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Pediatric Pharmacist Review: The Pharmacist Families Didn’t Know They Needed...Until Now | Pediatric Pharmacist Review · Pharmacy Podcast Network

• 0:05
  Speaker 1: You are listening to the global network of podcasters dedicated
• 0:09
  Speaker 1: to the pharmacy profession. Welcome to the Pharmacy Podcast Network.
• 0:29
  Speaker 2: Adverse drug reactions or ADRs, are a serious issue in
• 0:32
  Speaker 2: healthcare today. The pharmacist is the last line of defense
• 0:36
  Speaker 2: to help prevent ADRs. A rising role of the pharmacist
• 0:39
  Speaker 2: is the specialist who focuses on our children. Pediatric pharmacy
• 0:43
  Speaker 2: ensures safe and effective drug use and optimal medication therapy
• 0:47
  Speaker 2: outcomes and children up to eighteen years of age. Currently,
• 0:51
  Speaker 2: there are more than one four and fifty board certified
• 0:54
  Speaker 2: pediatric pharmacy specialists known as bps. If you're interested in
• 0:59
  Speaker 2: this expanding field of pharmacy, this podcast is for you.
• 1:03
  Speaker 2: All right, everyone, let's give it up for our host.
• 1:07
  Speaker 3: Hey listeners, welcome back to the Pediatric Pharmacist Review. After
• 1:11
  Speaker 3: taking a little bit of time off, we are back
• 1:14
  Speaker 3: and better than ever. Here in twenty twenty six. I'm
• 1:17
  Speaker 3: here with my co host Mary Vong. Mary, how you
• 1:19
  Speaker 3: been great.
• 1:21
  Speaker 4: We've just missed the podcast and we really wanted to
• 1:23
  Speaker 4: start this year off with a bank, so we wanted
• 1:25
  Speaker 4: to highlight one of our own pharmacists. But before we
• 1:27
  Speaker 4: do that, justin how does it feel to be on
• 1:29
  Speaker 4: the podcast as an official employee for Perfecting Peeds.
• 1:35
  Speaker 3: Yeah, the transition has been an absolute blast. So it's
• 1:39
  Speaker 3: been fun to be an official part of the Perfecting
• 1:42
  Speaker 3: Peeds team and make.
• 1:43
  Speaker 5: A little bit of a shift.
• 1:45
  Speaker 3: But I love the vision of what we're trying to
• 1:47
  Speaker 3: build here, and we're set to really continue to change
• 1:51
  Speaker 3: the paradigm for caring for kids. So let's keep doing it.
• 1:54
  Speaker 3: And I'm excited to be along for the ride.
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  Speaker 6: With you, Mary, and we're so lucky to have you.
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  Speaker 5: Yeah.
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  Speaker 3: Well, we have another great and amazing team member with
• 2:01
  Speaker 3: us that we want to highlight today. So Brian Sebeth
• 2:04
  Speaker 3: is one of our pharmacists who has a ton of
• 2:07
  Speaker 3: great clinical experience that Mary, you and I don't have
• 2:10
  Speaker 3: in the oncology space. So he fills an amazing gap
• 2:13
  Speaker 3: in our team. In the patients that he works with
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  Speaker 3: love him immensely, and so we're here not to talk
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  Speaker 3: about what we can do, but what our amazing pharmacists
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  Speaker 3: are doing. So Brian, thank you so much for joining
• 2:24
  Speaker 3: us on the podcast today.
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  Speaker 7: Hi, very nice to be here. Thank you for having
• 2:28
  Speaker 7: me on.
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  Speaker 4: You're going to give us a little bit of a background. Well,
• 2:31
  Speaker 4: first of all, I'll give you I'll toot Brian's horn
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  Speaker 4: for him. Brian is honestly the fan favorite of the company.
• 2:37
  Speaker 4: If there's a phone call and it's a patient, they're
• 2:40
  Speaker 4: most likely looking for Brian, and they most likely think
• 2:42
  Speaker 4: that I'm like his receptionist or something, because I'm usually
• 2:45
  Speaker 4: the one that will have to transfer calls. But you
• 2:47
  Speaker 4: can tell it in our reviews, you can tell it
• 2:49
  Speaker 4: in our NPS scores, you can tell it just by
• 2:51
  Speaker 4: seeing who calls and who they're looking for. Brian is
• 2:54
  Speaker 4: definitely the fan favorite, and we're extremely lucky to have him.
• 2:57
  Speaker 4: Can you tell us a little bit about your background
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  Speaker 4: and how he came to protecting peas Brian?
• 3:03
  Speaker 8: Sure, so bounced around a little bit. So, I'm from
• 3:06
  Speaker 8: Rhode Island. Went to school there, go Patriots? Since Super
• 3:11
  Speaker 8: Bowl is on Sunday, So did you? Pharmacy school at
• 3:15
  Speaker 8: University of Rhode Island. Graduated feels like forever ago now
• 3:20
  Speaker 8: and had my PGY one up in Maine Medical Center
• 3:24
  Speaker 8: in Portland. Did a PGY two in pediatric oncology at
• 3:27
  Speaker 8: Memorial Slone Kettering. Once I finished my PGY two, I
• 3:32
  Speaker 8: stayed on at MSK until twenty eighteen, moved to Chicago.
• 3:38
  Speaker 8: My wife got into grad school, so we swapped to
• 3:42
  Speaker 8: Rush University and so worked between the adult humon floor.
• 3:45
  Speaker 8: Helped open up PEDIAFTRIC and care pharmacy service while I
• 3:49
  Speaker 8: was there, so that was a lot of fun. Then
• 3:53
  Speaker 8: we moved to Miami because winters in Chicago are no fun,
• 3:58
  Speaker 8: so we came to where they're supposed to be no gold,
• 4:01
  Speaker 8: even though this week it's been as cold as Alaska.
• 4:06
  Speaker 8: And met Mary while working at Nicholas Children's on the
• 4:10
  Speaker 8: pe Temonk floor there, and so while.
• 4:12
  Speaker 7: I was there for a little bit, decided been.
• 4:15
  Speaker 8: Hemok specialists for a while, time to do something a
• 4:18
  Speaker 8: little bit different and swapped over to perfecting Pete's about
• 4:22
  Speaker 8: a little over a year and a half ago.
• 4:23
  Speaker 4: Now that's a fight actually our first full time pharmacist,
• 4:26
  Speaker 4: which is pretty exciting.
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  Speaker 6: He gets to wear that little badge. Just pretty awesome.
• 4:31
  Speaker 8: It's been interesting just with the seeing how many faces
• 4:36
  Speaker 8: there are on our team meetings, where it was four
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  Speaker 8: or five of us before for some of them, and
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  Speaker 8: now it's like over thirty, which is amazing.
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  Speaker 3: Yeah, it's definitely been fun to watch and now be
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  Speaker 3: a part of that growth. So, Brian, Mary already mentioned
• 4:52
  Speaker 3: that the families you work with love you, and so
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  Speaker 3: we want to give you an opportunity to tell us
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  Speaker 3: a little bit about a memorable patient care win that
• 5:00
  Speaker 3: really stood out in your career. What made it truly special?
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  Speaker 3: And of course everybody, we're going to do this in
• 5:06
  Speaker 3: a hip a compliant manner, but Brian, what is one
• 5:10
  Speaker 3: of those memorable patient care wins that you've had?
• 5:13
  Speaker 8: So one of my favorite things, and this was part
• 5:16
  Speaker 8: of that clinic, like the pharmacy service to that and care.
• 5:19
  Speaker 7: Clinic in Chicago. It helped start survivorship.
• 5:22
  Speaker 8: It's one of those things that they finally have fully
• 5:26
  Speaker 8: recognized kind of across the board now that after a chemotherapy, radiation,
• 5:31
  Speaker 8: all that ends.
• 5:32
  Speaker 7: It doesn't end there.
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  Speaker 8: Pretty much no one walks away from those therapies without
• 5:37
  Speaker 8: some type of scar. And unfortunately, and we're getting better
• 5:41
  Speaker 8: now at recognizing how do we support them in the
• 5:44
  Speaker 8: long term, How do we watch out for things like
• 5:47
  Speaker 8: secondary malignancies, make sure their hearts are working okay, they're
• 5:52
  Speaker 8: not having lasting to rap at thees.
• 5:54
  Speaker 7: How do we improve these things?
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  Speaker 8: And so one of the big changes actually happened within
• 6:00
  Speaker 8: the last few years or so, is that one of
• 6:02
  Speaker 8: the agents commonly used minus androne, they changed its cardiotoxicity equivalency.
• 6:09
  Speaker 8: And so now former patients where we didn't think of
• 6:14
  Speaker 8: them as being high risked for needing certain follow up
• 6:17
  Speaker 8: to echos things like that and doing these more frequently,
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  Speaker 8: now they're falling under more of a high risk category
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  Speaker 8: because we are recognizing that, hey, this has a little
• 6:26
  Speaker 8: more damage to the heart than maybe we initially thought.
• 6:30
  Speaker 7: So for one of our patients, that was the big thing.
• 6:33
  Speaker 8: With talking with mom going through she had mentioned, oh yeah,
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  Speaker 8: she had received that chemo and tried to just pull
• 6:42
  Speaker 8: through her chart as much as I can and put
• 6:44
  Speaker 8: pieces together between all the other anthracyclones that she received
• 6:49
  Speaker 8: to calculate it out and realize that, oh, shoot, we're
• 6:52
  Speaker 8: not following up on this enough, and it's one of
• 6:55
  Speaker 8: those things. It's not there's more just a change with
• 6:58
  Speaker 8: the changing guideline, but you can have things that fall
• 7:02
  Speaker 8: through the cracks a little bit, and so we were
• 7:04
  Speaker 8: able to help change that over to getting her at
• 7:08
  Speaker 8: the correct number of echoes, having her on a new schedule.
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  Speaker 8: So I think that I know it may not always
• 7:15
  Speaker 8: sound like the biggest thing, But for a lot of
• 7:19
  Speaker 8: the supportive care after and that survivorship, it's the little
• 7:23
  Speaker 8: things that if you can catch it early, you prevent
• 7:27
  Speaker 8: so many things down the road.
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  Speaker 6: That's a really big deal.
• 7:30
  Speaker 4: Though, like you're saying that it's not a big catch,
• 7:33
  Speaker 4: but that is a huge catch because of the pharmacist.
• 7:35
  Speaker 4: You know that that's something that needs to be monitored.
• 7:37
  Speaker 4: She could have had like downstream effects. So I would
• 7:40
  Speaker 4: say that's a huge patient care when I remember this
• 7:42
  Speaker 4: family actually, and I remember how challenging some of the
• 7:46
  Speaker 4: intakes were for them. Were there any other unique challenges
• 7:50
  Speaker 4: in this case and how did you overcome them?
• 7:52
  Speaker 8: I think a lot of it was trying to figure
• 7:55
  Speaker 8: out what their lifetime dose was and doing that accurately
• 7:59
  Speaker 8: because there's the well, this is the regimen, the protocol
• 8:02
  Speaker 8: that they were being treated on, but then actually confirming
• 8:05
  Speaker 8: well what did they receive with it? Did they receive
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  Speaker 8: any of the protective medications with it? When was the
• 8:12
  Speaker 8: timing between it? So more going back and trying to
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  Speaker 8: piece together the timeline between everything was probably the most
• 8:21
  Speaker 8: difficult part. But then what do you do with it?
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  Speaker 8: And trying to apply the guidelines to it to present
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  Speaker 8: it in a way to her doctors and teams to
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  Speaker 8: understand that, hey, this is something that we do need
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  Speaker 8: to take into account and look into a little bit
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  Speaker 8: more with our survivorship.
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  Speaker 3: Yeah, Brian, I've been learning a lot more about survivorship
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  Speaker 3: and I couldn't agree more that this is a growing
• 8:46
  Speaker 3: area of oncology practice that needs to continue to expand.
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  Speaker 5: It's really proactive care, right.
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  Speaker 3: You're trying to, as you've already mentioned, anticipate the downstream
• 8:54
  Speaker 3: effects from the treatment they've received to maximize quality of
• 8:57
  Speaker 3: life and functioning even afterwards. So would love to see
• 9:01
  Speaker 3: that continue to grow and excited to hear that it's
• 9:04
  Speaker 3: happening in pediatrics.
• 9:07
  Speaker 5: Rian.
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  Speaker 3: Another thing that I know happens a lot in ancology
• 9:11
  Speaker 3: space is collaboration. There are lots of people on care
• 9:14
  Speaker 3: teams involved in caring for kids with different oncologic diagnoses.
• 9:19
  Speaker 3: So how to collaborating with multidisciplinary teams contribute to positive
• 9:25
  Speaker 3: outcomes for the patients that you care for.
• 9:27
  Speaker 8: And it's really come down to what everyone brings to
• 9:30
  Speaker 8: the table with it. I always say that we're all
• 9:33
  Speaker 8: looking at the same patient, but depending on your background,
• 9:35
  Speaker 8: your training, you're looking.
• 9:37
  Speaker 7: At it through a different.
• 9:38
  Speaker 8: Lens, and everyone's bringing that experience to the table to
• 9:42
  Speaker 8: try to catch things that not everyone is going to
• 9:45
  Speaker 8: be thinking about. And it's not to say it's a
• 9:47
  Speaker 8: you know, someone's missing something. It's more of just when
• 9:51
  Speaker 8: you have multiple eyes on it, thinking of it in
• 9:53
  Speaker 8: different ways, you're more likely to get a full complete picture.
• 9:58
  Speaker 7: It's like that.
• 10:00
  Speaker 8: Old graphic of you have people examining an elephant in
• 10:04
  Speaker 8: the dark and everyone's kind of touching a different thing
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  Speaker 8: and they come up with, well, this obviously is a tusk,
• 10:09
  Speaker 8: and this must be a skeleton, this is this is that.
• 10:13
  Speaker 7: So that's what can happen with patient care sometimes.
• 10:16
  Speaker 8: So when you bring everyone in together, you get that
• 10:19
  Speaker 8: more complete side to it. So that's where you know,
• 10:23
  Speaker 8: following up on these parts on the doctors and all that, Hey,
• 10:26
  Speaker 8: this is what we're reaching for lifetime axes.
• 10:28
  Speaker 7: These are the side effects that.
• 10:30
  Speaker 8: They're having some of it too, especially in outpatient settings.
• 10:34
  Speaker 8: What I've seen that families are sometimes a little more
• 10:37
  Speaker 8: comfortable talking with the pharmacist or other parts of the
• 10:40
  Speaker 8: team is they don't want to let the doctors down.
• 10:42
  Speaker 8: They don't want to make it seem like they don't
• 10:44
  Speaker 8: know what's going on, or oh yeah, we understand exactly
• 10:48
  Speaker 8: what you told us, and then you talk to them
• 10:50
  Speaker 8: after and like can you like you want to go
• 10:52
  Speaker 8: through like oh yeah, we don't know what that meant.
• 10:55
  Speaker 8: So it just kind of helps fill in some of
• 10:57
  Speaker 8: those holes. And again it's not a downside to any
• 11:00
  Speaker 8: one part of the system. It's more of just trying
• 11:03
  Speaker 8: to get parts to work in collaboration with each other.
• 11:07
  Speaker 4: One of my favorite parts about this case, Brian, I
• 11:09
  Speaker 4: feel like you're not giving yourself enough credit, is how
• 11:12
  Speaker 4: complex it was, not only from a treatment standpoint, but
• 11:15
  Speaker 4: just from the social aspect of it. I remember we
• 11:18
  Speaker 4: had to get translators all the time, like mom didn't
• 11:20
  Speaker 4: fully understand, and then on top of that, the patient
• 11:24
  Speaker 4: was quite difficult because she did have ASD, So I
• 11:27
  Speaker 4: think like just trying to coordinate, like Brian was trying
• 11:29
  Speaker 4: to coordinate this echo where the child would have like
• 11:33
  Speaker 4: enough like distractions and stuff. So it was just like
• 11:36
  Speaker 4: it was so much more than just an echo. It
• 11:38
  Speaker 4: was trying to get like the translator, trying to get
• 11:41
  Speaker 4: like childlife or something in place, trying to get just
• 11:44
  Speaker 4: oral sedation or something to try to make this echo happen.
• 11:47
  Speaker 4: I think it was way more than just an appointment, Brian.
• 11:52
  Speaker 4: But what did you learn from this experience and what
• 11:55
  Speaker 4: do you carry on with it with you today?
• 11:58
  Speaker 8: Just persistence and kind of making sure that you're thinking
• 12:01
  Speaker 8: of the patient as a whole is like, yeah, I
• 12:03
  Speaker 8: had mentioned where it's not.
• 12:05
  Speaker 7: Always oh we just need to get this test, We
• 12:07
  Speaker 7: just need to get that test.
• 12:09
  Speaker 8: It's oh, do they have transportation to get there? Can
• 12:13
  Speaker 8: they sit through a imaging? Can they sit through that study?
• 12:19
  Speaker 8: So there's a lot of other pieces that usually when
• 12:21
  Speaker 8: you start to see things break down and you talk
• 12:24
  Speaker 8: to the family, it's never because of I just didn't
• 12:27
  Speaker 8: feel like getting it. There are other social reasons, economic
• 12:30
  Speaker 8: reasons that if you can try to understand what the
• 12:33
  Speaker 8: barriers work, you can come up with a better plan
• 12:35
  Speaker 8: on how to overcome it and make sure that they
• 12:38
  Speaker 8: have access to everything that they need to follow up
• 12:42
  Speaker 8: with their post chemotherapy appointments and things like that. So
• 12:48
  Speaker 8: I think just keeping in mind that barriers usually have
• 12:52
  Speaker 8: a solution, and it's better to understand what the barriers
• 12:56
  Speaker 8: are rather than just give up and say that they're
• 12:59
  Speaker 8: just not being client to us.
• 13:01
  Speaker 3: Ran I love that attitude that every problem is solvable, right,
• 13:04
  Speaker 3: we just need to surround it with the right information,
• 13:06
  Speaker 3: get the right resources, and then if we can do that,
• 13:09
  Speaker 3: the patients and their families to be taken care of.
• 13:13
  Speaker 3: Ran I want to step back a little bit and
• 13:15
  Speaker 3: ask you a little bit more about your background and
• 13:18
  Speaker 3: how you even got into pediatric chematology and oncology.
• 13:22
  Speaker 5: So what drew you to this practice area and what
• 13:25
  Speaker 5: keeps you motivated in this field.
• 13:27
  Speaker 8: Yeah, it's a great question, and it's one of my
• 13:30
  Speaker 8: favorite to answer on interviews. I think because of how
• 13:33
  Speaker 8: looking back, it's these small.
• 13:35
  Speaker 7: Moments that kind of led it to there. One of
• 13:39
  Speaker 7: the big things. When I was a kid, I wanted
• 13:40
  Speaker 7: to be a marine biologist, so I thought, I'm going to.
• 13:43
  Speaker 8: Go study sharks and off the coast of Block Island.
• 13:50
  Speaker 7: In high schools a.
• 13:52
  Speaker 8: Huge nerd probably still am, went to marine science camp,
• 13:55
  Speaker 8: was told I'll never get a job, so start looking
• 13:57
  Speaker 8: for things that you can do marine science.
• 14:00
  Speaker 7: Research into so you get a little bit of both.
• 14:04
  Speaker 8: And that's again what I thought I was going to
• 14:06
  Speaker 8: do going into school was like I'm going industry. I'm
• 14:08
  Speaker 8: going to go research with my pharmacy degree had orgo.
• 14:12
  Speaker 8: I'm sitting there pipe heading like this is not what
• 14:14
  Speaker 8: I want to do for the rest of my life.
• 14:16
  Speaker 8: And after that, like, I have no idea what I
• 14:19
  Speaker 8: what I'm going to be doing.
• 14:20
  Speaker 7: And so this is now.
• 14:21
  Speaker 8: The summer before I get into pharmacy school, I saw
• 14:25
  Speaker 8: and add to volunteer for a camp in Rhode Island
• 14:29
  Speaker 8: for kids recovering from cancer.
• 14:31
  Speaker 7: So I, oh, that sounds interesting. I'm going to do that.
• 14:33
  Speaker 7: And when the week was done, I was like, this
• 14:35
  Speaker 7: is it.
• 14:36
  Speaker 8: I'm going to go clinical and I want to work
• 14:38
  Speaker 8: in pediatric chema because the kids were amazing. I went
• 14:42
  Speaker 8: back into that camp another four or five times, and
• 14:46
  Speaker 8: every time I left it it was the same things, like,
• 14:48
  Speaker 8: this is absolutely what I want to do. Had a
• 14:52
  Speaker 8: rotation at Saint Jude when I was doing my APPY,
• 14:55
  Speaker 8: and that was kind of the part where it's like, Yep,
• 14:58
  Speaker 8: this is it. I love working with this population. The
• 15:01
  Speaker 8: kids are amazing. The science to it fascinates me, especially
• 15:05
  Speaker 8: now with all the cellular therapies that are coming out,
• 15:08
  Speaker 8: the immune based therapies, and yeah, so that's kind of
• 15:12
  Speaker 8: what with the fire in me and is probably one
• 15:14
  Speaker 8: of the most roundabout things literally because I saw the
• 15:17
  Speaker 8: movie Jaws when I was in the fourth grade that
• 15:20
  Speaker 8: I ended up a hema pharmacist later on.
• 15:22
  Speaker 6: From Jaws to pt Monk, I love it.
• 15:25
  Speaker 4: And it's funny that we both have that connection with
• 15:27
  Speaker 4: Camp as well, because that's one of the reasons why
• 15:29
  Speaker 4: I behame an aurology pharmacists because I fell in love
• 15:32
  Speaker 4: with Teizure kids at Feazure Camp. But Camp and just
• 15:36
  Speaker 4: the whole job I think of being a pediatric chematology
• 15:39
  Speaker 4: oncology pharmacist is really hard because not only are you
• 15:42
  Speaker 4: balancing the technical aspects of it, we're also balancing the
• 15:45
  Speaker 4: emotional side. So how do you balance just like being
• 15:48
  Speaker 4: so black and white with everything and talking about treatment protocols,
• 15:51
  Speaker 4: but also dealing with the emotional side of things because
• 15:53
  Speaker 4: it is a very tough time for these families.
• 15:57
  Speaker 8: That's a great question and one that's still a lot
• 15:59
  Speaker 8: of time. So I was there, I still was trying
• 16:01
  Speaker 8: to figure out the best way to balance it. Is
• 16:05
  Speaker 8: one of the ways I usually try to approach working
• 16:08
  Speaker 8: is I get to know the families, which is a
• 16:10
  Speaker 8: double edged sword because the winds are amazing and they
• 16:13
  Speaker 8: carry you through a lot of things, and then you
• 16:16
  Speaker 8: also know the families when there's losses, and that part
• 16:20
  Speaker 8: definitely like you have to give yourself time to grieve.
• 16:25
  Speaker 8: Have outlets where you can turn your brain off outside
• 16:28
  Speaker 8: of work. So talking with my wife a lot, we
• 16:32
  Speaker 8: have a lot of no shop talk because she works
• 16:35
  Speaker 8: in business. I work in pharmacy. We both get really
• 16:39
  Speaker 8: bored when the other person starts talking about what we do.
• 16:42
  Speaker 8: We see that glazed look. So trying to keep like
• 16:46
  Speaker 8: other activities going, stay involved in hobbies. I love playing hockey,
• 16:50
  Speaker 8: those types of things out. But I think one of
• 16:53
  Speaker 8: the biggest lessons I learned was like, no, it's okay
• 16:56
  Speaker 8: to grieve. It's okay to feel sad and upset, give
• 16:59
  Speaker 8: yourself a mome went to recover from things. It makes
• 17:02
  Speaker 8: the job more rewardable in a lot of ways too.
• 17:05
  Speaker 8: I think when you get to know the patient a
• 17:07
  Speaker 8: little bit better, that's why it shows up on camera
• 17:10
  Speaker 8: at all. One of my reminders of that is a
• 17:12
  Speaker 8: little car that a patient gave me kin. This was
• 17:16
  Speaker 8: like when I was just just starting out and he
• 17:19
  Speaker 8: was my little Boddy, And.
• 17:20
  Speaker 7: That's where every place I've worked, I've kept.
• 17:23
  Speaker 8: This car on my desk as just kind of a
• 17:25
  Speaker 8: reminder of the good times are great, it's okay to grieve.
• 17:28
  Speaker 7: And there's still a lot of work to be done
• 17:30
  Speaker 7: to get numbers better.
• 17:32
  Speaker 3: There's so much balancing that has to be done in
• 17:35
  Speaker 3: all pediatric practice areas. But yeah, pediatric ecology is a
• 17:39
  Speaker 3: unique one and it takes a special kind of person
• 17:42
  Speaker 3: to do it well, and you're clearly that type of person, Brian.
• 17:44
  Speaker 3: As I've gotten to know you, even in the last
• 17:46
  Speaker 3: few weeks working on the same team with you, there
• 17:49
  Speaker 3: are a few things we have in common. We both
• 17:51
  Speaker 3: love hockey in sports, but another one is we love
• 17:55
  Speaker 3: investing in young students right in future practitioners in pediatric pharmacy.
• 18:02
  Speaker 5: So I'd love to ask how has.
• 18:04
  Speaker 3: Your work with PGI one and pg I two residents
• 18:07
  Speaker 3: and even pharmacy students which you helped to lead here
• 18:09
  Speaker 3: at Perfecting Peds influenced your perspective on patient care.
• 18:14
  Speaker 8: That's been an amazing part of it because I always
• 18:16
  Speaker 8: feel like I learned new things, which as cliche as
• 18:19
  Speaker 8: it's true that I learned new things from the students,
• 18:22
  Speaker 8: from the residents, how they approach problems. Everyone has a
• 18:27
  Speaker 8: different way of learning, a different approach to problem solving
• 18:31
  Speaker 8: and still take.
• 18:32
  Speaker 7: Bits and pieces away from it.
• 18:34
  Speaker 8: One of my favorite favorite things is I get random
• 18:38
  Speaker 8: emails or text messages from students that I've had that
• 18:41
  Speaker 8: now are saying like, Oh, I just got a job here,
• 18:44
  Speaker 8: I'm the specialist at this part.
• 18:46
  Speaker 7: I took a teaching position.
• 18:48
  Speaker 8: Hearing what they're now doing in their careers and have
• 18:51
  Speaker 8: been moving on.
• 18:53
  Speaker 7: I always thought it was.
• 18:54
  Speaker 8: Really cool one that they still remember me to keep
• 18:58
  Speaker 8: me updated like that too, Just knowing that even if
• 19:03
  Speaker 8: it's a small amount that you can contribute, that's keeping
• 19:05
  Speaker 8: that next generation of pharmacists going and helping kind of
• 19:10
  Speaker 8: light some of that passion to keep on interested in pediatrics.
• 19:14
  Speaker 4: That's something really special too because Brian also didn't toot
• 19:17
  Speaker 4: his own horn, but he also leads the student programming
• 19:20
  Speaker 4: here at Perfecting Peeds and that was something that we
• 19:22
  Speaker 4: started from the ground up because we knew that it
• 19:23
  Speaker 4: would be important to give back to the profession. But
• 19:26
  Speaker 4: just going back on Perfecting Peeds itself, Brian, why did
• 19:29
  Speaker 4: you join? Because I think that's a big leap to
• 19:31
  Speaker 4: go from like a hospital job to switching over to
• 19:34
  Speaker 4: a peed startup and what impact do you hope it
• 19:36
  Speaker 4: has on the pediatric pharmacy practice.
• 19:39
  Speaker 8: So I think part of it, and this is one
• 19:41
  Speaker 8: of the big things I've kind of advocated for is
• 19:44
  Speaker 8: realizing too when you're starting to get burnt out from
• 19:47
  Speaker 8: a role, so that way you can take things to
• 19:49
  Speaker 8: keep yourself in the profession and take steps for it.
• 19:52
  Speaker 8: So it was kind of multipol It was one that
• 19:54
  Speaker 8: I had been a specialist.
• 19:56
  Speaker 7: At that point for HEIMA for think about twelve years or.
• 20:00
  Speaker 8: So, and so it was a lot of great experiences,
• 20:04
  Speaker 8: great teams, doctors I worked with. I was kind of
• 20:07
  Speaker 8: ready for a different challenge to apply skill sets to
• 20:12
  Speaker 8: and that's when kind of looking to seeing like, well,
• 20:14
  Speaker 8: what are the parts of my role that I've enjoyed
• 20:18
  Speaker 8: the most. And it was patient interaction, so having more
• 20:23
  Speaker 8: of an mcare like approach to it where you're more
• 20:25
  Speaker 8: one on one with families patients, you get to know
• 20:28
  Speaker 8: them a little bit better rather being you know, one
• 20:31
  Speaker 8: of six or seven people in a yellow gown and
• 20:34
  Speaker 8: a face mask on and two inches of your face
• 20:37
  Speaker 8: showing where they can see me walking down the hall
• 20:39
  Speaker 8: and say, oh, hey, Brian, how's it going.
• 20:42
  Speaker 7: So that part was huge for me. I love that.
• 20:45
  Speaker 8: I love being able to do the teaching end of
• 20:47
  Speaker 8: it working with adolescent young adult patients.
• 20:51
  Speaker 7: So it was trying to find what.
• 20:53
  Speaker 8: Are some of the outlets that I can keep going
• 20:56
  Speaker 8: with that, and they had looked through a few different things.
• 21:00
  Speaker 8: Everyone i think peaks over at industry and wonders what's
• 21:04
  Speaker 8: on the other side of things, But it's like, it's interesting,
• 21:07
  Speaker 8: but maybe not necessarily exactly what I was looking for.
• 21:10
  Speaker 8: And that's where when talking to Mary is actually again
• 21:13
  Speaker 8: how small instances can lead to things. We were at
• 21:17
  Speaker 8: a work event for I think it was a goodbye
• 21:20
  Speaker 8: party for somebody, and we were just talking more about
• 21:24
  Speaker 8: perfecting peeds, like, oh wow, you get to do am care.
• 21:27
  Speaker 8: You get to still be involved with patient care one
• 21:30
  Speaker 8: on one providing recommendations to teams, so you still get
• 21:34
  Speaker 8: to act as a specialist, but in a much different capacity.
• 21:38
  Speaker 8: And it's kind of cherry picking those aspects that I
• 21:41
  Speaker 8: really enjoyed with the opportunity to grow learn a lot
• 21:45
  Speaker 8: of new things, understand how startup works, which was something
• 21:48
  Speaker 8: that had always been very foreign to me, and I
• 21:51
  Speaker 8: think it was just things kind of kept building on
• 21:53
  Speaker 8: itself for making it very interesting both professionally. Career is personally,
• 22:01
  Speaker 8: and it's been all those things since I've joined. It's
• 22:06
  Speaker 8: been amazing getting to work with the families again to
• 22:09
  Speaker 8: not have to worry about borders with things that I
• 22:13
  Speaker 8: have great families that work with in Minnesota, Pennsylvania and
• 22:16
  Speaker 8: New York, and a lot of the different experiences kind
• 22:20
  Speaker 8: of learning how to problem solve through those things. It's
• 22:23
  Speaker 8: always something new and interesting every day.
• 22:26
  Speaker 3: Yeah, there's no question about that, Brian, I've seen that
• 22:29
  Speaker 3: already too. I want to ask a related question, looking
• 22:33
  Speaker 3: back at your transition in your career, what was the
• 22:36
  Speaker 3: biggest challenge in transitioning from an in person interaction to
• 22:40
  Speaker 3: a virtual environment and what advantages or disadvantages have you experienced.
• 22:45
  Speaker 8: So I always think it's easy, things become hard, hard,
• 22:49
  Speaker 8: things become easy.
• 22:50
  Speaker 7: With the flipover to.
• 22:51
  Speaker 8: Virtual is there were some things that was used to
• 22:54
  Speaker 8: like if I had to go double check a dose
• 22:56
  Speaker 8: with a family, I could just go pop over to
• 22:58
  Speaker 8: their room and be like, hey, how are we taking again?
• 23:00
  Speaker 7: And it's solved within a couple of minutes.
• 23:03
  Speaker 8: And now it's just those couple extra barriers of trying
• 23:06
  Speaker 8: to get your schedules to link up. Is the parent
• 23:09
  Speaker 8: working not working? Right now, can they talk for a
• 23:12
  Speaker 8: few minutes? So I think getting used to just the
• 23:17
  Speaker 8: changing dynamic from that end of it was probably one
• 23:22
  Speaker 8: of the bigger hurdles. Video though, has been amazing because
• 23:27
  Speaker 8: you still get to keep a lot of that face
• 23:29
  Speaker 8: to face relationship. It's better than a phone call. You're
• 23:34
  Speaker 8: not just the voice on the other end. You can
• 23:36
  Speaker 8: see the patient, you can see.
• 23:37
  Speaker 7: The family with them.
• 23:40
  Speaker 8: Some of it too, is just hey, Like everything at
• 23:42
  Speaker 8: a hospital was very regimented, where you know, pre rounding
• 23:46
  Speaker 8: is seven o'clock, a round start at eight thirty nine o'clock, afternoon,
• 23:52
  Speaker 8: grand rounds, tumor board, those things always were going to
• 23:56
  Speaker 8: be like set time that your day was more regimented.
• 23:59
  Speaker 8: And here you get to build a little bit of
• 24:01
  Speaker 8: your own schedule and having that flexibility has been amazing
• 24:05
  Speaker 8: and understanding how to do it, but it was just
• 24:08
  Speaker 8: very different from what I had been used to with
• 24:12
  Speaker 8: the hospital SATU.
• 24:13
  Speaker 4: I remember working in the hospital, policy would take like
• 24:16
  Speaker 4: five years for it to be finalized, but here you
• 24:20
  Speaker 4: have to be super quick on your feet in this
• 24:22
  Speaker 4: and just any sort of startup like It's really taught
• 24:25
  Speaker 4: us both to be very agile because I feel like,
• 24:27
  Speaker 4: if somebody has an idea, if someone has great feedback,
• 24:29
  Speaker 4: we're very quick to adopt, and we're very quick to
• 24:32
  Speaker 4: just try it out because you might as well.
• 24:33
  Speaker 6: So I think that's one of the special parts.
• 24:35
  Speaker 4: And Brian, I feel like you've just you've had a
• 24:37
  Speaker 4: very cool career because you've been all around the country.
• 24:40
  Speaker 4: First of all, you are our most decorated pharmacist for sure,
• 24:44
  Speaker 4: with the most licensure in the most states. And if
• 24:46
  Speaker 4: you worked in a bunch of different practice settings, what
• 24:49
  Speaker 4: advice would you give to young pharmacists who also want
• 24:52
  Speaker 4: to be like Brian and who want to just have
• 24:54
  Speaker 4: all these cool experiences to make a meaning, meaningful impact
• 24:58
  Speaker 4: not only in pediatric on college, but just pediatric pharmacy
• 25:01
  Speaker 4: as a whole.
• 25:02
  Speaker 7: Biggest thing I think is just be open to opportunity.
• 25:04
  Speaker 8: When I was going into my PGUI two, in my
• 25:07
  Speaker 8: head as again, I grew up in New England, and
• 25:09
  Speaker 8: this is no offense in the New York area. I
• 25:11
  Speaker 8: was just raised to not like New York. They have
• 25:14
  Speaker 8: the Yankees, they have the Jets. I'm supposed to be
• 25:17
  Speaker 8: in New England. And so that's what I thought for
• 25:19
  Speaker 8: the first couple of months and I fell in love
• 25:21
  Speaker 8: with it. It's like, you know what, I think the
• 25:22
  Speaker 8: better opportunity is here for me right now, and I'm
• 25:25
  Speaker 8: going to see.
• 25:25
  Speaker 7: Where this goes.
• 25:27
  Speaker 8: And a lot of where I am today has been
• 25:30
  Speaker 8: staying open to opportunities initiatives as that have come my wife.
• 25:35
  Speaker 8: Not to the point that you're overloading yourself. But if
• 25:38
  Speaker 8: you get asked to go speak at a conference, go
• 25:41
  Speaker 8: do it, because you don't know who you're going to
• 25:42
  Speaker 8: meet at that conference, who you're going to work with
• 25:44
  Speaker 8: along the way in doing that. If you get to
• 25:47
  Speaker 8: collaborate on projects internally at a hospital, whatever role you have,
• 25:53
  Speaker 8: same thing, you don't know who you're going to end
• 25:55
  Speaker 8: up working with from other departments.
• 25:57
  Speaker 7: That then open up.
• 25:58
  Speaker 8: New opportunities for you to do in that hospital, nationally,
• 26:04
  Speaker 8: across different conferences, things like that. So that's been my biggest,
• 26:08
  Speaker 8: biggest thing. I always tell students, think that what you
• 26:11
  Speaker 8: are going into right now and what you've had your
• 26:13
  Speaker 8: heart set on up to this point is what you
• 26:15
  Speaker 8: have to follow.
• 26:17
  Speaker 7: That changes can be good.
• 26:19
  Speaker 8: If it means you know, taking that PGI one on
• 26:22
  Speaker 8: the other side of the.
• 26:23
  Speaker 7: Country, go for it. It's only a year.
• 26:25
  Speaker 8: If it's going to live in a new city, jumping
• 26:28
  Speaker 8: to a role that you're partially familiar with, like within reason,
• 26:33
  Speaker 8: like give it a shot and you don't know how
• 26:35
  Speaker 8: it's going to work out.
• 26:36
  Speaker 7: Could be bad.
• 26:37
  Speaker 8: A lot of times it's really good and it's going
• 26:39
  Speaker 8: to open that next door to the next part of
• 26:41
  Speaker 8: your career.
• 26:42
  Speaker 3: Love that mindset, Brian, and I can just echo that
• 26:48
  Speaker 3: your patients benefit from that, your constant curiosity and willingness
• 26:52
  Speaker 3: to try something new, and you listen well to them,
• 26:56
  Speaker 3: and so your patients and perfecting.
• 26:58
  Speaker 5: PEDS is so lucky to have you here as part
• 27:00
  Speaker 5: of the team.
• 27:02
  Speaker 3: Do you have any last pieces of advice that you
• 27:05
  Speaker 3: want to give to other pharmacists to our INPEDS oncology
• 27:10
  Speaker 3: or maybe is there anything exciting about this field that
• 27:13
  Speaker 3: you are really interested in watching in the next few years.
• 27:17
  Speaker 8: From a transplant standpoint, just with cellular therapies and the
• 27:21
  Speaker 8: immune therapies, it's a whole whole new.
• 27:24
  Speaker 7: Frontier of treatments that are coming out.
• 27:29
  Speaker 8: And we have a lot of diseases that we've been
• 27:31
  Speaker 8: stagnant with. We have great results for all and it
• 27:35
  Speaker 8: seems like they keep getting better every few years. We
• 27:39
  Speaker 8: have a lot of things like osteosarcoma, youwing sarcoma that
• 27:42
  Speaker 8: we're still setting out about sixty percent survival, and the
• 27:46
  Speaker 8: newer therapies that are being targeted towards these harder to
• 27:49
  Speaker 8: treat I just think is amazing. And then same thing
• 27:52
  Speaker 8: with stem cell transplant. We're getting better at managing some
• 27:57
  Speaker 8: of the graph versus host disease, at making sure that
• 28:00
  Speaker 8: our chemotherapy isn't going to cost too much toxicity, but
• 28:04
  Speaker 8: we're going to be able to get the graphs in
• 28:06
  Speaker 8: with minimal toxicities after. So it's just it's amazing and
• 28:11
  Speaker 8: seeing everything kind of switch over from the beginning of
• 28:15
  Speaker 8: my career. We're hearing like a lot of these were
• 28:17
  Speaker 8: like the science fiction in the future, and now it's
• 28:21
  Speaker 8: flipped over from like we're using one from using drugs
• 28:25
  Speaker 8: that were derived from a weapon of mass destruction to
• 28:28
  Speaker 8: now we're modifying how a T cell works to clear
• 28:31
  Speaker 8: out your leukemia. And that part, I think is just
• 28:34
  Speaker 8: it's amazing. The the doors that are being opening where you.
• 28:38
  Speaker 6: Can go with that, you can truly hear.
• 28:43
  Speaker 4: You can hear Brian's like whenever anything comes up Monk Wise,
• 28:46
  Speaker 4: everyone was like, you know that little meme of like
• 28:48
  Speaker 4: better Man and everyone pointing to someone else, It's always
• 28:50
  Speaker 4: to him because you can just see truly how fat
• 28:55
  Speaker 4: he is not only about pe Monk and p T Monk,
• 28:58
  Speaker 4: but just about like taking our children as well. We
• 29:01
  Speaker 4: are so incredibly lucky to have you, Brian. Thank you
• 29:04
  Speaker 4: so much for joining the podcast this week. Thank you
• 29:06
  Speaker 4: for also being our first like full time pharmacist and
• 29:09
  Speaker 4: just rolling through on this journey with us.
• 29:12
  Speaker 7: Thank you. This was a lot of fun.
• 29:14
  Speaker 8: It was a lot of fun, kind of looking back
• 29:16
  Speaker 8: at how it all started with joining with perfecting peeds
• 29:19
  Speaker 8: where it's comm and you know, any time I get
• 29:22
  Speaker 8: to talk about he Mak, you never have to twist my.
• 29:24
  Speaker 7: Arm about it.
• 29:25
  Speaker 6: Thank you everyone.
• 29:27
  Speaker 2: That's all for today's episode. Thanks for listening, and remember
• 29:31
  Speaker 2: to subscribe on Apple Podcasts and leave us a review.