—genuinely interested in them—and build those relationships, they're going to be loyal and they're going to come back. It's a way for you to grow your business, but also make an impact in the community.

Thank you so much. I want to thank each of you—Jennifer, Eric, and Tony—for taking the time out of your day to do this. Like I said, it sounds like you're all very busy really taking care of your patients and your communities. And I wanted to also thank SingleCare for recognizing these and the many other outstanding professionals in the pharmacy field this year.

Click here to learn more about the SingleCare 2021 Best of the Best Pharmacy Awards.

Did you miss the rest of our SingleCare 2021 Best of the Best Pharmacy Awards coverage? Check out our interviews with Best Pharmacist winner 

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Four winners of the SingleCare Best of the Best Pharmacy Awards joined Drug Topics® to share their knowledge with fellow pharmacists and pharmacy technicians. 

Community Practice

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The Best of the Best: 2021 Pharmacy Award Winners  

In part 2 of this 3-part series, Drug Topics® sat down with Asteres® chairman and BioIQ CEO, Sean Slovenski to discuss 24/7 automated pharmacy pickup.

Sean Slovenski Expert Interview Part 2

ScriptCenter allows your pharmacy staff to maintain control of filling and checking prescriptions, while ScriptCenter takes care of the secure storage, tracking, pickup, and payment of your pharmacist-filled prescriptions.

Asteres® develops ScriptCenter kiosks and lockers for secure and safe pickup of prescriptions and healthcare products.

 That's very cool. You mentioned about the ATM sort of concept of it. Can you explain how the kiosks and lockers ensure the safety of the medications?

 Yeah, these are one of the things with our company we have spent a lot of time serving the Department of Defense in the US military. And so, these machines get deployed all over the world at military bases.

So, they've got to be pretty tough and rugged, and very secure. And that carries over into the way we use them in more of the domestic market. So, you know, they're all made of steel, they're locked, you can't get into them, they're video surveilled so that we know what's going on in and around them.

They're not 100% foolproof, just like an ATM can be wrapped with a chain and ripped off by a pickup truck, which is a trend in the US. You could try to do that with these, although they weigh about 500 pounds more than an ATM. So, it's going to be a little tougher, but they're kind of just a steel bulletproof box.

That unless you're the service technician, or the pharmacist with the special key in the code, nobody can break into it, at least not without a blowtorch, and a truck, and a tank and some dynamites are there. They're pretty tough.

In going off of the kiosks and everything about it. Can you tell me about the 24-hour animated pharmacy pickup and sort of how that works?

 Yeah, so you know, we talked a little bit ago about telemedicine. So, imagine and again, I because most people haven't seen these kinds of machines. But if you imagined yourself going up to an ATM to get some money out. And there was a button there that said, I need to talk to a live teller right now do you press that button, and a live teller would pop up on the screen and work with you Just like if you were inside the bank, but it would be like a a telemedicine visit with a bank teller. Same way here.

So, our medication machine has a big giant screen on it. And you can hit the button or pick up the phone if you want more confidentiality. And a pharmacist will come on, like a telehealth visit. Answer any questions that you have validate that it's you do the counseling visit that's required in most states, you know, have you taken this medication before?

Well, here are some side effects to expect that that kind of consultation, and then the medicine would dispense, and you would hang up so to speak with the pharmacist. So, it works just like that. That's wonderful. Can you tell me any personal accounts of for pharmacists that are listening about cost savings and how implementing the script Center can help with cost savings? Yeah, well, it does a few things. It does help with cost savings. But really, it's more about convenience and customer retention and revenue generation.

So, when you come up to the kiosk, or you come up to the locker system and kind of self-checkout, so to speak, same kind of concept, it's quicker and easier, you don't have to wait in line, right. So that's a convenience, your medication isn't any cheaper, though, it's the same cost that would be if you were standing with the pharmacist, where this is really helpful to a lot of communities and businesses are for after hours.

So, when a pharmacy closes at seven o'clock or eight o'clock at night, but the store is open till 10 or midnight or 24 hours, while you can still come get your prescription if that's when it's more convenient for you. And so, you actually add quite a bit more business to your pharmacy that you wouldn't normally do because it wouldn't be open.

And then when you have remote locations way out in the middle of rural America where, you know, they might have a discount store or gas station, maybe a Walmart maybe not, you know, having small community centers or police station or fire station where something like this is housed can be pretty convenient for people to versus driving an hour and a half into town to pick up, you know, whatever medication they need. That's awesome. And we definitely have a lot of independent pharmacists, that that definitely sounds beneficial for.

 So, going off of that. Can you tell me a little bit about how this also can ensure providing quality of pharmacist-patient interaction as well?

 Yeah. So, we'll take myself since I've obviously already established that I'm older and I've been taking my blood pressure medication for a decade. I don't really need to talk to a pharmacist, I just need to get it right. So, mail order for me is really nice and convenient. But when when somebody needs that consultation, and the thing that I always think about with pharmacists and why I think they're so important, is you know, the apothecary has been around for a few 1000 years.

And that pharmacist has been the doctor psychologist, the pharmacist, the nurse, the home caregiver, you know for decades and decades and communities. And while we can't replace that by having the telemedicine interface on the machine, or even an app where you can interact with that pharmacist, and even in some cases, the same pharmacist, you start developing that relationship that helps you understand your medication or your health conditions much better.

These machines not only dispense prescription medications, but they can also dispense over the counter medication. So just like you'd walk up to the front counter of the pharmacy and go so I've got an itchy rash on my left arm. I don't know if it's poison ivy or what do you think and what should I use? Well, you can have that same visit over the machine right because you've got the screen in the camera and you can go hey, look at this and the pharmacist can go well, you know, you probably need a cortisone cream with some aloe in it.

And you know what? That's 299 And we keep that in stock in the machine and boom, boom, boom, boom, and blanket pops out like the Canna Coca Cola at the bottom. And you take your medicine and go just like you would if you were in the store working with someone so it's it's as close as we can get to having 24-hour availability, without having a person physically there at that location.

Drug Topics® sat down with Asteres® chairman and BioIQ CEO, Sean Slovenski to discuss 24/7 automated pharmacy pickup in part 2 of this 3-part interview. 



The Benefits of ScriptCenter Kiosks for Pharmacies, Part 2

Shane Bishop Expert Interview Part 2

Shane Bishop, Pack4U's founder, is a pharmacist and entrepreneur specializing in innovative patient-care models and the use of technology to improve adherence, patient health outcomes and quality measures.

 Yeah, one of the things that, you know, with the experience of being one of the first pharmacies in North America to scale packaging automation, it's quite time consuming in your pharmacy, it's a great, it's a great piece of automation does a better job than humans at checking for medic medication, packaging errors and that sort of thing. But at the end of the day, it does. It is a lot of work for the pharmacy.

So, if we can shift that workload from community pharmacies to our central hub, the packaging side is a commodity let us do that, have the pharmacies actually focus on real time data flow into their pharmacy.

So, with our technology, pharmacies in the community and community actually have access to real time data, which includes, you know, when did the patient or when has a patient, you know, pulled out the poacher medication from a device, when we get a signal back in real time to the pharmacy, so pharmacists can now look at medication adherence and real time data, versus worried about checking, you know, packaging? So, we really like to shift that workload to our hubs and how pharmacies focus on you know, driving down total cost of care and increasing adherence.

 Right, that makes a lot of sense. How can this help improve patient outcomes? Or how have you seen this?

 I mean, you know, I think overall, the you know, we have definitely the best solution out there right now for, you know, not only packaging, multidose, drip packaging, ready provision checking off checking technology, including community pharmacy, so we're not going on in direct serving patients, we really are empowering community pharmacies, to scale with them so that they can look at this data.

The other thing that happens with our solutions is, like I mentioned, there's the bells and whistles, beep flash, pull out your, you know, reminder. But we ask questions at that time on our devices at our apps, you know, Marissa, how are you feeling today, you know, happy face to face, we get all this data back in real time. And then we have a group of clinical pharmacists that look at this data in real time.

And you can detect, you know, issues early on in the, you know, in the care cycle, and bundle up data to physicians who really keep patients out of the acute care setting, which is absolutely amazing.

So really leveraging, you know, the capacity of pharmacy to get data in real time, not just adherence data, but everything else to do with the patient, and then tree as an information in a timely fashion to, to the doctors involved in and really drive down that total cost of care.

 That's awesome. Could you talk a little bit about the 528-billion-dollar medication management problem?

 Yeah, I think the concept of medication issues in general, as you just mentioned, relate to major, major costs to the system, that could be via medication waste, because of the amount of medication that's floating around in the system. Most of the reimbursement for pharmacies, both in Canada in the US have really been based on 90-day supplies of a medication. 

So, if something happens to a patient, or there's a change within the first week, a lot of this medication is just getting, you know, flushed down the toilet, unfortunately.

But, you know, everything we do is in more of a short cycle, we drive, you know, 7, 14, 30 day supplies and medications at the most to drive down that that, you know, down the medication waste issues.

But when you look at medication here as an issue, obviously, if patients aren't taking their medications, they're more likely to end up in an acute care setting, which drives up you know, costs, but medication adherence itself is, is you need a multipronged approach to actually impact that, again, it's not just about the medication reminders and how to come up with reminder systems.

There's all types of gadgets on the market. Now, that'll beep and flash until the patients take their medication. But it's more around if a patient, as an example, thinks that the medication is not working, they'll just stop taking it.

So, how do you how do you communicate and engage a patient in a way that they understand that they still need to take it, if a patient has side effects from medication, they'll also stop taking it. What happens now is pharmacies everyone's blind to whether a patient's taking their medication or not.

There's no direct feedback patient comes into the pharmacy every 90 days, perhaps you will catch it then. But in the meantime, the patient hasn't been taking their medication. So, by engaging patients asking questions to our devices and getting those responses back, we can really look after no true adherence and keep patients on the acute care setting as a result and impact that you know, $500 billion issue.

Editor's note: This interview transcript has been lightly edited for style and clarity.

In part 2 of this interview with Drug Topics®, Shane Bishop, Pack4U founder discusses innovative patient-care models and the use of technology to improve medication adherence, patient health outcomes and quality measures.

Pack4U Expert Interview Part 2: Medication Delivery 2.0

Tony Makarich, PharmD Expert Interview Part 1

Tony Makarich, PharmD and vice president of clinical services at Catalyst Health Rx, sat down with Drug Topics® to discuss the benefits for health care providers of a relationship and team-based pharmacy model. 

This 3-part series dives into Catalyst Health Rx's current pharmacy model that values relationships with convenience for medication home delivery and assures that providers do not lose sight of the impact they have on their patients.

I am joined today by Tony Makarich, vice president of clinical services at Catalyst Health Rx. Thank you for joining me today, Tony.

 Can we start with you telling me a little bit about your background?

 I have a PharmD degree, Doctor of Pharmacy from The Ohio State University, spent some time in the retail pharmacy space with target pharmacy, which is now CVS pharmacy. I worked in long-term care for my own company for about 5 or 6 years doing consulting within nursing homes. I spent some time with a company called Prime Therapeutics and ran a large scale mail-order for them for about 4 years. And then I've been here at Catalyst for almost 4 years now, overseeing the pharmacy operations and clinical services for the network.

 That's wonderful. Can you tell me a little bit about the mission of Catalyst Health and what the organization does?

 Yeah. So, Catalyst Health is in a network of independent physicians. So, there are about 1000 independent physicians, all throughout the state of Texas. And our network is an accredited clinically integrated network. We have a care team of about 100 people that support those physicians to provide them clinical services for a wide range of disease states to coordinate their care, lower their cost of care, and just overall improve patient health.

 Wow, that's incredible. How can Catalyst Health work to revolutionize medication adherence through the model that you have and sort of that physician-relationship you have?

 Yeah. And so that's a really good question. The medication adherence component is relationship driven. And the way that our model is set up, it's a longitudinal model. 

So, a lot of care management has patients who come in and they're - let's use an uncontrolled diabetic, for example. And they work with a caregiver until their diabetes is under control, or they achieve a goal. And then they may unenroll from those services. And our medication management services are longitudinal.

And we are doing a check-in every month with those patients when we dispense their medications. And it's not a simple, "Do you have any questions?" Which is kind of common in the industry. 

We know if they have diabetes, or high blood pressure, and we ask patients specific questions to see if there's any information we need to share with the physician as their coordinator of care. And because we have those check-ins, and the medications aren't just mailed out simply to the patient, we build those strong relationships with the patients and can continue to have an influence on their overall health care. It's not just medications show up on a patient's doorstep. It's a set of curated clinical questions that happen for every patient, every month, before those medications are mailed out. 

So, it's tying the relationship piece with the convenience piece of home delivery, and making sure that you're not losing sight of the impact that the pharmacist and their physician have on that patient each month.

 You mentioned checking in with patients. Can you explain a little bit about how your organization's model overall differs from other models?

 Yeah, the key thing is, we are a direct extension of the physicians care team. And so, we have electronic medical record (EMR) access. We have the ability to directly communicate almost in real-time and the native system that each physician uses to ask for medication refills, potential dose changes, inform the physician of all the information that we gather from the patient in those monthly check ins, and quickly get the information back to the physician in a real-time fashion.

So, if, for example, I have a patient who started on a new medication and they're having some side effects. A lot of times patients will just stop taking the medication and wait till they see the physician if it's 3 months or 6 months down the road and then say, "I stopped taking that 5 months ago because I was having some side effects." Our pharmacists will do a check in with them that following month and say, "Marissa, how are you doing on your medication? Have you had any side effects?" And if there aren't some side effects or some information that needs to go back to the physician, we can quickly expedite that directly to the PCP in the EMR, rather than calling the office, sending a fax. It's a 1-on-1 conversation. 

So, why our model is different is, 1, we form those relationships with the patients, even in a virtual world. Also, we have those direct relationships with all of the thousands of physicians that we have to quickly overcome barriers that they need. 

Oh, that's incredible. Going off of that, can you explain a little bit about how this system promotes with integrated pharmacy services? How it sort of promotes overall that relationship?

Tony Makarich, PharmD and vice president of clinical services at Catalyst Health Rx, sits down with Drug Topics® to discuss the benefits of a relationship and team-based pharmacy model in part 1 of this 3-part interview.

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