APhA President-elect Jean Venable "Kelly" Goode speaks at second general session

Jean Venable “Kelly” Goode - APhA President-elect - March 6, 2016 - Baltimore, MD

“Engaging the Power of Community”

Pharmacists’ expanding opportunities to improve community health


Welcome and Acknowledgements

Good morning, friends and colleagues.  For years, I’ve been proud to serve alongside you as part of this tremendous pharmacist family.  And I’m honored by the opportunity to serve as the American Pharmacists Association’s 161st President. 

I hold with care and the utmost respect the confidence you’ve placed in me, and I will never take it for granted.  There are so many people to thank, too many to name here; but I’d like to at least recognize a few…

First and foremost, I want to thank my family.  We can’t match the Osterhaus numbers, but we’re no less supportive.  You have given me lots of love, direction and continual encouragement.  As special remembrance for my grandmother, a true pioneer for women in the field of medicine, and my brother, both always in my heart and watching over me.  My father, for steering me towards pharmacy, and my mother, for instilling pride for hard work.  My husband, Billy, for his constant support, even when I leave him at home with the team (now just our 2 dogs and cat).  My daughter, Ann-Robert, for recognizing at a young age how much I love my profession.  When she was in preschool, her teacher asked her where she was born, and Ann-Robert enthusiastically replied “Ukrops.”  

Please recognize my family who are here today.  I love you all.

Thank you Dean Dipiro, the faculty, staff, and superb student pharmacists at the Virginia Commonwealth University School of Pharmacy, who are so supportive of my involvement with this organization, and understanding of my time away from school to serve the profession.

Thank you so much to Ralph Small, Tom Reinders, Bill Smith, and Becky Snead for all your guidance!  And John Beckner for never being able to say no.  I have been fortunate to work with a fantastic group of Community Pharmacy Residency preceptors -- Andrea Brookhart, Michelle Fountain, Mary Beth Grimes, Anne Harrison, Tana Kaefer, Kelly Rea, and Sharon Gatewood.  And an even more enthusiastic group of current residents -- Anisha Doshi, Jessica McDaniel, Margaret Robinson, and Amy Sparkman, and the more than 50 residents who preceded them and are advancing community pharmacy practice.  You are a great team and you make it easy!  And a huge thank you to ALL the Virginia Pharmacists.

A special thanks, also, to Marialice Bennett, Matt Osterhaus, Steve Simenson, Kristen Weitzel, and all my other friends and colleagues from across the country who are role models and mentors, and working hard to drive patient-centered pharmacy practice. 

Former APhA Presidents who have taught me so much about leadership, including Harold Godwin, Ed Hamilton, Tim Tucker, and Bruce Canaday.  My co- Academy Presidents who made the team approach of practice, science and students work – Jon Schommer, Vibhuti Arya, Gary Smith and Dan Zlott.  Members of the APhA Board of Trustees with whom I have had the opportunity to serve.  And of course former APhA CEO, John Gans, for your vision and mentoring.

Many, many thanks to APhA and the APhA Foundation for being there throughout my career with all the tools and resources I needed for success. Every turn in my career maps to APhA’s innovation and leadership: 

  • BPS certification provided the opportunity to validate my knowledge and skills and strengthened my qualifications as a faculty member.
  • APhA Certificate Programs taught me about immunizations and springboarded my success in patient care, community outreach, and practice-based research.
  • APhA’s Academies offered networking and leadership opportunities.  Clearly, this helped me build my network of wonderful colleagues, mentors and friends across the country who taught me so much about patient care and practice change.
  • The Community Pharmacy Residency Program allowed me to train future innovative community practitioners and further enhance my leadership skills. We now focus residents on building new models of team-based care.
  • Education through the Annual Meeting and the Self-Care Institute enhanced my skills and knowledge, as well as provided a platform to share my patient care and practice experiences.
  • The APhA Foundation’s project IMPACTs allowed me to get involved with innovative patient care services such as management of hyperlipidemia, osteoporosis, and finally the ability to offer my homeless patients the proven outcomes of Diabetes IMPACT.

Every patient service I’ve just described leads us to the largest investment APhA has ever made in our profession – the quest for provider status, or more accurately, access for my patients to pharmacists patient care services.

The group of volunteers and colleagues I’ve thanked are all supported by a dedicated staff – Thanks to all of you for your dedication to the profession and for boatloads of encouragement for me.

Importance of Community

My connections to “community” have taught me so much about patient care and driving practice change.  Most importantly, they have reminded me, “to not follow where the path may lead.  Go instead where there is no path and leave a trail."  Don't expect perfection.  Be happy with every success, no matter how small.  The limits we set for ourselves and pharmacy practice exist in our minds.  Sometimes, if we let our hearts do the talking and believe in our ability to overcome past perceptions, we can create another reality.  A reality where pharmacists are engaged in their community and valued for contributions to patient health.

The underlying focus of my work can be summed up in one word: COMMUNITY.

When we think of community, we picture friends and neighbors, where we practice and where we live…the bricks and mortar of our everyday lives.  As pharmacists, our community is so much more than that.  It is a broader community: the community of patients and practitioners, of concerns and needs, of perspectives and service that surround us every day.

Mark Hyman once said, “The power of community to create health is far greater than any physician, clinic or hospital.” In fact, we know that 90% of a patient’s health care journey is outside the bricks and mortar of hospitals and clinics.  Much of the impact that we can make in patients’ lives resides outside of those traditional boundaries and definitions.  Pharmacists must be leaders in this area. Let’s talk about how.

I believe that thinking about the health care community from this broader perspective is almost like putting on eyeglasses with “community lenses.”  These lenses allow us to have a fresh perspective on the world around us and the changes that we can make in it. 

Consider this….  In our broader community, with the lens I have from this podium and in my role as a trustee, I can see pharmacists in every practice setting stepping up to meet health care needs. Indeed, community pharmacists, be they chain or independent, have refined skills to deliver essential care in their neighborhoods. And these services are increasingly getting the recognition they deserve. .  But often when reference is made to “clinical pharmacists” inference is suggested by some that it does not include community pharmacists. So, through residency standards, and in a soon to be published JAPhA article, the term Community-based pharmacist practitioner is presented, not as an ivory tower term, but rather to describe a pharmacist who routinely provides patient care services, yes – clinical services -- within the community.

Community refers to direct patient care delivered outside the inpatient health setting.  Pharmacists who provide patient care in independent and chain pharmacies, ambulatory or outpatient clinics, physician offices, patient-centered medical homes, and other community-based settings such as churches, community centers or in patients’ homes, are all community-based pharmacist practitioners.

Community-based pharmacist practitioners embrace 4 tenets:

  • Deliver direct patient-centered care in the community,
  • Contribute to team-based care by collaborating with other members of the health care team, community support networks, and patients and caregivers to provide access to care where people work, live, play, and pray,
  • Manage clinical services by aligning resources, developing and training staff, and ensuring quality of care, and
  • Serve as a leader for advancing patent care within their community-based practice settings, local communities, and broadly within the profession of pharmacy.

What does this perspective mean for pharmacists?  It means serving our communities through pharmacists’ quality patient care services and being recognized and valued members of the health care team.  Frankly, the community perspective is part of why we are so devoted to reaching provider status… we’re among the most accessible members of the health care team. The role we play when interfacing and connecting with patients and our communities is absolutely essential to optimizing medication use.

Recently, we lost one of the great woman pharmacy leaders and mentor to many – Mary Louise Andersen.  Knowing her love of community, I know she would be cheering us on.  Her commitment to serve communities and individuals in need and advancing the profession serves as a great example for the impact we can make.  She was known for “pushing the envelope” in her leadership roles within the profession and her work in the federal government.  Her 1970 address to the APhA House of Delegates before debating APhA’s generic substitution policy demonstrated the importance of taking bold steps, and has been a guide for me and others as we serve our patients, community and profession:

Leaders are called to stand in that lonely place between the no longer and the not yet and intentionally make decisions that will bind, forge, move and create history.

We are not called to be popular, we are not called to be safe, we are not called to follow.  We are the ones called to take risks, we are the ones called to change attitudes; to risk displeasures, we are the ones called to gamble our lives for a better world.

Thank you Mary Lou for your everlasting impact.

How many times have we heard “I wonder why somebody didn’t do something?”  Who is that “somebody” within our profession who can make a difference?  It’s you and me.  Making that difference is what has driven my work with APhA and my community.

I have found throughout the years that our communities, and the impact that we can have on them, are all so different.  Consider my own experiences…first, within my practice community at the Daily Planet, a medical clinic for the homeless, and second, the APhA community.

The team at the Daily Planet strives to improve the health of our community where integrated care delivery positions pharmacists as a vital member of the team.  We take responsibility for our wellness and prevention services (screenings, immunizations, smoking cessation and annual wellness visits), medication optimization (reconciliation, management, access, adherence), chronic disease management, high-risk patient management, quality improvement, medication information, and patient and staff education.  Our service goes beyond the 4 walls of the clinic, into the community where patients are.

How does that translate to work with APhA?  APhA provides support, tools and resources that help us engage within our communities.

Importantly, “Community-based pharmacy practitioners” are gaining recognition. CDC has recognized our work!  In a letter addressed to pharmacists, the CDC acknowledged the growth and public health impact we have made over 20 years, including expanded immunization authority, improved vaccination rates, and collaboration with other providers.  We really are, like they said in that letter, “walking the walk.”

The letter also recognized the 20th Anniversary of the Immunization Certificate Training program, an innovative program that teaches pharmacists the skills they need to be a primary source for vaccine information and administration.  That program has trained more than 280,000 pharmacists.  Please stand if you are an immunizer, trainer or partner in this endeavor.  Thanks for helping to keep our communities healthy!

We are impacting the health of our communities in many ways.  Results were just published of RxVaccinate, a project designed to provide pharmacists with the tools to increase pneumococcal vaccination rates through patient coaching by pharmacists -- and the data show it’s working!

Many other initiatives have positioned pharmacists to impact community health. For example:

  • Our work with HHS’s Million Hearts Program and CDC’s chronic disease division engages pharmacists in chronic disease management and heart health.
  • APhA’s development of community pharmacy residency guidelines 30 years ago has led to the training of thousands of pharmacists who continue to develop, advance and integrate patient care services in community practice, and
  • The APhA Foundation’s Patient Self-Management Solutions. When pharmacists employ this proven tool with, patients with diabetes the annual overall cost of care is reduced by $1,000 per person, while improving patient health and satisfaction.

All of these efforts, and more, make an irrefutable case that pharmacists MUST be in the community and on the team!

Local Community Stories

APhA’s and the profession’s commitment to patients and communities is demonstrated every day.  Here are a few examples that have been highlighted over this past year in Pharmacy Today.

There’s a neighborhood in Harlem, New York, where Yogi Chavada co-owns the Norwood Pharmacy.  He’s a treatment adherence coordinator, and he’s been organizing free monthly community events for the past year in a renovated room in the back of the pharmacy.  Events range from seminars on medication adherence, nutrition, and “Understanding Hep-C, PrEP & PEP,” to Friday-night-Bingo and art therapy.
 Most attendees know about the events from being regular customers of the pharmacy.  Some live several blocks away, where another pharmacy might be closer, but said they come to Norwood because the staff goes the extra mile for patients and the community.
One patient said, quote, “It’s like family here; you can always count on them.”

The Center for Pharmacy Care sits on the edge of Duquesne University’s campus in downtown Pittsburgh.  On a bus route and within walking distance for many, the ambulatory care center is a main point of access for primary and urgent care services for mainly African Americans and economically disadvantaged.  The pharmacy associated with the Center is the only dispensing pharmacy in the area.  Three clinical pharmacists, as well as student pharmacists and residents on rotations, provide medication therapy management services, smoking cessation counseling services, adult immunizations, extensive point-of-care testing, and more.  While they provide these services to students and faculty on campus, 70% of patients who come to the center are from the community, according to pharmacist Suzanne Higginbotham, director of the Center for Pharmacy Care.  She says, “They know we’re there, and we’ve established ourselves as a place they can come to get help.

Truman Medical Center is a disproportionate share hospital that serves low-income residents in Kansas City and Jackson County.  Many patients are either underinsured or without insurance, and because Missouri is not expanding Medicaid under the Affordable Care Act, the uninsured population is expected to grow.  That’s where 
pharmacist Andrew Bzowyckyj has a practice site serving patients in need of care to manage their diabetes and other chronic diseases, but primary care providers are in short supply. 
“Lots of patients here seem to have multiple specialists, but it can be difficult for them to regularly see a routine primary care physician, especially at an academic medical center,” Bzowyckyj said.

These pharmacists went above and beyond to take a community approach.  These pharmacists are making a difference…are changing lives…because they believe in their patients.  They believe in their community.

 Opportunities to Engage in Your Community

Our definition of community must truly extend beyond the walls of pharmacies, hospitals, and clinics…beyond even our patient care activities…to the many lives we touch as pharmacists.

Social elements beyond clinical care influence individual and community health: living environment, job, income, transportation, nutrition, and so much more.  Opportunities for better care exist within that broader lens; between our patients’ relationship with the medicine they take and the lives they live.

Look for unmet needs in your community, and find ways to help.  Opportunities are there for you to engage in your community.

For example, the CDC Center for Chronic Disease Prevention and Health Promotion funds state health departments to create community–clinical linkages for high-risk individuals with, or at high risk for, chronic disease.  Those grants specifically mention pharmacists – and state health departments in Utah, Colorado, Ohio, and 20 others link pharmacists who provide medication therapy management, hypertension and diabetes services to patients within those communities.

In another example, Eric Bing and Marc Epstein in their book, Pharmacy on a Bicycle, point out that in many cases it’s not a health care or a medical problem that our community needs to solve, it’s often a logistics problem.  Bing and Epstein tell the stories of social entrepreneurs around the world who have “taken health care the last mile,” by providing pharmacy services in remote communities.  There are multiple ways to serve community needs.

Martin Luther King said, “Everyone can Be Great Because Everyone Can Serve.”  Whether that’s serving your profession, community, or all the above, we have opportunities to make a difference. Look beyond your own walls for the opportunities to meet the needs of your community and make your world a better place.

APhA positions pharmacists to be community-based pharmacist practitioners.  APhA-led initiatives, training programs and resources are there to help you take advantage of these opportunities and assume expanding patient care roles – and all of these revolve around the power of community. 

We lead and support strong advocacy – provider status and team-based care.  We build “community” for our profession and patients through our many coalitions.  APhA offers certification, accreditation, and training to set you apart in your community.  We provide networking opportunities through Special Interest Groups, the Annual Meeting, the Engage platform, and publications.  And the APhA Foundation stimulates the research to prove our value.

Conclusion and Call to Action

My focus over the next year will be “The Power of Community.”

I ask each of you, What is YOUR community? WHO is in it?  How can you help?  Think of your community and the needs of your patients in everything you do, and you’ll find amazing fulfillment while changing lives. 

For the coming year, take advantage of an opportunity to engage the power of community!  And here’s how…

  • Develop a new partnership within your health care team and/or community.
  • Find new ways to use your expertise and enhance your patient interactions to bridge gaps.
  • Bridge gaps and create a more holistic care for the people you serve. 
  • Share your opportunities on the APhA Engage platform with your pharmacy colleagues but go beyond and share with communities everywhere using #APhAEngage on Twitter!

We want to hear how you are engaging the power of community to improve lives and help people achieve their goals!

At the end of the day, our communities go beyond where we and our patients live.  Together with your professional colleagues we can make a difference.   We have incredible opportunity, and incredible potential, and together, in OUR COMMUNITY, we will take our profession to new heights in serving the public health.

THAT’s making a difference -- in your community and in our profession!

“If you want to touch the past, touch a rock.  If you want to touch the present, touch a flower.  If you want to touch the future, touch a life.” 

US health care is moving rapidly to value-based payments and team-based care.  APhA is committed to advocating for your essential roles in the revolution, and to equipping you with the skills to engage and to touch lives.  From where I stand on this podium today, this community of pharmacists has a BRIGHT FUTURE!

It is truly an honor to have this opportunity to serve our community of pharmacists, this Association and the profession that means so much to me.  Together, we will engage the “Power of Community.”

Thank you all so much.

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