SPEAKER_02: 0:07

Good day, everyone, and thank you so very much for joining another session of speaking with Sandra L. The Patient Experience. Today, who I have on my show are the luck, lovely Dr. Pauline K. Long and Dr. Jennifer S. Campbell. They are both pharmacists, and they're not just your average ordinary pharmacist, although we don't have ordinary pharmacists. The pharmacists do so much work that we're not aware of, but they put the community first. In a time when pharmacies are going away, you know, in my community, they closed the CVS down, didn't tell us they were closing it, they just came in and closed it and said, okay, well, you can order your medicines through mail order. Well, but when you do that, you lose the fact that you don't have that communication piece that you have when you go into a pharmacist and actually talk to the pharmacist. So unlike what I normally do in when we're doing a podcast, I'm going to read an excerpt from my latest book, Your Voice, Your Tool, which shows you evidence of the work and the importance of a pharmacist. And it reads: the lack of communication is very often at the center of medication errors. First, there is a breakdown in communication between the medical provider who is prescribing the medication and the patient. Rarely is a patient made aware of the possible side effects of taking the medication. Additionally, they are not told what to do should they experience an anomaly. As a result, there is a breakdown in communication between the pharmacist and the prescriber provider. And looking at what are reported to be the four most frequent medication errors, dispensing and incorrecting medication dosage, strength, or dosage form, miscalculating a dose, and failing to identify drug interactions or communications. And that is actually something that has been written by Tariq and Sherbeck, who did who talk about the importance of pharmacists and why that lack of communication and where it comes from. And what we as patients need to know is that pharmacists, pharmacists are important. Unfortunately, in our country, unlike other countries who look at pharmacists for what the knowledge that they have and how they can guide us, in America, we don't have that same level of trust that we should have with the pharmacist. So if you are a pharmacist, I want to take the time right now to tell you thank you for all the important, important work you do and trying to make sure that when the doctor misses something, you're actually able to get it and say, you know what, hey, I understand you're not taking this medication because, but did you know? Right? Education is important. So for all the pharmacists out there, and especially Dr. You, Dr. Pauline, Dr. Jennifer, thank you so much for taking that time to say, hey, we can give back even when we can't, you know, we're struck because of the political system, right? We're stuck, but we're gonna still keep going. Right.

SPEAKER_00: 3:33

Thank you so much.

SPEAKER_02: 3:34

So much. So with that being said, and now that you know about the miscommunication and what the doctors and the pharmacists talk about behind our backs that we don't know about, right? Doctor, you sure you want to put them on 50 milligrams? You know, you did you know? Um, those conversations that we're not privy to as patients. Um, you guys have it. So thank you so much for that. So now I'm gonna go ahead and start with our conversation today. My first question is this how do the two of you ensure that pharmacy and wellness services offered by MedPlus is open to the needs and meets the needs of the community members?

SPEAKER_00: 4:18

Yeah, I'll I'll take this. So I think that for us, uh, we actually have almost 40 years, over 40 years actually combined of pharmacy experience from uh pharmacy intern, technician, all the way to district manager. Jennifer was actually a district manager with one of the big box chains. So we have uh very varied layers of experience in pharmacy, and we've both served in various communities. So, regardless of the socioeconomic background of the community, you know, the demographic makeup, we both have served in almost all communities in um the city of Birmingham and around Alabama. Um, and with that, that gives us a great degree of experience uh regarding what patients need. And when we were starting Meds Plus back in 2018, that's actually what was at the forefront of our minds based on the experience that we've had as pharmacists for the last, you know, 15 years each. What do we see day to day behind that pharmacy counter of those big box chains? Where is the gap in care? And so that is why we started Vance Plus, because we noticed that patients were not as educated on their chronic conditions as we would like for them to have been. Um they weren't educated on their medications. And even though, as pharmacists, that's our job, just the corporate structure of pharmacy made it very difficult to make sure that patients had the education that they needed regarding their medications. And we're talking about stuff as simple as, as you alluded to in your um statement from the book, drug interactions. Um, you know, we'll have those conversations with doctors, but patients need to know that too, so they can see the value of pharmacies. It's very easy for us to have a conversation with your doctor that you're not privy to. And when you get your medication, you just assume that everything is all good. Well, we've been talking back and forth with your doctor's office for the last couple of hours about your prescription. So just working in the community pharmacy for all of those decades, we were like, what is missing? Where can we bridge the gap? And that's where Meds Plus consulting came in. We decided to be consultants to kind of stand between, or not between, but partner with the patient and their health care provider with the ultimate goal of improving health outcomes.

SPEAKER_01: 6:47

Absolutely. And I'll just add to that, that was the starting goal, that was the foundation. Then, Sandra, we came from behind the counter and we were embedded in the community. So now we're getting FaceTime with patients that weren't coming in the pharmacy that was not on medication. And then when we saw that, we realized, oh wow, we're just scratching the surface. And how do we engage the people that are not engaged with the healthcare system, except when it's an emergency or things have gone too far? We could have prevented blindness or an amputation. So that's when we definitely were more community-minded as far as our presence. So bringing health care to the community. What did that look like for us initially? That was with the vaccines during the COVID pandemic. Showing up in spaces where people needed not only the vaccine, but the education behind it to help them to make an educated decision versus listening to misinformation. We spent a lot of time working with community organizations because they didn't know us. We felt like, you know, we were able to just show up in a community, underserved community that looked like us, and they would listen to us. We learned very quickly, you have to listen to them and meet them where they are and provide that information in bite-sized components that they can understand. So once we've done that, we've moved around town, partnered with community organizations who already had the trust in the community. And these were black and brown communities. So we're very proud of that work. But we did realize a lot of people are not even engaged in healthcare the correct way or have the proper relationship with medication taking as they should. For example, I'm gonna take my blood pressure medicine when I have a headache or if I feel bad, versus knowing the more adherent or taking the medication correctly, the better your outcomes will be. So in the community, face to face, now we're on a different trajectory for meds plus consulting, and its roots and foundations are in the community. A lot of pharmacies are started from the business aspect. We started from a community aspect, and that remains core to who we are.

SPEAKER_02: 9:29

And I thank you so much for saying that. You know, one thing that struck me as you were speaking was this we don't a lot of times in our community, we don't take our medicine like we're supposed to, because we don't know when we're supposed to take our medicine. Right? I, you know, and I tell people this all the time. It's the same thing with vitamins. You taking all those vitamins, do you know there's a specific time of day that you should? And this is why vitamins, medication, this is why it's important for you to take it when they safe for you to take it. You taking it outside that realm, you're not helping yourself, you're literally hurting yourself. And so if we, you know, and that's why education, patient education, especially in communities of color or communities where the resources are just lacking, and right now, it's all over the world, especially in our country. We have to take the color off and look at the fact that there are people in all communities that are hurting. We're hurting more so than others, but we are all in a hurting position right now, right? But if you don't know that, how can you do better? If you don't have people like you and and Dr. Pauline in the community saying, Hey, we know what you're going through because look at us, you know, like like we're look at us. Like we're women, we're African Americans, we have this business, this is what we do. So we're not just doing it because we ain't got nothing else to do, or we want to paycheck that part. We're doing it because we care, and we want you to know, and we want you to see that we care. And so I thank you so much for the work that you do in actually coming into the community because so many times people say, Well, you know what, we work with the community. Okay, well, working with the community and being in the community is two different things, right? And you cannot work with a community and not be in that community and understand what's going on, pick up on what's going on. You just can't do it. So I thank you so much for saying that.

SPEAKER_01: 11:42

Absolutely. And I just want to add to what you're saying um about the entrepreneur piece. And I'm so grateful and thankful at a time such as this, we're entrepreneurs as far as our decision making. Um, and Pauline and I made a concerted effort. Um, with we have a talk with our Facebook community every week. And as you said before, everyone is hurting and we're hurting right now. Whether you're directly affected, indirectly affected, we're all affecting or hurting somewhere where we made a decision to let our Facebook community know if you have to make a decision between your medication and your food, then you need to call us, you need to come see us and to let anybody else know. So that's the part I love of what we're able to wake up and do, and it fits the needs of the community and where we are in this space, in this place, in this world today.

SPEAKER_02: 12:43

And I thank you for that. And you know, and that leads to another one of my statements that I often make and that I often see happening. There is help available. You just have to know where to go to get the help. This is one reason why we do the work that we do and why we started doing adding a podcast in so people can go back and look and see, even go into our YouTube channel. They can go in and see three years worth of experience, people talking to them on various topics, so that if they get stuck or they need help, the help is there. And it's not a charge to it, so they can always go and get that help. But our our community especially needs to know. You know, there's no reason for you to go without food and without medicine. There's so many resources that you can get that will allow you to tap into both. Heck, maybe it ain't gonna tap into the fact that you want to go eat steak, right? You want some flame or some flam chops or something like that, but it will get you fed so that you can continue to live. So if you're listening to this, if you know someone that's going through this, please listen and do what you can because there's always help. You just need to know that who, where can I go to get the help, right? Right. I do want to ask you another question, and that has to do with the current state of affairs when it comes down to pharmacies and what your strategic plan is to continue to be a such a valuable asset to the community. When we have pharmacies across, I you know, I was I was talking to Dr. Pauline earlier, and I was like, you know, we had a CVS in our community. CVS close shop. And the only way that we knew that CVS was closing in our community was my husband called to get his medicine, and they was like, Oh, we're closed. He was like, You're what? He was like, We're closed. He's like, You're closed for the day? It was like, no, we're closed, we're permanently closed. Now, the where we had to go get our medicine was 10, 20 minutes outside of where the initial pharmacy was, but God blessed us with a car, so we had transportation to get to the pharmacy to pick the medicine up. But for those that didn't have you know, way to get there, how was they gonna get their medicine when you close and you didn't even tell anybody that you were closing? No signs, no nothing. They were a business as usual until the technical. So, how do you, as community pharmacists working within a community, how do you continue to go knowing that strategically? And and the other thing about that was so when we called, they was like, Well, you have mail order, you can get mail order. And I'm like, mail order is not you talking to the pharmacist because you have a question and saying, What should I be doing? They don't know you. And a lot of times with the bell in order pharmacies, you're not speaking to a pharmacist, you're talking to a call center person who has no idea what you're going through. They might transfer you to a pharmacist, might transfer you immediately. You may have to wait, right? So, how are you strategically planning to say, hey, we're sustainable and this is where we are, and this is where we will always be?

SPEAKER_00: 16:13

You know what? That's an excellent question. And it has so many layers, and we'll try to kind of explain uh what's happening in the pharmacy industry. So, first of all, you know, being a dispensing pharmacy um for a lot of organizations, the big chain pharmacies that you mentioned and independent pharmacies alike, um, oftentimes is not a profitable business. And the reason it's not is because uh we don't get to determine the price for our products. If we were to open a bakery shop selling cupcakes and all the goodies, we could determine the price of our product based on the price of the ingredients, the price of the labor to actually make them, the price of our rent and our lights and all the things that go into making a business. When you are dispensing medications, you're at the mercy of what's called pharmacy benefit managers, um, especially for people that have insurance, which is most of America. Um, and so those pharmacy benefit managers or PBMs actually determine what we make on a particular medication. And oftentimes, um, and this has been more so the last 10 years or so, we don't make a profit on a lot of the medications we dispense. So imagine if you were a baker and you sold a cupcake, and for you to sell that cupcake to the customer, it costs your business$5. You lose$5 or$10 or whatever it is. That's the position a lot of pharmacies are in right now. And that's why we're seeing the closures. It really has nothing to do with service or having enough help available to help the patients and the customers. It has to do with that pharmacy in general is not a profitable business. It is a business that's required. People need their medications, but pharmacies are having a hard time staying open because of PBMs or pharmacy benefit managers. So, what do we do? Um, pharmacies like ours, what we've done, and this is strategic, is we've diversified our revenue. So not only are we dispensing medications, but we're also consultant pharmacies, which means that we can help um patients, we can bridge that gap between them and their health care provider to help improve their outcomes. Uh, we also work with civic organizations and nonprofit organizations to help them with their health care initiatives, also businesses. Um, so we have an employer wellness service where we help businesses improve the health of their employees because if your employees are healthier, that directly goes to your bottom line. They're not calling in sick as often. They're not having to take extended medical leaves because their chronic conditions are out of control. So we found ways to diversify our revenue so that we don't depend as much on prescription dispensing to make our business healthy and sustainable.

SPEAKER_02: 19:22

And thank you. Go ahead, Dr. Jennifer. Was you gonna say something?

SPEAKER_01: 19:27

Well, no, I was just gonna tack. Well, yes, um, I was just going to tack on. Um, with what Pauline is saying and diversifying, um, we're also looking to the future too, the future of healthcare. And we know seniors are the fastest growing segment of the population. Now we have all of these um possibilities that could happen as it relates to health care insurance. But one thing we know for sure is there are enough, there are not enough beds in a nursing home, independent living facilities to house seniors. So, how do we care for our aging seniors? We have more medications that are allowing people, helping people to live longer. So the age of living has increased. So, how are we going to care for our seniors? So, how do we help them age in place at home? So we have to look to that. So we have delivery service. Um, we have what we call adherence packaging or blister packaging. This helps with the caregivers take um for their aging loved one to help them to manage their medication, or those who are able to do it themselves. It helps them to make sure that they don't forget. They can look back and see the dates and whether or not they took the medication or need to take it. So we're also looking forward from a community perspective and aging perspective, but also from a technological perspective. A lot of time innovation happens, but then it widens the gap. So when you talk about mail order, now that's just widening the gap. Because we know a lot of people get frustrated when you can't get someone on the line, people don't answer the phone because of spam calls, and now someone's trying to get in touch with them from the mail order to maybe get something set up or to do. Now that person is out of their medication and it gets extended longer and longer. So with the changes that are happening with the chain pharmacies, we're looking at ways to address that, to keep shortening that gap because it continues to get wider. One of the things that has plagued my mind, or I ponder, is why do we sit around and wait for companies like that to make a decision for us? And we're in the pharmacies maybe every 90 days, or maybe we're in the drive-thru. So yeah, these things are springing up on people and they don't even know about it. But we definitely try to get in front of as much people as we can to educate them on the services, to let them know what's available. But I think people are just afraid of the unknown, or I started to describe us as unicorns. People think unicorns are a fairy tale and they're not real, but we're real, we're right in front of you. We're telling you what we can and will do. And I think that we have a trust issue amongst our own people. So, you know, that's one of the things that we want to continue to do is to educate the public. So everything starts with education um on what we can do for them, how we can shorten that gap so that they're not caught up in what's continue, what is going to continue to happen. Businesses are making decisions based on the unstableness of our government.

SPEAKER_02: 23:16

And for that, I say thank you very, very much. And you are true, you you're right, right? We can come in, I don't care what color we are, and we're gonna take African Americans, brown and black people, talking to brown and black people. The trust level is very low already, right? And we're coming in, we're talking to them, and we're saying we do this, that, or the other, and they're listening, it goes in one ear, it maybe make it halfway in before it starts you know, going backwards. Why? Because we've seen time after time where it hasn't worked, what we're promised. It's like carrots dangling in front of our eyes, and we see those carrots dangling, we don't understand what they are, but we know that hey, this is something they're telling us is gonna help us. And then once they get our attention, there's no more, right? We don't see it, so we have to get past, and I give the two of you credit for doing this. We have to get past the talking, we have to get past the listening, and we have to get on to the doing. Absolutely. Because if we're not doing, we're not building trust. And if we're not doing and we keep talking, what happens is that trust level that we did have it starts to diminish, it starts to go down, you know. And the other important point that I want to bring out here is this there was a point in time, and um seniors, because heck, I'm a senior, are my babies. Um, I'll do, I'll go to the ends of the earth for most of them, most of them, because some of them are very, very stubborn and they don't want you going to the I got this, right? And they want to do it themselves. So you got to kind of stand back and say, but I could do it, it'd be so much easier. But they say, no, I got I could do this. And so you got you, you have to actually let them do it. So seniors are they always will forever hold this special part in my heart because I see what's going on. But the younger people, because of the climate that we're in, are gonna get caught up in what's going on. The diseases and the conditions that we were told once before were eradicated, we're starting to see them emerge. And they're emerging more and more. Our you know, young people who have in our state, and I'm not sure if this is in all states, but I know in our state, when they turn 18, they get taken off of Medicaid. So if their parents are on Medicaid, they come off, have to pick it up on their own. So imagine going into this, picking something up on your own when you didn't think this was ever gonna happen to you. And nobody's talking to them and nobody's telling them things, and it's not beating it into them, into their heads, but mentioning to them. Hey, you need to look out for this, or you need to do this, or you need to do that, in a way that they understand it. If we lose sight of those that start, and I say I love proactivity, so I'm saying 16, 17, so that they know, hey, this is what I have to look forward to, right? And we don't start paying attention to them when this climate gets back to the way that it was before, there's gonna be no help for them, right? They're like, where do I turn? What do I do? Right, you know what?

SPEAKER_00: 26:54

I completely agree with you, and you know, we've actually addressed that in a way. We have an um organization here in Birmingham called Birmingham Promise, and they reach out to the um students in the Birmingham City School system, and they offer a wide range of services, um, even you know, helping them go to college without incurring any costs. So they have the a captive audience um in those students. And one of the things we did was they had an event uh in Birmingham, and we actually went and performed health screenings. So we talked about, you know, we checked their blood pressure, we talked about what it means to be in charge of your own health. Because you're right, a lot of them, you know, their mom and dads or guardians took them to their pediatric appointments every year or whenever they got sick. And when you turn 18, like that's now your responsibility. If your parents still help you with that, great. But a lot of people are on their own. And what we've noticed in that community work that Dr. Jennifer was talking about is a lot of people just let that go. If their parent is not still there, making sure that their insurance is up to date, that they're seeing the doctor at least once a year, they completely let that go until something happens where they're going to the hospital because, you know, we um met a guy who was having uh issues with pain in his arm. Turns out he had diabetes, and he that that pain was actually neuropathy. Um, or we've had young people in their early 40s, late 30s having chest pains, having heart attacks because they've had untreated hypertension for decades because they haven't been seeing a doctor and nobody's been checking it. So we have made a concerted effort to reach out to what we're calling young people too, because they're younger than us, to make sure that they're aware of, you know, seeing a primary care provider at least once a year. We have a slogan that every home should have a blood pressure meter and at least one person in the home should know how to use it correctly because we know that hypertension is a silent killer. And if you don't, if you're not checking your blood pressure at least once a week and you know what those trends are, your first exposure to a healthcare provider outside of your pediatrician may be on the back of an ambulance because you're having a heart attack. So those are the the the um the programs that we're managing now to reach out to the young people to help them make that transition because it's so important.

SPEAKER_02: 29:25

It is, it it is, and that's one of the reasons why we actually started doing unseen health summits because you you know you're young, you're living your life, yeah, doing your thing, right? We want you to because heck, we've been there before. We nobody trying to stop your partying. But we also want you to be mindful of there are certain conditions that you won't know about because nobody is telling us in our community. Well, and you know, one of the reasons why is because we don't have a lot of specialists in our community to tell us this, then you're taking. Taking away the pharmacist. So we now we really don't have nobody's talk to, other than unfortunately, Dr. Google and Mr. Firefox, which would tell people please stay away in their way. But the doctor's doing it. Yeah, but the doctor knows the difference between Wikipedia and the dot gov or don't need to do right. And our young people are, you know, getting it, you know, using that social media, but you really don't know until, like you said, it's too late for them. So we have to be mindful and we have to keep our eye on the intergenerational learning in the integrational generational gap, um, which is what our learning. So we're on to launching an LMS platform that's health care, not wellness. Not wellness, not medical. They're interconnected. But what happens is that when you do and when it happens is when you do medical and you do wellness and you intermix it with healthcare, something's not gonna get picked up on. Have to pull them out to put them back together. So that's what the healthcare platform is based on. And so that's another method of actually reaching out to and allowing the young people to live their lives while also giving the older people and more seasoned people what they need as far as learning. So I once again continue doing that great work. And then my next question is this you both are a Stanford graduate. And my lovely Dr. Carolyn Coleman, who is our foundational guru when it comes to anything medical, love her, love her, love her. We do too, is also a Stanford grad. And she forever is talking about the awesomeness of the program we went through. So I know the two of you went through that same program. What did you learn at Stanford that actually said that you're still using today? What lesson did you learn that you're still using today?

SPEAKER_00: 32:08

Yeah, you want to take that one, Jennifer?

SPEAKER_01: 32:10

Okay, sure. So uh Sanford, um, a lot of people confuse Stanford Stan and Sam Sanford. So Sanford University, very proud graduates we are. I will say during the time we were there, we were like one of the top number one schools in the Southeast. Um, and then other schools started to open their pharmacy schools and that pulled students away. But what I love about Sanford, faith-based um school, and we were able to have that. I would say when I started, when I was in um the community and people heard that I graduated from Sanford, it was like a badge of honor. Nothing against the other schools, all of them, you know, teach the same similar curriculums, but it was just something different about Sanford. When I say my first year there, there was the Dean of Student Affairs who knew and learned everyone's name and called you by your name. That's how special they made us feel. She would also pick a time during the year where she would cook brownies for the entire class. And at that time, we had about 120 people entering the school at a time. So when I say they made a concerted effort to make you feel like you belonged and you were part of a family, that's what it was. When I graduated uh from Sanford and I became a preceptor and then became, you know, training students and giving them exposure. Anytime I wanted to step back or do something and be involved with the campus or with the school, they welcomed you with open arms. So much so they're doing that today. Um, it took them a minute to catch up with what we were doing. Um, but it's because we, you know, we just didn't have the word out. But once they caught up with us and saw what we were doing, they was like, oh no, we can you come to do this? Can you come and do that? Now, when we have different events, we um have, you know, partner with the organizations on campus. Um, we'll have the students with us. We also precept students. Um, actually, next year we're gonna have a student every month. Um, so very excited about that. And um, Mance Plus is getting the buzz on campus to where people are requesting our rotation. Um, and that's when they're in their fourth year and they spend five weeks with us and they see everything we do day in and day out. And I will give them credit um that now they're talking about entrepreneurship because when we were in school, what pharmacy entrepreneurship looked like was you work for an independent pharmacy. When that pharmacist was ready to retire, or prior to retiring, you would start buying into the business. And then once he got ready to retire, you worked out whatever deal, or if you bought it, you know, into the business 100% or what have you. Now it's totally different. So, especially for Dr. Pauline and I, starting from where we started. Um, so I will say that they're catching up or they have caught up with that. So now we're able to see pharmacist do more, um, integrate their ideas. One thing I'll say about this generation, they are more innovative thinking, um, I would say, than when I was, and the different things that you can do. And now they're catching up to allow that to be. Um, and I think that that's where the future is bright as it relates to pharmacist. Because once we became entrepreneurs, it wasn't until then we realized what or how much we could do. And we still have to rein it in because we want to do everything, and we know that that's not possible. So we run ourselves out.

SPEAKER_02: 36:30

Wow. It's like you you and you know what what's so good about that, like you working with the younger students and then bringing that innovation in the back of your mind, although you might not see it, right? What they're causing you to be, because you've been in it, like you're what they call OGs. You've been in it, right? Yeah, it's like, okay, no, y'all ain't gonna do this, and I ain't got nothing to say without it. Let me take a look at what's going really going on. It increases and it encourages you to keep looking and look at you know what you know versus what's coming. It pushes you to look at what's coming because you want to stay ahead of the game. You don't want to be in that same game that else is in, you want to push it out. So that you know, working with the younger person actually allows you to see what's ahead, right? And do your own planning, but then see, okay, well, how are they doing this? Is that gonna work for me? Um, because you know you, because you're established and you know which direction you want to go into.

SPEAKER_01: 37:34

Yeah, and we also have a high school student, as Pauline was talking about with the Birmingham promise. So um, I'm challenging her to help me to you know increase my social media game.

SPEAKER_02: 37:44

So and I'm sure she's all game for it.

SPEAKER_01: 37:51

Oh my goodness. But they did.

SPEAKER_02: 37:54

Dr. Pauline, did you want to add anything to that?

SPEAKER_00: 37:57

Yeah, I would say for me, um, you know, one of the things, and we graduated 20 years ago, so a lot has changed in uh in the pharmacy uh pharmacy education realm. But I mean, just you know, really helping me be a good clinician. Um, like Jennifer said, because Sanford is a faith-based institution, um, you know, we had a course in, you know, pharmacy ethics, and you know, Dr. Breseker, you know, taught that course. And a lot of it was how to engage with people, how to communicate with people. And I think that's a lost art now in healthcare because so many of our healthcare providers are, you know, brilliant minds, clinically smart, you know, can make amazing clinical conditions. But how many of them can sit across the desk from you or, you know, chair to chair and really listen? And listen for what you say and listen for what you don't say. Because a lot of that really makes a difference in how you treat someone clinically, um, is being able to listen and listen to the the body or watch the body language and things like that. So I really appreciate Sanford for that uh component of just helping me be a better clinician. And I I wish, and obviously I'm not in you know med schools and things like that, but I my hope is that that's not a lost um course. Um, just helping people uh communicate and really be able to verbally and nonverbally uh communicate with patients because it's so important.

SPEAKER_02: 39:37

And I totally agree with you, and that's the art that was lost when medicine became a business.

unknown: 39:43

Yeah.

SPEAKER_02: 39:44

Right? Like that went right out the window when medicine became a business, and when medicine, concierge doctors have a little bit different because they get to spend as much time as they want to with a patient. But if you're a provider and you're in working in a traditional medical setting, your business, your medicine is now your business. And so while you might want to be able to give, you're limited because your contract is saying you can't. But here in lies where it's encouragement, is that you, the two of you, could have very easily said, okay, well, our contracts ain't calling for this, and we're not having no money for this. But you made it up in your mind, and I think Sanford had a lot to do with the training that you learned from Sanford, had a lot to do with the fact that you was like, okay, so if they close this door, I'm just gonna go open up another door, right? And if that door ain't open up wide enough, I'm just gonna keep pushing until it opens up. You're not gonna tell me that I'm limited because the government cut my money off. Like, I can't help the people that need to be helped because I don't have, you know, I'm not getting paid for it. I don't have the time for it because I got all this other stuff. Sometimes you have to go outside that little four-wall box and say, how can I make a difference? Whether it's you're hiring an intern, whether you're working with a community organization that already has the ears and the eyes of a person or in the community and can help somehow or another connect with that person and say, okay, well, let me help the community grow because I have their ear. But you two have managed to, and like I said, I honestly believe it's because of how your foundation that you laid when you were in school, you laid that foundation and actually taught you, they told you and taught you how to actually go forth with it. And so now you're like, okay, well, if they say no over here, I'm going over here and over here, and somebody gonna let me for every no, there's a yes. And I'm just gonna keep going until I get a yes. So I thank you for that. Because once again, clinicians, whether you're a pharmacist, a doctor, whatever field you're in as a clinician, terms maybe helps realize is that your time is limited, right? And what we ask is what you're doing is to reach out to a community organization that's in doing what you're doing and saying, hey, we want to help, but we really can't. How can we partner or collaborate with you? Let you take the lead on it, and then reach back to us to ask for our information on what we think and how how we can help. And so thank you for being at that go-to the the go-to firm for the community. My next question is this what lessons did you learn during your work in the pandemic that you actually use till today?

SPEAKER_01: 42:39

Go ahead, Pauline.

SPEAKER_00: 42:40

Yeah, well, you know what? And and you alluded to it earlier, Jennifer, um, because a lot of our work was done in underserved during the pandemic, it was done in underserved uh communities in Birmingham. Um, and that's actually when we left our full-time jobs and became full-time entrepreneurs, was actually during the pandemic. So um it the lesson that I learned, the biggest lesson that I can remember from the pandemic, is um people value um realness, they value uh genuineness. And it's hard to go in and talk to someone about um, and I'm sorry, my phone is ringing. It's hard to go in and talk to someone about something that they they don't have a base knowledge of. Because again, you think about COVID. We didn't know anything about as lay people, the science community did, but we didn't didn't know anything about COVID. So as we were learning, we were out trying to relay that uh information to the communities that we were serving. And so sometimes things changed, sometimes they didn't. And you know, there were times people look at us like it, what? No, because I saw on YouTube that XYZ. Um, and so it was a it was a very valuable lesson in how to uh communicate clinical information to people that may have a low health literacy and how to build trust with people that have historically been, you know, marginalized and mistreated by the healthcare system. Um, even though we look like them. We we, you know, there were areas where we were in the communities where we grew up, and we still um, you know, had some resistance to the information that we were providing. But what did we do? We continue to show up, and that's what built the trust. And now, five years later, we're able to go back to those same communities, and what we say is taken with a lot more thought than just being dismissed because I don't know you, you know, where did you come from? Um, so that's one of the things I say we learned during the pandemic is how to modify the message depending on the community that you're in and still get the point across, and how to continue showing up, even though you may have some resistance in the beginning, because continuing to show up is what builds the trust.

SPEAKER_01: 45:07

Very well said. And I would say for me, humbling ourselves, well, I say for me anyway, but I'll never forget we were working in a community to where I had preconceived notions about that community, right? So we had a talk with the community director, I forget his exact title, and he was like, you know, we need to talk about this before we go and um this, that, and the other. I was like, well, they look like us, we look like them. He's like, no, you do not understand. So he really had to school us on that generational mindset. And they were used to what they were used to. I wasn't used to accustomed to that mindset. So he had the wherewithal or the forethought to like, okay, let me, let me, let me get these doctors what they need to be, right? Um, and it was a very humbling experience, and he was absolutely right. Um, I'm so forever grateful for that experience to where it helps me to approach new situations differently. I'll also add collaboration and how important collaboration is. You have got to have partners because you can't be everywhere every all the time. But when you show up, they understand the power of us being there. And I always um tell our interns, you know, we had to educate the community at large, particularly business people, what pharmacists can do, how we can enter a space, how we can improve it, what the knowledge, excuse me, the knowledge we bring with it, um, so much so to where I think we've hit the mark on that and they understand. So we're very appreciative of that during the pandemic. And I remember our humble beginnings where we wanted to collaborate with people, they hadn't heard of us. Um, so this is definitely a marketing 101 type thing. There were times when we were at events and the local news media wanted to speak to us. And I Pauline would say, Jennifer, you get it this time. Like, no, I did it last time. No, I don't feel like talking. Oh, this uh, but it helped, and people would start to recognize the colors, the emblems. Every time we would show up, they'd say, Y'all were UAB. So that goes to show you how people pay attention because they were used to that facility always showing up. So now we're known as the company or the organization that will show up. And guess what? We partner with UAB. So it's just been an incredible, wonderful collaborative experience or spirit that we have. Um, so when people um, we have what's called a health tech generator for founders in Birmingham. So when someone presents an idea that's healthcare related, they're calling Dr. Pauline and I say, hey, can you sit in on this presentation? Can you give us our thoughts? Or if they've been accepted, hey, can you introduce them to this person, this doctor, this um organization? So we are very, very proud of number one, showing up, being in spaces when we didn't know if we belonged or how we belonged. It just worked itself out itself out because we did show up. So we have um, so Pauline um didn't mention the fact of in the city, they have um our mayor has what's called the bold initiative, and it's for small businesses, uh community organizations, nonprofits, for-profits, and how we can better the lives of the Birmingham citizens because you're using taxpayer dollars. So we were awarded that grant twice, but Pauline did such a good job to where Pauline put herself out there and said, Hey, if you're applying and you need some help, let me know. I'll kind of give you, um, make sure you're on the right track. So we have a sister business who also helped us during the pandemic, and she was awarded the grant this year. So it's just phenomenal the effect. Um, we were just coming into the city trying to be known, to be seen, and now we're helping others to get a leg up. Um, and it's all synergistic. We all um, you know, we can refer to her business, she can refer to ours, um, and she's a nurse. So when we talk healthcare in the city, mass flus comes up in the conversation. And that came from our roots in the foundation in the pandemic.

SPEAKER_02: 50:07

Thank you so much for that. And what I'd like to say is that because you have that outlook and because you're going in the direction that you're going, you haven't veered. You know, people tell me all the time, Sandra, you've been doing what you've been doing for such a long time. That's because I love what I'm doing, and I love to be able to be of assistance to people. Not everybody will get it. And there are days and times that I say, I'm not gonna do it. Uh I there are days and times that me and God, I argue with him. Like, Lord, I'm not going to do this. Like, go take a nap. And when you wake up, you'll feel so much better. Um, but really, it helps the patient experience. And that's what this podcast is all about is the patient experience, is letting patients know that you don't have to be a loner, you don't have to suffer with, you know, the things that you're suffering with by yourself. Yes, Meds Plus is in Alabama. However, if you reach out to Meds Plus, they might be able to direct you to someone that has the same mindset as you do or as they do, so that you, wherever you are, can get that help. And who knows? Nowadays we have telehealth. They may even be able to set up a telehealth appointment with you and be able to walk you through or help you to see that you know, you being at home self-medicating or not medicating has nothing to do with love. But you tell me you love me, but you're not doing the things that you're supposed to do because you say I don't have help, but there's telehealth that you can get into and say, hey, I really like what they're saying and how they look, you know, how they're doing things. Maybe they can help me and maybe they can give me some help. And that's what the patient experience is about, making sure that patients, all patients, when you say inclusion, it includes all patients, have access to the best health outcomes. And you can only do that by aligning yourself with those who actually want to offer you and can offer you that best health outcome experience. So before we leave, I'm gonna ask you this last question. We talked about it a little bit from my standpoint, but from your standpoint, what does the future of pharmacy look like?

SPEAKER_00: 52:27

So, and are we talking about our dream for what the pharmacy future looks like or where we think, based on what's going on now, where we think we're headed? Because for me, those are two different things.

SPEAKER_02: 52:40

And for and for me, I want the God's to honest truth. Okay. So if you have to separate them, separate them. If you have to put them together, put them together. But I asked that question because I want you to dig inside yourself and pull out where you think the future of pharmacy, what direction is going in.

SPEAKER_00: 52:59

Yeah, well, I would say just based on kind of what's going on now in the industry, uh, the future of pharmacy is going to look like fewer brick and mortar stores in our communities, and we're already seeing evidence of that, what's going on now. So we'll have fewer brick and mortar stores, which means less access to the services that pharmacists provide, from answering your medication-related questions to um helping you choose the right over-the-counter product to giving you an immunization. Those kind of services will be uh fewer in the future because there'll be less brick and mortar locations. Um, there will also be an influx or an increase in mail order type facilities. Um, Amazon is already working on that model where, you know, there's a, and Walbrings is too, where there's a central hub pharmacy and uh computers and robots are doing primarily the filling, and it's just kind of shipped out to the patient or shipped out, you know, to a hub of a store where maybe there's a cashier there to actually sell you your prescription. So technology is going to take over. Um, we're already talking about what AI can do in terms of being able to offer clinical advice regarding prescriptions, healthcare conditions, and the whole thing. Um, but the the beauty of what is happening with organizations like ours is we are already in the point of transition where dispensing is not the primary focus of our business, it's health outcomes. And that's something that no machine or robot can do. We are focused on what patients need, what their um their health, what their level of health literacy is, and how we can uh modify our message and our consultations to help improve their outcomes. So when technology you know takes over, and it it probably will, and it's gonna be sooner rather than later, there will still need to be pharmacists who are educated, trained, trained in communication and how to disseminate information, will still be needed because we are the we have access to more information now than we ever have. Yet our population is less healthy than we've ever been. So there's gonna be somebody who's gonna need some person, not a robot, who's gonna have to come in and bridge that gap. And that's what that's where Meds Plus is headed. We want to be able to bridge that gap.

SPEAKER_01: 55:38

Yes, I definitely agree with the AI component. Um, it's going to be huge. And I would say that our country, our world is suffering from too much information to where they don't know how to disseminate it and apply it. It's information overload. You have companies now that will choose to have their employees on an app versus someone having one-on-one consultations. And I feel that that's part of the reason why we're still in a state of sickness, um, because that's not as effective. Are there some improvements that can be made? Yes. How do pharmacists help um pair technology with what patients really need? Because we still have a generation that does not know how to use technology, so we have to solve for that. The other part is personalization or personalized care. When we talk about genomic testing and getting the medications right, um, that is improving. The insurance hasn't caught up as much. The reason a lot of people don't know about it. But with genomic testing, we can eliminate um the treatment failures that we're seeing now, um, help people to have a better relationship with medication because now when they're prescribed the right thing the first time and they see the improvements, they're more likely to stay adherent. So I definitely would say personalized medication, um, pharmacogenomic, genomic testing, nutrigenomics with that. But prevention is key because you every time when I'm encountered with a patient with a chronic condition, their first question is, how do I get off this medication? So we have to shift the conversation to how do we keep from getting on the medication with preventative screenings, um, with wellness decisions you make every day with physical activity. And supplements are okay in the right place and complement to anything that's prescribed if if if that's um necessary. So shifting that conversation to preventative care. Um, and then we have large gaps of the population where they rely heavily on social media. And it's gonna be up to us, as you were stating at the outset, of putting the good information on the airways where people could trust and showing up and providing that information. That's why we do what we do, that's why you do what you do. But definitely for MESPlus consulting, um, we're gonna be a healthcare hub. We are a healthcare hub. We're only going to expand and get better based on the learnings. And we have dropped the title of Pivot Queens because, you know, when we see a need, we're ready to fill it. But we're we're being strategic, we're being thoughtful, we're walking, we're watching the changes and the needs of the people and being able to have a response for that. My idea, or if I could wave a magic wand for healthcare, it would be that you had your pharmacies on the corner, but it would be in a collaborative practice. You sit down with your pharmacists, you have your medications, we triage you to the different doctors. And then after you've seen the doctors, you come back to us. There's that educational piece. It's great that we have medical assistants, we have RNs, we have PAs, we have NPs. None of those um positions, I'm trying to think of another word, have the medical there you go, professionals, healthcare professionals have the medical expertise of a pharmacist. So going back to that article that you read, it needs to start and stop with that education with the pharmacist and that follow up as well. Because now we're able to do point of care testing, we're able to check an A1C, we're able to look at your foot and see if. You need to go to the podiatrist, et cetera, et cetera, et cetera. And it's not taking business or anything from another profession. It's the collaborative aspect that the patient is yearning for, the holistic approach. It's not pharmacist against the doctor versus anyone else. It's all about that patient, patient-centered care. And that's where it needs to head. That's where I wish we were. You do have some pockets, possibly in a healthcare system or one setting, but overhaul of the healthcare system. I said it.

SPEAKER_02: 1:00:41

And you know what? And I'm so glad you said it like that because with an exclamation point, what you both just sat here and said, it takes collaboration. It can happen without the collaboration, but there's power in collaboration. Each party of the sector understands where they fit in. They do their work that they fit in and they pass it along, not pass along and just drop it off, but they pass it along and keep their line of communication open with everyone else that their patient has into, you know, has had a relationship with or has encountered during that healthcare service or treatment where it actually matters. And it, you know, in some, like you just stated, in some areas it's happening, but come on, we we we're so far off the game that we really need to be working and pushing on getting it to where it needs to be. We, especially in our community, we have to stop competing against each other, especially when it comes down to the patient experience and the patient care. Because when we compete against each other, the patient walks away, and the patient is a key. And that key is just left there conversation because being pulled in to do something that they didn't a lot of times didn't go to school for, don't have an education to do, which is that clinical piece. So we've got to stop competing against each other. There's enough going around in this world right now with each of us. If we were to take 2,000 patients, there would still be so many more that needs our help, right? And whatever way. So if we can collaborate, we can ensure that that patient gets that help. I thank both of you for your time today and coming in to explain how the two awesome and dynamic doctors of pharmacy, how Meds Plus is pushing it together, putting it together and pushing it out, not keeping it to themselves, but pushing it out to the community. I'm hopeful that people that are watching this that maybe that you're also doing a med doing medication consulting firm. If you're in your area, you know, and there's some things that you need to talk about. Come on, let's talk. Let's talk. Because that's the only way we're going to get anywhere is by talking, laying a blueprint, and pushing it forward. You have a best practice model that you can use. I'm sure they wouldn't mind you using their model. So that you can use this so the patient experience can be uplifted. So that being said, I want both of you to enjoy the rest of your day. I do want to actually tell everyone the same I tell everyone every time we do a podcast, be kind always. You never know who might need you to be kind to them. Perhaps they're having the roughest day ever and they just need you to be kind. Perhaps they respond in an unkind way. That's not anything you did is something they're going through. But don't you let that stop you from being kind. And the best thing about being kind is absolutely free. Don't cost you what one cent, although cents are going away. So it don't cost you one nickel um to to be kind. It's free. So thank you, ladies, very, very much. I appreciate you.

SPEAKER_01: 1:04:17

Thank you.