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Integrative Care Impact and the Expanding Role of the Pharmacist | TWIRx · Pharmacy Podcast Network

0:01
Speaker 1: July tenth, twenty twenty six.
0:04
Speaker 2: This is Twerks.
0:24
Speaker 1: Hey, Hey, hey, and welcome to this Week in Pharmacy.
0:30
Speaker 1: I'm excited to be here. July tenth, Holy Smokies twenty
0:37
Speaker 1: twenty six. What is going on? If you could just
0:39
Speaker 1: take a break, pull over on the side of the
0:42
Speaker 1: road and take a break. It's going too fast people. Hey,
0:48
Speaker 1: we're headed to Orlando Thought Spot twenty twenty six. If
0:52
Speaker 1: you're going, please reach out to me, reach out to
0:55
Speaker 1: the Pharmacy podcast Network. Let's see you there. I love
0:59
Speaker 1: to collaborate in person. I love getting in front of
1:02
Speaker 1: pharmacists and pharmacy owners and really understanding what's happening in
1:07
Speaker 1: your markets. Your markets are so different from one side
1:11
Speaker 1: of the nation to the next. You do share some
1:14
Speaker 1: similarities and some pressures of what you're going through.
1:18
Speaker 2: But.
1:21
Speaker 1: The camaraderie and the lessons learned from one pharmacy owner
1:26
Speaker 1: to the next is huge, and we want to be
1:32
Speaker 1: a part of spreading that word. If you have success stories,
1:36
Speaker 1: if you have something that's working in your pharmacy, if
1:39
Speaker 1: something is working in your community, let's talk about it
1:43
Speaker 1: on this Week in Pharmacy. Join me on Twerks reach
1:48
Speaker 1: out to me.
1:49
Speaker 2: Let's talk.
1:51
Speaker 1: Hey up on Twerk's news. First of all, a shout
1:57
Speaker 1: out to Orsini or SI Specialty Pharmacy. Thank you for
2:02
Speaker 1: posting about Chronic Disease Day. This is honoring Chronic Disease
2:07
Speaker 1: Day today July tenth. Or scene posts something on LinkedIn
2:13
Speaker 1: recognizing the stresses, recognizing what people go through, what families
2:18
Speaker 1: go through, that are supporting those with rare diseases. And
2:22
Speaker 1: the specialty pharmacy sector is probably one of the fastest,
2:27
Speaker 1: if not the fastest growing sector of our pharmacy markets
2:32
Speaker 1: in what's happening and I'm so proud to be a
2:36
Speaker 1: small part, a tiny part of the communication side and
2:39
Speaker 1: pr side of specialty pharmacy. We will be headed to
2:44
Speaker 1: the NASP in Washington, d C. To celebrate the National
2:48
Speaker 1: Association of Specialty Pharmacy's annual event. We're going to have
2:52
Speaker 1: more news coming up on that. We'd also like to
2:55
Speaker 1: talk about it on an episode of Twerks and dig
3:00
Speaker 1: In and really preface what does the future of specialty
3:04
Speaker 1: pharmacy look like? Hey on Twerque's news from a specialty
3:08
Speaker 1: pharmacy continuum, thank you for flagging this information. Headline is
3:13
Speaker 1: beyond symptom relief yoga in the biology of chronic lower
3:18
Speaker 1: back pain. You have to read this, readers. This is
3:22
Speaker 1: really interesting. Lower back pain continues to be one of
3:26
Speaker 1: the most challenging conditions in clinical medicine. Even with the
3:30
Speaker 1: progress of pharmacologic, rehabilitative and intervention methods, significant portions of
3:38
Speaker 1: patients report persistent symptoms in lower back pain. And among
3:45
Speaker 1: the approaches that are finding a lot of relief for
3:50
Speaker 1: people throughout the world, throughout the nation is yoga and
3:55
Speaker 1: relating mind body interventions. This kind of plays into what
4:00
Speaker 1: we're going to be talking about today and integrative pharmacy
4:03
Speaker 1: and holistic pharmacy when we welcome Rob Kressback, the godfather
4:10
Speaker 1: of functional pharmacy, and doctor Bianca Bradshaw. So you're not
4:15
Speaker 1: going to want to miss that that's coming up on
4:18
Speaker 1: twerks on our first feature. Shout out to Pharmacy Practice News,
4:23
Speaker 1: thank you for submitting and giving us a heads up
4:27
Speaker 1: headline PBM Pharmacy collaboration improves Medicaid outcomes, Oh my goodness.
4:34
Speaker 1: With the pillaging of the traditional three big PBMs and
4:39
Speaker 1: attacking systems of funding three point forty b for example,
4:44
Speaker 1: and where our tax dollar goes getting sucked up into
4:48
Speaker 1: that almighty stock price. It's nice to hear that there
4:52
Speaker 1: are pharmacy benefit managers out there like Carolin our Ex,
4:57
Speaker 1: a subsidiary of Evilence Health, who is working on Medicaid
5:05
Speaker 1: reimbursement solutions in the PBM space. They started this project
5:11
Speaker 1: way back in twenty twenty one and concentrated in Ohio,
5:16
Speaker 1: I'm sorry, in Iowa and in Arkansas. And it's called
5:21
Speaker 1: the CPTC program, which promotes the use of community pharmacy
5:25
Speaker 1: centered care to simplify prescription management, increase medication adherence, improving
5:31
Speaker 1: quality of care delivered, enhancing the number of satisfaction and
5:36
Speaker 1: minimized health disparities. The program focuses on Medicaid members with
5:42
Speaker 1: chronic conditions, those who need extensive, coordinated care by pharmacists,
5:47
Speaker 1: and gives them the personalized support they need. This was
5:50
Speaker 1: explained by Nirelli Paith, the Clinical Strategy and Outcome Director
5:57
Speaker 1: for the CPTC, and she goes on being quoted. She says,
6:03
Speaker 1: participating pharmacists adhere to providing standard services such as free
6:08
Speaker 1: medication delivery, multidose packaging for members who are on multiple
6:14
Speaker 1: chronic medications. In medication synchronization, in medication reconciliation services. None
6:22
Speaker 1: of that is new to us. We know that independent
6:25
Speaker 1: community pharmacies throughout the nation have perfected all of that
6:29
Speaker 1: multi chronic management of your medications, the synchronization, and definitely
6:35
Speaker 1: the packaging. When I hear the word free within this
6:39
Speaker 1: free medication delivery, as long as the pharmacy is getting
6:43
Speaker 1: something for that in order to support that infrastructure, I'm great.
6:47
Speaker 1: I'm good with that. There has to be a baseline
6:50
Speaker 1: in Medicaid patient reimbursement for that prescription, but I'm going
6:55
Speaker 1: to keep my eyes on this. I shout out to
6:57
Speaker 1: Gina Shaw for writing a great article from Pharmacy Practice News.
7:04
Speaker 2: Hey, a shout out.
7:05
Speaker 1: To the MMM online. The publication that came comes from
7:11
Speaker 1: Hay Market Marketing Communications. And if you want a tongue twister,
7:17
Speaker 1: say Hey Market Marketing Communications, fast three times and I
7:22
Speaker 1: will give you one million dollars if you say it
7:26
Speaker 1: without stumbling. I don't have a million dollars, but you
7:30
Speaker 1: can still try to tongue tie that, all right. The
7:35
Speaker 1: article comes from the online news mmmdash online dot com.
7:41
Speaker 1: The title is five things for Pharma Marketers to know
7:44
Speaker 1: for Friday, July tenth, twenty twenty six. The main one
7:48
Speaker 1: I want to bring to your attention is the top
7:50
Speaker 1: contenders to lead the Food and Drug Administration, and they've
7:56
Speaker 1: been sent to the White House for final review and decisions.
7:59
Speaker 1: The finalists include Heidi Overton, she's a White House advisor,
8:06
Speaker 1: Jeffrey Vakareka vach Risika. I don't know how to say
8:12
Speaker 1: his last name, Jeffrey, We'll just call hi Jeffrey, doctor
8:16
Speaker 1: Jeffrey an oncologist and health system executive. And Stephen Ferrara,
8:22
Speaker 1: a health affairs official at the Defense Department. You know,
8:28
Speaker 1: the styles of our political leadership, especially at the top
8:34
Speaker 1: there at the White House, the styles of them, of
8:39
Speaker 1: those individuals, and then the trickle down effect of how
8:42
Speaker 1: that impacts public health is mind blowing. And there's goods,
8:48
Speaker 1: good and bad about so much of what's happened with
8:51
Speaker 1: the Trump administration. And there was very little, in my opinion,
8:56
Speaker 1: that was being done aggressively and proactively to really change,
9:01
Speaker 1: drastically change something of the diet and of the education
9:07
Speaker 1: of American of the American public. And as we listen,
9:11
Speaker 1: every single one of you that's listening right now, I
9:15
Speaker 1: really think You're highly educated, and I think that your
9:18
Speaker 1: education and your understanding of things go far beyond the
9:22
Speaker 1: lay person, far beyond me, for example, not being a pharmacist,
9:26
Speaker 1: not being educated like you are, and new physicians out there.
9:31
Speaker 1: So I'm hoping that the that the FDA chooses someone
9:37
Speaker 1: that has a background in health care and in medicine
9:42
Speaker 1: and in patient direct patient care. So I'm voting for
9:46
Speaker 1: doctor Jeffrey, the oncologist and health system executive. I don't
9:51
Speaker 1: know of Jeffrey, maybe you guys do. The reason is
9:54
Speaker 1: is because we have to come back to selecting people
9:59
Speaker 1: at such a high levels that immediately have credibility based
10:04
Speaker 1: on their credentials, based on their experiences, based on their education,
10:08
Speaker 1: and stop putting people that lean heavier to the political
10:14
Speaker 1: side instead of the baseline. There's nothing wrong with political opinion.
10:21
Speaker 1: Our culture here I go on my soapbox. Our culture
10:26
Speaker 1: has been taught to become hateful and to become combative
10:32
Speaker 1: when you start talking about politics, which makes things hard
10:35
Speaker 1: to ever come to any kind of middle ground, and
10:40
Speaker 1: when you select the sensitivity around medication management, food disparities,
10:48
Speaker 1: things that are really affecting the health and the well
10:51
Speaker 1: being of our public, and you don't have people that
10:55
Speaker 1: have credentials. It just loses credibility. Lying loses credibility when
11:02
Speaker 1: you find out that our highest of political leaders have
11:05
Speaker 1: lied in the past for narratives and for pushing agendas,
11:09
Speaker 1: and the whole debacle with the pandemic and everything we
11:13
Speaker 1: went through. So I'm hoping and I'm voting for Jeffrey
11:19
Speaker 1: vak a Rica. I'm not gonna say his name anymore.
11:22
Speaker 1: I need a pharmacist to read that Vaci r C.
11:26
Speaker 1: I'm gonna have it in the show notes. But look
11:28
Speaker 1: that person up. Send me a tweet, send me a
11:33
Speaker 1: LinkedIn post, tell me what you think of these selections,
11:36
Speaker 1: and if you know anything about doctor Jeffrey, it'd be great.
11:42
Speaker 2: Hey.
11:42
Speaker 1: Last up, closing Twerque's news with some good news because
11:46
Speaker 1: I'm so tired of the the bad news that's out there.
11:51
Speaker 1: Good news coming out of Oregon. Hillsboro Pharmacy opens with
11:55
Speaker 1: a familiar look and new familiar feel and a new look,
12:00
Speaker 1: and this organization, this pharmacy out of Hillsboro, Oregon, is
12:07
Speaker 1: now setting up resetting up. The Hillsboro Pharmacy in Fountain
12:12
Speaker 1: officially reopened just this week in pharmacy after they had
12:18
Speaker 1: a horrible commercial fire and the owner, Jasmine new In.
12:24
Speaker 1: I'm going to have to reach out to Jasmine because
12:25
Speaker 1: I love this model, this pharm of the pharmacy, what
12:29
Speaker 1: she's doing for the community. And they're going to be
12:32
Speaker 1: partnered with other pharmacies to do some of the procurement
12:36
Speaker 1: of their medications. But the special side of this that
12:40
Speaker 1: brings the community in is their fountain development, their pancakes,
12:46
Speaker 1: their coffee, their sandwich counter. Really to get the community
12:51
Speaker 1: involved in bringing them in in an untraditional pharmacy setting,
12:56
Speaker 1: and rather than filling prescriptions on site, medications are prepared
13:00
Speaker 1: at Newinn's Portland Pharmacy and delivered to secure pickup lockers
13:05
Speaker 1: inside the Hillsboro store, and customers can still receive assistance
13:09
Speaker 1: from staff in person or connect with a pharmacist by
13:13
Speaker 1: video telehealth alrighty if they have questions before taking their medication.
13:20
Speaker 1: Absolutely love this Newen has really been aggressive in battling
13:27
Speaker 1: how the PBMs have ruined independent community pharmacies throughout the nation.
13:33
Speaker 1: This Hillsboro Pharmacy is the oldest operating business in Hillsboro.
13:38
Speaker 1: The pharmacy was founded in eighteen seventy three holy smokies.
13:44
Speaker 1: I love this story. Look this up. This comes from
13:47
Speaker 1: Hillsborough News Times. Just put in Hillsboro Pharmacy and look
13:52
Speaker 1: up the news section to find this good news, news
13:57
Speaker 1: that we needed, news that.
13:59
Speaker 2: Is happy, happy stuff.
14:02
Speaker 1: You know, I can't see crap. If you're driving and
14:05
Speaker 1: you're listening to this podcast, you don't see me with
14:08
Speaker 1: my obnoxious sunglasses on. These lights are super bright, and
14:13
Speaker 1: I can't find my other sunglasses that don't look as
14:16
Speaker 1: shady as the shades do. But I can't see anything.
14:20
Speaker 1: Oh there, there you are, Now I can see you.
14:24
Speaker 2: Hey.
14:25
Speaker 1: We have two amazing interviews I want to share with you,
14:30
Speaker 1: Rob Cress and doctor Bianca Bradshaw coming up next on
14:36
Speaker 1: this On This Week in Pharmacy, What do you Say?
14:47
Speaker 3: This episode is sponsored by Independent Pharmacy Cooperative, widely known
14:51
Speaker 3: as IPC. Established in nineteen eighty three, IPC is the
14:55
Speaker 3: nation's largest group purchasing organization owned by Independent Pharmacy the
15:00
Speaker 3: mission of maximizing the success of community pharmacists. IPC works
15:04
Speaker 3: to provide members with access to effective programs and services
15:08
Speaker 3: designed to enhance profitability for independent pharmacy. Read more about
15:12
Speaker 3: our mission by checking out our website at ipcrx dot com.
15:16
Speaker 3: That's ipcrx dot com.
15:31
Speaker 1: Hey, returning back to this week in Pharmacy. My friend
15:35
Speaker 1: who I nicknamed the godfather of functional pharmacy, but is
15:39
Speaker 1: actually getting bigger than just focusing on just the pharmacy aspect.
15:44
Speaker 1: Rob Crass is back on the show. It's so good
15:47
Speaker 1: to see you.
15:48
Speaker 4: Great to see you, Tat, Thanks for having me. Yeah.
15:51
Speaker 1: I have talked with you for years now, and it
15:56
Speaker 1: is changing. It's funny to watch how we we dig
16:01
Speaker 1: into very specific things that are impacting our lives, our careers,
16:07
Speaker 1: the people that we're working with, in your case, patients
16:09
Speaker 1: that you serve, and you've now tripped into and I
16:13
Speaker 1: think it was purposely. I shouldn't say trip, because you
16:16
Speaker 1: don't trip when you're walking down the trail in the
16:18
Speaker 1: in the in the woods. When you're doing some of
16:21
Speaker 1: your presentations, you're you're very directed and very focused. But
16:26
Speaker 1: it's become bigger for you and and what your mission
16:29
Speaker 1: is and being a pharmacist that's involved in what is
16:32
Speaker 1: total health. Just share with our listeners some of the
16:36
Speaker 1: stuff you've been working on lately.
16:38
Speaker 4: Yeah, And actually I think trip is a good word
16:40
Speaker 4: because there's a saying in mythology that says, where you
16:44
Speaker 4: trip up, therein lies the treasure, and I think we
16:48
Speaker 4: got to recognize that in life. And that's exactly something
16:50
Speaker 4: that's happened.
16:52
Speaker 5: You know.
16:53
Speaker 4: I've created kind of a lens of medicine called orientation
16:57
Speaker 4: based medicine, and it's something that actually compliments functional medicine,
17:01
Speaker 4: allopathic medicine, integrated medicine. And what we've been putting together
17:07
Speaker 4: is a way to assess a patient's orientation literally where
17:11
Speaker 4: they are when they come to us, not just based
17:13
Speaker 4: off lab values. Most importantly, what their capacity is to
17:17
Speaker 4: make change. You know, in our clinical practice over the years,
17:21
Speaker 4: we've seen time and time again where if you primarily
17:27
Speaker 4: just practice off of what the labs say, even if
17:29
Speaker 4: their functional labs getting into drenals, getting into hormones, getting
17:32
Speaker 4: the GI sometimes they it might be mistimed, it might
17:37
Speaker 4: be misdosed, and it doesn't give that true patient speccificity,
17:44
Speaker 4: if that's the word I'm looking for. That we say
17:47
Speaker 4: that functional medicine has that personalized approach. So this has
17:50
Speaker 4: kind of taken it to that level to dial into
17:53
Speaker 4: who really is sitting in front of you and It's
17:56
Speaker 4: been an exciting process.
17:59
Speaker 1: I love what podcasting has done for my career, my
18:04
Speaker 1: network and bringing people in to really accentuate some of
18:08
Speaker 1: these topics. Introduce us to our special guests today on TWERPS.
18:12
Speaker 4: Absolutely, we got Bianca Bradshaw here. Who is She's part
18:16
Speaker 4: of my programs and she's truly a rockstar practitioner, pharmacist,
18:20
Speaker 4: human being and coach. Bianca is the owner of the longest,
18:27
Speaker 4: oldest continuing operating pharmacy in the state of California. She
18:31
Speaker 4: is an author of a book on anti inflammatory eating.
18:34
Speaker 4: She's an incredible entrepreneur and when you asked me, do
18:39
Speaker 4: I have someone to bring on here, Bianca immediately came
18:42
Speaker 4: to mind. And you know, even before you came on,
18:45
Speaker 4: I was complimenting her on how her coaching ability has
18:49
Speaker 4: just skyrocketed to the point where on our calls I
18:52
Speaker 4: sit back and she just takes over and for me
18:57
Speaker 4: not to talk it's a big thing, but I don't
18:59
Speaker 4: have to. Bianca.
19:01
Speaker 1: Welcome, Welcome, Bianca, thank you so much.
19:06
Speaker 6: I have been in pharmacy for twenty two years, primarily
19:09
Speaker 6: an independent pharmacy owner operator for the past twelve almost
19:14
Speaker 6: thirteen years, and about.
19:16
Speaker 7: Five years ago, I started.
19:19
Speaker 6: Really getting interested in what I was calling what I
19:21
Speaker 6: gave a name to a functional medicine. I didn't know
19:24
Speaker 6: the name when I started. I just thought everybody needs magnesium.
19:27
Speaker 6: So it's It's been a great experience, and I love
19:33
Speaker 6: the opportunity to join you here and excited to be
19:37
Speaker 6: a part.
19:37
Speaker 4: Of this well.
19:39
Speaker 1: I like this conversation rob for selfish reasons where I
19:44
Speaker 1: try to take a subject that's empowered by and fortified
19:49
Speaker 1: by the guest who then has reaches and prongs into
19:53
Speaker 1: other subjects that were very dear to on the Pharmacy
19:56
Speaker 1: podcast Network that to me, independent community pharmacy is one
19:59
Speaker 1: of my most favorite subjects that really pulls everything in
20:03
Speaker 1: and I want to confess to the listeners and obviously
20:07
Speaker 1: to both of you, as a talking head of the
20:12
Speaker 1: pharmacy profession, probably the longest talking the oldest of the
20:18
Speaker 1: talking heads in the form of podcasting in pharmacy. As
20:24
Speaker 1: a cheerleader, I'm always a half glass full kind of guy.
20:27
Speaker 1: I can't help it. It's my personality. I always want
20:29
Speaker 1: to talk about, you know, the good of what's happening.
20:33
Speaker 1: And then I've learned as a as someone that's not
20:36
Speaker 1: completely naive that there is the bad side of things
20:39
Speaker 1: and they're the negative side of things or the challenges.
20:42
Speaker 1: And I've really been excited about encouraging pharmacists more particularly
20:47
Speaker 1: our pharmacy owners, our independent pharmacy owners, to take the
20:50
Speaker 1: time to build revenues that aren't just about the prescription,
20:54
Speaker 1: not just about the dispensing fee, but slowing things down
20:57
Speaker 1: at the counter and inviting the patient to go into
21:00
Speaker 1: the counseling room and sit down and really hammer out
21:04
Speaker 1: a very specific, very personalized, very precision based plan. It
21:10
Speaker 1: is all about that individual, what's happening at individual's life.
21:13
Speaker 1: And so I've been talking about that concept for freaking
21:16
Speaker 1: twelve years and bringing pharmacogenomics into it and bringing labs
21:21
Speaker 1: and bringing the vitamin therapy at the right time, and
21:25
Speaker 1: not me, but trying to bring in content for people
21:28
Speaker 1: that do that. And that's glass half full. But you,
21:32
Speaker 1: as an owner, Bianca, when would you have time with
21:35
Speaker 1: you got to get out three hundred, six hundred prescriptions
21:38
Speaker 1: a day. You have all this happening, and your two
21:41
Speaker 1: texts ones on vacation, one quit suddenly, and your wholesaler
21:45
Speaker 1: isn't getting you the supply and something else is coming up,
21:48
Speaker 1: and insurance is due and buff and I'm this happy
21:52
Speaker 1: podcaster guy that wants you to just go make money
21:55
Speaker 1: and counseling, and but then the real world hits And
21:58
Speaker 1: so how do you transition from where you know, pharmacy
22:04
Speaker 1: should be going and pharmacy care should be going, and
22:06
Speaker 1: there is money in it, But how do you take
22:11
Speaker 1: the realm of the dispensing fee that keeps the life
22:14
Speaker 1: blood and the light lights on and transform into this
22:19
Speaker 1: next gen you know, pharmacy that's doing things that could
22:23
Speaker 1: bring money, but it's just like and it's better for
22:26
Speaker 1: the patient holistically. But boy, that's that's a whole podcast
22:30
Speaker 1: in itself. And I said, we only had twenty minutes,
22:32
Speaker 1: and I've I've thrown you into a trap just a.
22:36
Speaker 7: Little bit, That's okay.
22:39
Speaker 6: In about twenty twenty one, I realized that juggling everything
22:44
Speaker 6: you just said was becoming a challenge to my health,
22:50
Speaker 6: not to mention my sanity, and I decided to close
22:55
Speaker 6: the pharmacy for lunch every day. Novel concept. Suddenly I
22:59
Speaker 6: have a forty hour a week pharmacy. In addition, I
23:03
Speaker 6: personally have an hour lunch every day that I can
23:06
Speaker 6: either meet with clients on a functional medicine perspective, or
23:10
Speaker 6: take a meeting that I need to as an owner.
23:12
Speaker 6: It has created an opportunity for me. There were some
23:17
Speaker 6: challenges at first because I was always concerned about the
23:21
Speaker 6: overlap of the retail and the functional medicine. But what
23:25
Speaker 6: I found is that it's actually exciting and it wakes
23:28
Speaker 6: me up for the afternoon and gets me going to
23:32
Speaker 6: think about the moments that I've helped somebody a little
23:35
Speaker 6: bit on a higher level, and really that made all
23:39
Speaker 6: the difference for me.
23:41
Speaker 1: It's wild rob when you think of you know, we
23:46
Speaker 1: expect our patients, You expect the members of your consultation
23:51
Speaker 1: and your coaching to kind of follow the blueprint that
23:54
Speaker 1: you're helping them to build, to live better, to live healthier.
23:58
Speaker 1: But then people like any biggest hypocrite on the show
24:02
Speaker 1: today is like, hey, do this, do this, But then
24:05
Speaker 1: my workout plan falls to the side, or I'm not
24:08
Speaker 1: weightlifting every day like I'm supposed to be, and so
24:11
Speaker 1: the rubber meets the road, like I need help. You're
24:16
Speaker 1: one of my favorite people in in phiremacy, and I'm
24:19
Speaker 1: not even you. I'm not even your client yet, and
24:22
Speaker 1: I should be.
24:25
Speaker 7: Can I pop in there? He's got the mystical man.
24:31
Speaker 1: True. So yeah, to speak to that and the dangers
24:36
Speaker 1: of where we're at today, because I can't wait to
24:39
Speaker 1: talk about direct to consumer and how that's thrown a
24:43
Speaker 1: monkey or monkey wrench into things good and bad.
24:47
Speaker 6: Yeah.
24:48
Speaker 4: Well, I think what you just, what you just described
24:51
Speaker 4: within yourself is endemic in our society. And what it
24:54
Speaker 4: comes down to is nervous system adaptation, which essentially identifies
25:00
Speaker 4: what our capacity is to make change in life. So,
25:03
Speaker 4: for instance, Beyonca's example, I close the pharmacy for an hour,
25:07
Speaker 4: so she created space, She created an avenue to build
25:10
Speaker 4: capacity and to step into something new, whether it's a patient,
25:14
Speaker 4: whether it's us as practitioners. We're all experience and things
25:18
Speaker 4: like this. And I know sometimes it sounds like it's
25:20
Speaker 4: easier said than done, but I think sometimes it takes
25:25
Speaker 4: a proper evaluation of where we are and the changes
25:28
Speaker 4: that need to be made. And when you were saying
25:31
Speaker 4: the direct to consumer, you know, I think this in itself.
25:35
Speaker 4: We speak about patient care, and it's not to say,
25:37
Speaker 4: you know, direct to consumer offers patients some autonomy, some authorship,
25:43
Speaker 4: which I think is really important. That's something we've always
25:46
Speaker 4: asked for, and that's what the realm of functional medicine
25:49
Speaker 4: kind of grew off of. It was basically the female
25:52
Speaker 4: patients saying, you know what I want to change. I
25:55
Speaker 4: don't like what's happening. I'm demanding more and functional medicine,
25:59
Speaker 4: and before that, integrated medicine was there to answer it.
26:02
Speaker 4: So when we see that an example direct to consumer right,
26:11
Speaker 4: so we know it has its benefits autonomy, authorship for
26:14
Speaker 4: the patient, but I think sometimes it can fall into
26:17
Speaker 4: a lack of care. And the example we used before
26:19
Speaker 4: we went on here is the reach, you know, the
26:22
Speaker 4: reducing the black box warnings on estrogen. Now, estrogen has
26:25
Speaker 4: gone through the roof, but has patient care followed it?
26:29
Speaker 4: And I've got to say many times it has not.
26:32
Speaker 4: And I think that's where the opportunity is for us
26:34
Speaker 4: as practitioners to help guide our patients the right way
26:38
Speaker 4: because we're going from, as you said, kind of a
26:41
Speaker 4: you know, a fast food type of medicine, and we
26:44
Speaker 4: know fast food doesn't solve problems. So it's actually reorient
26:48
Speaker 4: in that direction of medicine on how we can overlay
26:51
Speaker 4: the patient care and find the opportunity for us as
26:54
Speaker 4: practitioners and doing so because they're not finding it through
26:57
Speaker 4: the conventional My practitioners paid to see me for.
27:01
Speaker 1: Seven minutes, so you know, we were, we were using
27:09
Speaker 1: me as an example before we started recording. And I can,
27:13
Speaker 1: I can fill out six questions for a prescription medication,
27:18
Speaker 1: and I could, I could answer that anyway I wanted
27:21
Speaker 1: to answer it in order to just get access to
27:23
Speaker 1: the medication. It might not even be true what I'm doing,
27:28
Speaker 1: And and that online mechanism of collecting that data has
27:32
Speaker 1: no way to read my facial expressions, take my blood
27:36
Speaker 1: pressure at the time, dig into deeper, you know, consultation
27:41
Speaker 1: of it. So where where, like you said, there's a
27:45
Speaker 1: where's the good and bad balance? I know you can't
27:47
Speaker 1: answer that question per se, but is there a lane
27:52
Speaker 1: where we are transactional that makes sense? Or should one
27:57
Speaker 1: hundred percent? You know, should should we not go direct
28:01
Speaker 1: to consumer at the mass scale? That seems like we're
28:04
Speaker 1: moving towards. It's a juggernaut that I don't think anybody's
28:07
Speaker 1: going to slow down.
28:10
Speaker 4: No, I agree, And you know, to speak to that, say,
28:12
Speaker 4: if someone was to fill out a questionnaire online just
28:15
Speaker 4: to get a medication because you can do that. You
28:19
Speaker 4: can lie, right, I mean easily. Do you have any
28:22
Speaker 4: health conditions? Nah? Are you in any other medications?
28:25
Speaker 1: Nah?
28:25
Speaker 4: Right, just give me the med And that's a sliberally
28:29
Speaker 4: slippery slope right there. I'm not one that is ever
28:32
Speaker 4: one to ask for more regulations. Actually, I think that
28:35
Speaker 4: gets us into another jugern out of issues. But on
28:40
Speaker 4: the other side of things. The example that I used,
28:44
Speaker 4: it was actually one of my pharmacist members reached out
28:49
Speaker 4: to me on something she didn't know how to operate
28:51
Speaker 4: or navigate. And it was basically, someone filled out a
28:54
Speaker 4: ten symptom questionnaire, a ten questionnaire and got hormones. Basically
29:00
Speaker 4: had an estrogen, progesterone and the DHA sent to them.
29:03
Speaker 4: I looked at the doses. The doses were horrendous. They
29:06
Speaker 4: were giving them a female who's still cycling, still impairmentopause, right,
29:11
Speaker 4: excessive doses of estrogen, accessive doses of progesterone, and the
29:14
Speaker 4: DHA was a man's dose. So this individual felt very agitated,
29:20
Speaker 4: was having sseuitoicidal thoughts, and was actually one to get
29:23
Speaker 4: a divorce within a realm of two weeks from her husband.
29:25
Speaker 4: So that's not good medicine. And I know that women
29:30
Speaker 4: need men need proper hormonal balance, but sometimes it doesn't
29:34
Speaker 4: come right from the hormone itself, like balance has to
29:37
Speaker 4: start first. Does that answer them? Yeah? Please?
29:43
Speaker 7: Oh, I was gonna say.
29:44
Speaker 6: I would add to that that in pharmacy, so many
29:48
Speaker 6: things are a pendulum, and I think that right now
29:51
Speaker 6: we are on the upswing of this, and there will
29:53
Speaker 6: end up we will see problems and patients will realize
29:57
Speaker 6: that they want to.
29:58
Speaker 7: Talk to a practitioner.
30:00
Speaker 6: But I live in a very rural area and sometimes
30:03
Speaker 6: getting into a provider is difficult and scary. If people
30:07
Speaker 6: are going to lie and try to just get what
30:10
Speaker 6: they want, I think they're going to do that anyway.
30:13
Speaker 6: That's been pharmacy hopping and doctor hopping and shopping for years.
30:17
Speaker 6: But I think there is a positive potential to this concept.
30:24
Speaker 6: It's just we need to find a balance where patients
30:26
Speaker 6: are getting the follow up care and there's an expectation
30:30
Speaker 6: that they will continue with the provider on some level.
30:34
Speaker 1: Bianca, is there a lane here? My glass always half
30:41
Speaker 1: full and not empty. To get community pharmacy, to get
30:45
Speaker 1: independent pharmacy quicker to revenue, so that we can eventually
30:52
Speaker 1: hire maybe a staff pharmacist or a shift pharmacist that
30:56
Speaker 1: does one hundred percent consults instead of having anything to
31:00
Speaker 1: do with prescription processing, which is our core. But do
31:04
Speaker 1: you have a pathway as a pharmacy owner to get
31:08
Speaker 1: that done.
31:09
Speaker 7: Are you familiar with scripted?
31:11
Speaker 1: Yeah?
31:11
Speaker 6: I have heard of that, Okay, I've been working with
31:15
Speaker 6: them for several years. Unfortunately, I've been in the position
31:20
Speaker 6: where I didn't have a full time staff pharmacist to
31:23
Speaker 6: really grow this program. I have met some resistance from
31:27
Speaker 6: providers because they feel like I'm operating outside my lane
31:31
Speaker 6: in scripted. But as I said, being in a rural area,
31:36
Speaker 6: I know there are situations where I've helped women with
31:40
Speaker 6: UTIs that get them twice a year and know that
31:43
Speaker 6: that's what it is, following a protocol, you know, talking
31:46
Speaker 6: to the patient, having them in front of me, taking
31:49
Speaker 6: there their temperature, making sure there's nothing crazy going on,
31:53
Speaker 6: and they were able to get a prescription for a
31:55
Speaker 6: UTI that day within two hours, versus is after the
32:01
Speaker 6: weekend sometime next week when the doctor can get them
32:04
Speaker 6: in and they didn't stress the resources of our emergency room,
32:08
Speaker 6: which is extremely overused in this area.
32:14
Speaker 1: Three times is expensive too. Mm hmm, ye, I love that.
32:18
Speaker 4: You know, if I can speak to that. I think
32:19
Speaker 4: what that really says a lot of is I think
32:23
Speaker 4: this is almost in the self image of a lot
32:25
Speaker 4: of pharmacists. It's almost like the arc type. We always
32:29
Speaker 4: just wait for permission. And I'm not saying to step
32:32
Speaker 4: out of the lines or the boundaries of what's legal,
32:34
Speaker 4: and I'm just saying we constantly, you know, it's you know,
32:37
Speaker 4: we wait for permission to do something. And I mean,
32:42
Speaker 4: Bianca on our call the other day, we were speaking
32:44
Speaker 4: with a pharmacist who, you know, My drive was, I
32:47
Speaker 4: think you just need to take the you need to
32:49
Speaker 4: take the leadership here, and you need to make it happen.
32:52
Speaker 4: Nothing's holding you back from it. Accept identity and self image.
32:56
Speaker 4: And I think there's a lot of opportunity for the
32:59
Speaker 4: independent pharmacy university staff to really say what they can do,
33:03
Speaker 4: to really speak of their expertise, and it's there. So
33:08
Speaker 4: I think that plays a role as well.
33:12
Speaker 1: All Right, mapping and blueprints And this is a good
33:16
Speaker 1: wrap up question, Rob, is there is there a model
33:19
Speaker 1: where a pharmacy owner who says, I really want to
33:23
Speaker 1: build a men's health clinic out of my independent community pharmacy.
33:27
Speaker 1: So it becomes a marketable, repeatable mode of not only marketing,
33:35
Speaker 1: but services provided that you'd have to go get a
33:39
Speaker 1: coach or have to like a way to get what
33:43
Speaker 1: you're doing plugged into independence in order to make it
33:46
Speaker 1: a program that is repeatable and could even become a
33:49
Speaker 1: revenue revenue program.
33:52
Speaker 4: Absolutely. I mean, whether it's a men's program, I think
33:55
Speaker 4: it's great to niche something and to do something that
33:57
Speaker 4: you're passionate about, but this would fall in line with
34:00
Speaker 4: women's health, whether it's perimenopause, whether it's menopause. Yeah, the
34:04
Speaker 4: mapping is there. I caution it not to fall into
34:10
Speaker 4: the practice in a box. You know, things that are
34:14
Speaker 4: often sold just do this test, this system, this test,
34:17
Speaker 4: but very simply yeah, I mean, whether it's from marketing
34:21
Speaker 4: or whether it's from how that patient journey works, because
34:25
Speaker 4: we can see people from one off. But turning things
34:28
Speaker 4: into actually a coaching program allows better patient care, better
34:33
Speaker 4: I think value to the patient, and also supports the
34:37
Speaker 4: practitioner one in sustainability, but also time spent, which is
34:43
Speaker 4: a n eemic for most practitioners. Yeah, I mean that's
34:47
Speaker 4: what we do you know, so you know, we give
34:49
Speaker 4: them the ways to do that, to make it easier
34:52
Speaker 4: to cut down on the time and all that.
34:55
Speaker 1: So it's the it's something though that can be implemented
35:00
Speaker 1: and can be turned into a program. I come back
35:03
Speaker 1: to Bianca, I'm thinking, you know, we just came back
35:05
Speaker 1: from covering podcast press as the McKesson ideas. Here I
35:11
Speaker 1: met up with a team that has a program through
35:14
Speaker 1: a company called full Script, and it is like a
35:17
Speaker 1: deep dive into the into the supplements industry, but it's
35:24
Speaker 1: tied directly into pharmacy care and pharmacy counseling. And it's
35:28
Speaker 1: not just hey, take this magnesium. It's no, we're not
35:32
Speaker 1: only gonna pretest, but then when you take, we're gonna
35:35
Speaker 1: take some you know, tests later to see how you're interacting,
35:39
Speaker 1: and we're really going to like dive into what our
35:41
Speaker 1: goal is. And it's just like it's so refreshing because
35:45
Speaker 1: the supplement industry is almost like the wild West in
35:49
Speaker 1: a lot of ways. And I just read an article
35:51
Speaker 1: where a six month old started having kidney issues because
35:56
Speaker 1: they're stupid ass parents. I'm allowed to say stupid ass
35:59
Speaker 1: because it's my show and the FCC is not going
36:03
Speaker 1: to bleep me out. But the parents were giving them
36:06
Speaker 1: protein powder every damn day in their in their formula,
36:10
Speaker 1: and it was like, what the hell? Like people do
36:13
Speaker 1: things that they interpret because of either doctor Google or
36:18
Speaker 1: hallucinations from AI or they you feed something enough, you're
36:24
Speaker 1: just going to justify why you think this is necessary
36:27
Speaker 1: to do. Like it's just like hold up and settle down,
36:30
Speaker 1: Like let's let's bring in your physician, let's get your
36:33
Speaker 1: pharmacists involved. Who's who's really dialed in and we want
36:36
Speaker 1: to know what your goals are for either your infant
36:39
Speaker 1: or yourself, or your your loved one, or your your
36:42
Speaker 1: your mother who has dementia. But let's slow down and
36:46
Speaker 1: let's get a pharmacist oversight of this. But Bianca, you
36:49
Speaker 1: have last words, since you're our special guest today.
36:55
Speaker 7: I think that.
36:57
Speaker 6: We are inundated with social media, with every sort of
37:02
Speaker 6: commercial that's out there, and unfortunately our customers are easily
37:09
Speaker 6: distracted by that. That being said, in a small, independent
37:13
Speaker 6: community pharmacy where I have relationships, I know that I'm
37:19
Speaker 6: getting the phone calls asking if this is a good
37:22
Speaker 6: idea before they buy. Maybe not one hundred percent of
37:25
Speaker 6: the time but it is so refreshing and so nice
37:29
Speaker 6: to pick up the phone and they say, I wanted
37:32
Speaker 6: to talk to you before I did this.
37:34
Speaker 7: So I think that the.
37:36
Speaker 6: Base role that pharmacists have always played with being accessible
37:40
Speaker 6: and being relatable, being a known part of the community
37:44
Speaker 6: is what makes us unique in this. We don't want
37:47
Speaker 6: people substituting a prescription medication for a supplement. We want
37:51
Speaker 6: them substituting a prescription medication or a supplement for common sense.
37:57
Speaker 6: And that's our biggest role, especially the realm of functional medicine,
38:02
Speaker 6: but also as an independent farm system.
38:05
Speaker 4: And I steal the last word, yeah, absolutely rough because
38:09
Speaker 4: it really speaks to what both of you just said,
38:11
Speaker 4: especially Todd the protein thing. I mean, we've become such
38:14
Speaker 4: a biohacking cultuure. People are looking for the quick fix.
38:18
Speaker 4: So the fact that people are checking with Bianca, that's
38:20
Speaker 4: the gold right there. And I think this biohacking, you know,
38:24
Speaker 4: And this is another reason I think Bianca and I
38:26
Speaker 4: work so well together. We recognize that we need to
38:29
Speaker 4: bring things back to more of a simplistic nature, more
38:32
Speaker 4: of the lifestyle, more of just getting out in nature
38:35
Speaker 4: and getting some sunshine. Like it's this quick drive that
38:40
Speaker 4: people have, and I think that sends us awry. I'm
38:42
Speaker 4: not saying all biohackens bad, but I'm saying we kind
38:45
Speaker 4: of lose our innateness. I think of what's going on
38:48
Speaker 4: in our own body as well as like this earth
38:51
Speaker 4: efforts standing on and how nature really created us.
38:54
Speaker 1: You know, Yeah, we're.
38:56
Speaker 7: Losing our instincts.
38:58
Speaker 4: We're losing our instincts, our intuitional Yeah, damn, I took
39:01
Speaker 4: the last word from you again, but we do.
39:06
Speaker 1: You both have to promise to come back to twerks.
39:09
Speaker 1: We have to unravel some of these issues. I want
39:11
Speaker 1: to dive deeper into scripted. I love the thought of
39:14
Speaker 1: that organization and how they're empowering The pharmacist Rob, I
39:19
Speaker 1: really appreciate you. You always give me a really good
39:22
Speaker 1: guidance and our listeners a really good content to think
39:26
Speaker 1: through and think about. Bianca. We'll have a link to
39:30
Speaker 1: your LinkedIn inside the podcast show notes. Shout out to
39:35
Speaker 1: our pharmacist, our technicians out there doing some amazing innovative things.
39:39
Speaker 1: Please bring your story to this week in Pharmacy. We
39:43
Speaker 1: would love to help tell the story of what you're
39:45
Speaker 1: doing to innovate and to push our profession further and
39:50
Speaker 1: change it. It's got to change. It can't stay where
39:52
Speaker 1: it is. It's been hijacked by the big insurance corporations.
39:56
Speaker 1: Which is another episode of Twerks that we can talk
39:58
Speaker 1: about later. But hey, I hope you guys have a
40:01
Speaker 1: great weekend. Thanks for being on twerks.
40:04
Speaker 7: Thank thank you.
40:17
Speaker 1: Hey. Today's episode is supported by suite Rx. This organization
40:25
Speaker 1: has been empowering independent community pharmacies long term care pharmacies
40:31
Speaker 1: for more than fifteen years. They've been innovative in the
40:36
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40:41
Speaker 1: long term care combo specialty pharmacies and three forty bter
40:46
Speaker 1: independent pharmacies throughout the United States. Once again sweet Rx.
40:51
Speaker 1: Check them out at suitearx dot com if you're looking
40:55
Speaker 1: for a different pharmacy management system that really customizes, especially
41:01
Speaker 1: the consulting side of the of the world. And we're
41:05
Speaker 1: going to be talking with organizations that work with sweet
41:09
Speaker 1: x specifically for long term care pharmacy consulting. I can't
41:13
Speaker 1: wait for you to hear that, and that's going to
41:16
Speaker 1: probably be this week in pharmacy over the next couple
41:19
Speaker 1: of weeks, and I'll make sure that you're all aware
41:23
Speaker 1: you have to listen to this next interview with my
41:28
Speaker 1: special guest Bonnie Callahan from Judy Health, which has a
41:35
Speaker 1: subsidiary Capital Rx's, which is the one of the PBMs
41:40
Speaker 1: that are changing the game, destroying the old models and
41:44
Speaker 1: ushering in solutions that are really patient centric, driven by
41:48
Speaker 1: our pharmacist. Up next on This Week in Pharmacy. Hey,
41:55
Speaker 1: welcome back to Twerks This Week in Pharmacy. It's Friday,
42:00
Speaker 1: and I'm excited to be here. I need a weekend.
42:02
Speaker 1: I feel like after the Fourth of July holiday, we're
42:05
Speaker 1: coming up. It's July tenth. What are you going to
42:08
Speaker 1: be doing this weekend, Bunny?
42:10
Speaker 5: Ooh, I am going.
42:11
Speaker 8: So I'm from southern California and I am going on
42:13
Speaker 8: a little staycation to us San Diego to celebrate a
42:17
Speaker 8: neighbor's birthday. So I am very excited to wrap up
42:21
Speaker 8: this bard week.
42:22
Speaker 1: I love it. I love it all right, Well, this
42:24
Speaker 1: is your first time on This Week in Pharmacy, not
42:27
Speaker 1: your first time on the Pharmacy Podcast Network. Back in
42:31
Speaker 1: the Crazy Pandemic era, we and I hooked up through
42:34
Speaker 1: LinkedIn July of twenty twenty one, so it's our five
42:38
Speaker 1: year anniversary. Happy anniversary, Bunnie, amazing exactly. And we had
42:44
Speaker 1: you on a show called Transforming in the Nation, which
42:48
Speaker 1: was really about what sociological issues are impacting healthcare specifically
42:53
Speaker 1: are there a pharmacists within those subjects that are becoming
42:57
Speaker 1: empowered and becoming champion of something that we're really missing
43:01
Speaker 1: and we do miss little pockets of care throughout everything.
43:06
Speaker 1: In your case, we were talking about how is demographic hatred
43:11
Speaker 1: or how is minority hate, like how is that impacting
43:14
Speaker 1: someone going for care? And then LGBTQ we were like
43:18
Speaker 1: really diving down into so we Russia had five years
43:23
Speaker 1: now where our lives are slightly different, but we all
43:26
Speaker 1: have the same missions. And it's so good to have
43:28
Speaker 1: you back. You're part of Judy Health. This is a
43:32
Speaker 1: rock star organization. Our listeners might know it better as
43:37
Speaker 1: the subsidiary or one of the components of Judy Health,
43:40
Speaker 1: which is the mothership. And it was Capital RX and
43:44
Speaker 1: you guys are heroes because you're transforming pharmacy benefit management
43:48
Speaker 1: care and I'm all for that for sure, And I
43:51
Speaker 1: just wanted to welcome you to TORCS. It's good to
43:53
Speaker 1: have you here.
43:54
Speaker 5: Thank you Todd.
43:55
Speaker 8: Always a pleasure, such a privilege to be able to
43:58
Speaker 8: speak with you today.
43:58
Speaker 5: So thanks for having me.
44:00
Speaker 1: All right, So the reason why I wanted to have
44:02
Speaker 1: you in Bonnie is tell our listeners a little bit
44:06
Speaker 1: about your career track being a pharmacist and now you've
44:12
Speaker 1: transformed your clinical passion into the world of pharmacy benefit
44:17
Speaker 1: management and how that's becoming what I consider I'm a
44:20
Speaker 1: half glass fool guy, so I'm always seeing the future
44:23
Speaker 1: of the positivity of being a pharmacist, and I see
44:26
Speaker 1: pharmacists going from transactional you know, the script gets paid
44:34
Speaker 1: and then that's kind of like the end, and I'm like, ah,
44:37
Speaker 1: the future is disease state management and specialty understanding and
44:42
Speaker 1: expertise where the Board of Specialties start in coming out
44:47
Speaker 1: with other standards and certifications, you know. And so you're
44:51
Speaker 1: a rock star that you have proven that a pharmacist
44:56
Speaker 1: moving much deeper into the business of pharmacy care is
45:01
Speaker 1: so necessary. So give our listeners a little overview on
45:03
Speaker 1: your background.
45:05
Speaker 8: Yes, absolutely so, I actually started my career got more
45:09
Speaker 8: than fifteen years ago now in the community pharmacy space.
45:12
Speaker 8: Did my residency with Kroger Pharmacy and the University of
45:15
Speaker 8: Cincinnati in Ohio. And really what drew me to that
45:19
Speaker 8: program and what I loved so much about it was
45:22
Speaker 8: not only was I able to get experience and what
45:25
Speaker 8: it was like to be on the bench and obviously
45:27
Speaker 8: doing the community pharmacist thing that we all know about, right,
45:30
Speaker 8: but in addition to that, what I wanted to really
45:32
Speaker 8: get into was pharmacist role in chronic condition management at
45:36
Speaker 8: the retail pharmacy.
45:37
Speaker 5: So I saw patients come to Kroger pharmacies, there would be.
45:41
Speaker 8: You know, a consultation room next to year we would
45:43
Speaker 8: do you know, diabetes, cholesterol, hypertension kind of checks and
45:49
Speaker 8: big referrals to physicians and things like that. We were
45:52
Speaker 8: able to do that in the community pharmacy space, and
45:55
Speaker 8: this was over fifteen years ago, and I thought that
45:57
Speaker 8: was the coolest thing, and that's how I started my career,
46:00
Speaker 8: and that really has been a through life through my
46:03
Speaker 8: career because I've always been interested in how pharmacists, the
46:06
Speaker 8: value of pharmacists in chronic condition management, and the beauty
46:11
Speaker 8: of me being able to get into now the PBM
46:14
Speaker 8: world is understand seeing how the payment side of that works,
46:21
Speaker 8: how we can incorporate chronic condition management and other types
46:25
Speaker 8: of medication related services in integrating that into the benefit
46:34
Speaker 8: structure of our clients. And I'm able to do that
46:39
Speaker 8: through Judy Health. I started with Caparax back Gosh in
46:44
Speaker 8: twenty twenty one and since that time, fast forward the
46:48
Speaker 8: five years here I and now VP of Clinical Programs
46:51
Speaker 8: here at Duty Health and able to have an amazing
46:55
Speaker 8: team of pharmacists and technicians and together we really own
46:58
Speaker 8: and operate the different types of clinical programs that our
47:02
Speaker 8: clients can elect, and we have pharmacies embedded, pharmacist anti
47:07
Speaker 8: dishes embedded within many of these programs to help ensure
47:11
Speaker 8: the best outcome for the member.
47:14
Speaker 1: I love it. I love the fact that you are
47:16
Speaker 1: so persistent in growing in your career and in bolting
47:22
Speaker 1: on the next thing to come out of the knowledge
47:25
Speaker 1: that you have. That's a shout out to pharmacists listening
47:28
Speaker 1: to this, and I kind of like want to start
47:31
Speaker 1: giving you questions to dig into that. And here's something
47:35
Speaker 1: I'm thinking of. So I learned about pharmacogenomics in twenty eighteen.
47:40
Speaker 1: It was from an administrative point of view, It had
47:42
Speaker 1: nothing to do with clinical. We were taking ICD nine
47:46
Speaker 1: codes at the time, because there were no such thing
47:47
Speaker 1: as ICD tens back then, and we were taking CPT
47:51
Speaker 1: codes and we were building this database thinking how can
47:54
Speaker 1: we help the PBM and how can we help the
47:57
Speaker 1: insurance company find where this test should be paid for
48:04
Speaker 1: based on the necessity based on the code, and then
48:07
Speaker 1: we gave that information a UPMC. At the time, this
48:10
Speaker 1: is years ago, and when that opened my mind up
48:13
Speaker 1: to PGX labs. So much data that's coming in that
48:18
Speaker 1: gets lost in the EHR because it's overwhelming. That poor overworked,
48:26
Speaker 1: over stimulated physician primary care who's like, all right, your
48:31
Speaker 1: labs came back, here's what's going on. Now, I got
48:34
Speaker 1: to kick you off to a specialist. And I'm thinking,
48:37
Speaker 1: hold on, before you get to this specialist, or before
48:41
Speaker 1: how about you give some of that data to the
48:42
Speaker 1: pharmacist over there who's hungry for it to really dig
48:46
Speaker 1: into this stuff. The remember, I don't know if you've
48:49
Speaker 1: ever seen a PGX results test, but it was like
48:51
Speaker 1: fifteen pages of yellow, green and orange and red, and
48:57
Speaker 1: it's like the red is like you're not going to
48:58
Speaker 1: metabolize and you're going to die and blah blah. So
49:01
Speaker 1: it's like so when I think of that when I
49:03
Speaker 1: think of all everything that's coming that's going to demand
49:07
Speaker 1: more of the reason that pharmacists became pharmacists and the
49:11
Speaker 1: experts in pharmacology, the experts and medication management. So there's
49:16
Speaker 1: PBM decisions. You need to be informed by the labs,
49:19
Speaker 1: the A one C, the LDC, renal function, all that stuff.
49:23
Speaker 1: So this makes prior authorization and that step therapy and
49:27
Speaker 1: medication optimization. It needs to be more precise because of
49:31
Speaker 1: the decisions that are there based on patient specific needs,
49:35
Speaker 1: based on evidence base. So talk to us about that
49:38
Speaker 1: and how people might not realize, Holy cow, that's that's
49:42
Speaker 1: what That's what PBM should be doing. They should be
49:46
Speaker 1: grabbing a doctor Bonnie and saying, hey, get to the
49:49
Speaker 1: bottom of this.
49:50
Speaker 8: M Yes, I love that question, and I love the
49:53
Speaker 8: topic of pharmacogenomics, and I would love to kind of
49:57
Speaker 8: give a relevant example.
50:00
Speaker 5: Where are pharmacists today on on.
50:03
Speaker 8: Our clinic program team here at you to help are
50:06
Speaker 8: actively working with PGX test results and connecting well, first
50:11
Speaker 8: of all, to your point about it being thirty pages
50:13
Speaker 8: and red, yellow, green, whatever, it is helping to interpret
50:17
Speaker 8: that for the member. So breaking it down for the
50:19
Speaker 8: member because it is so confusing and also at the
50:22
Speaker 8: same time looking at the report and saying okay, prescribe
50:26
Speaker 8: outreaching the prescriber and saying, hey, based on these results, here.
50:30
Speaker 5: Are some recommendations. Right.
50:32
Speaker 8: A lot of those times, you know, you can get
50:34
Speaker 8: a PGFS test ordered, it get sent you know, to
50:37
Speaker 8: you in the mail, you get the results, and that
50:39
Speaker 8: you kind of sit on it or it's up to
50:40
Speaker 8: the member to do something. And that's what I love
50:43
Speaker 8: about the r RX helix we call it program where
50:47
Speaker 8: you know, we have in house pharmacists there review the
50:49
Speaker 8: report after the member does the cheek swab thing, and
50:53
Speaker 8: then they hop on a call with the member and say, hey, look,
50:57
Speaker 8: this is this is what this means. And we're also
51:00
Speaker 8: going to talk to the doctor about, you know, specific
51:03
Speaker 8: changes to your drug regimen. And it's funny because we're
51:07
Speaker 8: as far as talking about the pharmacists and the clinicians
51:12
Speaker 8: role in this not only can they have a clinical impact,
51:14
Speaker 8: but we also did an analysis that we presented at
51:17
Speaker 8: Pharmacy Quality Alliance actually this past this year where we
51:22
Speaker 8: looked at really the impact of a clinician reaching out
51:25
Speaker 8: to the member too and the impact of that on
51:28
Speaker 8: the uptake of even doing the pg X test, because,
51:32
Speaker 8: as we know, it's kind of scary to say, well,
51:34
Speaker 8: I'll do this cheek swab, but like what am I doing?
51:37
Speaker 5: Am I sending my DNA in I don't you know?
51:39
Speaker 8: So we were seeing resistance there and so we we
51:43
Speaker 8: kind of looked at our we did an experiment and
51:46
Speaker 8: we found that, you know, by having one of our
51:49
Speaker 8: clinicians pharmacists or technicians make a telephonic outreach to the member,
51:55
Speaker 8: this increased the adoption rate of you know, doing the
51:58
Speaker 8: test itself.
52:00
Speaker 5: Significantly.
52:01
Speaker 8: So we're talking like ten percent versus a two percent
52:04
Speaker 8: uptake compared to not doing some type of telephonic outreach.
52:08
Speaker 8: So not only is the pharmacist you know, friend and
52:11
Speaker 8: center to help with digesting the clinical results, they're also
52:15
Speaker 8: really helpful from a proactive standpoint of consulting the member
52:18
Speaker 8: even before the test to say this is why it's important.
52:20
Speaker 8: And that goes back to the expertise right that pharmacists
52:23
Speaker 8: bring about PGX.
52:26
Speaker 5: There's not a lot of you know, you.
52:29
Speaker 8: Know, other clinicians out there who are feel comfortable in
52:33
Speaker 8: doing this and making these kind of consultations with the
52:35
Speaker 8: members and the prescribers, and I think pharmacists are really
52:39
Speaker 8: at the forefront of being able to do these types
52:41
Speaker 8: of interventions.
52:43
Speaker 1: Amen the most trusted healthcare provider at that level, the pharmacist.
52:47
Speaker 1: The access, the clarity, the demistifying describing to somebody what's
52:52
Speaker 1: going on. It just helps to It helps to put
52:55
Speaker 1: that patient at ease because it's driven by education and
52:59
Speaker 1: it's driven by an understanding. That kind of leads me
53:02
Speaker 1: to my next question for you, and that's collaboration directly
53:05
Speaker 1: with that treating physician or that treating specialist or even
53:09
Speaker 1: the team of people, especially when you start getting into
53:12
Speaker 1: really complex, rare diseases and the pharmacist is there to
53:16
Speaker 1: clarify therapy goals, confirm diagnosis, ask a lot of questions,
53:21
Speaker 1: review the previous treatment failures where things there might have
53:25
Speaker 1: been gaps, especially when you're talking about tie treating from
53:27
Speaker 1: one medication to another and then improving those turnaround times
53:33
Speaker 1: and then being able to select therapies based on all
53:37
Speaker 1: that information, all that tracking and data. So talk to
53:40
Speaker 1: me about how you, as a pharmacist who is plugged
53:44
Speaker 1: into such a powerful PBM, how you guys are managing that.
53:49
Speaker 8: Yes, so as far as you know, different opportunities to
53:54
Speaker 8: collaborate with the treating physician. I mean there's you listed
53:56
Speaker 8: out a number of different of opportunities. One of them
54:00
Speaker 8: is you know, suggesting alternative therapy and as even further example,
54:05
Speaker 8: a low cost alternative to a therapy that you know,
54:08
Speaker 8: maybe the prescriber wrote for a new product that's brand only,
54:11
Speaker 8: but there's other therapeutic goodpulpments out there that are you.
54:13
Speaker 5: Know, ten x cheaper, right, So that note, we do
54:16
Speaker 5: have a low cost alternative program. We call it our
54:18
Speaker 5: x smart say.
54:19
Speaker 8: This is where our in house pharmacists, specifically in our
54:23
Speaker 8: high touch offering for this program, they outreach to the
54:26
Speaker 8: physician directly when Judy, which is our edudication platform, identifies
54:31
Speaker 8: potentially lower cost alternatives for the member, and these low
54:35
Speaker 8: cost alternatives are aligned to the member's formula and benefit
54:38
Speaker 8: design because Judy is able to run a test claim
54:41
Speaker 8: to make sure that truly it is lower costs for
54:44
Speaker 8: the member and the plan. And they make outreach to
54:48
Speaker 8: the prescriber and say, hey, this is available and would
54:52
Speaker 8: you like to send a new prescription. If they say yes,
54:55
Speaker 8: they go ahead and send it. And then our pharmacists
54:56
Speaker 8: call the pharmacy, the dispensing pharmacy to make sure that
54:59
Speaker 8: they're filling you know, the lower cost alternative and not
55:02
Speaker 8: the brand right, just to kind of close that circle
55:05
Speaker 8: for the member. And so this process we've in program
55:08
Speaker 8: we set up to really reduce unnecessary denials because you
55:12
Speaker 8: don't want to you know, call them and say, hey,
55:14
Speaker 8: this low cost alternative, wait it's actually not covered, and
55:16
Speaker 8: you don't want to have that experience with the member either, right.
55:19
Speaker 8: It also you know, improves turnaround time to make sure
55:23
Speaker 8: the member has access to the medication and then helps
55:26
Speaker 8: the physician select the right therapy that aligns with the
55:29
Speaker 8: members plan design. So just an example of ways that
55:32
Speaker 8: you know, pharmacists at the PBM can can collaborate directly
55:36
Speaker 8: with the physician.
55:38
Speaker 1: All right, So I also want to talk about the
55:43
Speaker 1: patient touch and the connection. The first time I witnessed
55:48
Speaker 1: how a complex disease state and the realm of specialty pharmacy,
55:56
Speaker 1: I got to understand and listen to training recording calls
56:02
Speaker 1: that were de identified and the questions that were being asked.
56:07
Speaker 1: They didn't sound intrusive, they sounded like it was just
56:09
Speaker 1: a natural conversation. And the person that was gathering the information,
56:13
Speaker 1: was a pharmacy technician that was dedicated to that disease
56:16
Speaker 1: state management team, and then the pharmacist. After the call
56:21
Speaker 1: completed one stage, either a pharmacist would plug in or
56:25
Speaker 1: they would follow up maybe the next day or a
56:27
Speaker 1: couple days later, especially if it was like something that
56:30
Speaker 1: they got to get them started on a specific treatment,
56:32
Speaker 1: if there's a timetable. It really opened my eyes up
56:35
Speaker 1: to being like, holy cow, patients don't patients with these
56:41
Speaker 1: serious diseases. Number one, they're so scared, they're nervous. There's
56:44
Speaker 1: a financial issue for it. If you had a pharmacist
56:47
Speaker 1: that could hold the financial description of what's happening with
56:52
Speaker 1: the clinical description of what's happening in the best interest
56:55
Speaker 1: as the advocate of that patient's care, I would feel
56:59
Speaker 1: so much more cared about because it would start the
57:02
Speaker 1: mysteries of the care itself, and the disease itself is
57:06
Speaker 1: one thing, but the mysteries of me not knowing what
57:08
Speaker 1: this is going to do to my financial situation, that's
57:11
Speaker 1: a whole other thing. So that's where a pharmacist that's
57:16
Speaker 1: implanted in a highly intelligent AI infused you know, data
57:23
Speaker 1: kings and queens of pharmacy care through Judy Health. So
57:28
Speaker 1: talk to me about that situation of how you've really
57:31
Speaker 1: built that trust with the patient directly.
57:34
Speaker 8: Yes, I think there's multiple examples that come to mind
57:38
Speaker 8: if I were to kind of hone in on one.
57:41
Speaker 5: You know, many many of us.
57:44
Speaker 8: Probably all pharmacists at this point, know about medication therapy management.
57:47
Speaker 7: Right.
57:48
Speaker 8: This is a program where you know, is pharmacist led
57:51
Speaker 8: service that optimizes medication used through comprehensive medication reviews, making
57:56
Speaker 8: sure adherence is right, making sure what disease states are
57:58
Speaker 8: you on. Let's take a look at the whole regimen.
58:00
Speaker 8: And I think you know here at health we have
58:04
Speaker 8: a program like that, and I think being able to
58:07
Speaker 8: have a pharmacist look at the whole person, bring in
58:12
Speaker 8: all the disease days, bring in all the medications, look
58:15
Speaker 8: at you know, other alternatives. If it's from a financial perspective,
58:21
Speaker 8: bringing all of that together and combining it with an
58:25
Speaker 8: identification engine, right that can kind of look at claim's
58:29
Speaker 8: history and kind of you know, say hey, here are
58:31
Speaker 8: some alternatives, and to your point, leverage AI as well
58:35
Speaker 8: to help make that a more scalable solution. I think
58:39
Speaker 8: that's an example of where pharmacists who you know are
58:44
Speaker 8: are involved with that type of program.
58:46
Speaker 5: Can really continue to make an.
58:48
Speaker 8: Impact for for members to make sure they're on the
58:51
Speaker 8: right medication, right dose at the right time. And you know,
58:54
Speaker 8: I will say at Duty Health we had we have
58:57
Speaker 8: pharmacists who do do this type of service. We looked
59:00
Speaker 8: at twenty twenty five data from one of our large
59:02
Speaker 8: health plans and saw that the NTAM program interventions was
59:05
Speaker 8: able to save a plan an estimated cost avoidance of
59:09
Speaker 8: about a dollar eighty three per member per month, which
59:13
Speaker 8: is you know, it's significance savings or cost avoidance.
59:17
Speaker 5: And when we talk about cost avoidance.
59:19
Speaker 8: And referring to you know, what is you know, if
59:22
Speaker 8: member were adherent to their statin medication or their hypertension medication,
59:27
Speaker 8: that would have prevented, you know, additional doctor's visit or
59:29
Speaker 8: an additional ear visit. So those are that's what I
59:33
Speaker 8: kind of refer to when I talk about cost avoidance.
59:36
Speaker 8: But really that speaks to the fact that you know,
59:39
Speaker 8: MTM and pharmacist involvement allows us to proactively prevent these
59:43
Speaker 8: these issues and these unnecessary doctor's visits because at the
59:50
Speaker 8: end of the day, we're looking at total cost of care. Right,
59:53
Speaker 8: adherence is going to increase your pharmacy cost because we're
59:56
Speaker 8: saying take the medication, but we got to also see
59:58
Speaker 8: balance it out with well, how we're reducing the need
1:00:02
Speaker 8: to you know, go to the er or the need
1:00:04
Speaker 8: to do other things on the medical side. So I
1:00:06
Speaker 8: think it's important to look at the full picture with
1:00:09
Speaker 8: total cost of care when it comes to medication adherents.
1:00:12
Speaker 1: In particular, Bonnie, when you think of the graduating pharmacist,
1:00:18
Speaker 1: the P four that's listening in, or even the new
1:00:22
Speaker 1: pharmacist that's two years out, they're taking that position because
1:00:27
Speaker 1: obviously those student loans are coming in and they're they're
1:00:31
Speaker 1: gonna work in fast, fast paced retail or they're going
1:00:36
Speaker 1: to work in, you know, one of the chains, which
1:00:39
Speaker 1: is a wonderful place to start in my opinion, because
1:00:42
Speaker 1: you should really understand transaction, transaction, transaction and then situation,
1:00:48
Speaker 1: situation and communication. And I think it's like the boot
1:00:50
Speaker 1: camp for for a lot of pharmacists to start. But
1:00:53
Speaker 1: when they're listening today's interview, they're listening to you, what
1:00:57
Speaker 1: can you give a shout out to that pharmacist who
1:00:59
Speaker 1: is is very interested in the business side and the
1:01:03
Speaker 1: reimbursement side, and the and the benefit management side, and
1:01:07
Speaker 1: that's kind of where their brain kind of leans towards
1:01:10
Speaker 1: much more than maybe a bedside pharmacist store, maybe a
1:01:14
Speaker 1: community pharmacist. Maybe they're like, hey, I really want to
1:01:17
Speaker 1: get into the business side of pharmacy. What do you
1:01:21
Speaker 1: say to them? Like, what how do you how do
1:01:23
Speaker 1: you communicate and get them excited about the future of
1:01:26
Speaker 1: pharmacy care and where we're going with the next gen PBMs.
1:01:30
Speaker 8: Yes, yes, I would say, don't hold, don't don't lose
1:01:36
Speaker 8: sight of that, you know, dream and aspiration. I think
1:01:41
Speaker 8: that I agree with you. That's starting probably in retail
1:01:44
Speaker 8: and community. There's so much benefit to that because you
1:01:48
Speaker 8: really understand what what that transaction looks like, what that
1:01:51
Speaker 8: face to face member interaction looks like, all of that.
1:01:54
Speaker 8: And so, you know, I was I usually tell you know,
1:01:59
Speaker 8: the my students or aspiring pharmacists, you know, every experience
1:02:05
Speaker 8: is a good experience. Bring that with you to the
1:02:07
Speaker 8: next step. And also that you don't need to know
1:02:11
Speaker 8: where you're going to be in ten years, just know
1:02:13
Speaker 8: what the next step is. Because from my pharmacy career path,
1:02:17
Speaker 8: it wasn't straight. I started, like I said, in community,
1:02:21
Speaker 8: then I went into PBM, different PBM, and then I
1:02:24
Speaker 8: went into academia and then now I'm back at PBM. Right,
1:02:28
Speaker 8: So it's not linear and that's okay. And don't get
1:02:31
Speaker 8: bogged down and thinking, well, I'm now quote unquote stuff
1:02:34
Speaker 8: in retail.
1:02:35
Speaker 5: That's not the case.
1:02:36
Speaker 8: As long as you take your experiences and your expertise
1:02:40
Speaker 8: to that next position.
1:02:42
Speaker 5: And I would say meet the people along the way.
1:02:44
Speaker 5: We've said, we hear all the time.
1:02:46
Speaker 8: Pharmacy is a small world, and really make that effort
1:02:49
Speaker 8: to network and learn from others because you never know
1:02:52
Speaker 8: if you're going to be working with them next. That
1:02:53
Speaker 8: has happened to me multiple times in my career. So
1:02:57
Speaker 8: take those opportunities to learn more and do know there
1:03:00
Speaker 8: is life outside of community pharmacy and hospital pharmacy.
1:03:05
Speaker 5: I was in like I said, I was a student.
1:03:06
Speaker 5: In my past.
1:03:07
Speaker 8: I also worked in academia with students, and I think
1:03:10
Speaker 8: that a lot of times is the mindset.
1:03:12
Speaker 5: There's it's a binary path and pharmacy is not.
1:03:15
Speaker 8: I think we are so lucky to be in a
1:03:16
Speaker 8: profession where there are so many opportunities and I think
1:03:19
Speaker 8: the managed care world.
1:03:21
Speaker 5: There even within the managed care world, there are so
1:03:23
Speaker 5: many opportunities. At Juty Health. We have pharmacists embedded across
1:03:28
Speaker 5: all teams.
1:03:28
Speaker 8: And I'm talking not just our clinical organization within formulae
1:03:32
Speaker 8: and prior authorization and clinical programs. I'm talking also in
1:03:35
Speaker 8: the product space and in client services. There are so
1:03:39
Speaker 8: many opportunities where the pharmacist really is the trusted person.
1:03:44
Speaker 5: And so don't limit your your own.
1:03:46
Speaker 8: Vision for yourself and seek those opportunities as they come up.
1:03:51
Speaker 1: Bunnie, thank you so much for this. This is such
1:03:54
Speaker 1: a such a pleasure and joy to get you back
1:03:56
Speaker 1: on the show. We have to promise that it's not
1:03:59
Speaker 1: going to be five years that we wait for our
1:04:01
Speaker 1: next five year anniversary to get together.
1:04:06
Speaker 5: I promise, I Pinky promised. I would love to reconnect
1:04:10
Speaker 5: sooner than that.
1:04:11
Speaker 1: All right. I will put Bonnie's LinkedIn profile in the
1:04:14
Speaker 1: show notes for people that are interested in connecting with
1:04:18
Speaker 1: Bonnie active on LinkedIn, which is great. And a shout
1:04:22
Speaker 1: out to the Judy Health team. You guys are just
1:04:26
Speaker 1: you're on fire. You're doing the good work and transforming
1:04:30
Speaker 1: and I trust the organization. I've been following you for
1:04:34
Speaker 1: over ten years, like we both said when we started
1:04:37
Speaker 1: back when it was just capit rx, and now it's
1:04:39
Speaker 1: much bigger than that. So excited for where this is going.
1:04:43
Speaker 1: And it's a it's it's training our benefit coordinators at
1:04:47
Speaker 1: the at the employer level to think differently, stop accepting
1:04:54
Speaker 1: the old krusty PBM contracts that are that are nothing
1:04:59
Speaker 1: but ways of pushing revenue to the entity, and really
1:05:03
Speaker 1: start getting into the clinical and start getting into the
1:05:06
Speaker 1: word what did the word benefit mean when at first,
1:05:09
Speaker 1: you know, when whoever came up with pharmacy benefit manager,
1:05:14
Speaker 1: like when they said that there was supposed to be
1:05:16
Speaker 1: a benefit and the patient, the employer, they're feeling less
1:05:21
Speaker 1: and less and less of the benefit part of it.
1:05:24
Speaker 1: And it's like you guys are bringing that back. So
1:05:26
Speaker 1: I'm excited to see where this is gonna go.
1:05:29
Speaker 5: Thank you, Todd. Always a pleasure. Thank you so much
1:05:31
Speaker 5: for having me