Four people, a dozen pharmacy careers

Exactly two years ago, Drug Topics published Pete Kreckel’s account of the many pathways in pharmacy his family has followed. His generosity in giving back to the profession has brought him much recognition, including NCPA’s 2014 Preceptor of the Year award and the 2015 Alumni of the Year award from the University of Pittsburgh School of Pharmacy. Look for more stories drawn from his life in pharmacy in upcoming issues. By way of introduction, here is an update of his 2014 article.

Pete KreckelMy Dad was a welder who spent his free time welding garbage trucks for his buddy Kenny.  My Grandpa was a blacksmith, who raised eight kids in a three-bedroom house. Our family background is full of men with callouses on their hands. So how did I end up in a white lab coat in pharmacy school in 1977?

Not sure I can tell you, but there I was. Next to me was a very cute and charming lab partner, Denise Kubitsky, who eventually became Mrs. Kreckel. No healthcare background in this guy’s pedigree. But it sure was the start of something.

See also: 12 steps to a rewarding career in pharmacy

Large retail chain

The first position I landed upon graduation was with a large major chain store in a small town in Clearfield, Penn. The district manager was thrilled that I was interested in working there, since this was such a difficult store to staff.

Most pharmacists there were “doing their time” until something opened up in Pittsburgh. After I was licensed and hauling in the big bucks ($12.85/hour), I quickly realized that the low staffing level did not lend itself to patient consultations. I remember telling Denise, “If this is retail pharmacy, I made a serious mistake in choosing this career five years ago.”

Fifteen tech hours per week were not enough, but my district manager said to me, “Pete, I’ve watched you practice, and if you quit spending time with the customers, you will have plenty of time to do our paperwork.”

See also: 10 pieces of advice for new pharmacy grads

Indie retail chain

I was ready to apply for a graduate program at Pitt so I could get a PhD and teach, when my mother-in-law called and said there were two openings in the Altoona area: one with the store Denise interned in, the other in a newly opened location in Tyrone, Penn.

When I called the owner to ask about the job, ready to send him that impressive resume, he answered, “Anyone married to Denise Kubitsky has to be all right. Can you start next week?” All my years of “resume building” — class president for three years, president of the student council for two years — meant nothing in comparison to my wife’s reputation.

We moved into the community and became part of it immediately. We got involved in our church, nursery school, and parochial school.

For the first 20 years or so, it was the same old, same old … dispensing, counseling, managing inventory, the same gig all “bench” pharmacists know so well. My Lab Partner and I “compounded” three offspring together, the oldest of whom eventually revealed her ambition to follow in our footsteps. The store grew into a hugely successful business, allowing me all along to build relationships and connect to my patients. I much enjoyed working for an independent “chain.”

Pete Kreckel (right), 2015 recipient of the University of Pittsburgh School of Pharmacy's Distinguished Alumni Award, with son-in-law Mark Garofoli, daughter Gretchen K. Garofoli, and wife, Denise K. Kreckel.
(Photo courtesy of John Columbo/University of Pittsburgh School of Pharmacy)

From bench to podium

A phone call came from a colleague (actually the guy who brought us to Central Pennsylvania in 1981) letting us know that a teaching position at St. Francis University had opened up. Teaching pharmacology sounded easy for a seasoned retail pharmacist. I was interviewed by the eight faculty members and two students. Two other candidates also interviewed. I really connected well and landed the job.

Then the work began. No textbook, no previous notes. My didactic coordinator would hand me a list of goals/objectives and drugs to be covered. I remember that even “Cognex/tacrine” was on this list. Heck, I even had to update the list!

My Lab Partner and I spent every evening for a whole year down in the basement, creating lectures on subjects ranging from antibiotics to estrogens. To call the process “overwhelming” would be an understatement.

About that time, Gretchen, my oldest daughter, was accepted into our alma mater’s pharmacy school. Dr. Patricia Kroboth, the dean, pointed her out to the class of 100. “I had Gretchen’s mom, Denise, in my first clinical assignment at Pitt.”

Four-store Indie

After 25 years, Denise left the independent chain and headed to Geisinger Health System to manage a retail pharmacy in the clinic. A year later, I left and joined a four-store independent owned by Bill Thompson.

The previous 25 years had been great, but when the owner allowed nonpharmacists to make decisions that involved dispensing and work flow, and the focus shifted from prescriptions to giftware, I became dissatisfied.

I tell every student that I precept to remember that “your license hangs on the wall by a nail; it is not bolted there and it’s portable. Use this to your advantage.” When attitudes in management change and prevent you from practicing in the way you desire, take your license off the wall and find a new nail!

With the indifference that the major chains show for this profession, I often feel that they would be as happy selling roofing nails, cars, or sump pumps. They just see the profession as a way to sell the product they offer, in this case drugs.

Precepting students

My new employer, who loves the profession of pharmacy, assigned me to a 1,200-square-foot store that has been in existence since 1932.

At my first interview, I asked Bill whether he’d be comfortable with my continuing to precept students. He told me he often wanted to get involved himself, but most of his pharmacist staff was unable to take it on, due to store volume or layout.

Bill encouraged me to precept students, and my wife and I decided to “refill” our empty bedroom with out-of-town students who want to experience “rural pharmacy.” We allow students to live with us free, we charge them nothing for room and board, and, heck, we even pack their lunches for them. We have hosted student healthcare professionals who are pharmacists, physician assistant students, and even two optometry students; to date we have provided more than two years of free housing and board. Talk about developing interprofessional networking!

Online webinars

Through my connections with St. Francis University, I create online webinars for FreeCE.com. The first presentation was about HIV medications (my weakest subject at the time). I really stepped out of my comfort zone with HIV, and I was offered opportunities to do more. I cover most “retail” topics of interest, from outdoor first aid to medication adherence. The “bench” pharmacists appreciate my passion for this profession. I cover topics from OTC meds to HIV; I never filled an HIV med during my first 26 years; now I have seven patients and a real passion for treating this disease state.

Gretchen Kreckel Garofoli divides her time between teaching and independent pharmacy practice.
(Photo courtesy of Kreckel family.)

University teaching, telepharmacy

Just before starting her P3 year, Gretchen attended a Kappa Psi Pharmaceutical Fraternity convention in Boston, where she met a Pitt alum named Mark. He happened to be a cousin of two of our best pharmacist friends. They hit it off.

Gretchen completed a community pharmacy practice residency at Virginia Commonwealth University in Richmond and accepted a dual assignment as clinical professor at West Virginia University and clinical pharmacist for a local independent pharmacy. She shares her Mom’s passion, looks, and smarts.

After climbing the CVS ladder for a decade, Mark left and began performing MTM for Humana Healthcare in the work-at-home setting. He has now moved to a new opportunity in opioid management for the State of West Virginia, provided through West Virginia University.

Giving back to the community

Current events include my Lab Partner’s stepping down to flex time at Geisinger so that she can serve as a clinical pharmacist at Centre Volunteers in Medicine two days a week.

Here Denise really steps out of her comfort zone, working on formularies to benefit these most needy patients. She and her amazing support staff are able to get medications from the generous manufacturers who give free meds to the indigent.

Although this is a paid position, she spends countless hours developing protocols, formularies, and collaborative practice agreements.

At the clinic, she reviews charts and uses her smarts and charm to provide the patients and physicians with the benefits of evidence-based cost-effective prescribing.

Denise Kubitsky Kreckel gives much of her time to serving the needy. Here, she instructs patient in inhaler use. (Photo courtesy of Kreckel family.)

I continue to work in independent pharmacy for an employer who loves the profession, and I work half a day as well at the Altoona clinic for the uninsured, doing the same stuff as Denise does. Dr. Zane Gates (a pharmacist and physician) wants to change our role in healthcare and wants this clinic to be a future model. I implore you to see his “TED talk” on YouTube. This guy has vision.

A word for new grads

We often hear comments about how disgruntled many retail pharmacists are and about the apparent lack of opportunities in this amazing profession. My advice to my final-year students (currently precepting student No. 40) is to make connections, follow your passions, and do what you love to do. Remember, your license hangs by a nail — it is not bolted to the wall!

In an evaluation for a webinar, one retail pharmacist wrote a diatribe charging that I wasn’t a real pharmacist — that I practice “fantasy” pharmacy. I’d have to agree with him — times four!

Pete Kreckel and his Lab Partner live in Altoona, Penn. Contact him at pharmcanoe@aol.com.