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July 24, 2017

Brody Maack Is Driving Success at Family HealthCare

Brody Maack, Pharm.D., BCACP, CTTS

THE 100-YEAR-OLD BUILDING on the northwest corner of N.P. Avenue and Third Street North in Fargo, N.D., once housed Pence Automobile. Now, it is the home of Family HealthCare, a multidisciplinary clinic that has received the highest level of patient-centered medical home (PCMH) recognition in the country.

Although the healthcare staff in the building serve patients rather than service cars, it can be said that Brody Maack, Pharm.D., BCACP, CTTS, is a key component in the smooth running of the clinic’s engine. “I’m always looking at new ways to improve outcomes and make things more efficient,” Dr. Maack said. With that attitude as a starting point, Dr. Maack has become a crucial resource not only for patients, but also for other providers and administrators.

Patients benefit from his lifestyle medicine services, which focus on disease prevention and management of chronic illnesses. “One of my current clinical focuses is trying to increase the number of chronic heart disease patients who are prescribed statins or lipid-lowering therapy,” said Dr. Maack, a member of ASHP.

This initiative comes in light of a chart review conducted by his pharmacy students, which showed that a substantial chunk of patients who could benefit from statin or lipid-lowering therapy were not receiving these drugs. To ameliorate the problem, he has been working with the clinic’s other providers, offering them medication recommendations based on the best available evidence.

Dr. Maack (left) takes a patient’s blood pressure during an appointment, while 4th year pharmacy student Kanako Kabaki (middle) looks on. Students working with Dr. Maack begin their rotations in an observational role and progress to a nearly fully autonomous role by the end.

“We’re now also in the process of expanding my services to include counseling and medication management for patients with several other chronic disease states, including depression, which is important because at the moment we do not have mental health services onsite,” Dr. Maack said.

Highest Level of PCMH Recognition
Family HealthCare offers a cornucopia of services to its roughly 15,000 patients, including dental, optometry, and behavioral health services, in addition to physical therapy and health education. The facility includes 33 medical exam rooms, a laboratory, x-ray imaging facilities, and offices that are used for patient counseling. Interpreters are on hand to help with refugee health.

While those resources are surely put to good use with approximately 60,000 annual patient visits, staff like Dr. Maack help tie the components together in a way that has led to the truly great care that earned Family HealthCare the National Committee for Quality Assurance’s (NCQA) Level 3 recognition, which is the highest level of PCMH recognition. NCQA President Margaret E. O’Kane said the clinic “has the tools, systems, and resources to provide its patients with the right care, at the right time.”

According to Billie Jo Nelson, MLT (ASCP), the clinic’s Director of Quality Improvement, the PCMH certification was a facility wide collaboration, and Dr. Maack is an integral part of the team. “Brody’s work touches on a number of the measures we need to meet to maintain our Level 3 NCQA recognition,” she said.

For example, Dr. Maack helps satisfy PCMH standards by using the electronic health record system to document patient visit notes as part of the continuum of care, Nelson explained. “Helping chronic disease patients with their self-management goals is another way Brody directly contributes to us maintaining our PCMH recognition,” she said. “The time he spends with patients helps them reach a higher level of self-management, which is another standard.”

Medication reconciliations and medication therapy management services mean the clinic meets medication management standards as well, Nelson added.

Educating Patients … and Providers
For patients, Dr. Maack is a guide and partner; for administrators, he is invaluable; and for staff, he is an “excellent” resource, said Nurse Practitioner Kelly Polcher, DNP, APRN, FNP-C. “Brody regularly shares the latest findings and recommendations for medication management with other providers,” Dr. Polcher said.

Dr. Maack (left) reviews a spirometry report with 4th year pharmacy student Joshua Oliver (right), in preparation for an upcoming patient appointment for asthma management. Students enhance their direct patient care skills by taking an active role in seeing patients.

She added that Dr. Maack also helps clinicians select and initiate the most appropriate medical treatment and monitors patients after they start treatment. “This can help limit the excess costs that would otherwise be incurred if patients were to have frequent follow-ups with primary care providers,” Dr. Polcher said.

The staff also appreciates that, through medication reconciliation and chart reviews, Dr. Maack spots inconsistencies in medication use. “We are so fortunate to have Brody working at the clinic,” added Dr. Polcher.

Underserved Populations
Dr. Maack said one of his favorite aspects of the clinical work he does is partnering with underserved populations, including homeless individuals, new Americans, and refugees. “I cherish our refugee population and the opportunity to help them become wonderful friends and citizens,” Dr. Maack said, noting that these individuals also present with unique challenges, such as poor medication adherence.

“Patients who are homeless, for example, may not have a place to keep their insulin cold,” he said. “And new Americans might not be familiar with the idea of taking a medication chronically.” Other patients use forms of tobacco that are traditional to their home country, making smoking cessation best practices possibly less effective, Dr. Maack added. “The no-show rate is also higher with these populations, which is something we’re constantly trying to improve,” he said.

A Sense of Gratification
By providing such a wide variety of services at the clinic, it is no wonder that Dr. Maack is proud of his work. “I feel lucky to be part of a healthcare environment that offers such a breadth of services,” he said.

No doubt, his patients, colleagues, and clinic leadership feel the same sense of gratitude toward him.

By David Wild

 

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July 7, 2017

Jennifer Askew Buxton Unpacks Her Mentor Toolbox

Dr. Buxton (Right), mentors Allison Stilwell (Center), a student on rotation from the Eshelman School of Pharmacy at the University of North Carolina at Chapel Hill, as she counsels a patient prior to administering a vaccine.

THE MOST IMPORTANT PIECE OF ADVICE that Jennifer Askew Buxton, Pharm.D., CPP, FASHP, gives her students and residents is to create a mentor toolbox. People have different skills, noted Dr. Buxton, and having an assortment of mentors (a mentor toolbox) helps to provide a full breadth of expertise.

Although Dr. Buxton always knew that mentors were crucial to success, she didn’t at first realize the particular importance of having female mentors. “I was probably five to eight years into practice before I recognized the gender gap,” she said. “I realized that all my mentors were men, and I began to seek out female mentors who were pharmacist leaders and outstanding mothers.”

Making the Most of Mentors
Dr. Buxton considers herself fortunate to have had two strong mentors early on: her stepfather, a physician, and ASHP Past President Bruce Canaday, Pharm.D., FAPhA, FASHP, her Residency Director at Southeastern Area Health Education Center in Wilmington, N.C. Dr. Buxton credits her mentors with teaching her the importance of volunteerism and advocacy, both in associations and in the community.

Growing up, she had always leaned toward math and science, and her stepfather, J. Paul Martin, M.D., inspired her to go into a healthcare field. Dr. Martin, now a specialist in both addiction medicine and occupational medicine, was a family medicine physician in Asheville when Dr. Buxton was growing up. “He taught me about the importance of volunteering,” said Dr. Buxton. “He would take me with him when he volunteered at the local free clinic, and later on I did the same with my students.”

Dr. Buxton credits Dr. Canaday as being influential as well. “He has a passion for pharmacy association work that I don’t find in most people,” she said. “He has incredible problem-solving skills.” The two hit it off when Dr. Canaday was Dr. Buxton’s preceptor. “To this day, I seek his wisdom,” she said. “Whenever we are at the same meeting, we always share a meal, and he is always available by email or phone to help me make decisions.”

The Volunteer-Leadership Connection
Today, Dr. Buxton is Chief Pharmacy Officer and Co-Director of Mental Health Services at Cape Fear Clinic, in Wilmington, N.C., where she was a volunteer for almost a decade before accepting her current position. The clinic provides medical care to under- and uninsured, low-income patients in four counties in North Carolina. “It’s not a patient-centered medical home, but it works like one,” said Dr. Buxton, who runs all the pharmacy-related services, including immunization, clinical services, medication therapy management, medication synchronization, chronic disease management, and the clinic’s mental health program.

In North Carolina, pharmacists can have prescribing privileges, and Dr. Buxton manages the medication for clinic patients who are being seen by counselors, licensed social workers, and psychologists. “I’m practicing at the top of my license,” she said.

Dr. Buxton serves as the Chief Pharmacy Officer at Cape Fear Clinic, where she takes pride in providing pharmacy services to underserved patients.

She is also Director of the PGY1 Community Pharmacy Residency Program at Wingate University School of Pharmacy, Wingate, N.C., and she regularly precepts pharmacy students from all North Carolina schools of pharmacy. “I always encourage my students to ask for mentors,” she said. “Whether it’s me or someone else, it must be someone you connect with.”

Dr. Buxton is active in local, state, and national pharmacy associations. Dr. Buxton was elected to the Executive Committee of ASHP’s Section of Ambulatory Care Practitioners as Director at Large and has served as a member of numerous ASHP committees and advisory groups. She was recognized for her dedication to volunteer work with ASHP’s Distinguished Service Award and has served as President of the North Carolina Association of Pharmacists.

Influential Mother Network
When Dr. Buxton began seeking out female mentors, it was because “I wanted to speak with other women in healthcare management about how to navigate a male-dominated work environment,” she said. “The women were there — I just hadn’t started to cultivate those relationships.”

A few years later, as she was thinking about having children, she realized that her female mentors didn’t have children. This led to a search for a network of professional female mothers. “I started to reach out to women-mother mentors in a more formal way,” she said. “That’s how I rounded out my mentorship toolbox.”

What did she learn from her mother mentors? “I was terrible at work-life balance, and I realized I needed to do something about that. I’m very passionate about work — full time doesn’t mean 40 hours; it means however many hours it takes,” she said.

Dr. Buxton’s mentor network taught her several valuable lessons, including that sometimes family takes priority and sometimes work takes priority. Dr. Buxton learned that work-life balance doesn’t necessarily mean 50/50, but it is essential to have quality time dedicated to home and to not blur the lines between work and home. “Your goals don’t change, but how you achieve them might,” said Dr. Buxton, who gave birth to a daughter in December. This is where family is important, she added. She credits her husband as a total partner in parenting, and her younger sister, mother to a 9-month-old, as a role model.

ASHP Mentors
Dr. Buxton values ASHP because it’s where she can go for support, advice, and motivation. She cited ASHP Past President Diane Ginsburg, R.Ph., Ph.D., FASHP, as an inspiration for being a strong female leader. “I was so impressed with her accomplishments. I saw her as an excellent example of what women can achieve,” said Dr. Buxton.

ASHP staff has been very helpful to Dr. Buxton as well. “I have a circle of three mothers at ASHP who help me talk through time commitments with leadership roles so I can choose what I do and do it well,” Dr. Buxton said.

One of the most important lessons that Dr. Buxton learned from her mother network and her ASHP mentors is that she would be serving as a role model for her daughter. “She’ll watch me and look to me as someone who can show her how to be involved with community and profession,” she said. In other words, Dr. Buxton plans to lead by example, as she learned from her own mentors.

By Ann Latner

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