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Anita Brikman: When is the last time you talk to your neighborhood pharmacist? When it comes to self-care solutions, pharmacists can be an overlooked resource. They can offer advice not just about prescription drugs, but OTC medicine choices and dietary supplements. On today's CHPA Chat, how to make the most of that medicine expert behind the pharmacy counter.
Speaker 2: Welcome to CHPA Chat, conversations in the consumer healthcare industry with Anita Brikman.
Anita Brikman: Hello, listeners. Hope everyone is doing whatever they can to stay healthy and safe these days, as we continue to grapple with COVID-19 and its emerging variants. The pandemic has affected all of us, including those working in the pharmacy profession. And as health misinformation spreads like wildfire online, your pharmacist can be a trusted advisor on what's true and what's not.
Joining me to dive into this topic today is Dr. Wendy Mobley-Bukstein, Associate Professor of Pharmacy Practice at Drake University. Doctor, you are joining me from Des Moines, Iowa, so I believe I am chatting with a fellow Midwesterner.
Wendy Mobley-Bukstein: You are indeed. Yes, I'm in Des Moines and we have lovely weather today.
Anita Brikman: Absolutely. And the weather is nice here in DC as well, so let's dive right in. How has the role of the pharmacist evolved beyond prescription management, and did the pandemic accelerate that change?
Wendy Mobley-Bukstein: Well, I can tell you, I've been a pharmacist for 20-ish years, and when I was in school we were talking about all of these great things. And it's taken a long time just to have this transition, to show that the pharmacist really is that medication expert, that person that can really talk to you about the medications. We don't diagnose, that's not our job. Our job is to know once you have a diagnosis, what medication would be best to use to get the best benefit, and to help you with whatever disease or disorder you might have.
And so I would tell you that certainly during COVID-19, we have seen the pharmacists really come into their own in being able to do a lot of things. And being that accessible healthcare professional that we've always really been, especially the community-based pharmacist. But during the pandemic pharmacies didn't close. We were just like all the other healthcare facilities out there, we were open, we were there, and we were ready to help individuals in the community.
One of the biggest things, we can provide is vaccinations. In some states now we're also allowed to test and treat, so we can test people for COVID-19 and then provide an antiviral, if that's something that's available for you in your state. There are a lot of really great things that we can do. But like all other healthcare professionals, the pharmacist has really felt the pull on being able to provide those services, as well as continue to fill prescriptions.
Anita Brikman: Are pharmacists fielding more questions these days from people who have, okay, been searching on the internet. They're not sure what's wrong with them, they're worried about COVID. There is a proliferation of information out there. Some of it's trustworthy, but a lot of it's not. Are you getting more questions like, "What can I trust?"
Wendy Mobley-Bukstein: Absolutely, yes. We see a lot of that in the community pharmacy. I work in a doctor's office and I would say that I get a lot of questions like that. Sometimes the residents or the attending physician will come in and they'll say, "The patient just asked me about this and I don't know what they're talking about." And so we'll go in, we'll talk to them, try and find out, "Where did you find that information at," and see, is it a credible site that they found that information from.
Sometimes they're going and they're finding stuff on social media, they're seeing things in different places. And sometimes that information is misinformation or information that's coming in from other places that has some truth to it, but not everything that's there is truth or science-based. And so we're able to really help them find some credible information about what may be going on with them at the time.
Anita Brikman: And that is such an important resource. Now I'm going to take this back to myself and I'm hoping you can answer this. Sometimes, when I walk into my neighborhood pharmacy, I mean, first of all, it has changed so much. There are so many more supplements. The way the whole drugstore is organized is so different now that we're coming through that pandemic. And self-care in your solutions are so front and center.
But sometimes when I walk in, I can be a little overwhelmed. And if I have a question for the pharmacist, when I go back to the back of the store and I see that line of people, I think, "How am I going to bother this person?" This is not the end of the world solution I need, but I still have a question. What would you say to our listeners, as far as encouraging them to get over any trepidation and make a point of talking to the pharmacist?
Wendy Mobley-Bukstein: Honestly, I think that you would make that person's day. As a professor at a university, that's what we're teaching the students. That's what we want them to feel like. When anyone walks into that pharmacy and you're that person behind the counter, you're that trusted individual that has that knowledge and you want to share that with people.
And so I would say it's not a bother to go and ask the pharmacist for a recommendation or ask a question where they can make a recommendation and say, "It's over in aisle five. And I'll be with you in just a moment when I can get out from behind the counter." Or perhaps they'll have someone working in the store that they can say, "This is what I'm recommending. Could you show them where to find that at?" I think that there are a lot of ways that we can go about trying to make sure that we're sharing that information that we have with those individuals coming in from the community.
Anita Brikman: And what you're telling me is it doesn't have to be a question about a prescription medication. The pharmacist is willing and able to talk about the over-the-counter medicine options, dietary supplements, et cetera.
Wendy Mobley-Bukstein: Right. And so again, I teach in our self-care and non-prescription course at the college, so something very near and dear to my heart. And it's a required course for our students. Now every pharmacy school's a little different. Sometimes it's an elective course that students can take. Other times it's included in their pharmacotherapeutic series that they may take during school.
All of the students are educated in a similar manner, and they know about those things that are over-the-counter. So all of the over-the-counter medications, dietary supplements, herbal supplements, those types of things, they have information about all of those things.
Anita Brikman: So good to know. Well, we talk about what you do see in the pharmacy aisles over. Recent years we have seen...I'm thinking of the allergy category for example. A lot of medicines have switched, which is a big word in the consumer healthcare products industry. We're very big into switch from Rx-to-OTC. We've seen medications switch and so many more options be available over-the-counter. What do you think that has done for self-care?
Wendy Mobley-Bukstein: I really think, one thing that we talk a lot about with students is the fact that now you really need to know how to help individuals find those credible sources online, coming in and asking a question. Even if they go to their prescriber's office, they may end up getting prescribed something that's over-the-counter, so then they have to go and try and find that on their own. Making sure that they're coming back and that they're asking those questions of the pharmacist is really important.
Especially if the prescriber has written on a piece of paper and said, "Here, go find this at the pharmacy." It's really important for us to make sure that we're giving them information. I think those Rx-to-OTC switch items obviously have been looked at through the Food and Drug Administration, the FDA, which is our body that approves drugs. And they've looked at it and they've said, "These are safe. These are safe and effective, and they're okay to be used over-the-counter." Now it's just a matter of helping people find which one is the best one for them.
And so that's really something that I feel very passionate about as a pharmacist that I can help with, is I can say, "Okay, what time of day do you want to take your antihistamine for your allergies? Do you want to take it in the morning? Then we're going to try and find something that's nonsedating. If you want to take it at night, then maybe we'll find something else that perhaps could cause you to be a little tired, but then maybe it will be working by the time you get up in the morning and you won't be sneezing your head off when you wake up."
So there's a lot of different aspects to think about. And those are all questions that, if we're doing our job right, we're asking when the person comes in and we can help them find the right product for themselves.
Anita Brikman: That is so great that you can help them customize it, because you're right. They may be going to a doctor or nurse practitioner, et cetera, but are told to seek an option that is actually over-the-counter.
What about medication adherence, label reading? In this course you teach, what do you emphasize about the importance of...Even though something is over-the-counter, it doesn't mean that all the rules are out the window. You've got to follow what the instructions say. How do you really drive that home?
Wendy Mobley-Bukstein: We talk a lot about, one, not over-treating. So finding out what symptoms the person has, making sure that when you're recommending a product, you're recommending the product that only treats those symptoms. There's a lot of products out there on the market that are combination products, that contain more than one active ingredient. So really looking at that drug label and deciding, "Okay, do I need something for pain or fever? Check, that's in there. Do I need something for cough? Check, that's in there? Okay, so those two things work. Do I need something because I'm having sneezing," or runny nose or postnasal drip, where it's running down the back of your throat, that kind of thing. Is there something in there that helps with that?
Making sure that we're, again, as you said before, customizing that over-the-counter therapy for that person based on what's wrong at that particular time. And the one thing I always tell students, "Avoid medicine head." Don't make your patient feel groggy and medicine-y because you've given them too much medication. That you're only treating what is actually going on with them at that time.
Anita Brikman: No, none of us wants medicine head, absolutely not.
Wendy Mobley-Bukstein: No.
Anita Brikman: It makes it much harder to function. As a working individual, as a mom, no, no medicine head. I love that, I'm going to take that away from this podcast.
Now I've heard also a lot about burnout within our medical profession and also a nursing shortage. Are we seeing the same thing in the pharmacy workplace, in the pharmacy workforce?
Wendy Mobley-Bukstein: Yes, we are definitely seeing professional burnout everywhere, not just healthcare but everywhere, just a shortage of individuals coming back into the workforce since COVID. And I don't, again, don't really know what's causing that to happen, other than maybe that fear of what happens if we have another surge or something like that. And, "Now I'm going to be taken away from my family and I'm going to be working these long hours." And knowing that we're working under these shortage conditions right now, a lot of people are working long hours and they're tired.
Anita Brikman: Yeah, they're definitely tired. How do you give your students optimism and hope?
Wendy Mobley-Bukstein: I think the one thing for me is that this has helped, again, the pandemic and the pharmacist's ability to be an accessible healthcare provider and seen that way. We've been trying for what's called provider status for quite a long time, probably the last 10 years or so, and have really not been successful in being added to the Social Security Act, which allows us then to be considered healthcare providers.
And so even though we are medication experts and we have all of this knowledge to share, we still can't be reimbursed for some of the educational services that we provide, so counseling patients. Or perhaps the things that I do in the doctor's office, I'm not able to bill for the services that I do. I think that it's interesting to look at it from that point of view, but to show the students now, "Look, we're being recognized for all of these things." And now with the test and treat, we're being reimbursed for that.
And so I think it's just a matter of time where we show the value of what we can do and how we can help on that healthcare team, that we will be able to ensure ourselves provider status. And so I think it's really important to think of it from that aspect. And I think most of my students come into pharmacy school wanting to help individuals. And so, because they have that desire to help, I think that that's also one of those things that allows them to move forward.
Anita Brikman: Do you think the fact that COVID vaccinations moved away from very specialized, initially clinics and outreach centers, into the pharmacy, do you think that has helped with this?
Because I know all of a sudden it was very different from when I first started to try to get a vaccine, versus when I got my booster and I could just walk into my local pharmacy and make that appointment. It was very empowering for me, as opposed to the earlier period of time where I was on lists and waiting. Obviously that's also supply and demand, but the pharmacist became the vaccine provider.
Wendy Mobley-Bukstein: We did. And I think that that has really made a huge impact in just showcasing the skills that we have as pharmacists. And again, everyone has a role and responsibility on that healthcare team. And so I think that it's our time to shine perhaps with the different things that we can do.
And that community-based pharmacist is definitely a resource that's been underutilized. And now, all of a sudden, really shining the spotlight on those individuals and allowing them to do the things that we were trained to do.
Anita Brikman: That is great. Also, I think that the pharmacist and all the products now available within the pharmacy are really changing care for things like diabetes, for example, where there is so much more there that you can access to take control of this condition. And I know this is an area of focus for you.
Wendy Mobley-Bukstein: Sure. Yeah, so I am a diabetes specialist. That's what I do at the clinic, so I help manage and educate patients in our clinic about diabetes. And as far as self-care is concerned, I think the biggest thing is making sure that when you're selecting something over-the-counter, that it's not going to be something that's going to interact with your disease state. There are a lot of over-the-counter products like cough syrups, for example, that contain a lot of sugar.
And so making sure that we're being able to point an individual in the direction of something that perhaps is sugar-free or has less sugar in it, so that it's not causing their blood sugar to spike really high.
But additionally, the community-based pharmacist can help with testing, helping the patient know, "What is my goal range for my blood sugar? What should my A1C look like? And what are some different ways for me to be working to try and get my blood sugar better controlled?" And so those are also other things.
Disease state management in the community-based pharmacy is something that we've been working towards over probably the last 15 to 20 years. Diabetes is one of them, high blood pressure, high cholesterol. All types of different management, I guess management programs, if you will, but ways that we can just educate individuals on the different disease states and ways that they can potentially eat differently, manage different things with over-the-counter medications and/or physical activity. Just talking about some of those types of things with patients and being able to help them better manage their disease states.
One of the big things that we are really looking at doing is obviously employing more technology. Allowing pharmacy technicians to work at the top of their license, and then allowing the pharmacist to do the things that we've been trained to do, which is talk with people and ask questions and to help them find the medications and/or over-the-counter medications, herbal supplements, dietary supplements. Any of those types of things that might help them just feel healthy and remain well.
Anita Brikman: Your passion for your students truly shines through, even in your voice. I can see your face right now, but our listeners can't. Are there specific qualities you see in the younger generation of pharmacists-to-be that encourage you and inspire you, make you get up every day and go and teach?
Wendy Mobley-Bukstein: I would say that that's probably the one thing that keeps me going, is those students keep me young. They keep you on top of your toes. They ask a lot of great questions. And I think that that's perhaps one of the best things about going to work every day, is that they come in and they're so curious and they have questions for you. And sometimes they're questions, I don't know the answer to, but I always tell them, "It's okay not to know the answer, we just have to look it up." So sometimes we have to learn together, and we do that. And I think that that's probably one of the things that's probably a highlight for me during my days.
I teach primarily second-year pharmacy students of...The pharmacy program is a graduate program that students enter into after they've had at least two years of undergrad. So they have two years of undergrad, they can either apply and transfer into a pharmacy program. Or our students, if they come through Drake, they still have to go through an interview process. And there's a certain GPA requirement and those kinds of things, but they can track right in and it ends up being a six-year program altogether.
It's a doctoral-level program. They become a doctor of pharmacy when they graduate. And so I think that that's probably the thing that's really amazing to me, is they come in as a second-year student pharmacist and they've just come from the whole first year being all these hard, foundational science courses with maybe one communication course. And then they come in the second year and we start just throwing all of these medications and pharmacologic action of drugs and all of these different courses at them. And they come in and they're very curious, and they are wanting to work in a pharmacy and learn how to utilize these skills that we're teaching them in class.
Anita Brikman: And that is such a great way to end this podcast. Hopefully, you will be delivering many more excited and ready to learn and ready to help the world pharmacists to us. Dr. Wendy Mobley-Bukstein, thank you so much for being our guest on CHPA Chat and leaving us on such an inspiring note.
Speaker 2: Thank you for joining us here at CHPA Chat. For more information and to hear our entire catalog of shows, please visit chpa.org.
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The views expressed in this podcast are solely those of the speaker and do not necessarily represent the opinions of the Consumer Healthcare Products Association.
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