Iris Rosendahl

IF TINA STAVINOHO IS AN EXAMPLE, pharmacists have a great future at Cardinal Health. Sixteen years ago, she was hired as a manager of a small hospital pharmacy in <?xml:namespace prefix = st1 />

, just 8 months after getting a BS in pharmacy. It was an exciting opportunity because she had a chance to ?do everything? in a small operation.

Stavinoho, who also has an MS in pharmacy administration, worked her way up to director of a larger facility about 6 years later and then became a pharmacy consultant at Cardinal. In that position, she looked for ways to improve safety and productivity in hospital pharmacies and helped put automated dispensing systems in place at those facilities. From there, she moved into a corporate role, managing a group of 20 pharmacists who would step in as interim directors of pharmacies until permanent directors were hired.

Today, Stavinoho is director of training at Cardinal, a job she has had for about 6 months. She is responsible for developing and training directors of pharmacy, clinical managers, business unit personnel, pharmacists, and pharmacy technicians on key business and clinical practices to ensure effective performance. Her responsibilities also include development and delivery of continuing education (CE) programs accredited by the Accreditation Council for Pharmacy Education. As she says, ?my career path has given me the opportunity to develop skills based on my interests.?

, Cardinal Health is a global company serving the health care industry with products and services that help hospitals, physician offices, and pharmacies to reduce costs, improve safety, productivity, and profitability, and deliver better care to patients. The company offers pharmacists many career choices and employs ?more than 1200 pharmacists nationwide,? according to Tara Schumacher of the company?s media relations department. ?In the last fiscal year, our pharmacy services division alone has hired more than 200 pharmacists, including directors of pharmacy, assistant directors, clinical managers, staff pharmacists, and managers in training.?

Pharmacists can work in ?flexible full-time and part-time? positions in health system practice, management, nuclear pharmacy, and community pharmacy, explains Schumacher Internships are available as well as rotational experiences and residencies.

The company offers ?very competitive benefits packages,? adds Stavinoho. Health insurance and a 401(k) with a company match are offered to employees from the first day of employment. A stock purchase plan also is available, allowing employees to purchase Cardinal Health stock at a 15% discount. Employees receive annual merit increases and are eligible for bonuses based on reaching performance objectives. 

Pharmacists can obtain their CE credits online, through home learning and live workshops on-site. A tuition-reimbursement program also is available for pharmacists who may wish to pursue a PharmD or an MBA.

Nuclear pharmacy?a special niche at Cardinal?offers many job opportunities for pharmacists. The company provides nuclear pharmacy services to ?more than 8000 hospitals and clinics,? Schumacher explained, and ?compounds and dispenses 65% of all radiopharmaceuticals through its nationwide network of 150 nuclear pharmacies.?

She notes that Cardinal ?offers the largest nuclear pharmacy training program in the 

. Through its extensive training program, Cardinal Health provides the 200 didactic hours and 500 supervised practice hours required for certification as an authorized nuclear pharmacist.? Pharmacy students can take advantage of experiential rotation opportunities in nuclear pharmacies, Schumacher continued.

Cardinal also conducts a summer internship program that introduces nuclear pharmacy to students who may wish to pursue a career in this field. ?During the 10-week program, pharmacy students follow a structural process and work under the guidance of a pharmacy preceptor. Internship hours meet the experiential requirements for the authorized nuclear pharmacist designation and can be credited toward pharmacist licensure by the state board of pharmacy.? Cardinal also manages pharmacies in more than 350 hospitals around the country. Pharmacists are ?provided with the latest information on new drug indications and utilization strategies,? Schumacher noted. ?Pharmacists in these positions also work with industry experts in pharmacy workflow, accreditation preparedness, regulatory compliance, and medication safety.?

Articles

Ms. Rosendahl is a freelance writer based in Fort Lee, NJ.

WIDE-RANGING OPPORTUNITIES AT CARDINAL HEALTH

Nonyerem (Nony) Nwaneri - the latest winner of the 

/Wal-Mart RESPy award - is described as a young woman "who actually cares; she actually has a vision for helping underserved communities." This description comes from Nancy Nkansah, PharmD, BCPS, assistant professor of clinical pharmacy at the University of California, San Francisco (UCSF), who nominated Nwaneri for the RESPy award. "In my opinion, Nony not only has an unyielding desire to eliminate health care disparities, but also personifies the essence of dedication and hard work."

Nwaneri has been active in many outreach programs aimed at "increasing the number of underrepresented minorities in pharmacy school," Dr. Nkansah explained. She further stated that Nwaneri was the "individual who breathed a new sense of life to the UCSF Student National Pharmaceutical Association [SNPhA] organization. She is one of those people you meet who has a true sense of passion for a cause and [is] not merely a temporary/passive participant."

Nwaneri worked on 3 SNPhA-sponsored projects, among many other volunteer activities, including:

High School Outreaches in San Francisco. The goal of these outreaches is to educate high school students and promote the field of pharmacy as a viable career pathway.

San Francisco State University (SFSU) Graduate School Fair. This fair provided information to SFSU students on the UCSF School of Pharmacy program.

At UCSF, she also participated in the Latino Association of Pharmacy Students Undergraduate Day, an event that provides a pharmacy student panel that aims to expose underrepresented minority college students to careers in the health professions.

When looking at her various volunteer activities, Nwaneri said that she got the most satisfaction out of a revival of SNPhA's chapter at UCSF. She completed this feat with 7 officers of the student organization. "We structured and targeted the organization toward student pharmacists who share a common interest in SNPhA's mission" to focus on issues affecting minority communities?." The high school outreaches we conducted were predominantly located in underserved areas [in San Francisco]" and were aimed at members of minority groups who "needed some direction on the importance of going to college and pursuing a career in the health care field."

As an example of her work, Nwaneri points to a high school senior she mentored who attended one of the SNPhA meetings. Ashley, "who received my advice and additional advice from one of my pharmacy mentors," was recently admitted to the pharmacy technician program at her school and hopes to go on to apply to a PharmD program and become a pharmacist.

Nwaneri gives her parents credit for her career choice. She says, "Both of my parents, born in Nigeria, immigrated to the United States with nothing but a determined will to work hard and struggle in order to make something good out of themselves."

Nwaneri will receive her PharmD degree next year from the UCSF School of Pharmacy. After graduation, she hopes "to pursue an extra year of training" as a pharmacy resident. "While a resident, I am going to try very hard to intern in a community pharmacy, because direct patient care and interaction are what I enjoy most in a career in pharmacy."

A Passion to Help the Underserved

EVERY RETAIL OPERATION WANTSto stand out in the minds of its customers,so the pharmacies in Safewaystores make their mark by emphasizingpharmaceutical services. "We area very service-oriented company," said Brian Hille, RPh, director ofpharmacy care, Houston, Tex. "Weemphasize the convenience of thepharmacy in Safeway stores. Our programsare centered on health andwellness; we want to keep our customershealthy." 

Safeway offers a variety of pharmacycare services, he explained.Key programs include the flu vaccinationcampaign, disease statescreenings, and medication therapymanagement programs. As part ofthe flu vaccination program, pharmacistsadminister shots and conductin-store flu clinics throughoutthe season.

Safeway has also partnered withthe American Diabetes Association(ADA) to sponsor the ADA DiabetesExpo, which gives pharmacistsan opportunity to counsel thepublic about this disease and providescreenings, said Hille. TheExpo is targeted at all patients withdiabetes and their loved ones, heexplained. "The pharmacists providepatients with informationabout management of diabetes aswell as testing devices. They canshow patients how different deviceswork. In addition, dietitians areavailable to talk to patients aboutnutrition; podiatrists inform patientshow to take care of their feet;in some expos, dentists focus ondental care and ophthalmologistson eye care." 

Safeway pharmacists have anunprecedented opportunity to enhancepatient care and build new revenuestreams based not on dispensing,but on assuring safe and effectivemedication use through the latestprogram called Medication TherapyManagement (MTM), said Hille."The MTM program is an importantpart of Safeway's business strategy. Itincludes face-to-face consultationabout patients' therapy through aone-on-one interaction between thepatient and thepharmacist that canlast as long as anhour," he said. "Foryears, I have heardthe profession talkabout getting paidfor cognitive serviceson a widespreadbasis. Now it's comingtrue," said Hille.

What makes Safeway attractive tothe new pharmacist? Hille says "it'sour work environment. We willattract the pharmacists who want towork with the public. It's more thancount, pour, lick, and stick. We areoffering services that are beyond thestandard community practice. Thepharmacists are going to get a chanceto deliver these patient care servicesto their patients."

Ms. Rosendahl is a freelance writer basedin Fort Lee, NJ. 

SAFEWAY'S PHARMACIES EMPHASIZE SERVICES

SOME CAREER CHOICES AREobvious, some are not. Lois Adams, RPh,MBA, president and chief executiveofficer of HHCS Health Group inOrlando, Fla, has made some importantcareer choices in pharmacybased on her own life experiencesand those of the people who work forher. For instance, she set up a cysticfibrosis (CF) pharmacy in 1985because a friend named BeverleyDonelson "came to work with us andgot interested in cystic fibrosis whena grandchild was born with the disease," she said.

The child, now 21, became a cross-countryrunner in high school andcontinued the sport in college and isabout to graduate from college andget married.

"She had excellent care from birth.The disease is well under control," explainedAdams. "She had meconiumilueus and had a portion of her bowelremoved when she was 3 days old. It's adifficult disease forthe whole family." 

Donelson, knownas "Grandma Bev" to CF patients onthe Internet and allover the world, hasworked at HHCSHealth Group for 24years. She is on thelistserves of the CFpopulation, and patients often askher for advice on issues other thanmedical questions, says Adams.

Today, the CF pharmacy sendsmedicine all over the world. "We cancompound products and make itmore economical for patients," saidAdams. "And it all started with thisyoung lady. One of the insurancecompanies would not provide herwith a medicine (a vitamin E formulation)because of cost. I went to themanufacturer and asked them toreduce the cost and they refused. Ireformulated it for her and gave theformula to Duke University," becauseshe attended Duke and went to theDuke Clinic, Adams explained.

Other pharmaceutical manufacturerswere more generous. "When wefirst started the CF pharmacy, we gotfree medications from pharmaceuticalmanufacturers for those withoutmoney to pay," said Adams.

When she decided to change thestructure of the pharmacy's business,Adams got a revised pharmacy permitfrom the Florida Board of Pharmacyfor her operation. In addition to beingan infusion special permit pharmacy,HHCS also converted to a communityspecial permit pharmacy. "The permitenabled the pharmacy, which has 2000to 3000 patients from all over thecountry, to send medications such ascapsules and noninfusion medicationsto patients," she said.

Patients learn about the pharmacyfrom physicians, other patients, on theInternet, from CF organizations,health fairs and education days, andmedia advertising, says Adams. HHCSHealth Group is the umbrella namefor the corporations, with several otherwholly owned corporations as offshoots.These include the CysticFibrosis Pharmacy; Freedom Pharmacyand Wellness Centers; a DiabetesShoppe; a Center for Memory Disorders;the HHCS Research Institute;Freedom Specialty Division for specialtydrugs; International PharmacyCorp; HHCS Inc, a wholesale company;and Medipaws, a pet pharmacy.

Adams also has Florida AmbulatoryInfusions Centers where patients cancome to be infused if they do not wantto go to a hospital, and the centers havedisease management for other respiratorydiseases, women's health,autoimmune diseases, and oncology.Adams, a pharmacist for over 40years, set up the Center for MemoryInc, a 501(C)(3) not-for-profit corporationwhich is located in the samefacility as the pharmacies. It wasestablished as a legacy to her motherafter her mother's death fromAlzheimer's disease. Her mother, age92 when she died, "had the finestcare," said Adams. "She outlived it[the disease]." 

The Center for Memory Disordersconducts clinical trials and evaluates,diagnoses, and treats patients withmemory loss, with a staff thatincludes primary care physicians, aneurologist, a psychiatrist, a clinicalneuropsychologist, a clinical coordinator,a social worker, and pharmacistAdams.

In addition to her busy schedule atHHCS Health Group, Adams mentorsstudents from the University ofFlorida School of Pharmacy inGainesville, which has a branch inOrlando, and the High Tech Institute.

Located just blocks away from thepharmacy, the High Tech Instituteprepares students to enter the alliedhealth professions. "Students comeinto the store and we show themwhat a pharmacy is and what a pharmacistdoes," said Adams.

She also conducts clinical trials forpharmaceutical manufacturers at theresearch institute. "We had a lot ofpatients with HIV disease in Orlando,Tampa, and Miami," and the clinicaltrials focused on drugs for treatingHIV/AIDS. "We are getting readyto do [clinical trials] for memory disorders," she said.

Asked what advice she would give topharmacy students who are close tograduation, she said, "keep youroptions open, and think outside thebox. Many options are open." Pharmacists"need to be well rounded andunderstand that pharmacy can be avery rewarding field." She added,"there is more for you than a $100,000salary and an expensive car." 

Pharmacists should consider gettingan MBA, she continued. "Thefield is changing all the time. Theyneed to understand reimbursement,money, and health care in general." Pharmacists have to become familiarwith the basics of both the Medicaidand the Medicare program, includingMedicare Part D, because "it's animportant part of ultimate successin the profession." 

Students also should learnabout the legislative process, sheemphasized. "They must beproactive and work with legislators.They can't sit back and letthings happen." She urges pharmaciststo back candidates whowill help the profession andstresses the need to work withinpharmacy associations, as she haswith the Florida Pharmacy Association,the Florida IndependentPharmacy Network, National Associationof Compounding Pharmacists,and the American PharmacistsAssociation.

Community work also isimportant to Adams, as is the timeshe commits to the University ofCentral Florida, where she hasbeen inducted into the College ofBusiness Hall of Fame. She is therecipient of the Wyeth Bowl ofHygeia Award, the RQ RichardsPublic Relations Award from theFlorida Pharmacy Association,and the Elan Innovative PharmacyPractice Award.

"You must be involved. Thereare many opportunities in theprofession. If you have a passionfor something, it affects yourlife." She urges graduates "to carrythe banner. We're a very trustedprofession." 

She has worked hard to getwhere she is. As a single mom, shewent to graduate school for herMBA, had 2 jobs, and raised 3 children.She has 2 sons?Dr. Bo Evanswho is a family practitioner andByron Evans who is a recruiter?anddaughter Marlo Moore who is a full-timemother.

Adams says firmly, "I love what wedo." In fact, she finds the field sorewarding that she has no intentionof giving it up. "I have been askedabout selling, but I don't want to. Ihave wonderful employees, and Idon't want to retire." Besides, sheasks, "If I retire, what would I do?" 

Ms. Rosendahl is a freelance writer based

INDEPENDENTS HAVE MANY CAREER CHOICES?SPECIALTY PHARMACIES ONE OPTION

Getting a PharmD degree is an accomplishment for anyone, but for Cindy Mitman?January's RESPy winner?it is an even greater achievement. She managed to get her bachelor of science (BS) degree in chemistry and is in her last year as a pharmacy student in Philadelphia while raising 2 daughters, Kayla, 16, and Krista, 12. In addition, her husband David was in the military for some of that time. "I went to 4 different colleges before I got my [BS] degree. We moved around a lot," she said. She gives her family a lot of credit for helping her. "When I graduate," she added, "it will be a family graduation," accomplished with the assistance of her husband, children, parents, and brothers. 

Mitman, now 37, looks back to 2003 when her husband was in Kuwait for 3 months and she was working as a chemist. "He got there one week before the war started.We always sent care packages." Knowing what it meant to the soldiers to get these packages, she started a program while she was treasurer of the North Carolina branch of the American Chemical Society to collect donations for the troops and shipped them to the Middle East. When she began at Temple University School of Pharmacy, she was looking for a way to do community service. So she pulled together Operation Troop Support, beginning with a slide show made in Iraq and Kuwait that showed what it is like for soldiers while they are working and on their days off. 

The project grew larger when the director of alumni relations and external affairs, Brenda Malinics, got 8 pharmacies involved. "We made posters and collection bins. All the pharmacy fraternities and pharmacy organizations got involved, each taking care of 2 Rite Aids," to see that items were collected and the posters were kept fresh-looking." The dental school donated 15 boxes of dental supplies; the Office of Student Activities at the Health Sciences Campus gave Tshirts and mugs; and the bookstore contributed writing paper and disposable cameras,"said Mitman. "I think it was the first time I saw every school organization get involved in one huge project." 

"I also went to a couple of health fairs to educate providers and recipients," said Mitman. "The fairs were a great opportunity to counsel patients on medications and the health care system in general." 

As for the future, Mitman thinks she would like to do a residency at Lehigh Valley Hospital, which just started the program this year. "This will add another year to my pharmacy work, but I want to be a clinical pharmacist." 

Founded in 1901, Temple University School of Pharmacy in Philadelphia is located in the university's Health Science Center, which also houses the School of Allied Health Professions, Dentistry, Medicine, the Temple University Hospital, and Temple Children's Medical Center. Graduates are prepared to "deliver evidence-based and ethical pharmaceutical care to patients in a variety of practice settings," notes the school's Web site. 

Students are admitted to the PharmD program after completing a minimum of 60 semester hours of preprofessional collegiate study at an accredited community college or college/university. In addition to the doctor of pharmacy program, graduate programs leading to master of science and doctor of philosophy degrees in the pharmaceutical sciences are available. The school also offers a "unique and highly regarded master of science program in quality assurance/regulatory affairs." 

RESPy AWARD (Respect, Excellence, and Service in Pharmacy) is presented to the student who has made a difference in his/her community by demonstrating excellence in pharmaceutical care. 

A Challenging Path to a PharmD Degree

Volunteering is central to Kacee Vogt's busy life. She hashelped clean up an elderly man's home and yard after a hurricanein Port Arthur, Tex; assisted in the construction of a churchbuilding in Juarez, Mexico, by mixing concrete and laying bricks;sifted through debris for salvageable items after a tornado inCordell, Okla; worked at Frog Road Camp, a church camp nearTulsa, Okla, with children aged 8 to 18, where she was a smallgroup leader; volunteered at the Christian Villa retirement centerin Stillwater, Okla, where she visited and sang with membersof the center; and presented poison prevention information tostudents in elementary schools in Oklahoma City. This is only asampling of her many volunteer activities.

"Community service has always been a priority for Kacee. Hercurriculum vitae is steeped with activities [aimed] at serving theneedy and providing information that benefits the general publichealth," said Jane E. Wilson, PhD, assistant dean for studentaffairs at the University of Oklahoma College of Pharmacy, in herletter of nomination recommending Kacee for the 

Asked which of her volunteer activities she enjoyed the most,Kacee said, "spending a week with my friends from a campusministry serving the homeless in Houston. We took them foodand clothing and worked with inner-city children during VacationBible School. We played games with them and kept them busywhile school was closed. It is a different culture," she said. Kaceehas made this trip on every spring break for 5 years.

At the same time, she has maintained a 4.0 grade point averageat the University of Oklahoma College of Pharmacy, forwhich she received the college'smost prestigious award,the Mosier Scholar Award, saidDr. Wilson. In addition, she wasrecently elected by her classmatesto lead the school'sStudent Executive Council,where "she has worked quicklyto put her mark on the position,"added Dr. Wilson.

Kacee, now 24, says thatbeing president of theExecutive Council, whichoversees the student organizationin the college, "hasopened up many possibilitiesto me. It enablesme to usemy leadershipskills. I am a liaisonbetweenstudents and thefaculty. I can be avoice for the students."The councilmeets every otherweek and deals with problems that comeup; Kacee will continue in this position until the end of the springsemester. "She is a delight to work with," said Dr. Wilson in an interview."She is a good leader who is involved in our service projects.She is always there and is always available to her colleagues."

When asked about her future plans, Kacee said, "I think aboutit all the time, but I haven't figured it out yet. Every time I hear aspeaker [discuss his or her work], I think it sounds great. I amkeeping my options open. Pharmacy offers diversity and flexibility."A third-year student, she is strongly considering doing a residencyin the clinical aspects of pharmacy or working in an independentcommunity pharmacy because pharmacists there have"a better opportunity to have a relationship with patients."

University of Oklahoma College of Pharmacy

Pharmacy is the oldest professional program at the University ofOklahoma, and the first 2 graduates received the pharmaceuticalchemist diploma in 1896, according to the college's Web site. TheCollege of Pharmacy moved to the Health Sciences Center inOklahoma City in 1976 from the Norman campus. The centerincludes major hospitals, clinics, and research facilities, as well as theCollege of Allied Health, Dentistry, Public Health, Nursing, andMedicine and the Graduate College. The College of Pharmacyincludes the Henry D. and Ida Mosier Pharmacy Building, a 75,000-square-foot facility, which is well-equipped for contemporary pharmacyeducation, graduate education, and research in the pharmaceuticalsciences and continuing professional education.

In fall 2002, the college extended the professional program to theSchusterman Health Center in Tulsa. Students in both OklahomaCity and Tulsa complete the same curriculum using a number ofeducational technologies and distance education methods.

The college offers the doctor of pharmacy professional degreeprogram as the sole entry-level degree. A combined PharmD/MSprogram is offered to students seeking a graduate degree in conjunctionwith the professional doctoral degree. The Department ofGraduate Pharmaceutical Sciences also offers programs leading toboth the master of science and the doctor of philosophy degrees.These programs are designed to prepare scientists, educators, andpractitioners for careers in pharmaceutical education, research,industry, and related areas of specialized practice.