This podcast is the first in a 4-episode miniseries exploring the careers pharmacists can have in hospital pharmacy administration. In these episodes, pharmacy students will be interviewing a variety of professionals in different pharmacy admin fields and delving into how they got where they are and the intricacies of their jobs.
The information presented during the podcast reflects solely the opinions of the presenter. The information and materials are not, and are not intended as, a comprehensive source of drug information on this topic. The contents of the podcast have not been reviewed by ASHP, and should neither be interpreted as the official policies of ASHP, nor an endorsement of any product(s), nor should they be considered as a substitute for the professional judgment of the pharmacist or physician.
(upbeat music) - Welcome to the ASHP official podcast, your guide to issues related to medication use, public health, and the profession of pharmacy. - Thank you for joining us for ASHP's Practice Journeys podcast. This podcast invites members to share their stories about their professional path, lessons learned, and how their experiences shape who and where they are today. My name is Travis Schubert, a current P2 at Texas Tech University Health Sciences Center in Dallas, and today we'll be chatting with Dr. Travis Miller, a current PGY2 Hospital System Pharmacy Administration and Leadership Resident at the University of Utah Hospital System. Today he'll be speaking with us about his experiences and career path going into hospital pharmacy administration and how we as pharmacy students can learn and potentially follow the same path he did. - Thanks for joining us today. - Yeah, thanks for having me on Travis, it's great to be here. - Absolutely, I'm really excited to get to know you today and to start those questions off, can you give us a little bit of background about your current practice site and professional responsibilities? - Yeah, so I can start with a little bit of background on the University of Utah Health System. The U of U Health is the only academic medical center in the state of Utah and the Mountain West and provides patient care for the people of Utah and the surrounding states of Idaho, Wyoming, Montana, Colorado, and much of Nevada. So being an academic medical center, it helps to train many of the state's physicians, nurses, pharmacists, therapists, and other healthcare professionals. The system consists of five hospitals, 12 community health centers, and 17 community pharmacies located throughout the Salt Lake City Valley and beyond. So as a PGY2 HSPAL pharmacy resident, most of my time has been spent at the main hospital, but I've had rotations at different sites within our system over the past two years as well. So depending on the rotation, the day-to-day activities can change. For example, during my inpatient pharmacy operations rotation, I was able to spend a lot of time in the central pharmacy and worked on projects related to getting medications to patients in a safe and effective manner. During my supply chain rotation, I was able to work with the pharmacy purchasing team to facilitate a smooth transition to a new drug wholesaler. So various responsibilities, depending on the rotation that I'm on. Outside of those responsibilities for rotations, I also have the responsibility of being one of the intern managers for approximately 35 to 40 inpatient interns that work at the hospital. My co-resident and I split out this responsibility. So we create their work schedules and meet with each intern at least quarterly to check in and do performance evaluations. In addition to that, I have a certain amount of required staffing shifts where I staff independently, either in our central pharmacy to verify orders and manage the operations of the pharmacy or up on one of the patient floors helping to facilitate patient discharges. I also have the opportunity to lead a longitudinal project over the course of the year, which takes up some time on any given day. So as you can probably tell by that description, those day-to-day responsibilities can change, but there are always things to be working on. - Absolutely, Travis, it sounds self-grilling to say the least. I'm sure you always have a busy plate. Well, with that moving forward. So what's pharmacy, you know, specifically pharmacy leadership, something that you were always interested in? - Yeah, that's a great question. So I was always interested in pharmacy, especially after coming out of high school, but I can't say that pharmacy leadership was something that I envisioned when I started on this journey. With both of my parents being pharmacists, I figured I would end up becoming one as well. I really enjoyed the sciences and school and got to experience working in a pharmacy at a hospital as a pharmacy technician. This led me to go to pharmacy school. However, I didn't know much about pharmacy leadership and didn't even know what an HSPIL residency was until my P3 year of pharmacy school. Throughout school, I had the opportunity to take classes at the business school and obtain my MBA degree. I also joined a couple of professional organizations and had leadership roles within those groups. Those experiences opened up my eyes to pharmacy leadership and I began to seek out any opportunities that were available. When I started my happy rotations, I began to work on quality improvement projects that further grew my interest in leadership and administration. I had a mentor that introduced the HSPIL residency to me and I did some research on various programs that were out there. When I ended up applying for residency, I was lucky enough to match with the University of Utah and I've really enjoyed my time out here completing this HSPIL residency. - Absolutely Travis. I'm sure it has been such an exciting road for you. With that, with as many things as you have on your plate, what project as a resident has been the most interesting or your favorite? - Yeah, I think it's hard to decide since both of my longitudinal projects. So both my PG1 project last year and this year's project have both been pretty meaningful for me to work on. But I guess I'd have to go with the PGY1 project. So that project involved taking a look at the pharmacy workflow of our investigational drug service team or our IDS team. So they currently have a hybrid work model where some individuals work from home. Well, others are on site. The goal of this project was to see how efficiently the team was working in this model compared to the previous model of having everyone working on site, specifically looking at order verification times. So after assessing thousands of order verification times, it was determined that the team was operating just as efficiently, if not more efficiently, in this current hybrid staffing model. And the staff really enjoyed working in this current model. I was able to present those results of the project to the IDS staff, which was very cool to see. Another rewarding part of the project was being able to write the manuscript and ending up getting published in the American Journal of Health System Pharmacy, or AJHP. So that project was probably my favorite because it had a meaningful impact on the staff and the results were used to justify the current staffing model being used in that department. - Absolutely. I'll have to go read that publication in my off time. With that, kind of switching gears here. How would you say pharmacy school prepared you for this role? I know you're still in residency and for a lot of people, that's one block, one step of the career. But as someone who's in pharmacy school, it's the next big hurdle. So I'd love to hear. - Yeah, and it wasn't too long ago when I was in your same seat there. I think first and foremost, pharmacy school helps to provide the clinical foundation that is needed to be successful during residency. So most of my PGY one year was clinical and I relied on many of those principles learned in pharmacy school to help me be successful. I think that the leadership opportunities that were available during pharmacy school helped me to prepare for some of those experiences as an HSPAL resident. Being involved with student organizations and participating in the MBA program helped me to develop some of those essential skills needed like time management, communication, conflict resolution. So those skills have been further developed and refined over the course of this residency. But I started to develop them during pharmacy school. - Great answer, always good to hear that, hopefully all this work I'm putting in will pay off. Speaking more on the journey of how you got to where you are today, who were your mentors that helped you get to this point? - Yeah, so I've had so many people that have invested in me and have helped me get to this point where I'm at today. I think it started with my parents who encouraged me to embark on this journey into becoming a pharmacist and they've supported me along the way. So I did pharmacy school at Palm Beach Atlantic University, which is located down in West Palm Beach, Florida. During my time there, I had a mentor named John Doherty who spent a lot of time helping me to figure out what path I wanted to take. So along with teaching at the College of Pharmacy, he has been in pharmacy leadership roles throughout his career. He introduced me to the HSPL route and provided me with many valuable experiences to build my leadership skills during my happy rotations. I was initially hesitant to commit to the HSPL path, but through our conversations, he helped me to muster up that confidence to apply when it came down to applying for residencies. As I mentioned earlier, I was fortunate enough to match with the HSPL program at the University of Utah Health. So during my time here, I've had many pharmacy leaders within the system that have helped to guide me to where I'm at now. Specifically, my residency program director, Ashley Bowden, has been so supportive over the last two years and has helped me to grow as a leader. She's been able to tailor this residency experience to match my interests and she always finds time to check in and see how I'm doing. She's encouraged me to ask questions, which has led to growth. And I feel like I've been able to get the most out of this residency and the opportunities that were provided. I can't thank her enough for the time and effort that she's invested towards my future career as a pharmacy leader. - Sounds like an amazing program. That's so good to hear. Well, with that, with all the amount of time that you put into a residency, how long you're there, how much goes into it, what would you say is the most rewarding part of your job? - Yeah, I think I'd have to say hands down the most rewarding part of the job as an HSPAL resident here at the University of Utah has been getting to serve as an intern manager for our inpatient interns. So I've really enjoyed getting to know each one of the interns and hearing each person's unique story and journey through pharmacy school. I value these relationships and I've gotten to see tremendous growth in each of the interns over the last year. There have been so many people that have helped me throughout my journey and that has driven me to want to help those interns that are currently going through that pharmacy school process that I went through not too long ago. So I've definitely learned a lot from them and I'm excited to see all the great things they'll accomplish as they move into the next stage of their careers. - Absolutely, that's so exciting. And speaking of moving into their careers, what do you see yourself doing after you complete this program? Do you have a job specifically in mind? And yeah, where do you want to go from there? - Yeah, so well, my professional interests at this point are focused around inpatient pharmacy operations and clinical management. I just finished up my post residency job search. So I'm thrilled to say that I accepted a position as an inpatient pharmacy supervisor at Barnes Jewish Hospital in St. Louis, Missouri. So Barnes is a large nonprofit teaching hospital and I'm very excited to join their team this fall to help serve the patients in that area. This will be a great opportunity for me to continue to build upon those leadership skills that I've developed over the last few years and to do it within an area of inpatient operations, which I'm very passionate about. - Congratulations, Travis. I did see on LinkedIn, very excited to hear about the job offer and looking forward to seeing you succeed. - Thank you. - Of course, moving forward. In your opinion, what are some emerging trends or challenges in pharmacy management? And how do you anticipate these will impact the role of a just paliformosis in the future? - Yeah, I think this is a great question. So I think a major challenge that has existed for some time and will continue to remain a challenge for pharmacy leaders moving forward is the issue of drug shortages and supply chain disruptions. I think the ability to develop strategies to mitigate these interruptions is so important for patient care. So ASHP provides a pharmacy forecast report each year and this was a key topic that was mentioned in last year's report. So some of the strategies from the report that pharmacy leaders have identified moving forward include increasing domestic production of medications, utilizing emergency stockpiles of meds and performing research for extending drug stability data. So I think each of those has an aspect in helping to mitigate these drug shortages and disruptions moving forward. I think another challenge in pharmacy management moving forward is the increasing drug costs and reduction in reimbursements for services that are provided. So drug costs continue to rise each year which presents a challenge for pharmacy leadership. On top of that, reimbursements for services provided have been reduced in many instances. So having an environment of increasing drug costs and decreased reimbursements is not a sustainable model in the long run. I think it's important as a pharmacy leader to continue to identify ways to reduce costs and make processes more efficient. And it's also important to advocate for the work that is being done in services that are being provided so that payment reflects this. Ultimately, as a pharmacy leader, it's important to run a profitable operation so that the doors stay open and we can continue to provide the best care for our patients. - Absolutely, Travis. And with the ever-changing landscape of healthcare, in your opinion, what does the future of the HSPAL profession look like? - Yeah, I think there's many opportunities in the near future for the profession of pharmacy and pharmacy leadership in general. I think one of the things that has really taken off, especially through the COVID-19 pandemic, has been the use of telehealth pharmacy services. So there's growing evidence that supports positive clinical, quality and financial outcomes from pharmacy telehealth services. This was another key topic that was mentioned from the 2023 Pharmacy Forecast Report. I think telehealth services can continue to be leveraged in the future to provide equitable care. There's currently a growing number of service line models that have been explored for telehealth services. And some of those have included emergency medicine, remote patient monitoring and transitions of care. I think another opportunity within pharmacy as we move forward is the use of artificial intelligence or AI. So AI, in a sense, presents both an opportunity and a challenge. I think the use of AI in the pharmacy setting can help support clinical practice and make many of our processes and workflows more efficient. But on the other hand, the challenge that comes with that is making sure that information is accurate and free from bias when it comes to clinical decision making. As we navigate the world of AI and how it works, I think it's important for us as pharmacy leaders to stay engaged with the latest information and learn to understand some of those intricacies of AI and how it can be used for our benefit. - Absolutely, Travis. Very excited, not only for the prospective opportunities, moving into these next few decades, but very interested to see how the profession will change, especially and hopefully as I enter it. With our final question of the day, I'll ask, do you have any advice for pharmacy students out there thinking about pursuing a career in hospital pharmacy admin? - Yeah, I think first and foremost as a pharmacy student, it's totally okay if you don't know for sure yet, which route within pharmacy you want to pursue for your career. One of the ways to figure out if administration and leadership is right for you is to get involved with your school of pharmacy. Getting experience with a leadership position during pharmacy school was helpful for me to figure out if I enjoyed being in a leadership role. Another piece of advice would be to ask questions. So during pharmacy school, you have the opportunity to ask professors and preceptors, various questions, and it might be helpful to hear other people's journeys and how they ended up where they are now. I think another thing to remember is that there can be many different types of leaders and each leader is unique in their own way. Having those different personalities and character traits is a benefit to the team as you're able to learn from other leaders that think a little bit differently than you might. There are many great HSPL programs across the country that I think can help develop those leadership skills as you pursue the next step in your pharmacy journey. And it's a great opportunity if that is something that you're interested in moving forward. - Well, thank you for that advice, Travis. And I'm sure a lot of people out there are definitely interested in what you have to say and the profession as a whole. But with that, I think that's all the time we have today. I wanted to thank Travis Miller for joining us today and sharing his story. Join us here at ASHP official and the Practice Journey podcast as we learn about how our members seek out, grow, and evolve during their careers. Thank you, and goodbye. - Thank you for listening to ASHP official, the voice of pharmacists advancing healthcare. Be sure to visit ashp.org/podcast to discover more great episodes, access show notes, and download the episode transcript. If you loved the episode and wanna hear more, be sure to subscribe, rate, or leave a review. Join us next time on ASHP official. (upbeat music) [MUSIC PLAYING]
