ASHP InterSections ASHP InterSections

August 11, 2021

Free ASHP Membership Helps P1s Navigate Career Paths

Charlotte Tran

FOR FIRST-YEAR PROFESSIONAL (P1) STUDENTS, jumping further into health-system pharmacy can be exhilarating and overwhelming. There is an increasing number of career possibilities and numerous ways of deepening one’s involvement in the pharmacy community.

To help P1 students navigate this new experience, ASHP is offering a one-year complimentary membership. With all the resources students need to continue their schooling, they can start their career journey off on a solid footing.

Bound for Ambulatory Care

For Charlotte Tran, a Pharm.D. Candidate (2023) at Chapman University School of Pharmacy in Irvine, California, networking and leadership development offerings have been a couple of the most valuable aspects of her ASHP membership.

“Through events at ASHP’s student society, I’ve had the chance to meet and hear from pharmacists in different areas of the health system and see what their days look like,” said Tran.

Meeting practicing pharmacists has given Tran an appreciation of the range of responsibilities she can look forward to as she moves towards a residency and a career as a pharmacist.

Tran, who is president of her university’s Student Society of Health-System Pharmacists, said she has developed an interest in ambulatory care pharmacy, and chronic disease statement management in particular, because of the potential to develop long-term pharmacist-patient relationships.

“I think the best possible care for patients starts by spending time with them and building relationships,” she said.

With a career in ambulatory care pharmacy in her sights, Tran has been drawing on ASHP online resources, like career profiles, to better understand what “the road to a specialization in ambulatory care looks like.” Through the ASHP website, she has also gotten help with her CV and found tips for sharpening her interviewing skills, as well as guidance on ways to get involved nationally with ASHP.

“Through the ASHP e-newsletter and discussion posts, I’ve also been able to stay up-to-date with the latest news and issues related to health-system pharmacy,” Tran added.

ASHP Membership Facilitates Connections

Joining ASHP during the pandemic proved particularly valuable for Madison Noble, a Pharm.D. candidate (2024) at Virginia Commonwealth University School of Pharmacy in Richmond. Noble said she anticipated that the virtual school setting would make it challenging to feel connected with her fellow students and faculty.

Madison Noble

“However, ASHP provided me with opportunities to get to know my peers and to network within the school and hear from residents and pharmacists in fields of pharmacy I had not considered for my own future,” she said.

Online ASHP resources such as the “Why Should I Do a Residency” page have helped Noble solidify her interest in pursuing a residency, which she said she was unsure of when she began her P1 year.

“At the start of this year, I wasn’t totally clear on what a residency was exactly, and whether it was something I wanted to pursue,” she said.

While Noble is now sure she wants to go down the residency path, she has not yet settled on a specific pharmacy stream. Drawing on the career profiles section of the ASHP site has helped her explore the variety of possibilities available within health-system pharmacy.

“I’ve learned a lot just by reading through the overviews of different careers and finding out what a typical workday looks like,” she said. Preparing well in advance, Noble will soon be submitting her CV through ASHP’s CV Review Program, where it will be reviewed by a volunteer pharmacist and provided with valuable feedback.

For others thinking of taking advantage of ASHP’s free P1 membership, Noble said that joining the organization “is a great way to learn more about areas of pharmacy you may be interested in.”

“Just within this first year of membership, I have learned so much about what a pharmacist within the health system does, and I plan to further this learning and keep my membership throughout pharmacy school,” said Noble.

Although “free time is hard to come by these days,” Noble – who is also planning to seek out ASHP student leadership opportunities at VCU – said she likes to peruse the ASHP website when she can.

“I find something new every time I explore the website,” she said. “For example, I recently found the ASHP Wellness Wednesday Podcasts. I was excited to see one on meditation techniques geared toward the pharmacy workforce.”

New Opportunities to Explore

Khushali Sarnot, a Pharm.D. candidate (2024) at Southern Illinois University Edwardsville School of Pharmacy, felt being an ASHP member would serve her well as she moved towards a post-graduate residency. That feeling was affirmed when she took up a position as a hospital inpatient pharmacy intern at SSM Health Saint Louis University Hospital in St. Louis, Missouri.

Khushali Sarnot

“Every one of the pharmacists I’ve been working with recommended joining ASHP,” Sarnot said.

Apart from having access to career-building resources, one membership benefit Sarnot has enjoyed has been the daily ASHP email briefings, which have become a source of truth on all things COVID-19.

“Finding reliable and accurate information has been a challenge during the pandemic since there is so much misinformation in the media,” she said. “As the only healthcare professional in my family, I tend to be the person they look towards for information on COVID-19 and to explain some of the science behind the disease and treatments and vaccines. I’ve turned to information from ASHP to answer their questions.”

ASHP networking opportunities have also landed Sarnot an ASHP summer internship opportunity for this year. She will be working on several projects, including analyzing technician training programs.

“I hope the internship will expand my network, make me an outstanding candidate for residency and further establish my career,” Sarnot said.

After “peeking into what different specialties are doing through the ASHP website,” Sarnot is leaning towards pursuing a residency in cardiology. However, as a P1 student, she knows that her goals and aspirations could evolve in new and exciting directions as she gets more involved with the pharmacy community.

“I can’t wait to see what other opportunities I discover through my ASHP membership journey,” Sarnot said.

 

By David Wild

March 17, 2021

Kurt Kleinmann: From WW2 Refugee to Pharmacy Innovator

The Kleinmann family in April 1938. Left to right: Herta, Gustav, Kurt, Fritz, Tini, Edith

PIONEERING PHARMACIST KURT KLEINMANN, R.PH., HAS SEEN the worst and best sides of humanity. In 1938, as Hitler rose to power in Europe, his family was among the millions of others to bear the brunt of a growing tsunami of anti-Semitism.

“I remember as a child in Vienna having a Hitler youth push my head into the snow,” recalled Kleinmann, now 91 years of age. The Kleinmann family’s situation worsened in 1939 when his father, Gustav, and his older brother, Fritz, were arrested and sent to the Buchenwald concentration camp in Germany and eventually to the Auschwitz concentration camp.

Then in 1942, Kleinmann’s mother, Tina, and his sister, Herta, were rounded up and shipped to Minsk. Kleinmann’s father and brother survived seven years of forced labor at the concentration camps, but his mother and sister were killed three days after arriving in Minsk.

Fortunately for Kleinmann and his elder sister, their mother had the foresight to send them both off to the United States and England, respectively. This heart-wrenching decision was likely made knowing she may never see her children again.

Arrival in the States

Kleinmann’s time in Europe, which is written about in a recent book titled “The Boy Who Followed His Father into Auschwitz,” was the dark side of humanity, but when he arrived in the United States at age 11, Kleinmann was shown a level of generosity that he has reciprocated in equal measure, both inside and outside of his profession.

“I was taken in by a wonderful family in New Bedford, Massachusetts, and they really saved my life,” Kleinmann said. “Judge Samuel Barnet and his three sisters became like a new father and three new mothers. I always kidded that I had to behave so as not to spoil their reputation.”

Kleinmann was given all the opportunities that a child his age could hope for: summer camp and afternoons playing baseball, “which I enjoyed even though I wasn’t good enough to make the high school team,” he said.

As a high school student, Kleinmann set his sights on a career in aeronautical engineering but soon realized that pursuing this path required an element of tedium that wasn’t for him.

“My high school counselor said I needed to take mechanical drawing if I wanted to become an aeronautical engineer. The first nine weeks of the class were very boring and involved perfecting your handwriting, writing the letters of the alphabet over and over and over again in lower case and upper case,” Kleinmann recalled.

When he spoke to his counselor about dropping the course, she reiterated that mechanical drawing was a requisite for college studies in aeronautical engineering.

“I looked at her and said, ‘ok, so I’ll become a pharmacist!’ and that’s how I ended up with a wonderful career which I’ve loved ever since,” Kleinmann said.

Pharmacy Studies Interrupted by Military Service

Kleinmann spent 16 months as a hospital pharmacist in the military.

Kleinmann completed his undergraduate pharmacy studies in 1952 at what was then the Rhode Island College of Pharmacy, continuing on to graduate studies at Ohio State University with the intention of getting a job in pharmaceutical manufacturing. However, a year into the program, Kleinmann was drafted into military service and sent to Germany and Austria, where he spent 16 months as a hospital pharmacist.

The experience left him wanting to work in hospitals rather than industrial manufacturing. Kleinmann, who had applied for a residency at the Johns Hopkins Hospital prior to serving in the military, was offered a staff position in the pharmacy department on his return to the United States. He took up the offer and was eventually promoted to serve as the supervisor of their compounding operations. After two years there, Kleinmann decided he needed to get back on track with graduate-level hospital pharmacy studies.

He was accepted to the St. Louis College of Pharmacy’s residency program. He completed a placement at the St. Louis VA Medical Center–John Cochran Division, where he got a flavor of the possibilities within hospital pharmacy.

“My preceptor wrote a letter to every hospital in St. Louis saying, ‘I have a resident here, and I’d be happy to share him with you for a month, and you can work him as hard as you want, but you have to teach him something,’” Kleinmann recounted.

Big Break

It was at the tail end of his residency that Kleinmann had a career-boosting meeting with Paul Parker, a pioneer in hospital pharmacy who at the time was the executive secretary for ASHP, then known as the American Society of Hospital Pharmacists.

“Paul was asked to man the ASHP booth on his own at a convention for the Catholic Hospital Association, which had their headquarters in St. Louis, and my preceptor knew Paul and sent me to keep him company at the booth,” Kleinmann said.

The new graduate left a strong impression on Parker. After the meeting, the elder pharmacist introduced his colleagues at Grant Medical Center in Columbus, Ohio, to Kleinmann because they were searching for a new pharmacy director.

“Paul had received a call from the hospital administrator at Grant that they were seeking a new pharmacy director. He indicated to them, ‘I just met a young fellow in St. Louis, and you should give him a call,’” Kleinmann recounted.

Innovator

Kleinmann was hired for the job and went on to develop their pharmacy program. He and was also given the freedom to flex his muscles as an innovator. “In those early days, doctors on the floor wrote medication orders in the patient’s chart, and nurses would copy those by hand and send the copies to the pharmacy,” Kleinmann explained. “Needless to say, there were numerous transcribing errors and dispensing errors.”

Kleinmann has become a beacon of light to those around him.

To improve the safety of the prescribing process, in 1965, Kleinmann developed a standardized approach for physicians to send their original orders directly to the pharmacy. The published protocol touched on everything from the essential components of an order form to considerations around the color of the paper being used.

Marvin Lew, M.S., who worked at Montefiore Medical Center in New York, with Kleinmann during his 30 years as pharmacy director there, said Kleinmann was relentless in his efforts to advance the profession of hospital pharmacy.

“Kurt pushed innovative programs year after year, and when a project was successfully completed, we would all breathe a sigh of relief and say how thankful we were that it was over, only to find out there was an even greater project for the upcoming year,” he said.

Recognition

Kleinmann’s order entry innovation won him national recognition, and he was invited by ASHP to do a speaking tour across the country. Nearly 30 years later, Kleinmann’s ongoing contributions – including early advocacy for pharmacy specialization and greater pharmacist involvement in the continuum of care – were again recognized by ASHP, this time through the prestigious Harvey A.K. Whitney Lecture Award.

“ASHP and I have been very good partners,” Kleinmann told ASHP InterSections. “In fact, if you make a list of every committee that ASHP ever had, at one time or another, I chaired it.”

Giving Back to the Refugee Community

During his time at Montefiore Medical Center, Kleinmann also had the opportunity to pay forward the generosity he received from Judge Barnet when he arrived in the United States. While working at Montefiore, Kleinmann helped refugees from the former Soviet Union who had been nurses and doctors to re-integrate into the healthcare field in the United States.

“They did not meet the licensure requirements to practice their profession in the States, but I developed a program where they received English lessons at the local college and then completed a 10-week technician training program,” said Kleinmann. “I was able to place most, if not all, of these individuals at hospitals in the metropolitan New York area, where they re-entered the health care workforce and gave hospitals and pharmacy directors the chance to augment their pharmacy program.”

As Kleinmann’s list of deeds shows, despite his direct experience with the sinister side of humanity during his childhood, he has not only transcended the effects of the Holocaust, he has become a beacon of light for those around him.

“I can honestly say that if one were in Kurt’s presence and were willing to meet him halfway, he would make them a better individual and person,” said Lew, Kleinmann’s former colleague. “Indeed, being close to him on a daily basis for many years made me a happier and more positive person.”

An ASHP news article provides additional details about Kleinmann’s family and their experiences in Nazi Germany.

By David Wild

October 29, 2020

VA Clinical Pharmacy Practice Office and Pharmacy Residency Program Office Win ASHP Board of Directors’ Award of Excellence

Anthony Morreale, Pharm.D., M.B.A., BCPS, FASHP

WHEN ANTHONY MORREALE, PHARM.D., M.B.A., BCPS, FASHP, started working for the Veterans Health Administration (VA) in 1985, only a few pharmacists had advanced practice prescriptive authority in the ambulatory care setting, and the majority of their clinical practices were in hospital-based acute care. As the VA evolved into more of an ambulatory care-based system, the role of clinical pharmacists continued to expand.

Prescriptive Privileges

Now, a decade after the VA and Dr. Morreale launched a dedicated Clinical Pharmacy Practice Office (CPPO), the health system has a highly interactive, supportive infrastructure to engage pharmacy leadership, share best practices, and promote the role of clinical pharmacy specialists (CPSs) system-wide. Over 4,500 CPSs, about half of all pharmacists in the VA. have prescriptive privileges as part of their advanced practice roles managing patients in primary care, pain management, mental health, acute care, and antimicrobial stewardship.

It’s a primary reason why the VA Pharmacy Benefits Management CPPO and Pharmacy Residency Program Office (PRPO) were among two recipients of the 2020 ASHP Board of Directors’ Award of Excellence.

“The VA CPPO and PRPO developed and implemented comprehensive strategies to expand advanced clinical practice excellence and post-graduate pharmacy residency training,” ASHP said in a formal announcement. “These innovative efforts resulted in greater patient access to care, improved patient safety, identification and treatment of substance use disorders, and enhanced care coordination.”

According to Dr. Morreale, the CPPO work started in primary care with the VA’s system-wide adoption of the team-based care medical home model, which embraced pharmacists with prescriptive privileges playing key roles in those teams.

“That just happened to be a natural marriage that really helped expand the role of clinical pharmacy specialists in ambulatory care,” he said. “Having pharmacists embedded in all of those teams really launched a number of initiatives.”

Boot Camps for Pharmacists

The pharmacists initially helped manage patients with core diseases like diabetes and hypertension, said Dr. Morreale. Then the CPPO created clinical boot camps in different geographic regions to train primary care pharmacists on additional conditions they would encounter in ambulatory care, including osteoporosis and pain management, utilizing a train-the-trainer model where they would go back and teach their colleagues. In 2015-2016, with the approval of better drugs for hepatitis C, CPPO held national boot camps to train hundreds of pharmacists, who eventually managed over 30% of all hepatitis C patients, resulting in nearly 100% of those patients having a clinical cure from the disease.

More recently, CPPO, in conjunction with the Office of Rural Health, has held boot camps focused on expanded primary care, mental health, and pain management efforts to fill an identified gap in comprehensive medication management in the veteran population. In this project, over 180 CPSs were hired across 63 VA medical facilities focused on improving veterans’ access to comprehensive medication management in rural settings.

“The physicians really appreciate the comprehensive medication management support, because many of those disease states have either complex pharmacotherapy or require a lot of hand-holding of the patients, and they may not have the time or bandwidth to do it,” Dr. Morreale said.

Additionally, CPPO holds leadership trainings for pharmacy champions, conducts site visits with VA center leadership to promote the role of clinical pharmacists, and operates a coaching and mentoring program through which new clinicians and pharmacy leaders are paired with seasoned pharmacists. It’s been a multi-pronged approach to expanding roles for CPSs that was built one step at a time, said Dr. Morreale.

“We obviously don’t do all of this work to win an award—we’re doing it to do the right thing and take care of the Veterans,” he said. “But it’s always nice, after 10 years of hard work with some major successes, to have the recognition of ASHP and national attention to the program. Maybe as a result, there will be more programs that will start to implement the same type of strategies.”

Innovation in Residency Training

Lori Golterman, Pharm.D.

The VA also was recognized for its work in post-graduate pharmacy residency training. The VA operates the largest pharmacy residency program in the country, said Lori Golterman, Pharm.D., National Director of Residency Programs and Education for the PRPO, with some 272 residency program directors, and 628 residents and fellows. About 60% of residents are recruited into full-time positions with the VA when they complete training.

“We’re extremely innovative with our programs,” Dr. Golterman said. Residents have trained in a variety of areas including mental health, rural health, pain, neurology, and oncology. “We are the leaders in psychiatric training, with approximately 77 residents trained annually, as well as pain, neurology and other specialties such as ambulatory care. We were recognized with this award for our latest expansion of pain residencies. We are training 15 residents a year, and it continues to grow as former residents are eligible to become residency program directors.”

Besides monthly calls with residency program directors and residents, PRPO supports teaching and preparing for accreditation visits, responses to surveys, preceptor development, resilience, and much more, Dr. Golterman said. “PRPO supports its trainees throughout the year, with a variety of learning opportunities. The residency year starts with a project design and statistics course, a learning program for presenting articles and evaluating literature, quarterly leadership presentations, monthly conference calls, resilience training, and periodic surveys to check on well -being,” she explained.

The Federal Resident’s Council —a group of 25 residents that include VA and Indian Health Service residents (next year it will include the Department of Defense)—provides information to residents nationally through several committees such as a professional development committee; research committee; networking committee; and an IT committee. The Council works with the Residency Advisory Board to support issues like virtual interviewing and mentoring.

Promoting Resilience

The program also dedicates a lot of time to resilience. “We were among the first to identify stress, anxiety, and depression among

Virginia Torrise, Pharm.D.

residents and report it to ASHP,” Dr. Golterman said. PRPO brought in a psychologist to help with these issues and promoted using mental health resources offered through the VA’s employee assistance program. And, with the start of the COVID-19 pandemic, the residency program quickly adopted virtual training methods for situations where residents could not be on-site.

Dr. Golterman noted that receiving the ASHP Board of Directors’ Award of Excellence is a reflection on the entire team. Her residency advisory board has a combined 240 years’ experience in pharmacy. “They are the heartbeat of the program, and they spend a lot of their own time to support the residency program directors and preceptors and strive toward excellence,” she said.

Virginia Torrise, Pharm.D., deputy chief consultant of Pharmacy Benefits Management professional practice for the VA, added, “Drs. Morreale and Golterman have ensured that the VA has highly qualified, advanced pharmacist-practitioners serving our veteran patients on interdisciplinary teams to meet VA priority needs in primary care, mental health, and pain specialty.  Their work has ensured VA expanded clinical pharmacy telemedicine services to our Veterans who reside in rural health settings and addressed difficulties commuting to a VA clinic. I couldn’t be prouder of their leadership, foresight, and dedication to advancing residency training and clinical pharmacy practice in the VA.”

By Karen Blum

 

# # #

 

 

April 30, 2020

ASHP Continues to Support Members and the Healthcare Community Through the COVID-19 Pandemic

Dear Colleagues,

Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP

THE COVID-19 PANDEMIC is changing our country’s healthcare landscape every day. Critical health policy changes are occurring at an unprecedented rate. We continue to engage with state and federal policymakers to ensure that pharmacists’ expertise is fully utilized and that healthcare providers are equipped to safely and effectively respond to the pandemic.

Update on States’ Response Efforts

State governors are issuing executive orders that expand pharmacists’ ability to provide high-quality care to patients during this crisis. For example, Michigan now permits pharmacists within licensed health facilities to contribute to routine health maintenance and manage chronic disease states without physician supervision. This expansion alleviates burdens on primary care providers and expands access to care, especially in rural and underserved communities where pharmacists are the most accessible healthcare professionals.

We are also seeing a positive trend in pharmacists’ ability to manage therapeutic interchange. In Iowa and Kentucky, executive orders grant pharmacists the authority to substitute medications in response to drug shortages.

Point-of-care testing for COVID-19 is critical to the national pandemic response. Some states already permitted pharmacists, under their scope of practice or through collaborative practice agreements, to order and administer these tests. Pennsylvania, which previously allowed pharmacists to order and administer tests, has taken emergency measures to grant pharmacists explicit authority to order and administer COVID-19 tests. States like Florida, Illinois, Kentucky, and, most recently New York, issued executive orders that permit pharmacists to order and administer COVID-19 tests. State-level COVID-19 response is a rapidly changing situation as local healthcare providers respond to patient surges and the demand for testing. Please check with your state’s board of pharmacy for more information about the status of COVID-19 testing in your area. Helpful information on COVID-19 testing can also be found on the National Community Pharmacists Association’s website.

ASHP applauds state governors’ efforts to expand pharmacists’ scope of practice during this state of emergency. However, we are concerned that authorizing the expansion of pharmacists’ services without authorizing payment for those services will limit the delivery of care in some pharmacy practice settings. COVID-19 is already highlighting shortcomings in state Medicaid payment systems and commercial payer policies that prevent qualified pharmacists from fully serving patients. ASHP is working closely with our state affiliates and other organizations to request reimbursement for the new services they are providing under the state of emergency. This advocacy aligns with ASHP’s Pharmacy Readiness for Coronavirus Disease 2019 (COVID-19) Recommendations for State Policymakers. The recommendations address shortages of drugs and medical supplies and reimbursement of pharmacists for patient care services and also provide readiness and resilience resources for clinicians.

Pharmacists are Essential Healthcare Personnel

ASHP continues to voice our support for all pharmacists who are working tirelessly across the continuum of care in response to the COVID-19 pandemic. Yesterday, I sent a letter to the chief executive officer of Novo Nordisk responding to a full-page NovoCare ad that ran last weekend in the Wall Street Journal and other publications. Pharmacists were omitted from a list of individuals, including nurses, doctors, researchers, and other essential workers who were acknowledged for their caring efforts on the front lines of the COVID-19 response.

In the letter, I reinforced that pharmacists are highly skilled, licensed healthcare professionals who play a key role in selecting and optimizing medication therapy for patients. Pharmacists also oversee the entire medication-use process in hospitals and health systems, including the purchasing, distribution, preparation, and administration of pharmaceuticals. I further explained that, as members of interprofessional healthcare teams, pharmacists are providing a broad range of patient care services during the COVID-19 public health emergency, from directly caring for mechanically ventilated patients in critical care settings, to providing point-of-care testing and medication management to patients in community pharmacy settings and beyond.

It is my hope that Novo Nordisk will appropriately recognize pharmacists and the important role they play in future communications.

ASHP’s Response to Disruptions in Residency Training

In last week’s blog, I discussed the COVID-19 pandemic’s impact on residency training. As a result of disruptions in routine or elective procedures and reductions in inpatient hospital stays, some hospitals and health systems are facing the difficult situation of furloughing their PGY1 and PGY2 pharmacy residents. These actions can disrupt patient care and make residents ineligible for board certification and professional positions that require postgraduate pharmacy residency training. We believe that educating future generations of pharmacists is more critical than ever, and ASHP has issued a statement opposing the furlough of residents.

As always, ASHP is here to support residents and residency programs. If you need assistance with a furlough situation, please reach out to Janet Silvester, vice president of Accreditation Services, or Stephen Ford, director of Residency Accreditation Services.

ASHP is Here for You and the Entire Healthcare Community

Over the past several weeks, I have been sharing information about new and timely resources that ASHP has developed and made available to optimize medication use and patient outcomes during this public health emergency. The response to these offerings, which is captured in a new ASHP infographic, has been tremendous. We are immensely proud of our staff and volunteers who have been working tirelessly to deliver highly relevant information across multiple channels. Our COVID-19 Resource Center is updated regularly with new content and I hope you continue to find the tools and information produced by ASHP valuable as needs related to the pandemic response evolve.

Thank you for being a member of ASHP and for everything that you do for your patients and our profession.

Sincerely,

Paul

 

April 9, 2020

Important Wins on the Advocacy Front in the Fight Against COVID-19

Dear Colleagues,

Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP

AS THE IMPACT OF THE COVID-19 PANDEMIC CONTINUES TO ESCALATE ACROSS THE COUNTRY, there is increased urgency to ensure that frontline pharmacists, pharmacy technicians, and our healthcare partners have the medications and equipment they need to successfully treat their patients. ASHP continues to spearhead multiple advocacy efforts that support your ability to provide the best care possible for those in need.

Mitigating shortages of critical medications like propofol, fentanyl, midazolam, paralytics, and others remains a high priority. We continue to engage with relevant federal agencies to improve access to medications. I am pleased to report that the Drug Enforcement Administration (DEA) and the Food and Drug Administration (FDA) have taken critical actions in direct response to ASHP’s advocacy efforts.

ASHP, in coordination with the American Medical Association, the American Hospital Association, the Association for Clinical Oncology, and the American Society of Anesthesiologists, sent a letter last week to the DEA requesting an immediate increase in the annual production quota allocations for Schedule II controlled substances. This would enable manufacturers and 503B outsourcing facilities to increase the supply of opioids critical to the care of COVID-19 patients on ventilators. As a direct result of this collaborative advocacy effort, the DEA announced yesterday that it is taking immediate actions to address this critical issue. These actions include increasing the annual production quota for controlled substances, including fentanyl, morphine, and hydromorphone, that are used for the treatment of mechanically ventilated COVID-19 patients, and increasing the amount of ketamine, diazepam, and other controlled substances that can be imported into the United States.

We also sent a letter to the FDA advocating for regulatory flexibility in compounding drugs in shortage and compounding in hospitals. ASHP’s advocacy efforts, including significant staff engagement on the issue, directly triggered the FDA to clarify existing compounding guidance, including the removal of the one-mile radius requirement for hospitals compounding medications. FDA’s quick action to reduce regulatory hurdles for health systems is an important step to help clarify compounding guidance during this crisis.

ASHP will continue to advocate for additional compounding flexibility, including the expansion of FDA’s drug shortage list to include products ASHP has identified as in shortage. We will also continue to seek 503B outsourcing facility flexibility, particularly for hospital-owned or affiliated 503B operations, to help ensure they can meet hospitals’ medication needs.

Yesterday, we were pleased to see that the Department of Health and Human Services (HHS) authorized pharmacists to order and administer COVID-19 tests pursuant to the Public Readiness and Emergency Preparedness (PREP) Act. The authorization is responsive to the joint COVID-19 recommendations we created with other national organizations. While this authorization does not address pharmacist reimbursement, we are encouraged to see HHS providing pharmacists with a greater role in supporting the COVID-19 response, and we continue to work on that issue.

We also continue to actively advocate for Congress to recognize pharmacists as providers in the Medicare program to further support the COVID-19 response and beyond. Yesterday, ASHP and 11 other national organizations sent a letter requesting that Congress immediately support legislation that would establish pharmacists as providers in Medicare Part B on an emergency basis to provide COVID-19 and flu testing. This authority is an important step in being able to rapidly expand access to testing across our country to support the national response to this crisis. We also see this as a step toward expanded recognition of pharmacists by payers, including Medicare.

Finally, ASHP is also working with our members and other stakeholders to gain access to medications from the Strategic National Stockpile (SNS). Most recently, we joined with several organizations to request that FEMA immediately release all available quantities of a number of critical drugs from the SNS to the New York and New Jersey Departments of Health to address urgent patient care needs. We are also working to support other state affiliates and members across the country with these important requests.

ASHP and its government relations team will continue to work tirelessly with our collaborating partners to ensure that U.S. regulatory authorities are responding to the current needs of pharmacists and healthcare providers.

While our collective attention is on the needs of frontline practitioners, I wanted to take an opportunity to highlight some positive news about the newest members of our profession. ASHP’s 2020 Residency Match concluded this week, and I want to congratulate the 5,269 future pharmacists who matched with 2,551 PGY1 and PGY2 pharmacy residency programs across the country. This number represents a 46% increase in the number of available positions over the past five years – a remarkable rate of growth. I am pleased that our accredited residency programs have demonstrated an outstanding commitment to training during the pandemic. While managing multiple critical priorities, these programs continued to interview applicants virtually. This undoubtedly will be a unique time during which to begin a residency program regardless of its focus. ASHP is committed to ensuring that these young practitioners and their programs have the needed resources to successfully conduct critically important resident training this year and beyond.

In the same vein, please know that ASHP stands ready to offer you and your healthcare colleagues that same level of steadfast support. In addition to advocating to give you access to critical medications, ASHP continues to update and create new resources and tools that can be found on our COVID-19 Resource Center. We have also opened access to many evidence-based online resources and tools on ashp.org, making them widely available to all pharmacists and the broader healthcare community.

Over the last few weeks, I have heard countless stories from members and others about the challenges they are facing, but I’ve also heard many stories of hope and heroism. I, and David Chen, ASHP assistant vice president for Pharmacy Leadership and Planning, have listened in on calls from pharmacy leaders at major health systems in New York City, the pandemic’s current epicenter. We are incredibly impressed by how these leaders have shared their information and experiences and how they support each other and their frontline staff. This is a tremendous example of how peer-to-peer connection and communication can aid in the pandemic response. Their experiences and willingness to share their stories will undoubtedly help others in responding to COVID-19 in facilities across the country. We applaud them for these efforts.

Please also know that ASHP is here to support your well-being, which should remain a priority for all healthcare personnel during this challenging time. Please make sure that you are taking care of yourself and your family.

“ASHP has our backs.” These are the words of a member who recently reached out to us. This really resonated with me, and I can assure you that we will continue to work across all fronts, leveraging our talented staff, our valued partners, and our amazing members to provide you with the information, connections, and resources you need today and in the future.

Thank you for everything you do for your patients and the profession.

Sincerely,

Paul

February 18, 2020

Active Pharmacists Use Exercise to Boost Health and Well-Being

Abhay Patel, Pharm.D., M.S., R.Ph.

AFTER FOUR MONTHS OF TRAINING for a half marathon, Abhay Patel, Pharm.D., M.S., R.Ph., Pharmacy Manager for Ambulatory Services at Children’s Hospital of Philadelphia, was amazed by not only improvements in his endurance and strength, but also by how his attitude about his work had changed. “Things that used to be a source of stress did not seem as stressful anymore,” he said.

Benefits of Exercise

As Dr. Patel and other pharmacists are finding out, staying fit can yield a multitude of rewards, from bolstering mental resilience to reducing symptoms of depression and anxiety. Staying fit through regular exercise is also one way individuals can address the problem of burnout, which over 50% of pharmacists in acute and ambulatory care settings experience.

The benefits of a fitness regimen became clear to Dr. Patel after he finished a short jog in the park near his home in the summer of 2015, during his PGY-2 residency. “At the end of that day, I looked back and realized I had accomplished even more than I normally did on a day without any deliberate physical activity,” recalled Dr. Patel, an ASHP member since 2011.

Fitness Journey

That realization left him wanting to exercise more. After completing residency and starting his job, he began to integrate short bike rides after work, weightlifting at his local fitness center, and taking advantage of his workplace’s wellness services. “I started by squeezing whatever I could into my day, and that laid the groundwork for establishing a more targeted, consistent routine,” he said.

As it turned out, squeezing in those bits of exercise yielded additional benefits. “My demeanor began to change positively, I had more energy, I was more focused on the tasks I was doing, and I felt better about myself and about the care I was providing, as well as my role as a team leader,” said Dr. Patel.

Exercising is not a panacea, he admitted, and his days include “all of the same highs and lows that I had before,” but his ability to manage these fluctuations has improved. There have been important changes in his perspective on work and life, Dr. Patel added. “It’s clearer to me that professionally and personally, it is not just about the pursuit of the finish line, but about pursuing progress instead,” he said. “It truly is a marathon, not a sprint, and about appreciating the journey.”

Yoga Unites Mind and Body

Jogs and gym visits are two ways to stay fit, but exercise can take other forms, as Christina Martin, Pharm.D., M.S., CAE, ASHP’s Director, New Practitioners Forum, has shown.

Christina Martin, Pharm.D., M.S., CAE

Dr. Martin started practicing yoga roughly seven years ago, an interest she developed when she began her first post-residency pharmacy supervisor position and fell into the trap of working too much. “Things went out of balance,” she said. “Yoga was something that I could commit to beyond work.” Over the years, Dr. Martin has learned to enjoy not only the physical aspects of yoga but also its inward, meditative focus.

“The Sanskrit word for yoga is ‘yuj,’ which means to control or to unite, and that is what my yoga practice has transformed into – controlling the noise from the outside world and uniting my mind, body, and soul,” said Dr. Martin. “One of my teachers regularly reminds us that coming to the yoga mat is an escape to our own private island.”

Yoga has also added another layer of meaning to her life, she said, as she recently completed a hot yoga teacher training program so that she can share her passion for the practice with others. The 200-hour training program included learning about human anatomy, how to address common ailments that yoga practitioners face, as well as studies in yogic breathing, nutrition, and chakra theory. A chakra is a center of spiritual power in Hindu thought.

“Being part of any community – including the yoga community – can be an antidote to the pervasive isolation and loneliness that we see in today’s society,” Dr. Martin said.

CrossFit Champ

A strong sense of community built around the goals of fitness is one reason Robert Weber, Pharm.D., M.S., FASHP, Chief Pharmacy Officer at the Ohio State University Wexner Medical Center in Columbus, Ohio, has fallen in love with CrossFit, a high-intensity form of exercise.

Robert Weber, Pharm.D., M.S., FASHP

As Dr. Weber recalls, his journey toward developing a rigorous CrossFit regimen began after years of struggling with weight gain as well as complications from a colon cancer diagnosis in 2008 and chemotherapy and surgery that eradicated his cancer, but left him with neuropathic pain in his hands and feet.

“I was told that I should not and could not [do any vigorous exercise] because of the neuropathy and that walking with some light yoga was sufficient,” said Dr. Weber, an ASHP Fellow and member since 1980. He assumed his physicians were right, because at the time, “I wasn’t able to balance myself, jump, and do all the things that are part of exercising.”

With the neuropathic pain limiting his ability to exercise, Dr. Weber tried to stay healthy through a proper diet, but eight years of a sedentary lifestyle left him overweight, and in need of cardiovascular medications, he said.

“The turning point for me came when my brother died of cancer in 2017,” Dr. Weber recalled. “I was standing over his grave, and I said to myself, ‘I need to make a change and start exercising again and move the dial in terms of my overall health and wellness.’”

His daughter urged Dr. Weber, who is now 63, to take CrossFit classes. While the exercise leaves him feeling “tired and winded, once I’m done, I feel like a million bucks,” he said. Dr. Weber noted that he overcame the neuropathic pain in his feet by increasing the frequency and intensity of the exercises in “baby steps, and not pushing too hard at first.”

Today, as a result of regular exercise and proper nutrition, Dr. Weber is 42 pounds lighter and has been able to discontinue most of his cardiovascular and neuropathic pain drugs. “I’m now more stable on my feet, more confident, and I make better decisions at work,” he added.

For those in his age group interested in starting an exercise regimen, Dr. Weber cautioned first to get a physician’s approval and also to start at a low intensity. He noted that a personal trainer or coach has the expertise to design a safe exercise program customized to your needs. This is important because performing too many repetitions too early can cause cardiac stress, he said, and lifting too much weight initially can lead to several days of discomfort and possibly serious injury.

“Particularly at my age, it can be frustrating if you start an exercise program and get stiff and sore for a few days,” said Dr. Weber. “I’ve seen many people my age quit after a brief time because they can’t tolerate the soreness that follows exercising.”

With those caveats in mind, Dr. Weber believes that almost anyone of any age can build an exercise regimen that works for them and reap the benefits. “You can do anything you set your mind to do,” he said.

 

By David Wild

 

# # #

Older Posts »

Powered by WordPress