Thank you for joining us today. We are blessed to be able to gather here like this and need to remember our colleagues who were not able to be here because they are serving the health care needs of their communities or dealing with their own or family health issues. Coronavirus disease 2019 (COVID-19) has certainly taken its toll on society. I hope your time so far at the meeting has invigorated you personally and professionally and reinforced the idea that you are not out there alone.
Thank you for the faith you have placed in me—at this critical moment for our patients and our profession—by electing me president of this great organization, an organization that is focused on sustaining and advancing the relevance of our profession across the spectrum of practice and advocates for the necessary resources enabling you to make a difference in the lives you touch.
I would not be where I am today, standing before you as incoming President of the American Pharmacists Association (APhA), without the love and support of many. I will not try to list them all, but they know who they are. I thank my countless friends and family who have supported, mentored, and prayed for me. I do want to recognize the support of a few.
I am an independent pharmacy owner serving a community located on Florida’s Treasure Coast. I could not do what I do for our patients or profession without the support and encouragement of my great team at Bay Street Pharmacy. They are back home taking care of patients, but I want to say to them, Thank You! Representing the crew here today is our resident, Tina Finnegan.
I have been influenced by many lifelong APhA friends including my posse from Florida who are here to celebrate with me today. Thank you for humoring me and my wild ideas.
A special shout out to my mentors from Florida, Red Camp and former APhA President Ed Hamilton, who also became president in this great city!
My excitement for organizational involvement started at my alma mater, University of Florida, where I learned to make a difference and that you cannot sit on the sidelines. GO GATORS!
I have been fortunate to work with a committed group of volunteers and staff at the Florida Pharmacy Association (FPA) and APhA. They go above and beyond for our profession and the patients we serve. In particular, I would like to recognize FPA Executive Vice President and CEO Michael Jackson, who is retiring this year after more than 25 years in that role. I would be remiss if I did not mention our amazing and committed APhA staff and board—I am amazed at all you do for our profession. Thank you all for your guidance and support.
I recognize that we have to continue to innovate to stay viable in our changing health care system, and that we cannot do it alone. I am fortunate to be the lead luminary for Community Pharmacy Enhanced Services Network Florida, working with a group of committed pharmacists.
Last, but not least, a special thank you to my family. San Antonio is a special place for my family. Both my father and father-in-law were stationed in this city when they were in the U.S. Army. Each of them had a special influence on instilling in me the values of hard work and serving others. From my father-in-law, we have the legacy of the pharmacy that he opened in 1984. From my parents, I learned the benefits of owning a small business in a small town and the importance of taking great care of your customers. My in-laws are no longer with us, but their love and legacy lives on. My parents, siblings, nieces, and nephews could not join us at this meeting, but they are wonderful cheerleaders and counselors for me, and I am so thankful for their love and support. I also want to acknowledge that my sister, Carla, and my Aunt Gail are both APhA member pharmacists and are a special encouragement to me!
My final recognition is for my husband, Joe, and my 3 children, Taryn, TJ, and Taelyn. Taryn could not be here as she is finishing her last semester of veterinary school back in Gainesville, but the rest of them were able to join me. The best job I have is as wife, mom, friend, and cheerleader to them. You have each sacrificed so much to allow me to provide service to the profession of pharmacy, so I want to thank each of you publicly for allowing me to give back to the profession and our community. I love you all!
I did not start my career as a pharmacy owner and have personally experienced the challenges of those who are employed by small to large pharmacy organizations. Am I frustrated by what I and my pharmacy colleagues across the health care system have to deal with? You bet. But I also see the vision of where we could be.
I live on the Treasure Coast of Florida, called such because of its history of abundant lost galleons carrying gold and other wealth. The successful treasure hunters, like Mel Fisher, were persistent and did not let setbacks along the way take them off course in achieving their vision. The same holds true for our profession. It will take guts, stamina, and faith to reach our vision.
I have admired Mel Fisher and Greg Bell, author of “Water the Bamboo,” who have similar messages about dreams and perseverance. Do not allow negativity and barriers keep you from pursuing opportunities. Pharmacy has waited for this moment, and “Today’s the Day.” We need to embrace each day and opportunity as a way for pharmacy to stand out! We have made such a huge impact in our communities during the pandemic. Today’s the day for each of us, and others, to step up and recognize what we have known all along—our value to patient care and health outcomes must be recognized and appropriately compensated, like other members of the health care team. Every day is our today—time to find the treasure!
In every problem, there is a hidden treasure, and it is our job to find it, cherish it, and ensure that its value is enjoyed and recognized by all. Effective treasure hunters have 2 factors to help guide them.
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A need that drives them. For me that has been my belief in the value pharmacists provide to the health of individuals and communities. Our education has prepared us to assume greater and significant roles within the health care system, and we must be treated as valued members of the health care team. We are working harder than ever.
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A path to follow. APhA and the profession have utilized the Joint Commission of Pharmacy Practitioners Vision for Pharmacy Practice as its north star. The vision target is that “Patients achieve optimal health and medication outcomes with pharmacists as essential and accountable providers within patient-centered, team-based health care.” We have demonstrated through our actions that when given authority and ability to utilize our knowledge and skills, we can make a difference to public health and health outcomes. Pharmacy must remain focused on showing others its untapped treasures. We are following multiple paths to advance progress including legislative, regulatory, and collaborative approaches. But more importantly, an unrealized treasure is our relationship with our patients and community.
The hidden treasure in our pharmacy practices and within the health system that does not get the recognition it deserves is you and your team. Where would our country be without engagement of pharmacy teams? As a pharmacy owner, I recognize the business challenges throughout the health care system, but I also recognize the importance of having a committed team caring for our community and advancing our practice’s mission, and the relationships we have with our patients.
It is the possibility of having a dream come true that makes life interesting. It is easy to be sideline critics and place blame on others for not doing enough, but that does not bring about the change that is needed. APhA, as well as others at the national and state level, have been focused on changing the payment model for pharmacy practice that will support pharmacists’ ability to provide the patient care we have been educated to provide. But the payment model is not the end goal.
Corporate and organizational management, in addition to other decision-makers, need to provide the necessary human and other resources, as well as processes, that support our patient safety commitment. After all the contributions and sacrifices that we and our teams have made for the good of our communities, it is time for us to say ENOUGH! Employers—across all practice settings—do not discount our value or treat us like a commodity. The treasures within every pharmacy practice are the professionals working with patients and communities every day!
Like President Leal shared with us yesterday, all of us must raise our collective voices and also encourage others to address inequities on behalf of our patients and the patient care team who are at their breaking points. If we do not respond effectively and collectively to the challenges faced by pharmacy practitioners in the provision of patient care, we risk further erosion of public health and growth of our profession.
APhA has heard you, is listening to you, and is taking proactive steps to advocate on your behalf. The level of stress and burnout by pharmacy teams throughout the profession, identified through social media posts and informal and formal feedback from members, has never been so high.
Contributing factors to this feeling include but are not limited to payment policies; corporate policies impacting staffing levels; unreasonable metrics and workload; the level of available resources; harassment from patients, consumers, and coworkers; COVID-19 concerns; lack of recognition; patient safety concerns; salary levels and misalignment with work demand; and more. APhA, through its well-being initiatives and other activities, has issued statements calling for reform of the process and a need for dialogue between management and their pharmacy teams.
This past year, APhA partnered with the National Alliance of State Pharmacy Associations (NASPA) on 3 activities to facilitate dialogue and action among pharmacists, pharmacy personnel, employers, patients, health professionals, and those who govern pharmacy practice and health care delivery.
In June 2021, the Pharmacist’s Fundamental Responsibilities and Rights was released. The principles focus on pharmacists’ responsibilities and workplace expectations needed to fulfill those responsibilities. These principles were established as a guide for and to facilitate meaningful discussions. Several national organizations have signed on in support of the principles, including the National Association of Boards of Pharmacy (NABP). In announcing its support of the principles, NABP included in its statement, “pharmacists must be given the opportunity to understand their rights and responsibilities and preserve patient safety without fear of intimidation or retaliation.”
Fear of retaliation is real and was confirmed in numerous surveys that led to APhA and NASPA launching the Pharmacy Workplace and Well-being Reporting (PWWR) service. PWWR (or POWER) gives you a voice without fear of retaliation or retribution. How? PWWR is an ongoing online confidential anonymous service, administered by a patient safety organization, for pharmacy personnel to report both positive and negative experiences across all pharmacy practices. We have received almost 1000 reports since launch—both positive and negative. The positive reports ranged from helping a patient understand and use their medication properly, to positive feedback from a supervisor, and to discussing the implementation of new pharmacy processes prior to launch. The important finding is that those who submitted positive experiences indicated that they would have a long-term effect on their well-being.
The negative experiences reported included workload, staffing, and pharmacy metrics. In addition to increasing workforce, there were 2 key findings highlighted in the first report release that employers can address now. First, develop legitimate 2-way lines of communication. Right now, communication channels are not perceived to be open. Respondents did not believe that they were heard, or that workplace recommendations were valued. Second, harassment of pharmacy personnel by patients and consumers is real and must be addressed. The incidents reported range from verbal to threat or actual physical harm, to sexual harassment. Pharmacy team members are looking for reassurance and support that management has their backs and that team members can step away from the situation. In these instances of harassment and bullying, the consumer is not always right. Pharmacy teams are looking to their supervisors and management for action to support them.
To address the need for quantitative information to show how workplace issues can lead to patient safety issues, APhA and NASPA developed the national pharmacy workplace survey. The results validate the many anecdotal stories heard through national and state pharmacy association members and pharmacy-specific social media. Respondents indicated that work environment factors contribute to pharmacy personnel being unable to perform their clinical and nonclinical duties effectively. The feelings of not being heard or valued are risk factors that can cause stress, leading to occupational burnout. Issues identified as factors that contribute to the experience of stress and could lead to medication errors or near misses are (1) the increasing demands, harassment, and bullying by patients/consumers experienced by pharmacy staff; (2) concern due to insufficient and ill-trained staff; (3) employer focus upon production results; (4) constant interruptions or calls to insurance companies that disrupt the ability to evaluate appropriateness of treatments; and (5) adding more services with inadequate support for these services.
APhA hosted an invitational Community Pharmacy Workplace Summit, February 22-23, 2022, in Washington, DC. The summit brought together pharmacists, pharmacy employers, and pharmacy stakeholders and organizations to discuss the challenges of addressing the health care needs of individuals and communities—especially during the pandemic—as well as the increasing concerns and issues contributing to negative workplace and well-being experiences by pharmacy staff across the nation. The observations from the national pharmacy workplace survey and PWWR helped shape these discussions. The summit identified practical approaches to improve pharmacy workplace, well-being, and patient care expectations and addressed challenges in meeting health care needs. This is just the beginning as we continue to advocate for and facilitate meaningful dialogue between management and pharmacy teams.
As I stated earlier, it is up to each of us to use these tools to facilitate discussions and share our experiences. Change will not and cannot happen without your active engagement. APhA is working by your side to advocate for meaningful change. In addition, we must continue to identify opportunities to advance our roles in patient care. I have heard some ask why APhA and other pharmacy organizations are pushing for pharmacist authority to dispense or order antivirals. They say, “Please don’t place one more thing on my plate.” The answer is, like with any health professional, not everyone will want to provide a service that benefits patients, but those who do, and have the knowledge and skills to do so, should have the ability to do so. Keeping focused on the vision for pharmacy practice I mentioned earlier, and collectively and aggressively addressing internal and external barriers, will be the focus during my presidential year.
Theodore Roosevelt said, “In a moment of decision, the best thing you can do is the right thing to do, the next best thing is the wrong thing, and the worst thing you can do is nothing.”
To build on that, Alexander Graham Bell said, “When one door closes, another opens; but we often look so long and so regretfully upon the closed door that we do not see the one which has opened for us.” Let’s not continue to look at the closed door or sit around and do nothing.
To promote and protect our profession’s most valuable asset—you—and care for our patients, I ask you to
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share your positive and negative stories to PWWR—your experiences and suggested solutions will support our advocacy efforts.
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constructively engage in dialogue with employers and decision-makers—utilize the Pharmacist’s Fundamental Responsibilities and Rights as the framework for discussion and description for your preferred future.
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use state board–developed practice issue reporting tools to describe situations in your pharmacy you find to be compromising to your ability to take the best care of your patients. It is your license and your patient’s safety at risk.
Today is the day for pharmacists and our pharmacy teams to gain their earned recognition. Together, APhA will continue to be the collective voice for our patients, profession, and changes needed to improve care throughout our communities and the well-being of our team members. Join me in protecting our treasures.
Thank you.