Latest / Pharmacy Podcast Network / Trust Matters, Cell and Gene, & World Pharmacists Day | TWIRx

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Trust Matters, Cell and Gene, & World Pharmacists Day | TWIRx · Pharmacy Podcast Network

• 0:36
  Speaker 1: Hey there, Welcome to Twerks. My name is Todd.
• 0:38
  Speaker 2: You're a founder of the Pharmacy Podcast, and I'm the
• 0:42
  Speaker 2: happiest guy on the planet because it's tworks Day. It's
• 0:46
  Speaker 2: Friday Day, September twenty sixth. I need it to be Friday,
• 0:50
  Speaker 2: really really, really bad. Just had a normal week throughout
• 0:54
  Speaker 2: this week. I don't know how your week's been. I've
• 0:57
  Speaker 2: been in a very upbeat and happy mood. But it
• 1:02
  Speaker 2: was a recovery week. Just got back from three back
• 1:05
  Speaker 2: to back conferences the NSP focusing on our specialty pharmacies
• 1:09
  Speaker 2: and pharmacists. That's wonderful. Shout out to Sheila Quette and
• 1:13
  Speaker 2: her team. Just an amazing crew. We love that time.
• 1:17
  Speaker 2: Three part series is coming out. I think it starts
• 1:20
  Speaker 2: next week. Shout out to Brady let us know. I
• 1:23
  Speaker 2: can't remember exactly. Then we went to Framework LTC's innovation
• 1:28
  Speaker 2: conference concentrating on the technology of long term care pharmacy,
• 1:32
  Speaker 2: and that was my roots. That's how I entered pharmacy
• 1:35
  Speaker 2: way back in two thousand and four. I'm getting old.
• 1:40
  Speaker 2: And we were able to bring together their partners, their
• 1:44
  Speaker 2: clients and really set the stage for the future of
• 1:48
  Speaker 2: what pharmacy technology in the long term care space is
• 1:51
  Speaker 2: going to look like and guess what AI was everywhere
• 1:56
  Speaker 2: and there's lots of questions and confusion, and I think
• 2:01
  Speaker 2: the element of today, which our theme today is trust,
• 2:05
  Speaker 2: and we're going to be talking about how trust matters,
• 2:08
  Speaker 2: who to trust the Public's perception of healthcare today very weird,
• 2:15
  Speaker 2: especially just this last week selling gene therapy. Cannot wait
• 2:19
  Speaker 2: to talk to Joe today. And just a shout out
• 2:22
  Speaker 2: to my pharmacists, my favorite providers throughout the world. It
• 2:26
  Speaker 2: was World Pharmacist Day just passed. I think it was
• 2:30
  Speaker 2: yesterday on Thursday, the twenty fifth, and just proud to
• 2:34
  Speaker 2: be in the industry, proud to serve. If there's any
• 2:37
  Speaker 2: pharmacist listening right now that you'd ever like to join
• 2:40
  Speaker 2: me on this Week in Pharmacy and you really want
• 2:42
  Speaker 2: to dial into something that you're passionate about, please reach
• 2:46
  Speaker 2: out to me.
• 2:46
  Speaker 1: We would love to have you. Hey, we are going
• 2:50
  Speaker 1: to dive.
• 2:50
  Speaker 2: In and review some review some news today and I'm
• 2:54
  Speaker 2: excited that I get to have a co host with me.
• 2:57
  Speaker 2: Don't usually get a co host all the time, but
• 3:00
  Speaker 2: doctor Melissa Smith is not a stranger to podcasting. She's
• 3:05
  Speaker 2: leading our pharmacogenomics podcast initiatives with her new show, which
• 3:10
  Speaker 2: is doing very well. And I just want to say
• 3:12
  Speaker 2: Happy Friday and welcome to TWRKS.
• 3:15
  Speaker 3: Good morning, Todd. Thank you for having me with you today.
• 3:18
  Speaker 1: You're very welcome. We are, like I.
• 3:21
  Speaker 2: Said, in kind of a strange land. That is the
• 3:26
  Speaker 2: United States Healthcare System. It's stranger than ever. And I
• 3:30
  Speaker 2: want to get into some news with you. So it's
• 3:33
  Speaker 2: now time for twarks News. I need to have like
• 3:36
  Speaker 2: a little voice over that says something dramatic, like tworks
• 3:41
  Speaker 2: news or something like that.
• 3:45
  Speaker 1: Yes, that would be cute, all right.
• 3:48
  Speaker 2: So first up, I wanted to talk about the FDA,
• 3:52
  Speaker 2: and once again you and I before we are in
• 3:56
  Speaker 2: the green room, Melissa and I are talking and we
• 3:59
  Speaker 2: both agree that there should be a moat, big gargantuan
• 4:06
  Speaker 2: moat with walls and with barbed wire guarding it. There
• 4:10
  Speaker 2: should be an island called the United States Healthcare System.
• 4:13
  Speaker 2: And that moat protects us from politics, it protects us
• 4:18
  Speaker 2: from nuance, it protects us from non evidence based and
• 4:22
  Speaker 2: of course this is a fantasy land, Melissa, because we
• 4:24
  Speaker 2: live in the real world, and so one of the
• 4:29
  Speaker 2: questions that came up on a TikTok, and I rushed
• 4:32
  Speaker 2: to the US Food and Drug Administration's page was what
• 4:37
  Speaker 2: are novel drugs?
• 4:38
  Speaker 1: What does that mean?
• 4:39
  Speaker 2: And so the definition on the FDA's page is novel
• 4:43
  Speaker 2: drugs or drugs never before approved or marketed in the US.
• 4:46
  Speaker 2: C FDA for information about all seds, cders, approved drugs
• 4:54
  Speaker 2: and biologic products. First of all, Melissa, do you know
• 4:57
  Speaker 2: what a CDER is with the set standboard?
• 5:00
  Speaker 4: Oh boy, let's see here, because I.
• 5:04
  Speaker 2: Don't know what that stands for, but they expect us
• 5:07
  Speaker 2: to know. And this is a publicly accessible site. So
• 5:10
  Speaker 2: I'm like, why would they say cd R?
• 5:14
  Speaker 4: Yeah, Center for Drug Evaluation and Research.
• 5:17
  Speaker 2: Okay, excellent, all right. So the reason why I wanted
• 5:21
  Speaker 2: to bring this up to our listeners is and from
• 5:25
  Speaker 2: your perspective when you're because Melissa is a consultant and
• 5:28
  Speaker 2: she digs deep into people's issues. He personalizes the medicine
• 5:32
  Speaker 2: treatments she hears from the physician. She grabs the football,
• 5:35
  Speaker 2: the treatment ball, and then you run with it. But
• 5:37
  Speaker 2: then you're making jukes, you're making adjustments, you're jumping over
• 5:41
  Speaker 2: obstacles with the patient, and you're kind of like, I
• 5:43
  Speaker 2: can't I have to talk about football because football is
• 5:46
  Speaker 2: in my mind. So I'm going to do football analogies
• 5:48
  Speaker 2: for the entire time as Melissa's sprinting down the field
• 5:51
  Speaker 2: with the treatment.
• 5:53
  Speaker 3: Being in this situation, right, But talk to me.
• 5:57
  Speaker 2: About when you hear a a new drug and it's
• 6:02
  Speaker 2: in a picture interest for whatever reason, especially if it
• 6:04
  Speaker 2: have impacted one of your patients, where do you go
• 6:07
  Speaker 2: for your information to really dig into it.
• 6:11
  Speaker 4: Well, the FDA website is a great resource because that's
• 6:14
  Speaker 4: where it's going to be approving newly approved drugs, but
• 6:17
  Speaker 4: also giving us a list of these novel drugs that
• 6:19
  Speaker 4: could be used in clinical trials, et cetera.
• 6:22
  Speaker 3: After I go there, I go.
• 6:24
  Speaker 4: Into what's available to me as far as the pharmacokinetics
• 6:27
  Speaker 4: and the pharmacodynamics because I am a precision medicine pharmacist,
• 6:30
  Speaker 4: so I utilize genetics to my benefit to really look
• 6:33
  Speaker 4: at how a patient may respond to medication therapies. And
• 6:36
  Speaker 4: what's nice about the research of bringing a drug to
• 6:39
  Speaker 4: development is we're always going to have pharmacokinetic information, so
• 6:43
  Speaker 4: we have insight into the four fifty enzyme activity, other
• 6:46
  Speaker 4: types of pathways that are going to be responsible for
• 6:49
  Speaker 4: eliminating or activating our drugs. So for me, even if
• 6:53
  Speaker 4: it isn't aligning per se with the research at first,
• 6:58
  Speaker 4: I can still get some intuition around wants to be
• 7:01
  Speaker 4: expected when the genetics can come into play with the
• 7:04
  Speaker 4: major players that I look at every day. So those
• 7:08
  Speaker 4: are that's a that's a that's kind of a route
• 7:10
  Speaker 4: of attack I take in my mind when approaching new
• 7:12
  Speaker 4: drugs that may not necessarily have all the evidence based
• 7:15
  Speaker 4: information there yet.
• 7:18
  Speaker 2: So that makes sense, and I would I consume information
• 7:21
  Speaker 2: probably different than you and different than anybody because we
• 7:24
  Speaker 2: all lean. There's people that tell me I love video
• 7:28
  Speaker 2: you know, there's people that say, hey, I love reading,
• 7:30
  Speaker 2: and then of course me, I love podcasts. I can listen,
• 7:33
  Speaker 2: I can absorb, and then the ultimate is finding a
• 7:37
  Speaker 2: podcast that then I can go read what they're talking about.
• 7:41
  Speaker 2: And that kind of leads us to once again the
• 7:44
  Speaker 2: theme of trust where where we're getting our information. And
• 7:47
  Speaker 2: I really like how you said that you're going to
• 7:50
  Speaker 2: the FDA site, but you're also looking to other, you know,
• 7:55
  Speaker 2: other resources, so you can kind of like that that
• 7:58
  Speaker 2: is in and of itself evidence based medicine. It's Okay,
• 8:01
  Speaker 2: here's the journal article on hyper lipidemia. But here's another
• 8:06
  Speaker 2: article on hyperlipidemia, and here's another article on a And
• 8:10
  Speaker 2: now you've kind of perused and read all three. And now,
• 8:14
  Speaker 2: as the person that's responsible for the care at the
• 8:17
  Speaker 2: point of care, right in front of the patient right there,
• 8:20
  Speaker 2: now you get to make some decisions. And I think
• 8:22
  Speaker 2: that's the beauty of the craft and the practice and
• 8:26
  Speaker 2: the experience of being a pharmacist. And I can only imagine,
• 8:30
  Speaker 2: but because I'm not a pharmacist, But is that kind
• 8:33
  Speaker 2: of talk a little bit more about how you come
• 8:35
  Speaker 2: to some of your decisions.
• 8:37
  Speaker 4: Yes, you really can't rely upon one site or one
• 8:41
  Speaker 4: source of evidence to really make a clear determination. And
• 8:45
  Speaker 4: that's what I was taught in school as well, is
• 8:47
  Speaker 4: that you really have to research all avenues, all perspectives.
• 8:50
  Speaker 3: And all things that are.
• 8:54
  Speaker 4: Well vetted, if you will, in terms of what we
• 8:57
  Speaker 4: can go off of. So for me, it's important for
• 9:01
  Speaker 4: patient safety to really utilize all avenues at my disposal
• 9:06
  Speaker 4: when it comes to clearly defining what a medication outcome
• 9:11
  Speaker 4: looks like for a patient, for sure, but you also
• 9:14
  Speaker 4: have to collaborate and speak to other people as well,
• 9:17
  Speaker 4: you have to take in different perspectives. That's provider MD
• 9:20
  Speaker 4: perspectives as well, because yes they're diagnosing. They have an
• 9:25
  Speaker 4: oversight of more things than I usually have access to
• 9:28
  Speaker 4: when it comes to their family, and it's important for
• 9:31
  Speaker 4: that to happen as well.
• 9:32
  Speaker 1: So not only is it reading.
• 9:34
  Speaker 4: It's actually communicating and speaking in an interdisciplinary fashion with
• 9:38
  Speaker 4: other providers too.
• 9:41
  Speaker 1: I love it excellent, all right.
• 9:43
  Speaker 2: Next in news, I want to share with the listeners
• 9:49
  Speaker 2: an organization made up of originally two brothers nerdy as hell.
• 9:54
  Speaker 2: They're so nerdy and so fascinating and so intelligent. They're
• 9:58
  Speaker 2: thinking like ten steps of head of processes. They are
• 10:03
  Speaker 2: now funded by a bigger organization and the name of
• 10:06
  Speaker 2: the organization is Nested Knowledge. You can go to Nested
• 10:10
  Speaker 2: hyphen Knowledge dot com and Melissa.
• 10:14
  Speaker 1: They're going to.
• 10:15
  Speaker 2: Take buckets of data clinical of course, and they're going
• 10:20
  Speaker 2: to tie it into some other databases like maybe a
• 10:22
  Speaker 2: medi span or something.
• 10:24
  Speaker 1: They're going to cross reference articles.
• 10:26
  Speaker 2: They're going to cross reference other databases and EHR systems
• 10:32
  Speaker 2: and personalized soap notes and personalized treatments and.
• 10:35
  Speaker 3: That's health records too.
• 10:37
  Speaker 2: Yeah, all together, and they're going to give it to
• 10:42
  Speaker 2: the pharmacists, give it to the physician, give it to
• 10:44
  Speaker 2: the nurse practitioner, and I'm blown away.
• 10:46
  Speaker 1: So nested knowledge, just like this week is crazy.
• 10:50
  Speaker 4: That is going to blow up the industry in a
• 10:54
  Speaker 4: good way because there's always been a lack of communication
• 10:58
  Speaker 4: between different EHR system that different hospital systems use, long
• 11:02
  Speaker 4: term care systems use, and by able to for this
• 11:05
  Speaker 4: technology to allow visibility into different I'm hoping that that's
• 11:10
  Speaker 4: kind of the concept that sounds like it is that
• 11:12
  Speaker 4: will allow for a better management overall for any patient.
• 11:16
  Speaker 4: I'm assuming this is a technology integrated and for the
• 11:19
  Speaker 4: practitioner to gain access to all information patient wise.
• 11:22
  Speaker 3: Right, is that the kind of concept.
• 11:24
  Speaker 5: Here, right?
• 11:25
  Speaker 2: That's right, and it's it's all personalized. So, you know,
• 11:29
  Speaker 2: precision medicine really became a strong buzzword about ten years ago,
• 11:33
  Speaker 2: and then it solidified about five years ago.
• 11:35
  Speaker 1: Then it really popped back up again.
• 11:38
  Speaker 2: You can actually practice precision medicine today, and in your case,
• 11:42
  Speaker 2: you're doing it in my opinion, now that we have AI.
• 11:46
  Speaker 2: If you're doing it without AI, you're doing it the
• 11:48
  Speaker 2: hard way. Even though you're still doing it and you're
• 11:50
  Speaker 2: still you're still doing it the I would say, like
• 11:52
  Speaker 2: the old fashioned way or the ball and the ball
• 11:55
  Speaker 2: and pestel. You're grinding up the personalized medicine. But now
• 11:59
  Speaker 2: we have a to take all these other sources of
• 12:02
  Speaker 2: data and the most important one is the patient's very
• 12:07
  Speaker 2: specific notes. But now you're combining all the specific notes
• 12:12
  Speaker 2: with all this trusted sources of information.
• 12:17
  Speaker 4: That's incredible and we live in a very cool time
• 12:20
  Speaker 4: right now to be able to have this integrated. This
• 12:22
  Speaker 4: is something that when I was in pharmacy school and
• 12:25
  Speaker 4: then early in practice, thought this was far off in
• 12:27
  Speaker 4: the distance, like it was a problem that just seemed
• 12:30
  Speaker 4: impossible to solve, right. But with the integration of AI
• 12:34
  Speaker 4: into the mix, it allows for it to come to fruition, right.
• 12:40
  Speaker 4: So I'm excited about it. And it allows for me
• 12:44
  Speaker 4: to be able to not have to invest so much
• 12:46
  Speaker 4: time in the searching of information, and it can allow
• 12:51
  Speaker 4: me to expedite my process significantly, so that way, ultimately
• 12:55
  Speaker 4: we're getting things out to the patient in a more
• 12:58
  Speaker 4: effective way where they're feeling happier, healthier, more empowered.
• 13:02
  Speaker 2: I love this exactly, exactly, and I think it's going
• 13:08
  Speaker 2: to lead to pharmacists becoming very creative with what they
• 13:13
  Speaker 2: dig into. I think of Daniel Plummer and the world
• 13:16
  Speaker 2: of pregnancy, in the world of getting pregnant. I think
• 13:19
  Speaker 2: of Nadia Archimbaugh in the way that she coaches sexual
• 13:23
  Speaker 2: health and mental health and the fusion. And I think
• 13:26
  Speaker 2: of Genaquin and Pdah. Like, you guys are all champions
• 13:30
  Speaker 2: and you're you're already these in my eyes, you're like
• 13:32
  Speaker 2: these superheroes. But now you're going to have like this
• 13:34
  Speaker 2: extra toolkit to go even better and deeper and.
• 13:39
  Speaker 1: And just do so much more. So, Yeah, I'm excited.
• 13:43
  Speaker 4: I like that term toolkit and it's essential in our
• 13:48
  Speaker 4: arsenal of tips and tricks that we pull out for
• 13:51
  Speaker 4: us to be that much more proficientctly.
• 13:56
  Speaker 2: So if you go to once again nested dash Knowledge
• 14:00
  Speaker 2: dot com, you can get it for free.
• 14:03
  Speaker 1: Just try it out, poke around, tell it free.
• 14:07
  Speaker 3: That's even cooler.
• 14:08
  Speaker 2: Yeah, try it out for free and then you know,
• 14:11
  Speaker 2: let me know what you think. And then we'll get
• 14:13
  Speaker 2: back to the Calamus Brothers k A L. L. E.
• 14:17
  Speaker 1: Ms.
• 14:19
  Speaker 2: And they're just like I said, they're dynamic, and we're
• 14:21
  Speaker 2: going to be actually doing some work with them and
• 14:23
  Speaker 2: what they're going to help me with and By the way,
• 14:25
  Speaker 2: this stems off the word of trust. They're going to
• 14:28
  Speaker 2: be helping me with a standard, and the standard that
• 14:31
  Speaker 2: I've been working on since September of twenty twenty is
• 14:34
  Speaker 2: called evidence based podcasting. And what I've learned over podcasting
• 14:39
  Speaker 2: and pharmacy longer than anyone, and observing and listening to you,
• 14:43
  Speaker 2: and learning from pharmacists and learning from even patients and physicians,
• 14:49
  Speaker 2: and putting all this together, what I've learned is that
• 14:52
  Speaker 2: you have great respect for evidence based cataloging, data, repository journals,
• 15:01
  Speaker 2: and your podcasts that have exploded over the years. When
• 15:04
  Speaker 2: I started in two thousand and nine and they were zero.
• 15:06
  Speaker 2: Now there's about three hundred podcasts that are tied into pharmacy.
• 15:11
  Speaker 2: We have about forty two of those, and underneath that umbrella,
• 15:17
  Speaker 2: zero of those podcasts are evidence based. And that means
• 15:22
  Speaker 2: that your podcaster and your guest and the information that
• 15:26
  Speaker 2: you're talking about, and the journal that you're reviewing and
• 15:29
  Speaker 2: the article that you're digging into, that's well and fine,
• 15:32
  Speaker 2: it's still opinion because you didn't give it off to
• 15:35
  Speaker 2: two other people that have nothing to do with you.
• 15:38
  Speaker 2: They are completely unbiased. You know, they don't have any
• 15:42
  Speaker 2: reason to say anything this way or that way, but
• 15:45
  Speaker 2: they're going to critique, they're going to dig down, and
• 15:47
  Speaker 2: they're going to call you out if you've said something
• 15:50
  Speaker 2: on that podcast that is not truly evidence based. And
• 15:53
  Speaker 2: we're going to be coming up with this standard. The
• 15:55
  Speaker 2: standard is almost complete. We're about ninety eight percent completing
• 15:59
  Speaker 2: with the stand want to give a shout out to
• 16:02
  Speaker 2: pharmacists and continuing education providers that this is going to
• 16:07
  Speaker 2: revolutionize podcast supplemental learning. And I use the word supplement strongly, Melissa,
• 16:14
  Speaker 2: because I still don't believe that a podcast should ever
• 16:17
  Speaker 2: be the primary information. I think it should be secondary
• 16:21
  Speaker 2: and even evidence based podcasting. When you get to get
• 16:24
  Speaker 2: in your car and you're going to your treatment center
• 16:27
  Speaker 2: in a hospital, and you have a patient, it's a baby,
• 16:31
  Speaker 2: they have this blood disorder whatever, and now you can
• 16:34
  Speaker 2: listen to a podcast that on the way. It's a
• 16:36
  Speaker 2: fifteen twenty thirty minute show and it's the latest on
• 16:40
  Speaker 2: the XYZ disorder or whatever it was, and it's evidence based,
• 16:45
  Speaker 2: it's been peer reviewed.
• 16:46
  Speaker 1: So I think that that's important.
• 16:48
  Speaker 2: In an age where doctor Google has perverted medicine from
• 16:53
  Speaker 2: people diagnosing themselves and people are like, but I listened
• 16:56
  Speaker 2: to Joe Rogan, and people are like, I listened to
• 16:59
  Speaker 2: doctor Raw or this podcast or this podcast there, and
• 17:03
  Speaker 2: it's it's still not evidence based resources.
• 17:06
  Speaker 1: So what do you think of this concept?
• 17:09
  Speaker 3: I think it's important.
• 17:10
  Speaker 4: We're in an era where information online with I can't
• 17:14
  Speaker 4: tell you how many times I've had patients use that
• 17:17
  Speaker 4: same type of ideology of using Google to diagnose themselves
• 17:22
  Speaker 4: and then coming into a conversation with me with things
• 17:25
  Speaker 4: that are like just very low level of evidence or
• 17:28
  Speaker 4: just more I feel like whenever they go into let's
• 17:31
  Speaker 4: say Google or chat GPT, they're googling like very specific
• 17:34
  Speaker 4: things that they want answers to, and chat TOBT and
• 17:38
  Speaker 4: Google are not always going to give you the most
• 17:40
  Speaker 4: accurate interpretation of that information.
• 17:44
  Speaker 3: So that's important.
• 17:45
  Speaker 4: And that's where practitioners like physicians and pharmacists are so
• 17:49
  Speaker 4: instrumental and being able to be, you know, guiding lights
• 17:53
  Speaker 4: to that information because one we've gone through school for
• 17:57
  Speaker 4: so many years to be able to understand and interpret
• 18:00
  Speaker 4: this knowledge for you and truly err on the side
• 18:02
  Speaker 4: of caution for you to do no harm to you
• 18:04
  Speaker 4: as the patient. I mean, that's the idea here and
• 18:08
  Speaker 4: making a podcast available to practitioners and even out other
• 18:13
  Speaker 4: listeners who just want more evidence based, true information than
• 18:18
  Speaker 4: just listening to some influencer online about how they should
• 18:22
  Speaker 4: be correcting their cholesterol with this supplement over here that
• 18:25
  Speaker 4: probably doesn't even have what the active ingredients that they're
• 18:28
  Speaker 4: looking for in it, because nothing's being vetted that way either.
• 18:31
  Speaker 4: So we live in a very tricky time. And being
• 18:33
  Speaker 4: able to provide the public practitioners with a podcast that
• 18:39
  Speaker 4: truly vets the information and only showing the higher levels
• 18:42
  Speaker 4: of evidence that surround the different topics and conditions and
• 18:46
  Speaker 4: medications that we're trying to work with with our patients
• 18:49
  Speaker 4: is important and truly is a big responsibility. So it
• 18:55
  Speaker 4: takes a person like yourself Todd to be able to
• 18:58
  Speaker 4: bring all like minds together. They're in this and bringing
• 19:01
  Speaker 4: it to the forefront and making it available.
• 19:05
  Speaker 2: Yes, I and and the the fast track of all
• 19:09
  Speaker 2: of this is we we experimented with evidence bace podcasting
• 19:14
  Speaker 2: with Eli Lilly back in twenty eighteen when they when
• 19:17
  Speaker 2: they were doing a podcast on trulicity Doctor Doctor.
• 19:22
  Speaker 1: Yeah.
• 19:22
  Speaker 2: They they were intense and it took six months to
• 19:26
  Speaker 2: edit and to make that podcast truly evidence based and
• 19:31
  Speaker 2: pulling back the information and vetting it. And then they
• 19:33
  Speaker 2: had peer reviewers that were you know that we're encouraged
• 19:37
  Speaker 2: to review and give feedback, and we had to change
• 19:40
  Speaker 2: a couple of things. But it's there's no reason with
• 19:44
  Speaker 2: technology today and what we've done that we can't that
• 19:48
  Speaker 2: we can't.
• 19:48
  Speaker 3: Do this absolutely.
• 19:51
  Speaker 1: Yeah.
• 19:51
  Speaker 2: So also in the news, I want to give a
• 19:54
  Speaker 2: shout out. This comes from West Virginia News. That's wvnews
• 19:58
  Speaker 2: dot com. Shout out to that reporting they covered the
• 20:02
  Speaker 2: Orsini selected as a specially pharmacy partner for Krinetics. Pulse
• 20:07
  Speaker 2: of Paul SNIFFI, paulse NIFFI, I don't even know what
• 20:10
  Speaker 2: that drug is.
• 20:11
  Speaker 1: What is that drug melissautine.
• 20:13
  Speaker 3: I've never heard of the drug.
• 20:14
  Speaker 4: I'm going to be full transparency there. So let me
• 20:16
  Speaker 4: look at this and give you an.
• 20:18
  Speaker 2: Answer, obviously for a rare disease. But I want to
• 20:21
  Speaker 2: give a shout out to Nick Klla. He's a friend
• 20:24
  Speaker 2: of mine from Pittsburgh, Pennsylvania. He's been in specially pharmacy
• 20:27
  Speaker 2: for years. He joined me on the NASP podcast while
• 20:31
  Speaker 2: we were in Denver. I cannot wait to share his
• 20:34
  Speaker 2: interview with you, but a shout out to Orsini and
• 20:36
  Speaker 2: what you're doing in rare disease. I really enjoyed reading
• 20:39
  Speaker 2: this article and understanding that your partnerships with other companies
• 20:45
  Speaker 2: are opening doors, even though I had no idea what
• 20:48
  Speaker 2: the drug was.
• 20:49
  Speaker 4: Yeah, I'm looking at it right now, and it is
• 20:52
  Speaker 4: definitely a specialty drug for types of conditions like rare
• 20:55
  Speaker 4: endocrine disorders hYP prepare thyroidism, where blood disorders like sickle
• 20:59
  Speaker 4: cell dose and transfusion.
• 21:02
  Speaker 3: Let me see here, let's see here.
• 21:07
  Speaker 4: Specific for it though, it's the endocrine disorder, so hypo parathyroidism,
• 21:12
  Speaker 4: and then a pheno key tun urea PKU is also
• 21:16
  Speaker 4: a treatment, and then he So it's got a bunch
• 21:18
  Speaker 4: of indications hematology disorders like sickle cell like I was mentioning.
• 21:22
  Speaker 4: So yes, it's one of those specialty medications that I
• 21:26
  Speaker 4: don't necessarily see all time unless I'm in those particular fields.
• 21:32
  Speaker 2: Yeah, that's why it's especially they they're building workflow systems
• 21:36
  Speaker 2: for disease states now, and that disease state selection will
• 21:41
  Speaker 2: then open up libraries of information and treatment calls and
• 21:46
  Speaker 2: so especially it's crazy. It's it's one of my favorite
• 21:49
  Speaker 2: sectors of pharmacy, and how busy it's become.
• 21:52
  Speaker 4: Charmacists have to be in this line of work because
• 21:56
  Speaker 4: there's very specific pharmacists that are hired to only counsel
• 22:00
  Speaker 4: on this medication and work with the providers on the administration,
• 22:03
  Speaker 4: et cetera. I have a cousin that actually does that
• 22:06
  Speaker 4: in a specialty drug company. So yeah, it's involved. Because
• 22:12
  Speaker 4: it's not unique to the larger population, it's very specific.
• 22:17
  Speaker 1: Well, let's says your cousin. Is your cousin a pharmacist?
• 22:21
  Speaker 6: She is.
• 22:21
  Speaker 4: Yep, she's my cousin, Jason. He's a pharmacist with publics.
• 22:27
  Speaker 4: He is kind of higher up in publics in the
• 22:30
  Speaker 4: state of Florida. And then she has done this work
• 22:33
  Speaker 4: since she got out of school and it was a
• 22:34
  Speaker 4: long time ago when she graduated. I want to stay
• 22:36
  Speaker 4: back in two thousand and nine.
• 22:38
  Speaker 3: Is when they graduated from school. Wow, maybe it maybe
• 22:41
  Speaker 3: even a little earlier than that.
• 22:42
  Speaker 2: So it's cool it's in your family, yes, all right.
• 22:47
  Speaker 2: Next up, this kind of ties us back to the
• 22:50
  Speaker 2: word trust. And I've heard some disturbing feedback to some
• 22:57
  Speaker 2: of the boards of pharmacy throughout the country and how
• 23:00
  Speaker 2: once again it's just doing it the way. We've always
• 23:03
  Speaker 2: done it this way, So this is the way we're
• 23:05
  Speaker 2: going to do it. No, sir, you're not going to
• 23:07
  Speaker 2: do it that way. You're going to follow an evidence
• 23:09
  Speaker 2: space medicine. Shout out to Bernadette Melnick with this book EBP,
• 23:14
  Speaker 2: the EBP Competency Book Redefining Evidence Based Medicine. Her and
• 23:20
  Speaker 2: her partner Lynn Gallagher Ford doctor Ford and Ellen Overhault
• 23:26
  Speaker 2: wrote this book and this is what I based evidence
• 23:28
  Speaker 2: based podcasting on and being able to come up with
• 23:31
  Speaker 2: a format and a standard to assure that the information
• 23:34
  Speaker 2: that we're reviewing is in fact evidence based. And the
• 23:37
  Speaker 2: headline here from the Alabama Political Reporter is Alabama Board
• 23:42
  Speaker 2: of Pharmacy faces backlash over Open Meetings Act violation And
• 23:47
  Speaker 2: it kind of goes into the privacy issues that had
• 23:50
  Speaker 2: come up, as well as a settlement that's actually in place.
• 23:55
  Speaker 2: The trust that we think as the consumer that our
• 23:58
  Speaker 2: boards of pharmacy are assuring that information is phi is
• 24:04
  Speaker 2: kept in place. And it's just this is the third
• 24:08
  Speaker 2: time in a month that I've heard from news or
• 24:12
  Speaker 2: I've heard from a pharmacist that something's going on awry
• 24:16
  Speaker 2: at their board. Of pharmacy. And that's disturbing to me
• 24:19
  Speaker 2: because once again, I want to common denominator. I want
• 24:23
  Speaker 2: to hit the floor and I want to not sink.
• 24:26
  Speaker 2: I want to stay on something concrete, and I want
• 24:29
  Speaker 2: that to be based on health care trust. So the
• 24:33
  Speaker 2: boards of pharmacy are supposed to be kind of like
• 24:36
  Speaker 2: our police officers of the pharmacy industry and the standards
• 24:39
  Speaker 2: and making sure that one to two, one pharmacist to
• 24:43
  Speaker 2: two techs or you know, just the whole gamut of
• 24:46
  Speaker 2: what comes into play. But have you ever have you
• 24:49
  Speaker 2: ever had run ins either good or bad? And you
• 24:53
  Speaker 2: don't have to be specific, but anything tied back to
• 24:56
  Speaker 2: a board of pharmacy Melissa.
• 24:58
  Speaker 4: Not me personally, thank god, But I was reading a
• 25:02
  Speaker 4: little more deeply into this article and it's being pretty
• 25:04
  Speaker 4: vague about what the explicit like indicate what they're inferring
• 25:09
  Speaker 4: as far as an appropriate conduct with the Board of
• 25:13
  Speaker 4: Pharmacy members and one in particular through this. And that's
• 25:18
  Speaker 4: interesting that they're being that vague, right, because it almost
• 25:21
  Speaker 4: insinuates like a higher level corruption happening. And that's very
• 25:26
  Speaker 4: scary because when we have people that are coming into
• 25:29
  Speaker 4: what's supposed to be these unbiased entities that are overseeing
• 25:32
  Speaker 4: our practice of pharmacy in each of the states. We
• 25:35
  Speaker 4: can have a lot of overreach in those situations and
• 25:40
  Speaker 4: also more of a political sense of infusing things into
• 25:44
  Speaker 4: our practice as well, not necessarily, I mean, not always
• 25:48
  Speaker 4: in a bad way, but sometimes in a corrupt way
• 25:51
  Speaker 4: where it's more benefiting people outside of the practicing body
• 25:56
  Speaker 4: as a whole.
• 25:57
  Speaker 1: You know.
• 25:57
  Speaker 4: It just it is scary me personally, know, But I
• 26:00
  Speaker 4: mean when I think back into COVID times and then
• 26:03
  Speaker 4: that going into how we were administering the COVID vaccines
• 26:06
  Speaker 4: and the medications available, then I mean no, nothing, I
• 26:10
  Speaker 4: mean outside of that, I just it's more of me
• 26:12
  Speaker 4: thinking about how, in a blink of an eye that
• 26:15
  Speaker 4: we can have somebody just reach in and then really
• 26:18
  Speaker 4: differentiate what our practice looks like. So it is scary,
• 26:22
  Speaker 4: and you want people there that are you know, honest,
• 26:25
  Speaker 4: people that have the best intentions when going into that
• 26:29
  Speaker 4: particular role.
• 26:31
  Speaker 3: So yeah, unfortunately know, but thank you.
• 26:34
  Speaker 4: For making me aware of it. I'm going to be
• 26:36
  Speaker 4: following in a little more closely now.
• 26:38
  Speaker 2: Yeah, And I think a shout out to our pharmacists listening, Listen,
• 26:43
  Speaker 2: your boards of pharmacy. I think, down deep inside they
• 26:47
  Speaker 2: want to do what's best. I think they took those
• 26:49
  Speaker 2: positions because they felt a pride in securing and protecting.
• 26:55
  Speaker 2: But they're humans just like everyone else. They have stress,
• 26:58
  Speaker 2: they have, you know, things that are happening in their
• 27:00
  Speaker 2: own life which may impact the job of of and such.
• 27:04
  Speaker 2: I almost think that we have to almost come up
• 27:07
  Speaker 2: with rotations with boards of pharmacy to assure that someone
• 27:11
  Speaker 2: doesn't get complacent as someone who's ah there, I've I've
• 27:18
  Speaker 2: heard from pharmacists. There's some that are the the black
• 27:21
  Speaker 2: and white straight up and down really to the text
• 27:26
  Speaker 2: board of parmacy officer, and then the other ones maybe
• 27:30
  Speaker 2: they're bored or something like that. But yeah, So I
• 27:37
  Speaker 2: want to give a shout out to pharmacists listening today
• 27:40
  Speaker 2: once again it was World Pharmacists Day. Happy World Pharmacists Day.
• 27:44
  Speaker 2: To you, Melissa and into listening, You're very welcome. And
• 27:48
  Speaker 2: then a shout out to pharmacists interested in learning more
• 27:53
  Speaker 2: about precision medicine and pharmacogenomics. And if you don't know Melissa,
• 27:59
  Speaker 2: doctor Melissa Smith, please reach out to her on LinkedIn.
• 28:04
  Speaker 2: Very active, very involved, and you've helped a lot of
• 28:08
  Speaker 2: pharmacists understand what the potential is as making a pharmacogenomics
• 28:14
  Speaker 2: tool in their toolbox and their belt and really expanding
• 28:18
  Speaker 2: upon what it means to be a precision pharmacist.
• 28:22
  Speaker 3: Thank you so much.
• 28:22
  Speaker 4: Yes, I encourage anybody listening, especially pharmacists that are wanting
• 28:26
  Speaker 4: more insight into how to implement this.
• 28:29
  Speaker 3: I am available.
• 28:31
  Speaker 4: I've talked to pharmacists quite a bit about this because
• 28:34
  Speaker 4: there's so many reaching out with wanting to implement this,
• 28:37
  Speaker 4: and they know that it's going to be part of
• 28:39
  Speaker 4: clinical practice here in the upcoming years. It's here now,
• 28:43
  Speaker 4: but they're wanting to really champion it as well, and
• 28:47
  Speaker 4: speaking with me is helpful.
• 28:49
  Speaker 3: I give perspective.
• 28:50
  Speaker 1: It's right. Well, we've enjoyed this.
• 28:53
  Speaker 2: Thank you so much for being my co host today
• 28:55
  Speaker 2: on This Week in Pharmacy.
• 28:57
  Speaker 1: Shout out. What do you have any plans this weekend?
• 28:59
  Speaker 1: Are you? Oh, by the way, are you a football fan?
• 29:02
  Speaker 3: I'm a football fan.
• 29:03
  Speaker 1: I don't.
• 29:05
  Speaker 4: Well, I'm in Tampa area, so I'm with the Buccaneers.
• 29:08
  Speaker 1: Of course.
• 29:08
  Speaker 4: I went to University of South Florida. They just traded
• 29:11
  Speaker 4: divisions and they're they're doing well right now. They moved
• 29:15
  Speaker 4: up in the southeast, right, So those are typically the
• 29:18
  Speaker 4: ones I follow.
• 29:20
  Speaker 2: The Pittsburgh Steelers are in Ireland this weekend, and we'll
• 29:23
  Speaker 2: see what happens there. I don't even know who they're playing,
• 29:26
  Speaker 2: but I'm kind of like a lukewarm fan. I watch
• 29:30
  Speaker 2: and usually start watching a lot more seriously if there's playoffs.
• 29:33
  Speaker 1: But who knows.
• 29:36
  Speaker 3: I'm kind of I.
• 29:38
  Speaker 4: Follow, but I'm not not like some of my other
• 29:40
  Speaker 4: friends that are very die hard to their their different
• 29:43
  Speaker 4: schools they went to and what have you.
• 29:45
  Speaker 3: But what I want to do say is.
• 29:46
  Speaker 4: That I have my podcast episode airing on Monday here
• 29:51
  Speaker 4: on September twenty ninth. It was a great episode. I
• 29:55
  Speaker 4: was with my good friend doctor Vanessa Lesnski in that episode,
• 29:59
  Speaker 4: and we were talking about pharmacogenomics in the academics. She's
• 30:03
  Speaker 4: actually a faculty member at the Leecom School of Pharmacy
• 30:07
  Speaker 4: here in Florida and the Sarasota area, and we were
• 30:11
  Speaker 4: discussing a lot of things surrounding just implementing pharmacogenomics, what
• 30:14
  Speaker 4: it looks like for her with her students there, and
• 30:17
  Speaker 4: just kind of the undertone of enrollment with pharmacy. So
• 30:20
  Speaker 4: definitely take a listen.
• 30:23
  Speaker 2: If you would like to listen to all of those
• 30:26
  Speaker 2: podcasts under the banner of pharmacogenomics, just go to PGX
• 30:31
  Speaker 2: FORURX dot com. Once again, that's pg X four the
• 30:36
  Speaker 2: number four RX dot com and tune in on Monday
• 30:41
  Speaker 2: for the twenty ninth of September for the next episode
• 30:44
  Speaker 2: with doctor Melissa Smith.
• 30:46
  Speaker 1: I can't wait to listen.
• 30:47
  Speaker 3: Thank you, I appreciate it all right.
• 30:49
  Speaker 1: We will be right back on twerks. Don't go away.
• 30:56
  Speaker 7: Fueling lost with the complexities of pharmacy accounting.
• 30:59
  Speaker 8: In pharmacy today, there's so many different variables and issues
• 31:04
  Speaker 8: that impact the pharmacy, books, records, accounting, the profitabilities, sore
• 31:08
  Speaker 8: or so forth. There's different components of pharmacy that have
• 31:11
  Speaker 8: its own nuances from an accounting standpoint, and so it's
• 31:15
  Speaker 8: it's tricky, there's no doubt about it.
• 31:16
  Speaker 7: Ready to take your pharmacy to the next level, but
• 31:19
  Speaker 7: don't know where to start. Psychs and Companies here to help,
• 31:23
  Speaker 7: introducing the RX Assessment. With the RX Assessment, the pharmacy
• 31:27
  Speaker 7: CPAs and advisors at psykes will do a deep dive
• 31:30
  Speaker 7: into your accounting and tax situation and give you the
• 31:33
  Speaker 7: action steps you need to take to take your pharmacy
• 31:36
  Speaker 7: to the next level.
• 31:37
  Speaker 8: If you're interested in, you know, working with a team
• 31:40
  Speaker 8: who understands the industry and how the accounting and tax
• 31:44
  Speaker 8: should really be in a pharmacy, this is this is
• 31:47
  Speaker 8: your chance to get under the hood check of what's
• 31:50
  Speaker 8: going on and getting the feedback of any issues or
• 31:53
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• 31:55
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• 32:02
  Speaker 7: two five to two four eight two seven six four
• 32:05
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• 32:18
  Speaker 2: Hey, welcome back to this week in Pharmacy. Excited about
• 32:23
  Speaker 2: this next segment and just getting into news of the
• 32:28
  Speaker 2: day and things that are happening this week. We hope
• 32:30
  Speaker 2: that you've had a wonderful week in pharmacy and we
• 32:34
  Speaker 2: know that there's a lot of challenges in the industry
• 32:37
  Speaker 2: right now. We're hearing a lot from still from our
• 32:40
  Speaker 2: chain pharmacists. We just got to spend a lot of
• 32:43
  Speaker 2: time with our specialty pharmacies pharmacists out in Denver. We
• 32:49
  Speaker 2: attended the and the NASP be on the lookout. We're
• 32:52
  Speaker 2: going to be doing a three part series with the
• 32:55
  Speaker 2: National Association of Specialty Pharmacies. And then we're getting ready
• 33:01
  Speaker 2: for two conferences. We're going to be going to the
• 33:04
  Speaker 2: Explore event, which is Primary x's conference and their user
• 33:08
  Speaker 2: conference is going to be really exciting. It'll be in
• 33:10
  Speaker 2: New Jersey on October tenth. And then we'll also be
• 33:14
  Speaker 2: attending the NCPA, the National Community Pharmacist Association, the super
• 33:19
  Speaker 2: Bowl of all things independent community pharmacy. So I'm so
• 33:23
  Speaker 2: excited about that. I think that's on the twenty second
• 33:26
  Speaker 2: and twenty third, and we're going to have a show
• 33:29
  Speaker 2: probably next week or maybe the week after that. We'll
• 33:32
  Speaker 2: preview a little bit about what's happening, but we want
• 33:37
  Speaker 2: to jump back into the news quickly. I have two
• 33:40
  Speaker 2: special guests, and before we welcome them, I just want
• 33:44
  Speaker 2: to share with you news that I'm sure you're well
• 33:48
  Speaker 2: aware of.
• 33:51
  Speaker 9: First, effective immediately, the FDA will be notifying physicians at
• 33:55
  Speaker 9: the use of I said, well, let's see how we
• 33:59
  Speaker 9: say that acid of menifin acetamnifin, said okay, which is basically.
• 34:10
  Speaker 1: Commonly known as thailand all.
• 34:13
  Speaker 9: During pregnancy, can be associated with a very increased risk
• 34:20
  Speaker 9: of autism. So taking thailand all.
• 34:24
  Speaker 6: Is not good.
• 34:28
  Speaker 9: All right, I'll say it.
• 34:29
  Speaker 1: It's not good.
• 34:32
  Speaker 9: For this reason, they are strongly recommended that women limit
• 34:36
  Speaker 9: tiler will use during pregnancy unless medically necessary. That's, for instance,
• 34:43
  Speaker 9: in cases of extremely high fever. But you feel you
• 34:47
  Speaker 9: can't tough it out, you can't do it. I guess
• 34:50
  Speaker 9: there's that. It's a small number of cases, I think,
• 34:54
  Speaker 9: But if you can't tough it out, if you can't
• 34:56
  Speaker 9: do it, that's what you're gonna have to do. You'll
• 35:02
  Speaker 9: take a tile and all, but it'll be very sparingly.
• 35:08
  Speaker 2: So I want to welcome back Rob Cress, my godfather
• 35:12
  Speaker 2: of functional pharmacy, and gave you that nickname Rob quite
• 35:17
  Speaker 2: a while ago because you're pioneer, pioneering in the in
• 35:21
  Speaker 2: the world of holistic and and functional pharmacy.
• 35:25
  Speaker 1: And welcome back Rob.
• 35:26
  Speaker 5: Thank you, I appreciate it.
• 35:28
  Speaker 2: Another hero of mine. Lauren Castle, doctor Castle, thank you
• 35:33
  Speaker 2: so much for being here. It's it's great to have
• 35:35
  Speaker 2: you on twerks.
• 35:36
  Speaker 3: Absolutely thanks for having me.
• 35:39
  Speaker 2: All right, so I'm gonna start off with Lauren, and
• 35:43
  Speaker 2: I reached out to you. Thank you so much for
• 35:45
  Speaker 2: making this time for us at the last minute. Just
• 35:49
  Speaker 2: give us your your feelings about this week. In pharmacy,
• 35:53
  Speaker 2: where we're at and and and what you're what you're thinking.
• 35:57
  Speaker 3: Yeah, So as a woman, I first would have to
• 36:01
  Speaker 3: say that I don't think we should ever have to
• 36:03
  Speaker 3: just tough anything out. Unfortunately, when women's health, that sentiment
• 36:08
  Speaker 3: is way too commonly expressed. And so this whole discussion
• 36:13
  Speaker 3: really brings up an important point, which is research in
• 36:17
  Speaker 3: women's health, research in pregnancy, research for children. Right, normally
• 36:23
  Speaker 3: we're all about saying, yes, we need more of that,
• 36:25
  Speaker 3: But in this particular case, when the administration is actually
• 36:30
  Speaker 3: saying we need more of that, the established research that's
• 36:35
  Speaker 3: out there is pushing back and saying no, we don't
• 36:37
  Speaker 3: because we've already established that tilan All is supposed to
• 36:40
  Speaker 3: be the safest choice for pain and fever in pregnancy.
• 36:44
  Speaker 3: So we're getting kind of two conflicting narratives when really
• 36:49
  Speaker 3: the truth of the matter is it's not an either
• 36:52
  Speaker 3: or situation. This is a both and Right, we still
• 36:56
  Speaker 3: know that yes, tilan All is the safest option for
• 37:01
  Speaker 3: pain and fever in pregnancy, and there may be more
• 37:06
  Speaker 3: data that we don't fully know yet on how this
• 37:11
  Speaker 3: could potentially contribute to conditions that are being explored. So
• 37:18
  Speaker 3: if you're a mom, if you're a woman, if you're
• 37:20
  Speaker 3: listening to this right number one, we don't want anyone
• 37:23
  Speaker 3: feeling shameful about if they've used thilanol or if they're
• 37:27
  Speaker 3: going to need to use thailanol, because that's not the
• 37:30
  Speaker 3: point here where we actually are all agreeing. And I
• 37:34
  Speaker 3: think this is what is important to really focus in on.
• 37:39
  Speaker 3: Both President Trump, the FDA, and even groups like APHA
• 37:46
  Speaker 3: and the ACG all are saying, and I'm reading this
• 37:50
  Speaker 3: from the a COG website right now, judicious use at
• 37:55
  Speaker 3: the lowest effective dose for the shortest duration necessary in
• 38:00
  Speaker 3: consultation with a OBGUI or other obstetric care professional. I
• 38:06
  Speaker 3: would add pharmacists into that absolutely, because we know what
• 38:12
  Speaker 3: medications are safe or not safe for pregnant women. That's
• 38:15
  Speaker 3: a key part of our training, remains consistent with best practice.
• 38:20
  Speaker 3: That is exactly how I still feel, even using my
• 38:25
  Speaker 3: own functional medicine lens, the master's program that I went to.
• 38:29
  Speaker 3: You know, all of these things we're not disagreeing on
• 38:33
  Speaker 3: that a scene of menafin should be used at the
• 38:35
  Speaker 3: lowest effective dose for the shortest storation necessary. That's still
• 38:40
  Speaker 3: the bottom line. And so to me, when I think
• 38:45
  Speaker 3: about how I would talk to a pregnant woman who
• 38:47
  Speaker 3: comes to my counter and is saying, I have this headache.
• 38:52
  Speaker 3: You know, I'm really not sure what to take. I'm pregnant.
• 38:55
  Speaker 3: What should I do? A lot of pharmacists would, based
• 39:01
  Speaker 3: on our training, just say, oh, you can take a
• 39:04
  Speaker 3: tile and all, because that's the safest dose.
• 39:07
  Speaker 6: Right.
• 39:07
  Speaker 3: Don't take aspirin, don't take ibuprofen, just take a tile
• 39:10
  Speaker 3: and all. That will help your headache. In the functional
• 39:14
  Speaker 3: medicine world, the first answer is not going to be oh,
• 39:18
  Speaker 3: you can just take a tile and all for your headache, right,
• 39:21
  Speaker 3: And really, in conventional pharmacy, that also shouldn't be the
• 39:25
  Speaker 3: first answer.
• 39:26
  Speaker 5: Right.
• 39:27
  Speaker 3: Headache is a really common sign that something is wrong,
• 39:31
  Speaker 3: whether it's dehydration, electrolyte imbalance, or worse yet, an early
• 39:36
  Speaker 3: sign of pre ecclampsia.
• 39:38
  Speaker 5: Right.
• 39:38
  Speaker 3: If a pregnant woman comes to me and says I
• 39:40
  Speaker 3: have a headache, I'm taking her blood pressure immediately.
• 39:44
  Speaker 8: Right.
• 39:44
  Speaker 3: So, I think this is the most important part of
• 39:47
  Speaker 3: this whole conversation is that we need to be stepping
• 39:51
  Speaker 3: up our game as medical professionals, no matter what side
• 39:54
  Speaker 3: of the aisle we're on. It's really about taking care
• 39:57
  Speaker 3: of the patient that is in front of us at
• 40:00
  Speaker 3: the individual level.
• 40:01
  Speaker 5: Right.
• 40:02
  Speaker 3: Yes, we will still have tilent all as our backup
• 40:04
  Speaker 3: medication if we need to use it, but I would
• 40:08
  Speaker 3: like to see this whole conversation really push us that
• 40:11
  Speaker 3: much further into truly looking at the patient and looking
• 40:15
  Speaker 3: at all of the non pharmacologic options that we have
• 40:20
  Speaker 3: to treat pain, fever, headaches, all the typical things that
• 40:25
  Speaker 3: tailanol is used for. So that's my take on it.
• 40:29
  Speaker 3: I made a post on Facebook and LinkedIn, and I
• 40:32
  Speaker 3: was really shocked that it was shared like fifty plus times,
• 40:37
  Speaker 3: and by and large by women who were also saying yes,
• 40:42
  Speaker 3: like thank you for this. This makes so much sense. Right,
• 40:46
  Speaker 3: this isn't an either or situation. It's how can we
• 40:50
  Speaker 3: actually use these medications safely and how can we leverage
• 40:55
  Speaker 3: all of the other amazing potential solutions that we have
• 41:00
  Speaker 3: of before we get to that point of meeting medication.
• 41:03
  Speaker 3: And I think that's where most pharmacists stand.
• 41:06
  Speaker 5: I love it.
• 41:07
  Speaker 1: Rob Kress, my.
• 41:10
  Speaker 2: Functional pharmacy godfather, welcome to the show.
• 41:14
  Speaker 1: It's so good to have you.
• 41:16
  Speaker 2: Yeah, give us your input, because you and I you
• 41:18
  Speaker 2: you had jumped on an Instagram that I posted from
• 41:21
  Speaker 2: Mark Garrow fully and I always value your insights and
• 41:26
  Speaker 2: I if I could put a Brady Bunch panel together
• 41:30
  Speaker 2: today where I had like nine pharmacies all in a circle,
• 41:34
  Speaker 2: that would have been my preface. But it was a
• 41:36
  Speaker 2: blessing to get you on at the last minute. So
• 41:39
  Speaker 2: thanks for being here.
• 41:40
  Speaker 5: I appreciate it. I appreciate it, so you know, and
• 41:44
  Speaker 5: even regards to that, because it's funny. I'm not one
• 41:46
  Speaker 5: that gets traction on social media, but my god, the
• 41:49
  Speaker 5: last few days, so this is obviously a hot button
• 41:53
  Speaker 5: in a big way. So I'm grateful that the conversations
• 41:56
  Speaker 5: come up right. I'm glad that it was probably Bobby
• 42:00
  Speaker 5: Kennedy that brought this to the forefront, and I think
• 42:02
  Speaker 5: he did it rightfully so because I think the problem
• 42:05
  Speaker 5: we have in our training and in our country and
• 42:08
  Speaker 5: in our medical system is a casual use of over
• 42:11
  Speaker 5: the counter and prescription medications. Because the guidelines that Lawrence
• 42:16
  Speaker 5: has shared, few people practice in that, and it could
• 42:19
  Speaker 5: have to do with it's a busy day. We think
• 42:22
  Speaker 5: it's safe, but you can give it. Save we're talking
• 42:25
  Speaker 5: about pregnant women, you can actually give it judiciously and
• 42:28
  Speaker 5: someone in front of you. But what we're not talking about,
• 42:31
  Speaker 5: because medicine is not black and white. We live in
• 42:34
  Speaker 5: a big gray area. And what happens when they go home,
• 42:37
  Speaker 5: what happens with the use of the seed and menfin
• 42:39
  Speaker 5: there because we know the problem is, and this is
• 42:41
  Speaker 5: one thing I wanted to bring up, is it creates
• 42:44
  Speaker 5: a metabolite in our body that choose up this master
• 42:47
  Speaker 5: ani accident called gluethione. And if we want to bring
• 42:51
  Speaker 5: the name of autism into it, there are some studies
• 42:53
  Speaker 5: that will show that some autistic people do have local
• 42:57
  Speaker 5: dethione levels. Now there's also studies that show some don't, right,
• 43:01
  Speaker 5: So that's one thing. And what I had a lot
• 43:04
  Speaker 5: of people shoot me studies, shoot me studies, and I
• 43:07
  Speaker 5: want to talk about that as well, because we really
• 43:10
  Speaker 5: shouldn't work off of individual studies. That's the beauty of
• 43:13
  Speaker 5: a meta analysis, right, We're bringing a whole bunch of
• 43:16
  Speaker 5: people into it, and population based studies, but once again,
• 43:20
  Speaker 5: in every one of those, it's never your patient, so
• 43:23
  Speaker 5: there's so many other variables that can affect it. So
• 43:26
  Speaker 5: I think the importance of this thing is the conversation
• 43:29
  Speaker 5: came to the public. I've had a lot of people,
• 43:31
  Speaker 5: even on my TikTok telling me the issues that they
• 43:33
  Speaker 5: did have during pregnancy with talanol. So a genomic component
• 43:37
  Speaker 5: can come into play, right, their mitochondrial insufficiency or sufficiency
• 43:41
  Speaker 5: come into play. We could probably connect the dots with hypothyroidism.
• 43:45
  Speaker 5: So I think the important thing is not to say
• 43:48
  Speaker 5: it's safe, And that was my thing with your post.
• 43:51
  Speaker 5: I don't think anyone conclusively say that that's a generality,
• 43:55
  Speaker 5: but we owe it to our patients and even into
• 43:57
  Speaker 5: ourselves and our own individuals practice when we want to
• 44:00
  Speaker 5: put the patient first, to look at everything and look
• 44:03
  Speaker 5: at alternatives and options. Like how many people that go
• 44:06
  Speaker 5: to medical or pharmacy school or whatever, no one ounces
• 44:09
  Speaker 5: the nutrition. How many know that they can actually recommend
• 44:12
  Speaker 5: or learn about homeopathy which is approved by the FDA,
• 44:15
  Speaker 5: which can treat pain, which can treat fevers. And then
• 44:19
  Speaker 5: the other thing is how many people are educated on
• 44:22
  Speaker 5: when they really need to treat a fever. Right, A
• 44:25
  Speaker 5: lot of times we have a knee jerk in our society.
• 44:28
  Speaker 5: There's a fever, give them something, give them something, But
• 44:30
  Speaker 5: that fever, it has a biological purpose, and yes, it
• 44:34
  Speaker 5: can get too high, that can be dangerous. So I
• 44:36
  Speaker 5: think there's this proper education one for practitioners and to
• 44:40
  Speaker 5: convey that to the patients that needs to be had
• 44:43
  Speaker 5: as well. So I think all this brings upon a
• 44:46
  Speaker 5: critical you know, poles that are in our system on
• 44:50
  Speaker 5: how we can progress better.
• 44:54
  Speaker 2: So just the both of you, just to understand from
• 44:58
  Speaker 2: my perspective, in the in the group, you two are
• 45:02
  Speaker 2: the doctors. So I'm definitely going to take your advice
• 45:06
  Speaker 2: and take your individual device based on me compared to
• 45:10
  Speaker 2: someone else, right, and obviously talking with my physician, But
• 45:15
  Speaker 2: that's not our public today. Our public has been conditioned
• 45:21
  Speaker 2: to Kneeds York react. Our public has been conditioned to
• 45:27
  Speaker 2: take a pill for anything and everything and it just magically,
• 45:32
  Speaker 2: you know, is supposed to make you better. Why isn't
• 45:34
  Speaker 2: this working. Why isn't this you know, specific medication working.
• 45:39
  Speaker 2: Maybe it's because you're not eating right, or you're drinking
• 45:41
  Speaker 2: too many sodas or something else is happening that it's
• 45:45
  Speaker 2: not all about just taking a pill and being done.
• 45:48
  Speaker 2: And then now add in the hyper sensitivity around mixing
• 45:54
  Speaker 2: politics with evidence based medicine, with people who have degrees
• 45:59
  Speaker 2: with with the combination of but I read on Google,
• 46:04
  Speaker 2: or I read on TikTok for God's sakes or went
• 46:07
  Speaker 2: So the public is just in such a different position
• 46:12
  Speaker 2: than when I was growing up, where he had the
• 46:15
  Speaker 2: newspaper for God's sakes or a shiny looking magazine. And
• 46:19
  Speaker 2: now information is so quick, and then there's the world
• 46:23
  Speaker 2: of the chatbots, and there's the world of the clickbait,
• 46:26
  Speaker 2: and then there's the world of getting people's attention that
• 46:29
  Speaker 2: makes your jobs, Rob and Lauren so much harder. And
• 46:35
  Speaker 2: I can only imagine the physician after they saw this.
• 46:38
  Speaker 2: So my point beyond taking the the you know, the
• 46:43
  Speaker 2: post of a pharmacist and reposting it like I did
• 46:46
  Speaker 2: through Pharmacy podcast Network is and why it's so important
• 46:50
  Speaker 2: to have multiple input is for us to slow down
• 46:55
  Speaker 2: as a profession first and saying how are we going
• 46:58
  Speaker 2: to get ahead of this. As a matter of fact,
• 47:00
  Speaker 2: the APHA put out a public statement. Then it was
• 47:04
  Speaker 2: a blanket statement, which I in my opinion, that's a mistake.
• 47:09
  Speaker 2: They said right outfin's absolutely fine, this is great, blah
• 47:13
  Speaker 2: blah blah, and it was kind of just a black
• 47:14
  Speaker 2: and white statement, which is nice because you do want simplicity. However,
• 47:20
  Speaker 2: the both of you are semi contradicting where you're saying
• 47:25
  Speaker 2: it's individual and we have to really take blood pressure,
• 47:29
  Speaker 2: like Lawrene just said, and kind of get some factors
• 47:31
  Speaker 2: into what what's the headache, what's really happening, rather than
• 47:35
  Speaker 2: just quickly taking a pill, quickly taking something expecting that
• 47:39
  Speaker 2: it to be you know, okay, and then you come
• 47:41
  Speaker 2: you put that it's it's even more complicated because now
• 47:45
  Speaker 2: it's a pregnant it's it's a pregnancy and you have
• 47:47
  Speaker 2: another life that you're thinking about, and so wow. But
• 47:51
  Speaker 2: my point becoming the consumer and not the pharm d's
• 47:56
  Speaker 2: and certainly not the mds. As I stand back as
• 47:58
  Speaker 2: a I would con myself a little bit more of
• 48:01
  Speaker 2: a educated consumer is number one. I know how to
• 48:05
  Speaker 2: say a cit of minivan or hyperlipidemia or pharmacogenomics, and
• 48:09
  Speaker 2: it took a.
• 48:09
  Speaker 1: Long time to get like that.
• 48:11
  Speaker 2: There's the vilbon abs that I cannot get out. There's
• 48:14
  Speaker 2: like six or seven nab drugs. I can't say them.
• 48:18
  Speaker 2: But my point in my irritation was President Trump and
• 48:25
  Speaker 2: his administration and Bobby Kennedy.
• 48:28
  Speaker 1: They know what I just described.
• 48:30
  Speaker 2: They know that there is a heightened level of political sensitivity.
• 48:35
  Speaker 1: They know that no matter.
• 48:37
  Speaker 2: What some of the administration says, that that the opposite
• 48:42
  Speaker 2: of what that administration of those people like on the left,
• 48:45
  Speaker 2: for example, is going to just no matter what's being said,
• 48:47
  Speaker 2: they're going to get all upset. And so it's the
• 48:51
  Speaker 2: poise in the way something is being said to the
• 48:54
  Speaker 2: public that I have the biggest problem with, and that
• 48:57
  Speaker 2: is instead of being a square and pounding a square
• 49:04
  Speaker 2: peg in a round hole, which is President Trump's, that's
• 49:08
  Speaker 2: his whole He's just constantly pounding stuff, just like if
• 49:13
  Speaker 2: it were polished and you looked at the camera and
• 49:15
  Speaker 2: you're like, hey, listen. Interesting study coming out of Harvard
• 49:18
  Speaker 2: saying that autism could be linked could be linked in
• 49:23
  Speaker 2: some cases with a seed of minifin. We're going to
• 49:26
  Speaker 2: be looking into more of this, but we'd like to
• 49:27
  Speaker 2: give the public, based on h Health and Human Services,
• 49:32
  Speaker 2: just a warning that we really want you talking with
• 49:34
  Speaker 2: your pediatricians, we want you talking with your your physicians,
• 49:38
  Speaker 2: we want you talking with your pharmacists.
• 49:41
  Speaker 1: But here's what the studies, here's why we're saying this.
• 49:44
  Speaker 2: Rather than coming you know, at the camera and you're
• 49:47
  Speaker 2: just like a seed of minifin will kill you and
• 49:51
  Speaker 2: your baby's gonna die. Like it's just like there's just
• 49:55
  Speaker 2: a there's a poise that really irritated me as a
• 49:58
  Speaker 2: consumer and saying why did he say it like that?
• 50:02
  Speaker 2: To the point that everybody that hates you now hates
• 50:05
  Speaker 2: you even more than they hate you, and they disrespect
• 50:08
  Speaker 2: for you. And then the keyboard warwyors start going to
• 50:11
  Speaker 2: town about he's full of crap and blah blah blah,
• 50:14
  Speaker 2: and then now it's just creating like we didn't need
• 50:17
  Speaker 2: any more public distrust of health and human services or
• 50:23
  Speaker 2: big government or I mean, goodness, gracious.
• 50:25
  Speaker 1: And now now here we are. So that's my.
• 50:28
  Speaker 3: One todd When people watch this back, they literally should
• 50:33
  Speaker 3: take the sound clip of you articulating this because you
• 50:37
  Speaker 3: did it perfectly. You really did just now Like if
• 50:40
  Speaker 3: they could have just aired that clip, everyone would have
• 50:43
  Speaker 3: been fine. This whole thing was like definitely very politicized,
• 50:48
  Speaker 3: and again that that is where the harm happens, and honestly,
• 50:53
  Speaker 3: at the root, I think that is what all of
• 50:56
  Speaker 3: these different organizations are truly upset about. Right, we can
• 51:00
  Speaker 3: come to the table and we can have discussions, and
• 51:03
  Speaker 3: I do think that the letter that they came back
• 51:05
  Speaker 3: out with again after the fact sort of hinted to
• 51:09
  Speaker 3: that that this is the precautionary principle, Right, We're trying
• 51:14
  Speaker 3: to avoid using a scene of menaphine if it's not needed,
• 51:18
  Speaker 3: and maybe to their you know, in their minds, it
• 51:22
  Speaker 3: was being used more than it should be. We don't
• 51:25
  Speaker 3: really know for sure, but hopefully everyone can kind of
• 51:29
  Speaker 3: take a step back, take a breath, you know, and
• 51:32
  Speaker 3: just again try to find the middle ground in this,
• 51:35
  Speaker 3: which I think is where the truth really lies. You know. No,
• 51:39
  Speaker 3: these were not necessarily new studies that they were quoting
• 51:42
  Speaker 3: in this FDA article, but that doesn't mean that in
• 51:46
  Speaker 3: the future we won't have more studies. So I think
• 51:49
  Speaker 3: for us, when we're thinking through the functional medicine lens,
• 51:51
  Speaker 3: we're truly we're trying to understand the mechanisms behind how
• 51:55
  Speaker 3: this might play a role in it, even if we
• 51:58
  Speaker 3: don't have concrete studies suggesting beyond the shadow of a
• 52:02
  Speaker 3: doubt that it is. If we're thinking critically into the mechanisms,
• 52:07
  Speaker 3: then that's where we can say, okay, let's just use
• 52:10
  Speaker 3: the safest options possible. And as pharmacists, we know that
• 52:14
  Speaker 3: that can be non pharmacological first and then using medications
• 52:17
  Speaker 3: appropriately when they're actually indicated.
• 52:21
  Speaker 1: I love it.
• 52:22
  Speaker 5: Let me be the devil's advocate. Yeah, those all conversations
• 52:26
  Speaker 5: need that. So, you know, it's really interesting. And I
• 52:30
  Speaker 5: thought that because you know, eloquent he is not. And
• 52:37
  Speaker 5: Bobby Kennedy probably, I mean, I will say RFK Junior
• 52:42
  Speaker 5: is probably more well studied on medical literature than most
• 52:46
  Speaker 5: doctors pharmacist practitioners out there. Most people read headlines and
• 52:51
  Speaker 5: the abstracts. This guy dives into it. He has brought
• 52:55
  Speaker 5: decades of information that's already been out there to the forefront.
• 52:58
  Speaker 5: No one else has done that, so now he brought
• 53:01
  Speaker 5: it to a bullhorn. So the fact that we're in
• 53:06
  Speaker 5: the spot where this information has come to life, you know,
• 53:10
  Speaker 5: Kay Corpus and I, we don't recommend Alean on our practice.
• 53:13
  Speaker 5: We never have, Like it's always been off the table
• 53:16
  Speaker 5: unless it's absolutely necessary. But even that we seek for alternatives.
• 53:20
  Speaker 5: So this is not new information. Yes, these studies are old,
• 53:24
  Speaker 5: but they've never been shared on a large platform. Now,
• 53:28
  Speaker 5: as far as Trump, I was kind of wondering this
• 53:31
  Speaker 5: because you know, I crinsed a little bit the way
• 53:32
  Speaker 5: he was saying it and the results. Though I wonder
• 53:36
  Speaker 5: if it was like Oz talking about it, would it
• 53:40
  Speaker 5: have gained any attention at all? Would it have been
• 53:42
  Speaker 5: this nice, passive quiet letter from the FDA that any practitioner,
• 53:49
  Speaker 5: it's no big deal. Right, So as divisive as it
• 53:54
  Speaker 5: probably has been, and as there has been harm from it,
• 53:59
  Speaker 5: right because there's been not smart people down in a
• 54:02
  Speaker 5: bunch of talinol and ending up in the emergency room
• 54:05
  Speaker 5: who are also pregnant to try to combat that, that
• 54:08
  Speaker 5: is not his fault, but it does come as a
• 54:11
  Speaker 5: reaction to it, and I think that speaks of really
• 54:16
  Speaker 5: the environment that we're in, and it's been a devisive environment.
• 54:20
  Speaker 5: So I don't know where I sit on that, honestly,
• 54:23
  Speaker 5: because I don't think it would have gotten the necessary
• 54:26
  Speaker 5: attention that it needed because Bobby will be there in
• 54:28
  Speaker 5: front of Senate and he'll talk all this stuff. But
• 54:31
  Speaker 5: has it gone anywhere? No, Like I don't think, I mean,
• 54:35
  Speaker 5: you know, they talked about have be taken off of it,
• 54:37
  Speaker 5: thank god? Right? And if honestly, if he didn't say that,
• 54:42
  Speaker 5: then would people even know that, like for an infant
• 54:44
  Speaker 5: in a newborn So I hear what you're saying, and
• 54:48
  Speaker 5: it puts a hair up on most of our nex
• 54:51
  Speaker 5: and you know, also to speak to the point, Lauren,
• 54:54
  Speaker 5: You're absolutely right about people feeling shamed, and I'm I
• 55:00
  Speaker 5: think it's great that because no mail has a bit,
• 55:02
  Speaker 5: no mail can be in that position, so we can't
• 55:05
  Speaker 5: speak to that. And the funny thing was I talked
• 55:08
  Speaker 5: about that because we all have our things that we
• 55:10
  Speaker 5: react to and it's not to disqualify it. But you know,
• 55:13
  Speaker 5: lately I've been coming to face with a lot of mine,
• 55:15
  Speaker 5: like defensiveness, right, and the stories that I create, and
• 55:19
  Speaker 5: it's never that person attacking me, right, it's me and
• 55:22
  Speaker 5: my story. And I'm not saying that's what it is.
• 55:24
  Speaker 5: Could have been done in a much more eloquent way,
• 55:27
  Speaker 5: like I wonder if we could have brought it to
• 55:28
  Speaker 5: sixty percent, right, make it seem impactful in major So
• 55:33
  Speaker 5: it woke things up, but not so much. You know,
• 55:38
  Speaker 5: I don't I wouldn't want to hurt as say it.
• 55:40
  Speaker 5: I think it would have gone nowhere.
• 55:43
  Speaker 2: That's a really it's a good point of communications. And
• 55:47
  Speaker 2: I want to give a shout out to our pharmacists
• 55:50
  Speaker 2: are in our future pharmacist I'm going to be attending
• 55:53
  Speaker 2: my fourth time going to WVU School of Pharmacy on Monday,
• 55:59
  Speaker 2: and I'm gonna be spending time with pharmacy students and
• 56:02
  Speaker 2: it's the p threes, and I'm constantly going over the
• 56:04
  Speaker 2: importance of communications, social media usage, constantly writing, keeping the
• 56:10
  Speaker 2: writing going, keeping their opinion going, get getting themselves out there.
• 56:14
  Speaker 2: That communication is such a critical part of what is
• 56:22
  Speaker 2: trust in healthcare and who that trust is coming from,
• 56:27
  Speaker 2: and and how vital it is that pharmacists can be
• 56:32
  Speaker 2: that barometer regardless of the political surgeing of the tides
• 56:38
  Speaker 2: and and what's going on. And it's and that's why
• 56:41
  Speaker 2: I love what I do, because I feel like I
• 56:43
  Speaker 2: can always run to LinkedIn and putting put in a keyword,
• 56:47
  Speaker 2: and I have a first connection to a pharmacist that
• 56:50
  Speaker 2: knows exactly what sickle cell what's going on in sickle
• 56:53
  Speaker 2: cell disease, and what's you know, a hyper liberidemia or
• 56:55
  Speaker 2: something in pregnancy or something. And then you know, Lauren,
• 56:59
  Speaker 2: your work and and digging down into the holistic medicine
• 57:02
  Speaker 2: and taking your own time to build an entire association
• 57:06
  Speaker 2: to support other pharmacists that want to go in that direction.
• 57:09
  Speaker 2: And we have a whole podcast by doctor Marina Boskov
• 57:13
  Speaker 2: that is is nothing but holistic discussions and she goes
• 57:17
  Speaker 2: super nerdy, deep into the weeds. And I absolutely love
• 57:22
  Speaker 2: listening to pharmacists. I don't understand necessarily all of it,
• 57:25
  Speaker 2: but I love listening to practitioners and providers talking to
• 57:29
  Speaker 2: each other.
• 57:31
  Speaker 1: A shout out to both of you. I'm not sure
• 57:33
  Speaker 1: if the.
• 57:35
  Speaker 2: If, if the listeners know Lauren, but I want, I
• 57:39
  Speaker 2: want you to take a look at doctor Laurencastle dot com.
• 57:44
  Speaker 2: Once again, that's doctor Laurencastle dot com. That's the website
• 57:50
  Speaker 2: that it's gorgeous website by the way, I've I've looked
• 57:54
  Speaker 2: through it. I think it presents a lot of value.
• 57:58
  Speaker 2: We're also doing some retreats. Talk to our listeners about
• 58:01
  Speaker 2: some of the things that you're doing for the education
• 58:04
  Speaker 2: of other providers in holistic in medicine that you're working on.
• 58:09
  Speaker 3: Sure, So yeah, that's my personal website. The other website
• 58:13
  Speaker 3: you might want to check out and then I think
• 58:15
  Speaker 3: would be more relevant to this conversation is actually the
• 58:17
  Speaker 3: one listed in my little subtitle, which is FMPHA dot org.
• 58:22
  Speaker 3: So that's the Functional Medicine Pharmacist Alliance and that organization.
• 58:27
  Speaker 3: I started out as just a Facebook group back in
• 58:29
  Speaker 3: twenty seventeen and then we formalized our organization in twenty twenty.
• 58:33
  Speaker 3: We have a membership. We're an inter professional partner with
• 58:36
  Speaker 3: numerous functional medicine organizations, and we're also working on some
• 58:39
  Speaker 3: cross functional partnerships with several pharmacy organizations. But the key
• 58:44
  Speaker 3: thing that we offer is our Functional Medicine Pharmacists boot Camp.
• 58:47
  Speaker 3: So if you hear Rob and I talking about functional
• 58:49
  Speaker 3: medicine and you're wondering what this is and how to
• 58:51
  Speaker 3: specifically do it as a pharmacist, we have a ten
• 58:54
  Speaker 3: week program that will walk you through every step along
• 58:57
  Speaker 3: the way before you need to go out and spend
• 58:59
  Speaker 3: thousands of dollars on certifications that take numerous years to complete.
• 59:04
  Speaker 3: This really sets you up at the business plan from
• 59:06
  Speaker 3: the beginning to understand how to apply functional medicine in
• 59:09
  Speaker 3: pharmacy practice. So our Fall cohort is enrolling and we'll
• 59:14
  Speaker 3: be closing enrollment on Sunday the twenty eighth, So if
• 59:17
  Speaker 3: anyone is watching this this weekend and would like to
• 59:19
  Speaker 3: be part of it, please just reach out to us
• 59:22
  Speaker 3: and we'd be happy to get you started.
• 59:25
  Speaker 2: Thank you so much. I also want to mention Rob's environment.
• 59:30
  Speaker 2: I've been watching you for years. I can't believe it
• 59:32
  Speaker 2: makes me feel old that I can say what twelve
• 59:36
  Speaker 2: fifteen years ago and connecting with you and watching your
• 59:39
  Speaker 2: services grow and your But if you go to robcrest
• 59:43
  Speaker 2: dot com.
• 59:44
  Speaker 5: That's not it, that's not it. Functional pharmacy dot com.
• 59:48
  Speaker 1: Oh, functional pharmacy dot com.
• 59:50
  Speaker 2: You guys got to update your seos out there, Functional
• 59:54
  Speaker 2: pharmacy dot Com.
• 59:55
  Speaker 5: It was like, wow, I still have that thing out there?
• 59:58
  Speaker 1: You do. Yeah, it's the world of SEO. I tell
• 1:00:01
  Speaker 1: you what.
• 1:00:02
  Speaker 2: I Yeah, got out to Josh Paristini. That helps me
• 1:00:05
  Speaker 2: with mine and keeps us at this point. But yes,
• 1:00:10
  Speaker 2: just a shout out to our pharmacist. It was World
• 1:00:12
  Speaker 2: Pharmacist Day this week. I'm so proud of Pharmacist and
• 1:00:16
  Speaker 2: what they're doing on a global scale. Shout out to
• 1:00:18
  Speaker 2: the FIP, the Federation of International Pharmacists. I can't wait
• 1:00:22
  Speaker 2: to go to one of their one of their events,
• 1:00:25
  Speaker 2: and and you know, I just want to say thank
• 1:00:28
  Speaker 2: you to both of you for acting. I just just
• 1:00:30
  Speaker 2: for people's sake. It's it's a crazy Friday. And Lauren
• 1:00:35
  Speaker 2: and Rob uh Took. I text them both and got
• 1:00:38
  Speaker 2: them on immediately, and thank you so much for being
• 1:00:41
  Speaker 2: on this Week in Pharmacy to can I mention real quick?
• 1:00:44
  Speaker 1: Absolutely?
• 1:00:45
  Speaker 7: Yeah.
• 1:00:45
  Speaker 5: So if you go to Functional Pharmacy dot com, you
• 1:00:48
  Speaker 5: know I, Lauren and I work together on all this
• 1:00:50
  Speaker 5: and I do have a program also called Beyond the
• 1:00:53
  Speaker 5: Labs because if you can't tell like my thing is labstone,
• 1:00:56
  Speaker 5: why by they never tell the whole story. So, you know,
• 1:00:59
  Speaker 5: working with Farmer assist on the implementation role the coach
• 1:01:02
  Speaker 5: and how to really expand to implement and elevate what
• 1:01:05
  Speaker 5: they're doing. And the hugest passion of mine right now
• 1:01:08
  Speaker 5: is men's health physical, mental, emotional, spiritual of what's going
• 1:01:11
  Speaker 5: on there, so the Midlife Man Collective as well. I'm
• 1:01:14
  Speaker 5: working with male and female pharmacists one on one to
• 1:01:18
  Speaker 5: really step into this area of men's health that is
• 1:01:21
  Speaker 5: sorely needed.
• 1:01:22
  Speaker 1: So excellent. Thank you for that, Thank you so much
• 1:01:25
  Speaker 1: for that.
• 1:01:25
  Speaker 2: In the show notes, there's going to be the updated
• 1:01:28
  Speaker 2: links to both Lauren's connection as well as Rob's connection.
• 1:01:33
  Speaker 2: I'm also going to put in some of the LinkedIn
• 1:01:35
  Speaker 2: connections so that other practitioners, other providers can reach out
• 1:01:39
  Speaker 2: to you, Lauren and Rob.
• 1:01:41
  Speaker 1: Thank you so much, Thank you, Thanks Tom, all right,
• 1:01:45
  Speaker 1: we will.
• 1:01:53
  Speaker 7: This episode is sponsored by Independent Pharmacy Cooperative, widely known
• 1:01:57
  Speaker 7: as IPC. Established in nineteen eighty three, ip is the
• 1:02:00
  Speaker 7: nation's largest group purchasing organization owned by independent pharmacy with
• 1:02:05
  Speaker 7: a mission of maximizing the success of community pharmacists. IPC
• 1:02:09
  Speaker 7: works to provide members with access to effective programs and
• 1:02:12
  Speaker 7: services designed to enhance profitability for independent pharmacy.
• 1:02:16
  Speaker 1: Read more about our mission.
• 1:02:18
  Speaker 7: By checking out our website at ipcurx dot com. That's
• 1:02:22
  Speaker 7: ipcarx dot com.
• 1:02:40
  Speaker 2: Hey, And on this weekend pharmacy special guest, and before
• 1:02:44
  Speaker 2: we introduce him, there have been several instances where I
• 1:02:48
  Speaker 2: travel the nation for different conferences. We just got back
• 1:02:52
  Speaker 2: from the NASP, the National Association of Specialty Pharmacy. We
• 1:02:56
  Speaker 2: will have a three part series coming out. I think
• 1:02:59
  Speaker 2: it starts next week and there's a just packed full
• 1:03:03
  Speaker 2: of information and how many times the topic of how
• 1:03:06
  Speaker 2: will artificial intelligence be leveraged into pharmacy operations, into workflow,
• 1:03:12
  Speaker 2: into therapeutic data, interchange decision making, into prior authorization and
• 1:03:22
  Speaker 2: insurance debacles and the confusion that that can drive based
• 1:03:27
  Speaker 2: on some of the PBM differences and tries. And so
• 1:03:31
  Speaker 2: what's important to us is to constantly come back to
• 1:03:34
  Speaker 2: topics that we just don't think are getting enough discussion.
• 1:03:38
  Speaker 2: And we hear from pharmacists where they'll ask me, the
• 1:03:41
  Speaker 2: non pharmacist, the talking head of pharmacy, Hey, what are
• 1:03:47
  Speaker 2: you hearing more about sell and gene therapy and the
• 1:03:51
  Speaker 2: advanced studies and the advanced research. And I am lucky
• 1:03:55
  Speaker 2: to have this show and to have this platform because
• 1:03:58
  Speaker 2: we attract the best of the best in our industry.
• 1:04:00
  Speaker 1: And i'd like to welcome back.
• 1:04:02
  Speaker 2: I think this is his third time on the shows
• 1:04:05
  Speaker 2: and a mixture of different shows, mister Joe Dipinto with McKesson,
• 1:04:09
  Speaker 2: head of Cell and Gene Advanced Therapies.
• 1:04:12
  Speaker 1: Joe, it's so good to see you.
• 1:04:15
  Speaker 5: Hey, Todd, it's great to see you.
• 1:04:17
  Speaker 1: Thanks for having me, absolutely so.
• 1:04:19
  Speaker 2: Just in case people haven't heard you, you've been on
• 1:04:22
  Speaker 2: our Sembia shows I think twice. Tell us who you are,
• 1:04:28
  Speaker 2: What are you kind of overseeing through mckesson's ventures into
• 1:04:31
  Speaker 2: cell and gene therapy and why are you so passionate
• 1:04:34
  Speaker 2: about this?
• 1:04:36
  Speaker 6: Yeah, Todd, thanks again for having me. My name is
• 1:04:38
  Speaker 6: jod Depindo. I'm the head of cell gene and Advanced
• 1:04:40
  Speaker 6: Therapies at McKesson. I've been here now. This is just
• 1:04:44
  Speaker 6: celebrated my third anniversary and I joined three years ago
• 1:04:48
  Speaker 6: to build out the vertical for McKesson and selling gene therapy.
• 1:04:52
  Speaker 6: As you said, the science is so exciting here right.
• 1:04:55
  Speaker 6: It is game changing for patients, There's no doubt about it.
• 1:04:59
  Speaker 6: Our ability to un understand the human genome and cells
• 1:05:02
  Speaker 6: and the micro environment has produced great outcomes for patients.
• 1:05:07
  Speaker 6: And now how does McKesson and our vertical, which we
• 1:05:11
  Speaker 6: call in Spirogene help our biopharmaceutical manufacturers, providers as well
• 1:05:18
  Speaker 6: as payers and patients navigate the complexity of the commercial
• 1:05:22
  Speaker 6: value chain for selling gene. And that's what we do
• 1:05:25
  Speaker 6: at inspiro Gene. So that's what I've been here doing
• 1:05:28
  Speaker 6: the last three years. It's great to be so close
• 1:05:30
  Speaker 6: to this high science work and it's really fun to
• 1:05:34
  Speaker 6: help see patients get access to this groundbreaking technology.
• 1:05:39
  Speaker 2: Joe, are there any specific disease states that stick out
• 1:05:44
  Speaker 2: to you in the you parallel the world of specialty,
• 1:05:48
  Speaker 2: You parallel the world of rare disease? Is there anything
• 1:05:52
  Speaker 2: that sticks out to you with regards to success or
• 1:05:56
  Speaker 2: outcomes or studies around a specific condition.
• 1:06:00
  Speaker 6: You know, when I think about cell and gene advanced therapies,
• 1:06:04
  Speaker 6: it's still very nascent, it's in early days of these
• 1:06:07
  Speaker 6: this area, but it's been focused predominantly on he malignancies
• 1:06:12
  Speaker 6: as well as rare diseases. And that's the focus that
• 1:06:16
  Speaker 6: we've seen, both malignant hem and non malignant hem as
• 1:06:20
  Speaker 6: well as rare diseases. But what's really exciting is when
• 1:06:24
  Speaker 6: you look at the clinical research in the later phases
• 1:06:27
  Speaker 6: now going to autoimmune disease, diabetes, larger patient populations, really
• 1:06:33
  Speaker 6: taking a look at that research moving from clinical phases
• 1:06:37
  Speaker 6: to commercialization eventually, it's really important that we get it
• 1:06:41
  Speaker 6: right regarding the value chain in the rare disease space
• 1:06:45
  Speaker 6: as well as the hem malignancies in some of the
• 1:06:48
  Speaker 6: non malignant hem so that when these bigger indications come
• 1:06:52
  Speaker 6: out with a lot more patients, bigger patient population, that
• 1:06:56
  Speaker 6: we really understand how this all scales.
• 1:07:00
  Speaker 2: So just this week, if you've been paying attention out
• 1:07:04
  Speaker 2: there to the news wires, it says this week's Biopharma
• 1:07:08
  Speaker 2: news phase three trial for Parkinson's disease in cell therapy,
• 1:07:13
  Speaker 2: and this news is coming out of Europe and it's
• 1:07:16
  Speaker 2: exciting to see for what we would consider behavioral health
• 1:07:22
  Speaker 2: and in senior care and how that collides to pharmacists
• 1:07:27
  Speaker 2: understanding what that means and then where the option is,
• 1:07:31
  Speaker 2: and Joe explained to the listeners where that gear gets
• 1:07:35
  Speaker 2: shifted from a traditional pharmaceutical product to a selling gene
• 1:07:41
  Speaker 2: therapy product. When does the physician, pharmacist, nurse practitioner care
• 1:07:47
  Speaker 2: team say, hey, can we try this here?
• 1:07:51
  Speaker 5: You know that's you said the key word there, care team.
• 1:07:55
  Speaker 6: It's really important when dealing with the complexities of selling
• 1:07:59
  Speaker 6: gene therapy. That is just not one stakeholder here. It's
• 1:08:03
  Speaker 6: truly an interdisciplinary team. It can be everything from the
• 1:08:06
  Speaker 6: pharmacy coordinating with the cell lab, coordinating.
• 1:08:10
  Speaker 5: With the service line.
• 1:08:12
  Speaker 6: You saw Parkinson's disorder, their neurology, right, you have also oncology.
• 1:08:17
  Speaker 6: It's really understanding the intricacies of patient identification, appropriate patient identification, qualification,
• 1:08:25
  Speaker 6: benefit verification, all of that works as a team to
• 1:08:29
  Speaker 6: deliver these products. It's not linear. Sometimes it's circuitous in nature,
• 1:08:34
  Speaker 6: but it really it really is very team oriented. The
• 1:08:39
  Speaker 6: approach to treating these patients. So you nailed it when
• 1:08:41
  Speaker 6: you talk about the treatment team.
• 1:08:44
  Speaker 1: Yeah.
• 1:08:44
  Speaker 2: And as we just started before introducing you to the
• 1:08:49
  Speaker 2: Turks listeners, we're talking about the NASP and how many
• 1:08:53
  Speaker 2: times while I was there, of the thirty some guests
• 1:08:56
  Speaker 2: that we talked to, probably a third of them chimed
• 1:09:00
  Speaker 2: into artificial intelligence and how AI is being leveraged. And
• 1:09:05
  Speaker 2: it's not imaginary anymore. It's not what might be coming,
• 1:09:09
  Speaker 2: it's what's being used today. And there's an article that
• 1:09:13
  Speaker 2: just came out this week and it says AI transforms
• 1:09:15
  Speaker 2: sell in gene therapy manufacturing with real time insights. What
• 1:09:21
  Speaker 2: aspect of artificial intelligence are you excited about, Joe inside
• 1:09:26
  Speaker 2: the bucket of selling gene therapies.
• 1:09:30
  Speaker 6: Yeah, So what you're pointing at there is clearly a
• 1:09:33
  Speaker 6: barrier that has been a challenge for many manufacturers is
• 1:09:37
  Speaker 6: the complexity of manufacturing some of the celling gene therapies
• 1:09:40
  Speaker 6: and looking at how do I optimize the time to
• 1:09:43
  Speaker 6: delivery of these products, how do I make it more efficiently?
• 1:09:46
  Speaker 6: How do I get quality products to the right patient?
• 1:09:49
  Speaker 6: We track and we trace it appropriately, especially if it's
• 1:09:53
  Speaker 6: a specific autologous or matched product that needs to go
• 1:09:56
  Speaker 6: to that specific patient. So using technology here is a
• 1:10:00
  Speaker 6: common theme to overcome barriers. And look, if we're going
• 1:10:04
  Speaker 6: to scale the value chain and selling gene, it needs
• 1:10:07
  Speaker 6: to be done in a combination of intimately understanding the
• 1:10:11
  Speaker 6: core different components of how these products get delivered, and
• 1:10:14
  Speaker 6: that starts with the manufacturing process. This is not made
• 1:10:19
  Speaker 6: all the time the same way. If you've seen one
• 1:10:21
  Speaker 6: cell therapy, you've seen one cell therapy. Gene therapies get
• 1:10:24
  Speaker 6: made differently, right, So using technology like AI and I
• 1:10:28
  Speaker 6: see a lot of activity in AI, and I'm excited
• 1:10:31
  Speaker 6: about it, but I'm also curious to see how this
• 1:10:34
  Speaker 6: is going to continue to evolve, because it seems to
• 1:10:36
  Speaker 6: be evolving weekly.
• 1:10:39
  Speaker 5: At this point.
• 1:10:41
  Speaker 6: And look, if we can challenge, if we can overcome
• 1:10:45
  Speaker 6: some of the barriers to access through technology, I'm all for.
• 1:10:49
  Speaker 1: It, absolutely. It is.
• 1:10:51
  Speaker 2: It's like as scary as it is exciting sometimes when
• 1:10:54
  Speaker 2: you hear what AI is doing, and as long as
• 1:10:58
  Speaker 2: we don't lose the physicians over and the pharmacist input,
• 1:11:02
  Speaker 2: I'm all for it. Gene and cell cell and gene therapy.
• 1:11:06
  Speaker 2: I've said I'm intertwined and been corrected in previous conferences.
• 1:11:10
  Speaker 2: Joe so I have to be careful that the that
• 1:11:13
  Speaker 2: the gene comes after the cell and the if you
• 1:11:17
  Speaker 2: go to Google and put in cell in gene therapy McKesson,
• 1:11:23
  Speaker 2: you're going to pull up the very first landing page
• 1:11:25
  Speaker 2: is the inspirer Gene by McKesson, and it's an incredible
• 1:11:29
  Speaker 2: site to answer a lot of your questions if you're listening,
• 1:11:32
  Speaker 2: if you're wondering about specialty distribution or specially pharmacy in general,
• 1:11:37
  Speaker 2: and you want to just learn more about what mckesson's doing.
• 1:11:40
  Speaker 2: What excites you most? Let's say you said it best.
• 1:11:44
  Speaker 2: I mean, it's week to week that things can change, Joe.
• 1:11:47
  Speaker 2: But what's exciting, what's exciting, what's exciting to you being
• 1:11:52
  Speaker 2: part of this McKesson team as you're as you're leading
• 1:11:56
  Speaker 2: sellingen therapy.
• 1:11:58
  Speaker 5: So where I like to.
• 1:11:59
  Speaker 6: Think think of this time of year as the season
• 1:12:02
  Speaker 6: of selling gene therapy. And the reason I say that
• 1:12:05
  Speaker 6: is we're coming up against so many important conferences like
• 1:12:08
  Speaker 6: the Alliance for Regenitive Medicine that's happening in the meeting
• 1:12:12
  Speaker 6: on the MESA in Arizona next month, and you have
• 1:12:15
  Speaker 6: a lot of different value conferences around value based care
• 1:12:19
  Speaker 6: and selling gene therapy. So there's a lot of activity
• 1:12:22
  Speaker 6: in the space. The space continues to evolve as the
• 1:12:25
  Speaker 6: science evolves. So I'm excited about how as a industry,
• 1:12:31
  Speaker 6: as a cell in gene therapy ecosystem, we can all
• 1:12:34
  Speaker 6: get together to talk about how through cooperation collaboration, we
• 1:12:40
  Speaker 6: can all work together to overcome some of the complexities
• 1:12:43
  Speaker 6: of the value chain and complexities of patient delivery of
• 1:12:47
  Speaker 6: these products. Because, look, the science is unparalleled in many instances.
• 1:12:53
  Speaker 6: It's great to see the success scientifically. We now need
• 1:12:58
  Speaker 6: to start to accelerate commercial success and that can only
• 1:13:01
  Speaker 6: happen through collaboration of the entire ecosystem. The providers that
• 1:13:06
  Speaker 6: are deciding whether or not those patients get the products,
• 1:13:10
  Speaker 6: the sites of care where they get the products, the
• 1:13:13
  Speaker 6: manufacturers who are going to manufacture the product and make
• 1:13:16
  Speaker 6: sure it gets delivered, and the players who ultimately pay
• 1:13:18
  Speaker 6: for the products.
• 1:13:21
  Speaker 2: All Right, so we know of pharmacists who have wonderful
• 1:13:24
  Speaker 2: relationships with their physicians. I think of Jenna Quinn in
• 1:13:27
  Speaker 2: the realm of pediatrics, and she's always squawking back to
• 1:13:30
  Speaker 2: the pediatrician just to give them a heads up of
• 1:13:32
  Speaker 2: what's going on. There's going to be pharmacists out there
• 1:13:35
  Speaker 2: who are nerding out on sellingen therapy and really going
• 1:13:38
  Speaker 2: to like the advancement and the technology. What's your advice
• 1:13:42
  Speaker 2: to pharmacists to number one, learn more about it in
• 1:13:45
  Speaker 2: its application and number two, how to be more collaborative
• 1:13:49
  Speaker 2: with the physician leading the leading the parade.
• 1:13:53
  Speaker 6: You know, we talk about that a lot when we
• 1:13:56
  Speaker 6: think about some of the barriers for commercial adoption is
• 1:14:01
  Speaker 6: the referral process and when you talk to sites of
• 1:14:07
  Speaker 6: care as well as clinicians and pharmacists that do that well,
• 1:14:12
  Speaker 6: it's always about having a strong communication and referral process.
• 1:14:17
  Speaker 1: That it's just you.
• 1:14:18
  Speaker 6: Don't throw literally or figuratively throw the patient over the
• 1:14:23
  Speaker 6: fence and referram. It's that constant collaboration conversation around the
• 1:14:28
  Speaker 6: appropriate patient as a target for specific product and that
• 1:14:33
  Speaker 6: that patient has a good understanding as well as the pharmacist,
• 1:14:38
  Speaker 6: the caregiver, the whole team. Right.
• 1:14:40
  Speaker 5: So appropriate communication.
• 1:14:42
  Speaker 6: Is really important there and it helps in the referral
• 1:14:45
  Speaker 6: process because if you look at.
• 1:14:46
  Speaker 5: Some of the data and selling gene, some of.
• 1:14:49
  Speaker 6: These patients may not sit locally where the sites of
• 1:14:53
  Speaker 6: care are right, So it's important to do that. One
• 1:14:56
  Speaker 6: of the pieces that we've developed that in Spyrogene is
• 1:15:00
  Speaker 6: our Inspirrocare Hub, and that hub is a little different
• 1:15:05
  Speaker 6: than the typical hub. It really acts as like sort
• 1:15:08
  Speaker 6: of a case management component for the providers as well
• 1:15:13
  Speaker 6: as the patients. They're caregivers, and it helps them manage
• 1:15:17
  Speaker 6: the complexity of navigating patient access, everything from benefit verification
• 1:15:23
  Speaker 6: to a coordination of delivery of the product and communication.
• 1:15:28
  Speaker 6: The more transparent and communicative we can be, I think,
• 1:15:31
  Speaker 6: the better off everybody's experience will be.
• 1:15:36
  Speaker 1: Agreed.
• 1:15:36
  Speaker 2: If you would like to learn more, go to inspirogene
• 1:15:41
  Speaker 2: dot com. That's I n spiro Gene inspirogene dot com
• 1:15:47
  Speaker 2: by McKesson. We're going to have a link if you're driving,
• 1:15:50
  Speaker 2: if you're walking, you're doing something you can't see, don't worry.
• 1:15:53
  Speaker 2: There's going to be a link in the show notes
• 1:15:55
  Speaker 2: as well as a link to Joe's LinkedIn. Joe, this
• 1:16:00
  Speaker 2: has been wonderful. Really enjoy the insights. You're constantly giving
• 1:16:04
  Speaker 2: us new information. We appreciate that. Thanks for being on
• 1:16:06
  Speaker 2: this Week in Pharmacy.
• 1:16:08
  Speaker 5: Thanks tot Hey.
• 1:16:10
  Speaker 2: We'll be right back with more twerques in the works.