Transcription of Maine’s Pharmacy Experts #164
Speaker 1: You’re listening to Love Maine Radio with Dr. Lisa Belisle, recorded in the studio of Maine Magazine at 75 Market Street, Portland, Maine. Dr. Lisa Belisle is a physician trained in family and preventative medicine, acupuncture and public health. She offers medical care and acupuncture at Brunswick Family Medicine. Read more about her integrative approach to wellness in Maine Magazine. Love Maine Radio is available for download free on iTunes. See the Love Maine Radio Facebook page or www.lovemaineradio.com for details. Now, here are a few highlights from this week’s program.
Catherine: What drives our economy on a national basis is entrepreneurism, and there is no question that here in Maine it’s an even greater extent, right? You have to be creative and entrepreneurial for the most part here in our state. That’s really what drives our economy here.
Greg: We couldn’t be happier to see business cooperate and collaborate, and be seamless between their business practices and the educational opportunities. We continue to strive to do that.
Dr. Jim: We are considered the drug information expert. Our patients really should count on us for that information. It’s something we rely on heavily in pharmacy education is a lot of time and communication and how they can communicate directly with their patients, and in a simple language that the patient feels comfortable with so they can retain that information and hopefully improve the outcome.
Dr. Kayla: I started looking for other opportunities for me to still use my science background, but actually meet patients and make a difference. I looked into a pharmacy school and I just knew that pharmacy was going to make a lot of sense for me professionally and personally. Once I finally started studying pharmacy, I realized that it was exactly where I needed to be.
Speaker 1: Love Maine Radio is made possible with the support of the following generous sponsors: Maine Magazine, Marci Booth of Booth Maine, Apothecary By Design, Michael Page and Beth Franklin of RE/MAX Heritage, Tom Shepard of Shepard Financial, Harding Lee Smith of The Rooms, and Bangor Savings Bank.
Dr. Lisa: This is Dr. Lisa Belisle and you are listening to Love Maine Radio, show number 164: Maine’s Pharmacy Experts. Airing for the first time on Sunday, November 2nd, 2014, pharmacists do much more than dispense medication. As pharmacy science experts, educators, and community liaisons, they are important members of the healthcare team.
Today, we speak with guests who have a special interest in the education of Maine’s pharmacy experts. Catherine Cloudman, principal at Apothecary By Design, Portland’s economic development director, Greg Mitchell, Dr. Jim Krebs, Assistant Dean of Experiential Education at the University of New England, and newly minted pharmacist, Dr. Kayla Stewart of Apothecary By Design. We know that you will enjoy getting to know these members of the healthcare team. Thank you for joining us.
Here on Love Maine Radio, we think a lot about the wellness of our communities, not simply from an individual standpoint but really from a collaborative standpoint. These individuals that I have with me today have been thinking about this quite a lot themselves. We have Catherine Cloudman who is one of the founding partners of Apothecary By Design and also Greg Mitchell, Portland City Economic Development Director. Well, if you have some thoughts on what’s making Portland a healthier place to live? I’m glad you’ve come in to talk to us today. Thank you.
Greg: Thanks for having us.
Dr. Lisa: We’re going to talk more about the University of New England and the Pharmacy School, which is really a big interest of Apothecary By Design. First, I wanted to talk to you about why it is that we need to have new businesses coming into Portland and doing things that are slightly different and taking risks? Because this isn’t something that we always think about as we’re going through economic challenges.
Catherine: We closed on our financing for our business the day before the stock market crashed in October of 2008. It was a very scary time to be starting a brand new business, but myself and my 4 business partners, we were well on our way and we opened our doors almost 6 years ago and it has been a very interesting ride. We wouldn’t be sitting here today without the help of a bunch of other community partners. The City of Portland and Greg, in particular, have been very supportive of our business as have FAME and Bangor Savings Bank. We have a terrific working relationship with the University of New England and their Pharmacy School. A lot of those things have come together on such a way that have allowed us to grow the business and find great people, and fund our business and fund our growth. We’ve grown to having 70 employees and 80 million in revenue this year.
Dr. Lisa: This must be music to your ears, Greg. You must really enjoy hearing about businesses that took a chance and started something new on the deepest part of the recession, and then have found success. Actually, I want to say you were recently recognized INC 5000. You’re one of the top growing business, I believe, across the United States?
Catherine: That’s correct.
Greg: One of the most gratifying aspects of my job is watching businesses grow and prosper. In the case of Apothecary By Design, the city really works hard to basically create the environment to support growth. Well, the company partners were risk takers on their business. I want to point out they are risk takers in where they decided to invest. They’re located down in Bayside which is the new front door to downtown Portland. This is an area that the city concentrated on extensively with an area wide plan to support the retransformation of an industrial area that has scrap yards, warehouses to repopulate and repurpose it for businesses like Apothecary.
They were risk takers into where they invested. They’re one of the first. I call them a pioneer in terms of supporting redevelopment effort in Bayside. You can see the results of that today with Trader Joe’s and Whole Foods, more housing, more commercial investment. It’s enormously gratifying to set the stage for investment to makes sure that the city is doing what it can in a supportive role, everything from road to utilities. Also in the case of Apothecary, we ended up with direct financing relationship to help support one of their phases of growth. They’ve grown beyond their initial location to a second location.
Having those kind of anchors in our community, they’re creating significant high wage job employment and taking advantage of the programs that are offered, for example, at UNE creates the full circle for making an economy work well.
Dr. Lisa: As we think about health and wellness, we think about the ability to find places to run or find places to walk, or have clean air or have clean water and some very basic health fundamentals. What we also need to think about are have places for people to work. You need to have places where people can get health insurance, and there are so many different layers of need when it comes to wellness.
I guess I think I just read a statistic about unemployment and how it really impacts families. I believe the statistic was something like families who deal with unemployment are more likely to go through emotional turmoil like divorce. On the opposite side of that, having jobs available like the 70 jobs at Apothecary By Design or the pharmacy jobs through UNE, that’s a really important thing.
Greg: Absolutely. I couldn’t agree more. We’ve got to have a pathway for employment kind of an economic ladder starting at entry level positions and working your way up to support growth. We’re striving for that in terms of supporting growth in our economy with a very diversified base and creating that environment. Again, when you talk about health and wellness, we’re proud of the fact that in the area in Bayside, the city planned design and invested in the Bayside Trail to interconnect hardscape trail system through Bayside, all the way round the peninsula to Back Cove.
We’re taking advantage of our water views, the picturesque views but also people mobility. We’re a very walkable community. We’re trying to be full service not just in the type of businesses that we attract and the type of employment, but also to create the right environment to move people from housing to work or just take a break during the day.
Catherine: I’ll just speak to that little bit at Apothecary By Design level. Some of what you’re speaking to Lisa is stability and creating stability for people, despite whatever their ground might be. I think one of the things that we feel really proud about is having created jobs across a real economic spectrum. Whether it’s a cashier or someone in shipping and fulfillment, or a nurse care coordinator or a clinician, one of our pharmacists, it’s a really wide spectrum. We are also really dedicated and committed to providing a full spectrum of benefits for these folks as well, so that there is some stability and safety to them coming to work each day.
Whether it is a flexible work day or health insurance that we pay a very high percentage of, or our 401K plan where we have a mandatory contribution that we make to people who are qualified to participate in our 401K plan. We’re really focused on trying to do a lot of those things that provide them the stability because if they’re feeling stable, they’re going to be more productive at work. That’s part of what makes us more successful in what we’re trying to do for our patients.
Dr. Lisa: Wellness is very important to Apothecary By Design. I know that a lot of the work that you do focuses around specific areas like, for example, hepatitis and fertility and other issues that are more disease specific or more problem specific. At Apothecary By Design, you actually are focusing on also keeping people … Getting people before they get to a place of disease. You have supplements. You have educational sessions, and you really have people who understand … You have a naturopathic doctor who works with you. You have people who understand what is necessary to keep people on an even keel.
Catherine: That’s true, and I think that is very much our focus and we’re very much an integrated pharmacy across all aspects of pharmacy. The nutritional health and well-being is a very big component of that. Part of what we’re trying to do is look at how to help people manage side effects of medications that they might be on, and to the extent that we can support them in such a way that keeps them healthy and keeps them from getting more sick than they might be. Then that’s good for everybody in the healthcare system.
Dr. Lisa: Greg, it must be interesting for you. You were born and raised in Maine. You went to Cheverus. Not too far way to Vermont to get your undergraduate degree. It must be interesting for you to come back and see what has happened. You spent some time in [inaudible 00:12:14], and you’ve been all around the state working with municipalities and also as a private consultant. Portland has changed a lot.
Greg: The landscape has changed dramatically over the last 30 years. I remember growing up here in the late ‘70s and the Old Port was not what it is today. I remember my parents telling me, “That area is off limits. That’s not an area that you should be going.” What a dramatic change to see that kind of hop of activity, that vitality, which is serving as a magnet and really is selling Portland’s lifestyle.
Nationally and internationally, we continue to make a number of short lists in terms of safe place for people to raise their kids. A very hip place, a foodie place, of course. It has to do with just the feel and the buzz of what’s going on in the community. Very metropolitan experience at a very small scale, and it’s very intimate that way with the Old … It’s 6 degrees of separation, I say, in Maine and Portland’s 2 degrees of separation in terms of people’s connections and overlap.
It’s an easy story to tell and it’s one that we’re working very hard on, not just from a visitor experience in arts and entertainment but also from a business experience. Hence, the reason we’re here today. We’re a good place to start a business. We’re a good place to grow a business and Apothecary is evidence that you can not just survive, but you can really thrive in Maine and attract the talent that you need to support a workforce of 70 jobs in a relatively short period of time. It’s phenomenal for me to be a part of the experience and to have a hand in trying to shape and direct the economy. It would all be for not without business investment, I’ll say that.
Catherine: Well, piggybacking on that, one of the things that is really important … I know this is an initiative of the city and it’s something that we’re certainly benefiting. That is the hip vibe that Portland has makes it a lot easier to attract and retain qualified, young professionals to the community. It’s a reinforcing kind of thing. Here we have this fabulous partnership with the University of New England and we provide a great experiential education for the students that are within our … That come and visit our pharmacy. We probably have 6 plus students in our pharmacy at any given time.
It’s a great opportunity for us to get to know them and them to get to know us. If they were all graduating from Pharmacy School and then moving out of the city of Portland because there’s no jobs to be found here or they don’t love the community, then we’d be in a very different place but that’s not the case. The students that come here and attend University of New England or Husson¸ or many of the other schools in the area fall in love with Portland and fall in love with Maine. They want to try and figure out how to be creative and how to stay, and for all the reasons that Greg talked about. That’s a pretty fun thing to be able to segue way them out of their graduate degree program into a position enabling them to live in a city that is really a fun place to be right now.
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Dr. Lisa: What’s interesting to me also is that what you are doing and offering an educational alliance with the University of New England is something that required you to be able to have some vision when you first started creating these plans. We know that we needed more pharmacies, more pharmacists. We know that we have an aging population. The type of education that you’re offering at Apothecary By Design, I think, is unique for these students.
Catherine: Oh, I think it’s very unique. For one thing, you don’t find a lot of pharmacies out there that have the breadths and depths, the services that we provide. They’re seeing both alternative therapies and our nutritional health and well-being area. They’re seeing compounding both non-sterile and sterile compounding. They’re seeing the more traditional retail pharmacy environment, and they’re also seems specialty pharmacy, which is a up and coming fast growing area of pharmacy where they’re really getting ingrained and in a specific disease state, and learning about it in an in-depth way from a clinical perspective.
Seeing that range of services is a unique experience for them. We don’t just have them in our store or in our specialty pharmacy doing mundane tasks. We have them doing research and presenting to our clinical team on a particular topic. That’s really educational for our team and it’s a great experience for them to stand up and present in front of a group of clinical people who are going to ask them difficult questions but probing questions. It’s a great experience for them and it’s a great experience for us as well.
Dr. Lisa: It must also be helpful for them to be able to have this. I guess this front row seat in a new business because I’m thinking Greg of your situation on economics and medicine for quite a long time were not necessary talking to one another. Now, we can’t help but talk to one another so to have students who are going through and to remind them that, yes, this is a business like all businesses for us all to be able to develop our brains in such a way so that we are cognizant of that.
Greg: Absolutely, Catherine talked about capturing that student population. It’s graduating and that’s the target audience of ours. We find that once people experience Portland in Maine, they fall in love with it and the next step is we’ve got to find them an employment opportunity. Professional employment opportunity is challenging, that they feel is the right next step from school so they can support themselves and their family. We couldn’t be happier to see business cooperate and collaborate, and be seamless between their business practices and the educational opportunities. We continue to strive to do that from the city perspective in terms of making those connections but actually have relationships that are working to give those students a different experience, a business experience, a hands-on experience that they can now capitalize on that.
Our whole visit, they stay in May. We continue to see employment growth in this sector to employ them. Even if they leave the state, they have skills that are very marketable that will make them much more attractive in the workplace. It’s the way of the future. I think all schools are recognizing that to be successful there has to be a pathway to employment beyond the degree. Those business relationships are critical and so important from my perspective.
We’re continuing to try to find ways to create matches. It happens organically and naturally. If there’s ways that we can collaborate and support our educational institutions providing a trained workforce to businesses and then offering those kinds of high quality experiences that Catherine is describing are invaluable to really keep that person committed to Portland for the longer time. It’s helping drive down our average age in Portland which is below and it’s driving up our educational attainment.
Our Portland residents 25 years and older 45%of our resident population, 25 years and older, has a bachelor’s degree or high level of education. That is a phenomenal statistic that compares well across this country with major metropolitan areas, including Boston. We have some phenomenal assets to capitalize on if we can just support an economy to grow business, grow jobs and capture that youth, attract that youth here at Portland.
Catherine: What’s really valuable in terms of that experiential education is that they do see all aspects of the business. They’re not isolated to just some of the clinical activities. They really do understand what are the economics of dispensing a particular medication all the way through to counseling the patient and all aspects of how that works. What drives our economy on a national basis is entrepreneurism. There is no question that here in Maine it’s an even greater extent, right? You have to be creative and entrepreneurial for the most part here in our state. That’s really what drives our economy here.
To the extent, these students can come out of their graduate degree program, not just with the clinical expertise but with the business skills to be able to thrive in an entrepreneurial community. That’s a real benefit to us as business owners but also to themselves, particularly in healthcare. We have seen the importance of developing the business skill side of the equation as we move through all of the changes that are happening in healthcare.
Greg: I totally agree with those comments. From my perspective, this company was a startup in 2009 and here we are today with a company with 70 jobs and 80 million in revenue. From the inside looking at that kind of growth and expansion for the youth to see that to see how that’s managed, in addition to the services that are provided, is a phenomenal education. It doesn’t get any better than that.
I’ve seen that with my boys and some of their employment. I have encouraged them to take those kind of risks with startup companies. Nothing against older and more established and mature companies but companies with startups, you stand against so much more insight, so much more knowledge by watching the growth, the identification of market opportunities and their ability to capture that opportunity and be successful.
Six years is a very short period of time for any company’s evolution to achieve the level of success of this company Apothecary has achieved. I’ve been doing this for 30 years and I’ve seen business evolution from start to finish. Again, that educational interface with the workforce and the training but to reinforce Catherine’s comments on entrepreneurship training, it doesn’t get any better than living it.
Dr. Lisa: I’m also struck by the necessity of communication skills and the ability to communicate across a broad spectrum. If you are a pharmacy student, you need to be able to talk with other pharmacists. You need to be able to talk with physicians and healthcare providers. You need to be able to talk with patients. This is really no different than any other successful business where if you’re a business person, you need to be able to talk sales. You need to be able to talk numbers. I think that we’re heading away from that siloed approach to education which is very specialty driven, and we really are starting to understand that communication is key.
Catherine: I think that’s true and I know you’re going to be speaking with one of our new hires. She was a pharmacist and she does a wonderful job presenting, and has given a number of presentations to our clinical staff. I think you’ll enjoy your time with her. That’s been one of the things. In fact, we had her present when we had the year accreditation committee come in for our on-site visit. That was an example of a newly graduated student. In fact, I don’t even think she had graduated by the time [inaudible 00:27:14] actually came in to visit.
She had to be able to have the wherewithal and the comfort to stand up in front of these on-site accreditors and speak to some of our quality initiatives that we were working on. Our clinical staff needs to have the ability to go out and be on a sales call with practitioners and talk to them about the range of services that we provide. Also, that’s the business angle of that visit, but also they need the credibility around the particular clinical topic that they’re speaking to so that they have the respect of the persons across the table.
It’s exactly what you’re speaking to, Lisa. They really need both, one hand on the clinical dashboard and the other hand on the business dashboard, so that they can relaly bring those 2 things together in a way that makes them credible and confident in a variety of different settings.
Dr. Lisa: Well, I’m very excited about the work that you’re both doing. I think also having grown up in Maine and seeing all of the shits and transitions … and I believe that when we moved here in ‘77, marginal way and where Apothecary is in the Bayside area just looked incredibly different. It’s so gratifying all of the shifting. I know Maine magazine and Old Port magazine were excited to see what’s coming up. We get to speak to a lot of people who are doing interesting things and to know that this is the same types of interesting things that are going on in healthcare. It’s really wonderful. It’s really a great thing.
Well, we’ve been speaking with Greg Mitchell and Catherine Cloudman. Greg is Portland City economic development director and Catherine Cloudman is one of the founding partners of Apothecary By Design, and encourage people to learn more about what Apothecary By Design is doing in this area and also to learn more about the city of Portland. Greg, is there a website or a way that people might learn more about what’s happening economically in the city?
Greg: Absolutely. We’ve got a couple of websites we can refer people to, city of Portland, Maine. The other website that’s worth the visit is called liveworkportland.org. That is an arm of the city, a nonprofit that we’ve established that’s focusing on marketing and bringing us outside of Maine and internationally. The emphasis of those programs are people recruitment, people attraction, entrepreneurship and support. Both of those websites people can contact me directly at city hall, and we’d love to interface with folks. We want to learn more about what’s going on in Portland.
Dr. Lisa: Catherine, Apothecary By Design. How can people learn more?
Catherine: Apothecarybydesign.com is a great place to visit and also follow our Facebook page. We have ongoing posts happening regularly about wellness activities that we’re working on, events that people are presenting at and just updates on what’s happening with our business.
Dr. Lisa: Well, thank you very much Catherine Cloudman and Greg Mitchell. We appreciate your doing all the wonderful work you’re doing for the city of Portland and beyond and keep it up.
Catherine: Thank you.
Greg: Thank you.
Dr. Lisa: As a physician and a small business owner I rely on my Marci Booth from Booth Maine to help me with my own business and to help me live my own life fully. Here are a few thoughts from Marci.
Marci: When was the last time you took a break from what you were doing, from the work that was piled up on your desk and just looked up? I know that during the course of my days I often forget to take a moment or 2 to just breathe, look up at the sky and dream. Terrible that I have to remind myself to breathe but when I do I feel energized because in those moments I’m able to let go of the daily grind and think more about what I want to accomplish, how I want my business to grow.
Sometimes those are the aha moments. If we all took a few moments out each day to stop what we’re doing and dream a little about our business futures not only would we feel a great sense of calm but we may come to realize that these dreams can in fact come true.
I’m Marci Booth. Let’s talk about the changes you need, boothmaine.com.
Speaker 1: This segment of Love Maine Radio is brought to you by the following generous sponsors: Mike LePage and Beth Franklin of RE/MAX Heritage in Yarmouth, Maine. Honesty and integrity can take you home. With RE/MAX Heritage it’s your move. Learn more at ourheritage.com.
Dr. Lisa: As a family physician for many years I have had the good fortune to interact with pharmacists in lots of different ways in the hospital setting and also in the community. Today, I’m going to interact with 2 pharmacists who are far more than just your average pharmacist I believe. You’ll understand as you get to hear more about them. We have Dr. Jim Krebs and is it Dr. Akayla Stewart at this point? Dr. Kayla Stewart.
Kayla: You can say it again if you want. It sounds really nice.
Dr. Lisa: I’m sure. Dr. Kayla Stewart. Dr. Jim Krebs is UNE’s Assistant Dean for Experiential Education and Dr. Kayla Stewart is a University of New England graduate and now an Apothecary By Design pharmacist. Thanks so much for coming in and taking time out of your busy schedule and talking to us about this really interesting collaboration that the University of New England has with Apothecary By Design and also about pharmacy education in Maine.
Dr. Jim: Right, thank you Dr. Lisa.
Dr. Kayla: Thank you.
Dr. Lisa: Pharmacy has really come a long way, I think, probably since you, Jim, were studying this at the University of Rhode Island.
Dr. Jim: Absolutely. Traditionally we were in a dispensing role which is what most people are familiar with, the community pharmacy. They see us behind the counter in a white coat. Really now we are direct care providers. Having a provider status we can meet with our patients one on one 15, 20 minutes, an hour and chat specifically about their disease and drug therapy but the goal being to really reduce hospital admission, decrease health care cost and just have better outcomes for our patients.
I think a lot of people will be surprised to see that they can find … To go to their pharmacist to get immunizations and have changes in the drug therapy in collaboration with the physician or PA or nurse practitioner now so that has greatly changed.
Dr. Lisa: I can attest to that. As I was saying, when I first started in medicine the way that I understood my relationship with pharmacy was much different than I understand it now. As I’m seeing a patient now if I have somebody that I know is going to need more counseling on a medication, I actually have said to them before, “Look, here’s some basics on this medication I’m prescribing but the pharmacy really can give you a lot of great information.” Sometimes it’s more user friendly. They don’t feel quite as intimidated as sitting there with their doctor.
Dr. Jim: Actually. I mean we are considered the drug information expert so our patients really should count on us for that information. That’s something we rely on heavily in pharmacy education is a lot of time and communication and how they can communicate directly with their patients in a simple language that the patient feels comfortable with so that they can retain that information and hopefully improve the outcome.
Dr. Kayla: I think that’s incredibly important. There are so many different walks of like that come through. You may even council a nurse on a medication that they’re not as familiar with but as far as the patients go, making sure that they can understand what you have to explain to them is incredibly important. I think that’s an awesome thing. I really enjoy doing is relating to different kinds of people and making sure they feel comfortable with all the medications that they take.
Dr. Lisa: Kayla, you are originally from Windham. You went to the University of Maine and you are part of the second graduating class of the University of New England. Is it the School of Pharmacy? Is that what it’s officially called?
Dr. Kayla: Yeah, the College of Pharmacy.
Dr. Lisa: College of Pharmacy. How did you decide that you wanted to go into this field?
Dr. Kayla: I got my undergrad at U Maine in biochemistry. I really liked science. I started kind of practicing and studying for my masters in biochemistry and I realized that I didn’t really enjoy working alone in a lab with test tubes and with no one to interact with so I started looking for other opportunities for me to still use my science background but actually meet patients and make a difference. I looked into Pharmacy School and I did a tour at UNE and it was everything I was looking for. The faculty was incredible and I just knew that pharmacy was going to make a lot of sense for me professionally and personally. Once I finally started studying pharmacy I realized that it was exactly where I needed to be.
Dr. Lisa: Jim, you also have a Master of Science in Medical Education and Leadership from the University of New England, College of Medicine. For you education and communication has been very important for quite a while.
Dr. Jim: Yeah, I think even from the beginning I think our pharmacy education teaches us about the importance of educating our patients and other health care professionals. Early in my career I was involved in Brown Bag Series in the mid coast area. At each hospital we’re responsible for educating physicians, nurses, pharmacists, various health care professionals on drug therapy. That even led me to go to Saudi Arabia where I was a part of a program with the royal family. We were there to educate the Saudi pharmacists and Saudi students to help take over the pharmacy and this was in many disciplines. Eventually Saudi took over their own health care system instead of having the westerners run their health care system.
That led me eventually to UNE. UNE has been a wonderful experience where I really thought it was my time to give back. Starting at the college in 2008 as a founding member I was greatly involved in hiring faculty and recruiting the first class of students. It’s been wonderful to educate the students but that led me to think, “You know what? I need a few more skills.” So I did complete a Masters on Medical Education at the University of New England at the College of Medicine.
That was an amazing actually online program where … There’s anywhere from 8 to 10 students in your cohort so I worked with physicians in many disciplines all over the world. Being the only pharmacist in there it was incredible dialog between us on how we’re going to educate the next generation of health care professionals.
Dr. Lisa: I’d like to back up and learn a little bit about what it takes to get your doctorate in pharmacy because this is something that I think people don’t … We think about people who have medical degrees or people who are doctors, who are dentists or vets, veterinarians but it’s a lot of work to become a doctor of pharmacy and it must require not only time spent in the classroom but also hands on time.
Dr. Kayla: We absolutely spend a lot of time in practicum, in labs. We had an incredible opportunity at UNE to really work in a real life setting. We had this incredible laboratory, the Hanford Lab, right? We had labs where we would practice counseling patients. We had actual patients come in for some of our classes so that we could counsel them, practice, really become more immersed in the actual practice of pharmacy as opposed to just the lecture and the didactic portion and along with the things we did in school. We had a number of rotations outside of school that allowed us to really expand ourselves as professionals.
Dr. Jim: To elaborate on that UNE it’s a 4-year doctorate degree. Students can come in either with 2 years of prerequisites but most of our students come in with a 4-years bachelor’s degree already. The curriculum is a total of 4 years where the first 3 years involves primarily work in the classroom with a little bit of internships we call experiential learning. The whole final year, the fourth year, is experiential. Every 6 weeks our students have a new experience. They work under the leadership of a pharmacist throughout Maine, the country, throughout the world to complete those internships. They can be anywhere from an institution rotation at a hospital to a community pharmacy like Apothecary By Design. They can be in Thailand or Spain for global education which is programs that Kayla and I both have participated in.
Dr. Lisa: What types of things can you learn in Spain for example about pharmacy that you couldn’t necessarily learn in Brunswick?
Dr. Jim: I’m going to let Kayla answer. She was really engrained in it there.
Dr. Kayla: That was by far one of the most incredible experiences and I think that it really has made me a better pharmacist as a result. I think the importance of studying not only another culture but their health care how they practice providing for their patients, how they practice pharmacy over there is really incredible.
They have a universal health care system that we are moving towards now. It’s really important for us to learn from people that have already established this kind of health care system so that we can improve upon our own.
I think one of the other things that I really took from my experience was understanding what it’s like to not be understood. I think that that translates everywhere but especially in pharmacy I’ve met a number of patients that don’t speak English as their first language or aren’t as able to understand medical terminology. Really understanding what it’s like to feel as if nobody understands you. I think that that has really opened my eyes to the kind of patient care I need to provide for my patients and it needs to be very individualized.
Dr. Lisa: As you’re talking about this I’m thinking about some of the work that recently they’ve been doing with doctors really across the country and trying to help them understand the importance of medical literacy, of health literacy and terms that doctors think about like congestive heart failure. When you say that to a patient they’re thinking, “Oh my gosh, my heart is failing? What does that mean?”
Some of the things that have long been held … Have made doctors into gods these things are falling that we now know. We can’t just be throwing out terms just because the vocabulary sounds kind of specific and good to us. People need to understand what’s actually going on with their own bodies. They need to participate in their own care.
Dr. Jim: Absolutely. Something that you may not be aware of Dr. Lisa is that’s something we work diligently on at UNE. UNE is one of maybe 7 schools in the nation, or universities in the country I should say that have an interprofessional education collaboration. That means we are really fortunate at UNE that we have a College of Medicine, a College of Pharmacy, a College of Dental Medicine. We have social work, Pas, we have so many health care disciplines that we work together as a team to work on interprofessional education. A lot has to do with educating our patients together in terms that they understand.
One way that’s really amazing that UNE is really proud of is our simulation lab. I think it’s a new trend in medicine where we have in a sense a controlled environment where we have a patient that could be alive or could be a mannequin where we can go in and educate on challenging our difficult cases. It could be a language barrier. It could be maybe a complicated delivery or it could be education for a patient with diabetes. It gives us a chance to really practice that role in a safe environment, to not feel threatened.
Me as an instructor it’s really wonderful to go in there and say, “They don’t know what congestive heart failure means. How are you going to explain it to them?” The students are like, “What do I do?” I’m like, “You’ve got to figure it out. You have this patient right in front of you. What are you going to say them?” They figure it out. It’s pretty amazing actually.
Dr. Lisa: This one thing is also wonderful to hear from you, Jim, because you obviously have quite an extensive educational background yourself and you were able to be there ground floor, let’s create a pharmacy school. Let’s do it in a way that makes sense for today’s students like Kayla when she was going through. I mean that’s a really exciting opportunity and one that I think doesn’t exist everywhere.
Dr. Jim: It doesn’t. I felt really privileged to be a part of that system. When I joined UNE in 2008 I really felt it was my time to give back. I still believe passionately that what we are doing for our profession is amazing and what we are doing for the state of Maine is equally important. For many years we had the brain drain. There was not College of Pharmacy in Maine so our students would leave to go to Boston or Rhode Island or Connecticut and then not return. I thought that was really, really important after being a pharmacist in the 90s where we had a huge shortage.
It’s been really invigorating. I think the thing we really focused on is our commitment and our relationship to our student that we are student focused. One of the things that we find really important from our students is their engagement with the faculty. They feel that it’s a really nurturing environment for learning. They’re just not a number. I think we are a family and I think Kayla can attest to that that our faculty have an open door policy that we’re committed to our students and to our profession in Maine.
Dr. Kayla: Yeah, I would absolutely agree. I established a number of relationships with faculty that really do transcend the relationship traditionally seen between a student and a professor. You really have the opportunity to speak with them about not just the test you took last week or the questions you got wrong, but hey, I’m applying for a job, I need help. I don’t know what salary to ask for. I don’t know what job I need to look for. Those sort of guiding mentorship type relationships and I’ve met quite a few faculty members that have definitely influenced my career and how I practice and given me somebody to look up to and really interact with even after school has ended.
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Dr. Lisa: Kayla, I would think that it would also be very interesting for you as a student have experienced say the Hanford Pharmacy, the Walgreens, Apothecary By Design and to really see that there are different business models, there are different patient-provider interaction models and have the opportunity to decide where you best fit.
Dr. Kayla: I think that’s where the experiential education became extremely crucial in understanding not only pharmacy but myself and where I wanted to practice. I went to a number of incredible sites. I was in Norway, Maine at a small hospital, Stephens Memorial and it was a beautiful commute. It was in the fall so all the leaves were changing.
I was in Spain. I went to Apothecary By Design and I saw pharmacy practice in so many different lights and it was incredible to glean a little bit from each of those sites and really incorporate that into how I practice and really how I wanted to continue my career. I think it was absolutely the experiential education that showed me the parts of pharmacy that I didn’t necessarily knew existed or knew were so amazing.
Dr. Jim: Thank you Kayla. I think what we do is really, really important. I mean as I said earlier, students have to complete 6 internships or rotations. They do gain something a little bit from each of them. It’s pretty amazing now we’re in autumn and they’ve just been doing this for 3 or 4 months. They’re still a little nervous. For me to see where they’re going to be in February, March, April it’s amazing just the maturity and growth that comes along. May comes around it’s like, “Wow, they’re ready to practice” and it makes us feel really good.
Dr. Kayla: You would think that after all the school that you have completed those first 3 years before you go off that you would be fresh and ready to go and know everything and then once you get into practice you realize that nothing is like the book. It’s really a different kind of learning altogether. There definitely is a transition between your first rotation where you’re nervous and you don’t even know where to start. Everything that you’ve practiced in your books, “No, this doesn’t really apply here. Clinically that’s really not relevant.” It definitely is a huge transition as a person, as a professional to start at week 1 in your first rotation and then actually finish your last rotation and think about sitting for your boards and taking care of patients. There’s an incredible evolution in that last year.
Dr. Jim: It’s really wonderful. Nothing makes me happier to have a student say in September, October, “Dr. Krebs I don’t know what I want to do.” I’m like, “Great, because you’re going to figure it out by May.” I’ll see them in April and they’ll be like, “You know what? I’ve taken a position here” or “I got accepted to a residency.” It’s amazing the growth that occurs in the last 9 months of the education.
Dr. Kayla: It’s terrifying too because you go out, it’s your last year of school. You should be thinking about getting a job. You should be thinking about applying, residencies, interviews, and it becomes very daunting. I know when I first started my first rotation I went to Spain and I thought I’ve been doing everything wrong. I should be living Spain. This is amazing. I love it here. I almost tossed my passport in the river and stayed but I knew I had to finish school and I came back and I was so lucky to have had Apothecary as my first American rotation.
I didn’t realize how incredible pharmacy could be. As much as I loved it before I came to Apothecary and I realized that these people are on the phone for an hour with insurance companies to get a paid claim to go through. They are talking to patients. They are on call on the weekends to make sure if patients have problems or questions they are available to answer them. I was very lucky because I thought … I came back from Spain and had that post Europe depression deal. What am I doing with my life? Apothecary was incredibly inspiring.
Denali she was my preceptor at Apothecary, one of the pharmacists there, she became an inspiration to me, a mentor and a friend. I knew after the first week that I needed to work there. I finished the rest of my rotations and I loved them. I learned a lot at every one. Always in the back of my mind I knew Spain was not an option at this time so I thought, “If I’m going to stay here I would just love to work at Apothecary. I would be just so lucky to have that opportunity.” A position opened up and I snuck right in there and I haven’t had any regrets.
Dr. Lisa: The main thing I think is … I mean the main connection I think becomes more important that we realize. I know that Jim you’ve worked up at Mid Coast and now you’re at UNE and apparently you and I knew each other unbeknownst to me at a time when I was prescribing medicine when I practiced in Yarmouth.
Dr. Jim: It was all appropriate.
Dr. Lisa: Yes, I’m sure … I’m assuming I did a good job with my prescriptions. It really is interesting to me that especially in Maine people are more connected than we realize. I mean you can meet somebody and then 10 years later you can actually put a name to a face. The relationship becomes so important especially, Jim, you are in South Freeport is that where you live?
Dr. Jim: Yeah, the connections are incredible. I mean I came to Maine in 1994 when I had my BS in pharmacy and I worked for [inaudible 00:53:08] Hospital but I also worked per diem for Hanford Pharmacy and I traveled throughout the state because there was a huge pharmacist shortage. I got to meet pharmacists and people from all over the state and it’s amazing 20 years later of who knows who. I think that’s been part of my –
Dr. Kayla: It’s kind of scary.
Dr. Jim: It is scary. It’s part of my success at UNE is the connections. I think that’s part of UNE’s branding is about our connections but it is really important especially in Maine. I think old school is who you know but I think it’s more about the relationship you build with them but the connections are amazing, yeah.
Dr. Lisa: I would think also Kayla with you having been raised in Windham, I mean you work at Apothecary there’s got to still be people that you know from –
Dr. Kayla: All the time. I run into people who knew my nanny or lived next door to my uncle and it’s an incredible … I bring up, “Hey, yeah, I work at Apothecary.” “Oh, really? I know somebody that works there.” “Yeah, my friend writes prescriptions and they send him over there all the time.” It’s just you never can escape it and that’s one of those beautiful things that you always have support no matter where you are in Maine anyways. I’ve always felt like anywhere I turn I’m going to run into somebody who knows somebody. It’s incredible.
I did a lot of traveling in Maine for my rotations. I did one in Calais and I reached out up there a friend of mine who went to Calais before me for a rotation had said, “Hey, there’s this really great girl, this lady Ede. She’s awesome. You’re going to love her. You should stay with her. Reach out to her. See if you can stay with her.” Because I had to find a place to stay for that 4 weeks I was up there.
I reached out and made a great friend in her. It was all because I knew a guy who had gone there before, who had met somebody and made a friend and connected me with them. I feel like a lot of my rotations have all been about reaching out to people that I know. Hey, I’m going to be in your area for the next 6 weeks. I need a place to stay. Everybody has always been happy to take me in even if it’s a friend of a friend.
Dr. Lisa: I’ve also found … I just saw a patient yesterday who I was in Girl Scouts with, 30 something years ago. I used to deliver babies of people that I went to high school with. I have found also that it really contributes to the sense that you do want to care for these people in your community, in your life because they’re important. They are your nanny’s friend or they’re somebody that went to school with your brother. I mean this is our community and being able to offer advice as a pharmacist or care as a doctor it’s something that you really want to be able to do.
Dr. Jim: Absolutely. You made me think, Dr. Lisa, students as we chat about career options and they’re like, “Jim, I’m not sure if I want to be a hospital pharmacist. I don’t want to be on call and I don’t want to work holidays.” I always say, “You know what? I never got frustrated when I had to work Thanksgiving or any other holiday because I was like I’m taking care of my community. Yeah, it stinks I’m not home with my family but you know what, it’s important that I’m hear.” I try to share that with our students. I hope they’re getting it.
Dr. Kayla: Yeah, yeah, I absolutely agree.
Dr. Lisa: Where can we find out more, Jim, about the University of New England and their Pharmacy School?
Dr. Jim: The best thing to do is go to www.une.edu and link on the College of Pharmacy. I really encourage people to drop by the college themselves.
Dr. Lisa: Kayla, can you remind us how we can learn more about Apothecary By Design?
Dr. Kayla: Yeah, you can definitely stop by. We love to meet new people and you can always find cool stuff at our retail location. You can visit us online at www.apothecarybydesign.com.
Dr. Lisa: Well this has been an exciting conversation for me. I always learn things when I sit down and talk to people about what’s going on and I think what’s happening here with pharmacy in the state of Maine is exciting. It’s exciting for doctors and health care providers but also for patients and community members. We’ve been speaking with Dr. Jim, James Krebs who is the University of New England’s Assistant Dean for Experiential Education and Dr. Kayla Stewart who is –
Dr. Kayla: Yay!
Dr. Lisa: Yay! Congratulations on that doctorate. I know you worked hard for it. Who is a University of New England graduate and now an Apothecary By Design pharmacist. Thank you for the work that you’re doing and for the education that you’re bringing to our community.
Dr. Jim: Great, thank you.
Dr. Kayla: Thanks Dr. Lisa.
Dr. Lisa: You’ve been listening to Love Maine Radio Show No. 164: Maine’s Pharmacy Experts. Our guests have included Catherine Cloudman, Greg Mitchell, Dr. Jim Krebs and Dr. Kayla Stewart. For more information on our guests and extended interviews visit themainemag.com/radio. Love Maine Radio is downloadable for free on iTunes. For a preview of each week’s show sign up for our enews letter and like our Love Maine Radio Facebook page. Follow me as @doctorlisa on Twitter and see my daily running photos as Bountiful One on Instagram.
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This is Dr. Lisa Belisle. I hope that you’ve enjoyed Maine’s Pharmacy Experts. Thank you for allowing me to be a part of your day. May you have a bountiful life.
Speaker 1: Love Maine Radio is made possible with the support of the following generous sponsors: Maine Magazine, Marci Booth of Booth Maine, Apothecary By Design, Mike LePage and Beth Franklin of RE/MAX Heritage, Tom Shepard of Shepard Financial, Harding Lee Smith of The Rooms and Bangor Savings Bank. Love Maine Radio with Dr. Lisa Belisle is recorded in the studio of Maine Magazine at 75 Market Street, Portland, Maine. Our executive producers are Kevin Thomas, Susan Grisanti and Dr. Lisa Belisle. Our assistant producer is Leanne Ouimet. Audio production and original music by John C. McCain, our online editor is Kelly Clinton.
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