Erin Albert, MBA, PharmD, JD

At Butler University, the mission is to integrate core liberal arts and sciences (LAS) education with professional education as our founder, Ovid Butler, described. And, as a passionate writer myself, I make it my personal mission to provide writing and publishing opportunities for students, both inside and outside of our pharmacy program.

Cases in point: we have a new, open-access, multimedia health care journal called 

, which is open to all majors on campus to run much like a law review at the undergraduate level, and anyone, anywhere, can submit articles for publication consideration (including you, reader!). For senior projects, we’ve had several interprofessional teams of students write, illustrate, and publish 7 different book projects on STEM (science, technology, engineering, math) education, immunizations, asthma, diabetes, pharmacy, and antibiotic stewardship, just to name a few.

But beyond the intrinsic rewards of writing and publishing before graduation from pharmacy school, how can one leverage this amazing opportunity into standing out from the crowd and showcasing it with potential employers? Here are a few tips:

Publish Before Graduating from Pharmacy School

1. Find a mentor/professor to partner with.

 Even if your school or college of pharmacy doesn’t require research projects or publishing, you can usually find a mentor or professor within your college to pair up with for a publication. You gain some credibility as a first-time or early-career writer when you pair up with a professor with years of experience.

 Even though the holy grail of publishing might be original, double-blind, randomized research, that doesn’t mean that other types of writing are less valuable. In 

, for example, students write almost in a long-hand journalistic style, rather than focusing on original research. In the children’s book projects, students are writing for children in an “edutaining” way about public health topics. (And, by the way, writing children’s literature is one of the hardest forms of writing to do well.)

3. Begin with the end in mind for publication planning.

 After you have your mentor or faculty member and topic on board, next, before you even start your research, you need to target which type of article, journal, and/or book you want to write. If you want to publish in a peer-reviewed journal, do your homework and fully understand the publication parameters. Details matter, so know the rules before you get started so you’re not rewriting your paper. For example, with 

, we have detailed descriptions on our website of what we seek for publication consideration. See 

4. Can’t find a journal? Publish a book! 

In the era of self-publishing, if you have good content, you don’t need permission to publish: just go ahead and write your own book! You have e-book options that cost next to nothing, all the way up to spending thousands of dollars to purchase advanced copies of your book. Caution: writing and publishing a well-edited book is a long, arduous, and sometimes painful process. Keep that in mind when you’re considering going for the gusto!

Now that you have a few pre—pub-planning tips, let’s fast forward to the good part: you’re published. Now what? How can you leverage your experience into meaningful conversations (and jobs with potential employers)? Here are some thoughts:

Leverage Your Publication for Great Conversations and Job Offers

1. Include your publication on your social media portals.

 Check on copyright beforehand, but if your publisher allows you to reuse your content, blast it through your social media channels! (If they are smart, they’ll encourage you to do so because traffic is something publishers welcome these days.) LinkedIn is an excellent place to highlight your publications, and in an era when recruiters pay more attention to your LinkedIn profile than they do your résumé, it’s imperative that you use this free tool to promote your writing and publishing experiences. Also, if you’ve paired up with a faculty mentor, use social media to thank them for working with you and post the link to the work.

 Peer-reviewed publications are just one type of publication you can include on your résumé or CV. Other categories might include letters to the editor, opinion/editorial pieces, newsletter articles, posters, workshops, abstracts, and features. If you write, but not in health care, writing is still a critical skill that employers don’t have enough of in this era, so feature it and include it in discussions with employers. Solid writing transcends technical knowledge, and employers want your technical acumen!

3. Take your interviewers on a publishing journey with you.

 If you’ve interviewed for a job before, you’ve probably been hit with 1 or 2 questions like, “Tell me about a time where you [INSERT SKILL HERE] like, led a team, worked in a group, had to solve a problem, etc?” This is an opportunity for you to tell the story behind the story of your writing and publishing outcomes. What method(s) did you use to pick your topic, target your publication or journal, research your article, write, edit, and collaborate on your article? This shows that you can be a project-based, outcomes-focused employee. It shows you are organized. It also shows that you are intrinsically motivated to finish what you start … all of these skills are highly coveted in the workplace.

4. Take a copy of your work to the interview

. Show and tell! Leave behind a copy of your work with your résumé or CV. Everyone will have a résumé or CV at an interview fair—that’s a given. But if you’ve got a publication to go along with it, you’re golden. Not everyone will have a publication under her or his belt&mdash;it will separate you from the herd.

The pen is mighty. It can even get you published—and hired. So, don’t leave behind your writing passion if you head to pharmacy school. Instead, leverage it as a way to share with others what you’ve learned in school&mdash;what sets you apart.

Erin Albert, MBA, PharmD, JD, PAHM, is a health outcomes pharmacist and pharmacy fellowship director for Myers and Stauffer, LC, a co-host of The Pharmacy Podcast, writer, entrepreneur, attorney, preceptor, career coach, and STEM advocate. She would like to thank one of her mentors, Joe Fink at the University of Kentucky College of Pharmacy, for the idea of this article. More on her at her blog, www.erinalbert.com.

Articles

Don’t leave behind your writing passion if you head to pharmacy school; instead, leverage it as a way to share with others what you’ve learned in school.

Pair Up, Publish, Promote, and Prosper: Why and How to Write Before You Graduate from Pharmacy School

 made just for this article to find out — then read on!

With the number of licensed pharmacists approaching the amount of open pharmacist positions, the market has become, particularly in some metro areas, saturated with more pharmacists than jobs. Differentiation has never been more critical for the individual pharmacist in any other point in history than it is right now.

One way to differentiate yourself and perhaps get more credentials right after pharmacy school is by taking on a residency, fellowship, or both. But, what are the differences between them? Do you have to complete a residency before a fellowship? Which path should you choose?

Let’s take a look at both types of learning opportunities, along with some truths and myths that follow them around, and, best of all, let’s give you some questions to ask yourself about which type of postgraduate education is right for you.

According to the American Association of Colleges of Pharmacy, residencies in pharmacy first appeared in the 1930s and were branded more like internships. In 1962, the American Society of Health-Systems Pharmacists (ASHP) first established residency accreditation, with the goal of standardizing this type of postgraduate experience.

 They’re currently labeled by year of postgraduate experience—a postgraduate year 1 (PGY1) residency occurs after the first year of postgraduate education, a PGY2 tends to be more specialized, and occurs after the second year, and so forth. There have even been mentions of PGY3 and PGY4 residencies for pharmacy, much like in medicine.

Fellowships were originally established in medicine as more research-focused, postresidency experiences. Many fellowships in pharmacy had origins in the 1970s through 1990s.

 However, pharmacy’s approach to fellowships has been different in that a student does not necessarily need to complete a residency in pharmacy first before moving on to a fellowship. In fact, completing a residency in pharmacy 

 to a fellowship as a requirement is a myth.

Similarities and Differences Between Residences and Fellowships

Although it is difficult to generalize because each residency and fellowship is different, the elements, similarities, and differences between fellowships and residencies are laid out in the Table.

There are benefits to completing a residency first, if you desire to ultimately work in a hospital setting, or really enjoyed therapeutics or want to learn more about general medicine. If specializing in a therapeutic area is your style, then a PGY2 in addition to a PGY1 might be in order. Managed care is another type of residency that could almost feel more like a fellowship because it sometimes deals in administrative or managed lives rather than direct patient care.

Fellowships generally are within the pharmaceutical industry, government, academia, or all of these. They can either be 1, 2, or up to 3 years in duration. Relative to the pharmaceutical industry, they can focus on clinical research, medical affairs, drug information, clinical research, health economics, or several other areas within a pharmaceutical company. They usually combine social and administrative teaching topics within academia, and government involvement in a fellowship may include work at a governmental agency, like the FDA or NIH.

Start with your pharmacy school’s director of residencies and fellowships. There is, of course, the ASHP Residency Match Program, and ACCP has a database of residencies and fellowships. AACP has a list of out-of-the-box or nontraditional pre- and postgraduate experiences. Now FellowMatch exists as well, which is part of the Industry Pharmacists Organization. AMCP also has a listing service for fellowships and residencies.

Last but certainly not least, you can go to the hospital site of your choice, or the drug company you’ve always wanted to work with, or the entity in health care you admire and check their website for post graduate opportunities. If one doesn’t exist, why not ask and see if you could start one?

Talk to your professors. Take APhA’s Career Pathway Evaluation Program for Pharmacy Professionals, or any quiz that helps you understand yourself.

 Get educated during your education, and don’t forget to keep your grades up, and sign up for those extracurricular activities that demonstrate leadership qualities—all important for your applications.

Erin Albert, MBA, PharmD, JD, PAHM, is a health outcomes pharmacist and pharmacy fellowship director for Myers and Stauffer, LC, a co-host of The Pharmacy Podcast, writer, entrepreneur, attorney, preceptor, career coach, and STEM advocate. More on her at her blog, www.erinalbert.com.  

American Pharmacists Association. Requirements of post-graduate residency training background prepared for the 2007-08 APhA policy committee. aacp.org/governance/COMMITTEES/professionalaffairs/Documents/RequirementofPost-GradResidencyTrngBackground0708APhAPolicyCmte.pdf. Accessed September 12, 2016.  

Jennings, D. Is PGY3 the future of clinical pharmacy training? 

website. pharmacytimes.com/contributor/douglas-jennings-pharmd-fccp-faha/2016/04/is-pgy3-the-future-of-clinical-pharmacy-training. Published April 6, 2016. Accessed September 12, 2016.

Rutgers pharmaceutical industry fellowship program history.  Rutgers University website. http://pharmafellows.rutgers.edu/history.php. Accessed September 12, 2016. 

American Pharmacists Association. APhA career pathway evaluation program for pharmacy professionals. APA website. pharmacist.com/apha-career-pathway-evaluation-program-pharmacy-professionals. Accessed September 12, 2016.

Differentiation has never been more critical for the individual pharmacist in any other point in history than it is right now.

Residency, Fellowship, Both, or Neither: Which Should I Choose After Pharmacy School?

Ever since I was little, even before I had my eureka moment in high school chemistry class of becoming a pharmacist, I loved to read. My library card was, and is to this day, a magical passport to learn about other ideas, other worlds, and other lives. 

	My love of reading is also one of the reasons I chose to attend Butler University College of Pharmacy and Health Sciences (BU COPHS). (Full disclosure: I work here currently.) Butler has a great pharmacy school, certainly, but it also offered me something that was equally important—a strong core liberal arts and sciences program. I sought a school that could train and challenge me both in pharmacy and in reading and writing basics. It was important for me to explore and develop both skill sets during my college experience, and I believe strongly that both have enhanced my career.

	Great communication skills—both oral and written&mdash;are a must-have for pharmacists today. Pharmacists who write and publish are leaders in the profession. They can clearly articulate new and better ideas to grow our profession in a positive direction and, most importantly, they can challenge all of us to rethink why we do what we do as pharmacists, which ultimately improves patient care.

	Now that I am a professor, I continually look for ways to share my writing and pharmacy passions with my students. One of the best ways I can do this is by creating potentially once-in-a-lifetime opportunities to write and publish before pharmacy school graduation. 

	This spring at Butler and moving into next academic year, we have several exciting projects that will help students hone both their writing and pharmacy skills: 2 children’s book projects, an open-access student-driven health care journal called 

, and a brand new pharmacy-driven writing fellowship. These projects help students polish their writing and editing skills, but they also do something more: I would argue they improve leadership skills (Table.) 

 is an open-access, multimedia, student-driven interprofessional health care journal started in 2015 by Butler University College of Pharmacy and Health Sciences through a Butler University Innovation Grant. The inaugural issue will be published online in May 2016. Log on to the website at http://digitalcommons.butler.edu/buwell/ for more details. All professionals are welcome to submit articles that fit the theme of this journal! During the 2016—17 academic year, the theme of the journal is the future of health care.

	They say the pen is mightier than the sword. I say it’s also a great way to maximize one’s career in pharmacy practice, at least for those of us who love to write. If you share this passion, read on to learn how to enhance both your career and your purse strings via writing. With the help of 2 current Butler COPHS pharmacy majors who also love writing and are graduating this spring— Katie Kieffer and Nichole Szczerbowski&mdash;following are 5 major reasons why I think writing will benefit you and your pharmacy career:

		Writing makes pharmacists more creative. Szczerbowski said her first writing project in elementary school was like being given a hardcover book that was completely blank. 

		“I was always so excited when we received that book because I knew it was a blank canvas through which I could tell and illustrate any story I wanted,” Szczerbowski said. 

		Kieffer stated that she became excited and involved in writing projects around BU COPHS because she was “attracted to the idea of starting something from scratch.” 

		Personally, I just began writing fictional children’s books in 2014, and it has helped me think in ways I had never considered! I have no doubt that writing increases one’s creativity.

			Both students remarked that they became interested in our student-driven health care journal project at Butler, BU Well, because of its potential to improve their leadership skills. 

			As head of the policy team for BU Well, Kieffer talked about stretching her leadership skills: 

			“[BU Well] taught me the importance not only of providing autonomy to team members, but also of laying down a framework and guidelines at the beginning of a project.”

			Szczerbowski, who headed the first semester bylaws and sustainability team for BU Well, was also able to explore her leadership skills. 

			“I was able to try different methods of management and organization and tailor those skills based on feedback and outcomes,” she said. “I learned the importance of being a leader who is passionate, open-minded, and receptive, and who works alongside colleagues to accomplish goals.”

				In our busy, information-overloaded world, not only do writers need to be strong technically, but they also need to get to the point quickly. 

				“No one wants to read a 5-page email,” Kieffer said. “In today’s world, where most communication is done electronically, the ability to convey a message accurately and concisely is important.” 

					Szczerbowski believes that better writing skills will get her to the career level she aspires to attain: involvement in academia. 

					“Medical writing has been shown to have many benefits for pharmacists, such as satisfaction with the profession, more support for research, and the ability to teach graduate level courses,” she said. “As a future pharmacist who is interested in academia, I believe writing is a vital skill that will enable me to become a more effective educator.” 

					I love to write because it helps me think through ideas on how to teach better. It also leads me to other networks and professions. Other professions have great ideas that I can bring back to pharmacy and implement in order to make the profession more exciting.

				Part of good writing is also learning ruthless editing. Strong editing skills can lead to concise, solidly written art. 

		Starting things from scratch is difficult. Some of the best-implemented ideas begin with a well-written plan. Both students mentioned that they were intrigued by the blank canvas concept of building something from scratch, and writing scratched this itch for them both. 

		In fact, Szczerbowski and Kieffer have taken their passion for writing and are working together on their senior pharmacy school project, which centers on the writing skills and courses being offered at all 130 schools of pharmacy in the United States. In doing this project, they are also building a plan to offer even more writing opportunities for students on the BU campus. 

Great communication skills both oral and written are a must-have for pharmacists today.

5 Benefits of Penning in Pharmacy Practice: Writing Your Way to a Great Career

When it comes to enjoying a life-long career, mentoring, networking, and learning are all critical. Where can you go to power up on this trifecta of career development all at once?

	Pharmacy association annual meetings, of course!

	There is power in attending and participating in pharmacy professional associations. Learning the trends, getting up-to-date education, and reconnecting with mentors and colleagues can all happen when you take the time to attend professional society or association meetings.

	The start of a new year is always a good time to seek new opportunities to try or new career areas to explore. With so many meetings to consider, I decided to note all of the national pharmacist association society meetings on a calendar and 

	I’ve been lucky enough to garner some of the best ideas I have ever had when it comes to my career while attending annual pharmacy association meetings. The following are just a few examples.

	The drug information association (DIA) offers a great meeting for medical information professionals in the pharmaceutical and biotechnology industries. The DIA was one of the places where I first got the bright idea to publish a book about medical science liaisons. I also learned a lot through this organization about the different types of careers that are possible within the pharmaceutical industry, such as regulatory affairs, clinical operations, medical and drug information, health outcomes research, and medical science liaisons. The 2016 DIA annual meeting is June 26—30 in Philadelphia, Pennsylvania.

	When it comes to women in leadership positions in health care, we have a paucity of women at the helm. That is why I appreciate the healthcare businesswomen’s association (HBA)—its annual meeting honors some of the best and brightest women in the industry. The association helps educate women and expose them to leaders in health care and pharmacy. We all need more diversity in leadership&mdash;in both health care and pharmacy practice. The 2016 HBA annual meeting is November 2—4 in St. Louis, Missouri.

	I met one of my current managers at the american college of clinical pharmacy (ACCP) annual meeting several years ago. That was the ultimate networking experience because I actually got a job out of that connection, and it was a job that never even existed before! Also, ACCP offers several courses for board certification in many clinical specialties. Board certifications are exploding in health care and pharmacy careers. If clinical pharmacy is your passion, consider attending ACCP’s 2016 annual meeting October 23—26 in Hollywood, Florida. 

	Academic pharmacists attend the american association of colleges of pharmacy (AACP) annual meeting. When I attend AACP, I get the chance to catch up with friends and colleagues from other pharmacy schools across the United States. In 2015, I also had the chance to learn more about running editorial content for a journal, which has become handy as the founding editor for a health care journal created by and written for students at Butler University. The 2016 AACP annual meeting is July 23—27 in Anaheim, California.

	 Now that I am a lawyer, a pharmacist, and a teacher of pharmacy law, my hands-down favorite meeting is the american society for pharmacy Law (ASPL) because I can earn continuing education credits. (Full disclosure: I am on the board and a member of ASPL.) I have been fortunate to find many mentors, inspiration, and speakers through this organization. While many think pharmacist-attorneys are rare, this group is growing. Legal issues in pharmacy are exploding, which gives us more challenges and policy for the profession to manage. ASPL’s 2016 fall conference is November 10—13 in Austin, Texas.

	Regardless of your area of practice or the passions you have in pharmacy, do yourself a favor and attend a few pharmacy association meetings this year. Although the cost of attending is high in terms of both time and money, the rewards from participating in these conferences can be immense, from meeting up with colleagues and discovering best practices to learning how to get more involved in pharmacy on a larger level.

	See you at the meetings, and happy 2016! 

Erin Albert, MBA, PharmD, JD, is an associate professor of pharmacy practice, director of continuing education, and founding executive editor of BU Well at Butler University College of Pharmacy and Health Sciences in Indianapolis, Indiana. She is also a health outcomes pharmacist for Myers and Stauffer, LC. For more on her books and writing, visit her website at www.erinalbert.com. 

When it comes to enjoying a life-long career, mentoring, networking, and learning are all critical. 

The Power of Attending Pharmacy Association Meetings

In the summer of 2015, I was lucky to be a part of Seth Godin’s inaugural altMBA class. Godin is a well-known author in the change management, marketing, and publishing spaces. Many follow his blog, and he has published several books on his own and marketed them in interesting, creative ways. I have also recommended several of his books to pharmacy students. (Yes, he is the author who wrote about purple cows!)

The altMBA is all about change: how to make solid decisions, how to harness change, and how to act on that change. What I most wanted to learn about was the decision-making objective, and thankfully, I did through the program.

The program itself is not what I wanted to discuss in this article, however; it is that going through the program made me aware of how slowly the profession of pharmacy evolves. Candidly, it moves at a glacial pace. We are slow, if not staunchly opposed, to change in pharmacy in many ways. I believe this resistance to change could be a detriment to the profession if we let it.

When tackling change, we must start with ourselves. Within this article, I want to share with you some ways you can manage and even promote positive change within the profession of pharmacy, and hopefully turn our professional Titanic around into the 21st century.

We desperately need more change agents in our profession, and the old techniques are not going to work moving forward. The world is just changing too quickly, and pharmacy as a profession must keep up with the pace of change.

Here are a few ways to promote and embrace change:

Try new things in your life. That can be as easy as going to lunch with a different colleague every day or reading new books, or as challenging as developing a business plan for the pharmacy to provide a brand new service or product line. While it is scary to go first, there are rewards to making the effort, such as the ability to shape the future. Also, try to change by using your strengths. For example, I am a futurist, so positive change for me means that I want a stake in what my future looks like. Therefore, I am going to try and create my future, rather than merely sit back and wait for it to show up. How can you leverage your strengths to make positive change in your life and at work or in your community?

. Write that plan and present it. Put that idea down on paper and own it. Your boss wants you to add value to the organization and the business; that was part of the reason you were hired. You already have permission! You just need a solid business case to back up whatever resources, time, energy, and people you will need for this new idea, and show the return on investment.

. Your ideas have value. Show that value to your managers and your business by promoting new ideas, early and often. Develop the reputation for being the go-to idea gal or guy in your organization. Be the agent of change!

. The average adult needs to hear or see something 9 times before it sticks. In addition, timing can play a huge role in whether or not change happens in an organization. You have to realize in advance that not all your ideas will be sticky enough for rapid change. Care less about whether or not all the ideas stick; care more about being the person who puts ideas out there.

5. Realize a “no” today does not mean a “no” tomorrow

. Timing, again, is crucial. A no today from your manager is just a no today. Tomorrow is a whole new ballgame. Keep asking yourself if you are passionate about it, and back up that passion with data and a strong business case. Persistence trumps talent (as stated by another favorite author of mine, Daniel Pink).

. Don King was probably the most famous boxing promoter ever. However, he once said, “I don’t promote boxing. I promote people. Boxing is a catalyst to bring people together.” All of us in pharmacy need to be change promoters and champions, as it is a way to bring people and ideas together. Be open and ask everyone to contribute ideas. A culture of trying new ideas can go a long way with employee satisfaction and strong customer service too.

. Of all the steps, this is probably the idea that pharmacists struggle with the most, myself included. As pharmacists, we pride ourselves on not making mistakes, protecting our patients, and being accurate in everything we do. We must get over this, however, if we want to try new ideas and grow as a profession. Throw a failure party and burn all the failures, if need be, to celebrate failure. Get a cake and party favors. Do whatever it takes to make failure fun, because we do not grow unless we fail. Even bones need stress to get stronger. Through our stress and failures, we grow.

. Getting work done in Godin’s world is “shipping it.” Just do it. Start somewhere. Even if it is a tiny step, even if it is going to take extra work and time, ship it. Stop talking about it and just start doing the work, and next thing you know, you will be changing your life and changing the environment around you!

Pharmacists must drive the positive change within the profession. If we wait for others to tell us what we can and cannot do outside of our profession, we could be waiting a long time, and worse yet, be handed something that we do not want to do. Or, we could be limited by someone else on what we can and cannot do! We have a choice: either be the change, or wait for the change to happen to us via outside forces. Own it, or it will own you. I would rather own it. How about you?

Erin L. Albert, MBA, PharmD, JD, is an associate professor of pharmacy practice and the director of continuing education at Butler University College of Pharmacy and Health Sciences. She is also a health outcomes pharmacist with Myers and Stauffer LC. Her books and blog can be found 

Here are 8 ways to promote and embrace change in pharmacy.

Want to Lead the Profession of Pharmacy? Embrace Change

Lifelong learning is key for successful niche hunting.

Currently, there are nearly 10,000 different prescription products alone listed in the Orange Book, and over 6600 New Drug Applications. While pharmacy tends to attract the best and brightest, there is no way that any individual pharmacist can know every statistic, side effect, and pharmacokinetic profile of every drug on the market. Nor can a single pharmacist know everything about the profession—like being a strong leader, advocating for the profession, communicating to a wide variety of people, and managing others.

The need to specialize in this area of pharmacy practice isn’t just a luxury anymore—it is a necessity. The good news is that because pharmacy is so vast, it allows pharmacists to find their favorite niches, creative corners, and the areas of practice they are passionate about, which allows for higher job satisfaction and promotes lifelong learning for pharmacists. The challenge becomes the question, “Where can I find my own creative corner of pharmacy practice?”

There are many therapeutic board certifications and advanced degrees a pharmacist may now earn. Equally exciting, specializing in an area of pharmacy or health care practice provides more opportunities for pharmacists to speak, write, teach, and share their knowledge in order to grow and strengthen the profession. This, in turn, demonstrates the value proposition of pharmacy to the health care team, drives the profession forward in new and interesting ways, and ultimately, offers better care for patients.

How does a pharmacist find his or her particular corners of interest within the profession? Here are a few real-world examples from 4 different pharmacists in the trenches who have been lucky enough to discover their own creative corners of practice.

, a pharmacist with Walgreens in Indianapolis, found her creative niche by developing Well Babies, a woman and baby wellness service, out of frustration from her own personal experience as a mom.

“After having my first baby, I realized that breastfeeding was not as simple and intuitive as I originally thought. The lactation consultant was excellent, but other health care providers lacked training to provide appropriate advice,” she said. “Even as a pharmacist, there was so much I did not know. Upon returning to work, I provided education to a moms’ group on medication and lactation. My passion was born as I discovered the need for better access to support, better information for moms, and better training for health care professionals.”

, director of pharmacy at Good Samaritan Hospital in Vincennes, Indiana, became a quick study of employee prescription drug formulary management when costs for the self-insured hospital were skyrocketing.

“Employee prescription costs are a significant expenditure for hospitals that are sometimes overlooked, as most pharmacy directors focus primarily on the pharmacy department budget and our inpatient/ambulatory care drug costs,” he said. “We traditionally have done an outstanding job of controlling inpatient costs with strategies, like therapeutic interchanges approved by our P and T Committees, but, at the same time, our hospitals are spending $7 per capsule for proton pump inhibitors for employee prescriptions when similar medications are available for $0.10. There are clearly opportunities for the pharmacy departments to impact hospitals’ health insurance expenses by becoming active in looking at ways to control employee prescription costs.”

Another driver for finding a passion in pharmacy relative to policy at a broader level was discovered by 

, at the Office of the National Coordinator for Health Information Technology (health IT) at the Department of Health and Human Services.

“This is an exciting time in healthcare. Change is taking place and at a pace like no other time in history, and I want to ensure that our profession has a seat at the table,” she said. Dr. Wilkins earned her PhD in health outcomes research to help patients and the health care system at a broader level.

, also wanted to improve wellness for patients at Butler University. “Every patient during my residency in southcentral Los Angeles had diabetes,” she said. “Coupled with my family experience of watching some diabetic relatives just giving themselves more insulin when they ate cake, I realized that no one was discussing preventive education at all with patients. There had to be a better way.”

When asked if their creative niches were always obvious, a majority of these pharmacists did not think so.

“I would never have guessed this path for me at the time of graduation from pharmacy school,” Dr. Lenell said.

Jim Eskew found his niche in formulary management later in his career.

“As I moved from a large academic medical center to a smaller community hospital, I was challenged by our chief executive officer to look at ways to control and decrease our employee prescription costs, and then became very interested in formulary management.”

Dr. Maffeo cites her residency experience as key to finding her passion in employee and patient wellness programs.

“The residency really sparked it for me, where I had the opportunity to start tobacco cessation and diabetes risk prevention programs.”

Dr. Wilkins knew she had a passion for policy after taking a pharmacoeconomics class in pharmacy school. Working in health IT was not expected, nor does she claim to being an expert in the area. “It’s not about being an expert in the field. It’s understanding the needs of the patients, gaps in care, and then making the connections between desired outcomes and the technology that enables them.” She currently supports meaningful use of health IT in her policy work.

While all professionals ultimately became pharmacists, the niches arrived at various times and places throughout their professional careers.

If you’re lucky enough to have located your area(s) of pharmacy passion, which may not always be obvious, the next step to take to help you bloom in the niche is to seek extra training, learning, and development. While some can stay within the profession to find quality training, sometimes sharpening the saw of the niche requires seeking training outside of the profession. Both Eskew and Dr. Lenell cite training outside of the profession for their chosen niches.

Dr. Lenell learned more about breastfeeding and maternal and child health outcomes from public health professionals and conferences for lactation consultants, nurses, and pediatricians.

“I am usually the only pharmacist wherever I go, but I see that as an opportunity to show other health care providers how valuable the pharmacist is to the team.”

Eskew learned a lot about formulary management and employer-managed pharmacy benefit managers (PBMs) by working with the hospital’s consulting agency for health care insurance. “The consultants are very knowledgeable, and as pharmacists we can certainly learn a number of concepts related to overall employer health care costs from these organizations.”

Dr. Wilkins learns from everyone around her, especially in health IT, and was excited to find a PhD program within a school of pharmacy for policy. However, she also cites that there is value in learning from other professions.

“When you have a team to enlist, no one person walks around knowing everything. You learn together—from other agencies, other stakeholders, listening to those in the field and outside the field, then thinking about how all those inputs can come together to improve health care. It is a lot of learning as you go.”

“What we do for our patients is reduce barriers to wellness in our program,” Dr. Maffeo said when discussing the employee wellness program she built at Butler University. “Technology is great, but if we can, for example, produce lab results for employees before they go see their doctors, that reduces a barrier—both in cost and in outcomes&mdash;for the patient. We research and find evidence-based tools and technology to help reduce barriers for our patients.”

If you don’t know your own personal niche yet in pharmacy, here are suggestions from the experts. Eskew recommends hunting for areas of pharmacy practice in which you can make a difference: “With health care reform, there are going to be many new opportunities for pharmacists. I would recommend studying the Affordable Care Act (ACA) in some detail and examine how the ACA is going to drive pharmacy practice, then develop an expertise related to that opportunity.”

Dr. Wilkins agrees. “Technology is not new to pharmacy. We’ve been using sophisticated systems for decades. The question now is, how do we take the traditional dispensing role and merge it with other skills we have—clinical knowledge, medication management, etc&mdash;and integrate ourselves as members of the health care team to better manage health care and outcomes for our patients?

“Be open and willing to try new things. Also, if you find a niche, make it known,” Dr. Wilkins suggested.

Dr. Maffeo cites passion as a hallmark for finding your niche. “When I teach the immunization elective, a few students ‘geek out on vaccines’ every year. That is, they tell me they go out and find learning beyond the class to know more about a subject—like watching CDC videos or asking how to build a business plan around a service. Follow your passions and your gut.”

Dr. Lenell recommends having an open mind to new opportunities. “Loving what you do is so important. Sometimes work and your life outside of work will intersect, and that’s OK. Also, it is helpful to have a plan, but sometimes more helpful to have an open mind. You never know what opportunities will come up.”

Last but certainly not least, all of the pharmacists interviewed cite lifelong learning as a key for niche hunting. Jim Eskew is very focused on discovering how pharmacists may fit into new policies around the ACA, but this interest found him later in his career.

Dr. Lenell is now pursuing a passion around public health, based on her work with Well Babies. “Low breastfeeding rates and barriers to breastfeeding are public health issues, so at meetings for these topics I have encountered information on other public health concerns, such as obesity, that I’m interested in pursuing. I am contemplating more training in public health in my spare time.”

Dr. Wilkins loves the idea of anticipating and preventing health care challenges in patients of the future with data collected from electronic medical records. “We’ll have freeflowing data—what can we do with it? I see a world where we will do predictive analytics and stay one step ahead of problems like medication nonadherence and proactively identifying risk factors in patients to optimize care.”

Dr. Maffeo cites lowering barriers and her passion for public health. “Right now, I’m asking our point-ofcare lab testing manufacturer when the B12, TSH, and other tests are going to be made available for our point-of-care testing machines, so I can lower the barriers to care even further for our patients.

“Ultimately, in our practice setting, we are teaching what’s next in pharmacy. We always ask—are we in a good position to provide a new service? Why can’t we do it for our patients? It all comes down to identifying needs, turning them into opportunities, asking whether pharmacists are wellpositioned to perform those services or needs, identifying the resources necessary to make it happen, building a plan, and then implementing,” Maffeo explains. “This could be true for any creative niche in pharmacy practice, and any profession.”

Creative corners and niches in pharmacy practice are necessary to expand the profession and move it forward. Although niches are not always top of mind and easily identifiable according to our experts in pharmacy practice, they are not only important but also critical to improve the profession, deliver better care to patients, and evolve the health care system itself. Each professional can also attest to life-long learning and a constant search for new niches and creative corners not once, but over one’s entire career in pharmacy practice. Happy hunting for your niche(s)!

Director of pharmacy, Good Samaritan Hospital, Vincennes, Indiana

Niche: Saving money and increasing medication adherence by managing a self-insured employer PBM

Associate professor and director, Health Education Center, Butler University, Indianapolis, Indiana

Niche: Employee wellness program management

Pharmacy manager, Walgreens, Indianapolis, Indiana

Niche: Developer of Well Babies program, use of drugs in pregnancy and lactation

Policy analyst, Office of the National Coordinator for Health IT, Washington, DC

Niche: Passion for blending policy and health IT