Pharmacy Is In My DNA
Why I became a pharmacist and how I would like to practice in the future.
Every child gets asked the question, “What do you want to be when you grow up?” Depending on how old I was when asked this question, I would respond with either figure skater or pharmacist. My father and grandfathers were pharmacists, so it’s literally in my DNA, and I grew up immersed in the environment. My maternal grandfather was one of the last pharmacists in Connecticut to become one by apprenticeship. Unfortunately, he passed away when I was seven years old. Still, on family holidays, I would listen to my uncles and cousins tell their pharmacy stories along with their memories of my grandfather in his store, which my uncle ran for decades.
Aside from the rare occasions when I actually needed to visit a medical doctor, my father knew just what I needed to recover from my illness 95% of the time. Television commercials from my childhood always showed the happy pharmacist counseling patients in the drug store, and that was the pharmacy field I knew. Just search the phrase “Friendly Pharmacist,” and you’ll see a description of my father, just like the ones in those now vintage commercials. I always knew that someday I’d grow up to be a pharmacist and happily make others feel well too. While most teenagers had jobs at the mall or in fast food, I balanced my time working at the ice arena and my father’s pharmacy.
Exercise and mostly healthy eating were part of my childhood. I say mostly healthy because my family is still working on decreasing sugar intake! Exercise, however, has deep family roots. My father’s love of tennis and racquetball and my mother’s obsession with aerobics in the 1980s set the tone for immersing exercise in my daily life. Today, in her mid-70s, my mother does multiple exercise classes a day, including tap, Zumba, line dancing, and jazz. She has lofty goals, as she compares herself to those in their 80s and 90s who are more advanced than she is. My parents are shining examples of why lifestyle choices are important. I’m sure they’ll live to be 100.
However, my pharmacy career was sidelined while I spent my post-high school years traveling and coaching as a professional figure skater. During this time, I also earned a degree in Hotel Management, which combined my passion for traveling with increasing the joy in the lives of others. I then became a military spouse, and it seemed that my goal of becoming a pharmacist would never happen. However, in 2007, my father, noticing my discontent as a stay-at-home mom and military spouse, told me that it was now possible to earn a Doctor of Pharmacy (PharmD) degree through distance education. Shortly after, I started my long journey to becoming a Doctor of Pharmacy.
I can only begin to imagine the expression on my grandfather’s face if he knew the amount of money and years it took me! The knowledge I gained was completely worth it, though. I was surprised to find the curriculum had nothing to do with a retail pharmacy or that retail was only one of many career options for a pharmacist. Once I had mastered core classes like biochemistry, pathology, microbiology, and immunology, I went on to pharmaceutics (physiochemical Principles of Drugs), pharmacology, pharmacotherapy, medicinal chemistry, pharmacokinetics, biostatistics, pharmacy law, immunopharmacology and biotechnology, pharmacogenomics, and many more. I gained experience in nuclear pharmacy, compounding pharmacy, specialty pharmacy, ambulatory pharmacy, and hospital pharmacy, including intensive care units (ICUs), emergency rooms, operating rooms, and pediatrics. I was part of collaborative, interdisciplinary work that included teams of specialists who highly regarded pharmacists for their medical expertise. Even through these experiences and clinical training, my goal was still to be like those friendly retail pharmacists who spent their days counseling patients on disease states and medications to improve their quality of life.
I thought I would grow old as a pharmacist working for a well-known retail chain but quickly noticed the changes in the industry. The days of spending time with patients, understanding their needs, and explaining their medications with possible lifestyle changes, were long gone. I was stunned at the number of people who were living with pain, depression, and/or lifestyle-related diseases who were taking multiple medications yet did not understand their disease states or realize that there were ways to improve their health, decrease their amount of medications, and live a happier life. Each week, I saw patients newly diagnosed with Type 2 diabetes who were not aware of its causes or the lifestyle changes that could improve or potentially reverse the condition.
There was no time for this education, however, because metrics now valued retail pharmacists. My days were measured by how fast I could dispense hundreds of medications, including large quantities of opioids, correct doctors prescription errors, figure out why insurances denied a prescription, or even what prescription insurance a patient had, give vaccines to whole families, answer phones within 60 seconds, train technicians and get the cars through the double drive-thru, all before the ice cream held by my patient waiting in line had time to melt. I thought of opening my own pharmacy, but in today’s model, independent pharmacies struggle to stay afloat as pharmacy benefit management companies (PBMs) steal their profit, and insurance companies choose chain pharmacies for their preferred contracts. All around me was not the image of the friendly pharmacist, but rather a burnt-out pharmacist struggling to meet the unrealistic, potentially unsafe, job requirements. There was also a huge rift in communication between the practitioners who diagnosed the disease states and prescribed their medications and the pharmacist who was dispensing the medication. I found it almost impossible to speak with the prescriber when I had questions about a prescription. It was a far cry from my hospital experiences as a student.
As technology has changed other industries, it is now doing so with retail pharmacies. We’re living in a time of rapid change, and the pharmacy profession is trying to keep pace while operating in an outdated model. Pharmacists have heard that robots will replace them for years, but we now know the reason is not solely due to advances in technology. It’s also due to changes in lifestyle. The irony is that at the same time as science advances — robots do surgery, cars drive themselves, and food is delivered almost instantly — the American public is now unhealthier than any time in our history. We have higher rates of chronic disease states, and maternal mortality surpasses any other developed country. This crossroads of change creates the perfect time for pharmacists to transition from a traditionally dispensing role to one of consulting as part of a complete care team. I left my retail job two years ago, and a door to a new world of medicine and patient care opened up before my eyes. I now fill my time balancing hospital pharmacy with a consulting business specializing in using personalized medicine to support women suffering from malnourishment due to extreme nausea and vomiting during pregnancy. I also educate providers on treating this condition and advocating for equity that is lacking solely due to sexism and racial disparities. I’m fortunate to use my pharmacy knowledge to treat these women whose disease state is often disregarded and ignored by both society in general and the medical community. I am once again in an environment where doctors, nurses, and other practitioners value a pharmacist’s knowledge, and I get to educate and counsel my patients.
In my network of entrepreneurial pharmacists, colloquially called pharmapreneurs, I’m surrounded by colleagues who naturally evoke the image of a happy pharmacist. I await the day that the retail pharmacists, whose spirit has been broken, will complete their metamorphosis and emerge as a butterfly. As the revolution continues, next on the horizon is for pharmacists to finally be listed as health care providers by The Centers for Medicare & Medicaid Services (CMS) so that other insurances will follow that lead. Along with many others, I also have a vision of all medical offices and health care systems having a pharmacist on staff. The potential is unlimited as modern medicine combines the old and new: returning to preventative medicine, treating root causes of diseases, and using food and exercise as fuel ƒwith cutting-edge science that personalizes medicine based on a patient’s genetic variations and uses vectors as targeted therapies.
I’m smiling while awaiting the challenges and opportunities that lie ahead and hope that my colleagues, in all aspects of healthcare, are open to using the knowledge and clinical training of a pharmacist and considering us as part of the healthcare team.
