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.?

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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