Using Your PharmD/MBA-Joanna Lewis
HB: Alright, so today we have a special guest on the Talk to Your Pharmacist podcast. Our guest, Dr. Joanna Lewis, is the 340b compliance coordinator at Baptist Health in Jacksonville, Florida and creator of the Pharmacists Guide blog. Joanna is a graduate of MUSC School of Pharmacy and the Citadels MBA program. She’s worked in a variety of practice settings and began the Pharmacists Guide blog as a way to connect with other pharmacists. Joanna, welcome to the Talk to Your Pharmacist podcast!
JL: Thank you. It’s great to be here.
HB: Well, thanks for joining us. And now that our listeners have heard a little bit about your background, maybe you can fill in any gaps from that intro and maybe share a little bit more about your personal life.
JL: Sure. First of all, I’ve had a lot of experience in a lot of different practice settings. And mainly, I’m blaming this on my husband. But mainly because he was in med school when we met. And then through his residency and his first job, we moved around a lot. So I was able to — my first job I did community pharmacy and then I did part-time at a small hospital. And I got a wealth of experience there. And then we ended up in North Carolina for five or six years, so that’s the area I was in was Research Triangle Park, which is such a hub of great healthcare. So I got some clinical experience there and administration. And then we moved onto Florida, and that’s where we are currently.
HB: Awesome. Yeah, it’s neat how a lot of time, pharmacists are often end up marrying other pharmacists or doctors and kind of have a little healthcare family. So neat to hear about that. So Joanna, can you share a little bit more about your journey of starting the Pharmacists Guide and what that is?
JL: Definitely. So in two of my roles, I worked — one, I was a clinical pharmacist. And I worked very closely daily with clinicians. And what I found is everyone pretty much liked the work they did, but it kind of — there was just so much negativity everywhere, either about administration or, you know, against different healthcare providers. And then I moved to administration and kind of saw a different side of it. Where I worked there, the administration team was such a positive group of people. And they really were trying to do the best they could. But so often, there was a disconnect between administration and maybe the clinicians. Like they still were a little disgruntled. So with the Pharmacists Guide, the initial reason I started — first of all, we had moved from this job that I loved for my husband’s job. And I didn’t really know anyone, and I wanted to jump back into the world of pharmacy. And I just wanted to connect with people in a positive way. And there weren’t a lot of people on social media in healthcare at that time, but internationally, there were a lot of people who I connected with. And it just seemed like I was just getting a lot of good feedback. And then students, mentoring students was always one of my favorite things to do at all of my jobs. So I kind of tried to have little sections for students, like what do pharmacists do, why you should go to pharmacy school, how to get a residency interview, things like that. And it kind of just took off from there. I’ve been able to connect with a lot of pharmacists. And the more I have done the Pharmacists Guide, I do see there is a lot of positivity in our profession. But there is still a lot of negativity. So that’s what we’ll talk about later, how Ashley and I are kind of trying to address that.
HB: Yeah. Well that’s neat. And yes, because you’ve built up a big following. If anyone is on Instagram, definitely check out Joanna’s Instagram profile. She’s got a great following and puts some great, positive messages on there. And you can find her at The Pharmacists Guide. And so you know, talking about some of the things that you guide pharmacists on with the blog is kind of about positivity, mentoring students. Are there any other particular topics that people are particularly interested in?
JL: Right now, I’m talking a lot — so for me, I kind of walk through my journey as well. Like I had to go through a lot of maybe personal ups and downs just, or things I’ve had to work through as a practitioner. Like how do I address burnout? How do I address work-life balance? I had my first child when I was at a very busy, intense job that I had been working maybe 10 hours a day, and I had to cut back. And it was just a struggle for me just because I felt like I should be home, but I should be working, and where’s my heart at? So I kind of try to talk through that and mainly just share my story and how I navigated it. And maybe I could — obviously, that might not work for everyone, but hopefully I’ll be able to help a few people along the way.
HB: Yeah, awesome. So tell us a little bit more about the book that you’re working on with our mutual friend, Ashley Clements-Hayes (?), who is the founder of RxAshley. Tell us a little bit more about that.
JL: OK. So first of all, I met Ashley just through social media. And she has been such like a light in our field. I feel like she, I feel like we kind of share the same message, and we’re trying to get the same points across. So meeting her was just very serendipitous, I guess. And the more we talked, the message that we’re trying to get out is the same. And I love writing, so that’s — hence the Pharmacists Guide. I write occasionally for Pharmacy Times. And that’s really my medium and how I connect with people. And I told her, like, “This has always been a dream of mine. I’ve wanted to write a book.” And basically, she almost — what’s missing is for me, I have always just been the kind of person, like I have it in my head, I know what I want to write, I’ve been making outlines for years. But actually like doing it is a whole different story. And Ashley was really — she coached me through just like starting, like just start and we’ll see where it goes. And basically, we address burnout in the book. We address, you know, a lot of practitioners, how you feel stuck or how you feel like either you’re tied to your job because of the money, like the golden handcuffs or because you feel like the job market is bad or you feel like I didn’t do a residency, I can’t — certain jobs are closed to me. So we talk about all of that. And then just really taking your life to the next level and how we can elevate our pharmacy profession.
HB: Yeah, no, that’s exciting. And what’s the book called?
JL: It’s called “The Pharmacist’s Guide to –”. It’s pretty much to elevating your profession or elevating your practice. But we talk about redefining your goals, following your dreams and elevating your practice.
HB: And that will be out this spring or summer?
HB: Of 2019?
JL: Yes. We are shooting for February or March. So very soon, yeah.
HB: Awesome, very soon. Yeah. Well that’s exciting. We’ll have that in the show notes so anyone can check out that. And so Joanna, you have obviously had a lot of different opportunities within pharmacy, but how did you decide to pursue your MBA? Because a lot of pharmacy schools have a dual MBA program or, you know, sometimes people do decide to go back. What were some of your decision points in choosing to get your MBA?
JL: So when I was applying to pharmacy schools, this kind of — and we talk about this in the book too about nontraditional pharmacy roles. My role — and I know you and I talked about this before — I had always envisioned myself working for the FDA or maybe for industry in some sort of capacity with compliance and quality and regulatory, which is funny how that’s what my job is right now. But so I didn’t really see myself as maybe going the full residency route. I connected more to the MBA side and to the finance side. So when I applied to pharmacy schools, the pharmacy school that I went to was MUSC, the first year they had an MBA program, the first year that they were doing it. And it’s funny because the person who started the program and who was the director of MUSC at the time in pharmacy was Dr. Paul Bush. And then I ended up working for him at Duke maybe like five years later. So it’s kind of funny how it all worked out. Back to the question about the MBA, I did summer school and then like one class a semester was our MBA class. So it was a little bit of an extra workload with pharmacy school, but it never felt like that just because the classes were so different and just challenging in a different way. I loved it.
HB: Oh, got you. So you did it while you were in pharmacy school, but it was just through the Citadel, kind of a joint partnership.
JL: Yep, it was a joint.
HB: Got it.
JL: And our electives kind of covered, cross-covered a little bit. But yeah, there was probably about 10 people in my class who did it.
HB: Yeah. Wow. So how would you say it’s helped you, you know, get to your current role, which is 340b compliance officer? And then maybe you can tell us like what exactly 340b — a very general overview and kind of the importance of that role.
JL: Yeah. So first off, my MBA helped me a lot at my role at Duke in administration just because, you know, it’s pretty much a lot of management training and leadership training. You throw in accounting too. But it was a lot of project management, which is what I did at Duke. So with 340b, all of my experience with that comes from either that the regulatory and quality stuff that I did while I worked as a pharmacist at Duke or with the MBA. I’ve done a lot of the finance. And right now, you know, there’s a lot of changing regulations. So just keeping up with the regulations, working with our purchasing department, it’s kind of an ongoing — especially even now with the shutdown right now and there were a lot of new 340b regulations that went into effect in January, so it’s exciting. I love it. It’s kind of my passion within pharmacy.
HB: Yeah. Yeah. And I was telling you earlier before we started recording that I had been involved with the 340b program as an intern at the Health Resources and Services Administration’s Office of Pharmacy Affairs, which was a really small group within the federal government that administers the 340b program, which is a government-administered program basically to allow any safety net organization like a federally qualified health center or a disproportionate share hospital. There are several other covered entities, as they’re called, that are eligible to get discounted prices on medications through manufacturers. And the manufacturers are required to participate if they are participating with the different Medicaid and Medicare programs, which they all, of course, do. So it’s been around since I believe 1992. And it’s changed a lot, and I’m sure if anyone has Googled 340b, there’s a lot of different pros and cons that you’ll see out there. But it certainly helps to get hospitals like where you in Jacksonville to stretch those resources to be able to care for patients in need that are going to the hospital. So lots of regulations, of course, for you to stay up-to-date with because it is a federally administered program. So Joanna, how do you stay current about what’s going on in healthcare, and more specifically, within the pharmacy field?
JL: So first of all, Hillary, thank you for that good overview of 340b. I totally just was talking and assuming everyone knew what it is. But you’re right, it is a very complicated program. So with pharmacy, I try to attend meetings. I went to Midyear last year. And basically, especially with 340b, I just read a lot. And there’s always something changing with new drugs being — with the drug shortages, we kind of have to always have a backup plan for that. And that is a lot of 340b. So basically, I just read a lot and then I network. And we just have a lot of meetings within our pharmacy department and try to stay on top of things.
HB: Yeah, definitely. I think meetings and networking are certainly a great way to stay involved. So what excites you most about the future of pharmacy?
JL: So I think, especially nowadays with social media and just even if you go on social media and look at all the pharmacists who are active, I think that we’re at such a great place in our profession. We’re starting to kind of shed the old way of doing things and embrace change, I think. I think pharmacy has been such a traditional profession that we always do things the same way. And technology has just taken off so we can connect to our patients in a whole different way. And I think jumping on top of that and just being a resource for our patients is one of the most exciting things. And then secondly, I think it was last week in Ohio where the provider status, I believe that’s going to be — I don’t think it’s an “if” question now. I just think it’s a “when” question. Like when are all the states going to have provider status? So I think getting our profession to band together. And even if we can get some sort of continuity with how we approach provider status, and we all either develop practice guidelines and just showcase how much we know and how much we can offer. I’ve seen a lot of pharmacists kind of going towards the nutrition route, which I think is amazing because we do have so much with functional medicine and with nutrition to offer there. What do you think? I know you’re involved in a lot of this too.
HB: Yeah. I agree. I think that it is exciting to see, you know, every state differs in their pharmacy practice act, and so it’s interesting because I talk with pharmacists all over the country in my role at Dispensary of Hope, and you see variations in practice. And we’ve talked a lot about as a profession, how do we standardize so that when someone goes to the pharmacy in Florida and Tennessee, they get the same type of experience with a pharmacist? And so I think that different states who are kind of leading the way and championing all of the different services that pharmacists can provide is exciting. We’ve been working on that at the federal level for quite awhile with the medically underserved act, which kind of ties back into underserved populations. And I agree, I think the nutritional and functional medicine aspect is going to be a big area for pharmacy to step in and pharmacogenomics.
HB: It’s definitely something. You know, we’ve got to keep looking at, you know, what are the things that we as pharmacists are really good at? We’re the medication experts, and so pharmacogenomics and nutrient depletion or things like that where the whole nutrition kind of comes in and associated with medications. And then just overall, adherence. So it is, it’s exciting. And as you pointed out in the beginning, the social media aspect is a great way to be able to connect with others. And I am just kind of getting on the bandwagon with that. And so finding, you know, my voice with Talk to Your Pharmacist on Instagram and some of the other platforms, but it’s great to — yeah, that’s how I even was able to connect with you.
HB: Was Ashley said, “Hey, interview Joanna. She’s doing some neat things.” So that’s really fun. So as our final question, Joanna, what is some advice that you would share with your younger self or for other pharmacists who are just getting started in their career?
JL: I guess two things. Piggybacking off of what we just talked about with the projects, I think that new wave of pharmacy students and graduates has such an eager energy. And I don’t want them to get bogged down or to get discouraged by maybe if there’s older, disgruntled pharmacists, which in every profession, there’s jaded people. But I do feel like pharmacy kind of is very depleting, which is, again, why Ashley and I are addressing burnout so much. But I want you younger students out there or you new graduates just to jump on your project and champion it. Don’t let other people talk you out of it. If you see a hole or you see something that needs to be done, I think go for it. And then secondly, when I was a new pharmacist, I took everything personally. And I do think it added to me just being — I would just go home and be so emotionally exhausted, I’d be too tired to exercise or too tired to do other things. And it was because I didn’t know how to, at that point, really practice self-care. And any patient at the pharmacy who was mad, any nurse who was mad about her medicine or any doctor who was upset about something, I just internalized all of that. And I think having an outlet for that or a healthy, just a healthy view that, you know, they’re mad at the system. Don’t internalize it. These are sick patients. I think I would have probably just, especially in my first year too, been a lot more effective.
HB: That’s a great point. And I think that kind of goes back to like how a lot of times, there’s the disconnect between administration and a staff or clinical pharmacist. And you’ve kind of just got to really focus on communication and then also, it’s how you choose to receive information.
HB: You know, like you choose how you’re going to be. And you know, it is a choice and not taking things personally and thinking about it from a bigger and broader perspective. And so I think, you know, for me too, it’s just been wisdom that I’ve gained a little bit over the years of being out and being in practice and just getting more experience under my belt. But that’s such a great point, Joanna. And it was such a pleasure to have you as a guest on the Talk to Your Pharmacist podcast!
JL: Thank you so much for having me. It was lovely to be here.
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