Senior Care Pharmacy: One Exploding Population, Many Career Paths (Part 3)

Pharmacy Careers, Pharmacy Careers Spring 2020, Volume 14, Issue 1

The third senior care pharmacist featured in this series is Craig Stiens, PharmD, cofounder of Medication Managers and COO of RxConcile.

The senior care market is exploding. The first class of baby boomers is projected to turn 85 in 2031; in the United States, 10,000 people turn 65 every day. The exciting part is that there are so many career opportunities to serve this unique and growing population. Now is the time for senior care pharmacists.

Read our interviews with the 4 pharmacists in our ongoing Pharmacy Careers® series. Each one has an amazing senior care pharmacy story. These pharmacists also shared their stories with students at a recent American Society of Consultant Pharmacists Annual Meeting.

The third senior care pharmacist featured in this series is Craig Stiens, PharmD, cofounder of Medication Managers and COO of RxConcile.

GROWING UP WITH A PHARMACY INFLUENCE

Stiens was one of the first college graduates in his family. “I grew up on the west side of Cincinnati, Ohio. In high school, I was a pitcher on the baseball team, and [I was] on the golf team. I was the senior class president, in charge of the spirit committee, involved in tutoring students in the community, [and I did] community service repairing old buildings in the inner city. My freshman and senior chemistry teachers were pharmacists as well. I also worked in a community pharmacy when I was 16, mopping floors and delivering meds.

“My senior year, we had to do a career project, and I chose pharmacy. My grandfather also said if he could have attended college, he would have been a pharmacist or a dentist. I also love to teach.”

AFTER PHARMACY SCHOOL

Stiens’ high school experience working in a local independent pharmacy, along with the influence of his teachers, pointed him toward a career as a pharmacist. “My pharmacy was sold when I still had a year left in pharmacy school. I worked for a couple of independents and chains over the next 4 years. One of the independents serviced a couple of local nursing facilities. I would often fill their unit-dosed boxes [during] the day. The pharmacist would go to the facilities and do the consulting once per month. I knew about senior care but was not really involved.

“After graduating, one of my peers from pharmacy school, Chad Worz, started to work for an independent LTC [long-term care] pharmacy. He talked me into working with him. He had a vision for changing senior care pharmacy, and he knew it would be exactly what I would like to do and was good at. He wanted to see patients in the LTC facility, not just review their charts. He wanted to talk to the patients, nurses, and doctors, and help them make better decisions about their medication therapy.”

ONE CAREER, MULTIPLE GIGS IN SENIOR CARE PHARMACY

Stiens is a cofounder of Medication Managers, LLC, an independent consulting group. In addition to LTC consulting, he helped open and manage full-service, not-for-profit pharmacies, and he works 3 days a week in a federally qualified health center and primary care office, where he sees patients and teaches a class for patients with type 2 diabetes.

Stiens is also the COO of RxConcile, a telehealth business that is focused on educating patients about their medications as theytransition from long-term or postacute care to their homes. To decrease hospital readmissions, RxConcile initiates a conversation with patients about their home and discharge meds, and the company prepares them for their future visits with the primary care provider. The conversation is recorded, so it can be reviewed by caregivers, family members, or the patient.

FAVORITE PARTS OF SENIOR CARE PHARMACY

Stiens loves the challenge of “having access to all of the patient’s health care information, [including] medications, diagnoses, [and] lab results....The ability to collaborate with nursing and medical staff and then include the patients in treatment decisions is the most rewarding part of my practice,” he said.

CHALLENGES AND FRUSTRATIONS

When asked about the parts of senior care pharmacy Stiens finds most challenging or frustrating, Stiens said, “First, overmedicated patients that we inherit when we take on a new home. Now that all medications can be viewed as inappropriate, I hope to see a stronger move within the profession to deprescribe.

“Second, the push for provider status across [the] pharmacy [industry] makes me crazy. If we were moving toward a fee-forservice model, I would say, ‘Be careful what you ask for.’ Someone other than the patient will determine your value; a third party will never reimburse you the full value of your service.… We have NPI [National Provider Identifier] numbers. We have the ability to create relationships with payers and employer groups. We do not need provider status,” he said.

OPPORTUNITIES IN SENIOR CARE PHARMACY

Stiens sees an opportunity in senior care pharmacy to meet with patients where they are already living. “Patients are desiring to age in place. They don’t want to end up institutionalized. We need to take health care to the patient. The in-person, hands-on, looking deep into the patient’s eyes [and] soul and discussing their health care, needs to be the start of the relationship. We can also use technology to enhance the relationships that we have built. We need to meet the patient where they are, and embrace motivational interviewing. If the patient is part of health care decisions, she or he will have a better chance for success,” he said.

ADVICE FOR INTERESTED STUDENTS

Stiens suggests that students get involved at the state and national levels when they are interested in any field of pharmacy. “Help shape the future, or someone else will do it for you. We have a tremendous need for senior care pharmacists coming our way, and the practice will need to change and adapt faster now than ever before. Be creative and be fearless. You need to take risks and put yourself out there. Don’t be afraid to fail. You will fail if you are pushing yourself and the profession. Embrace it.

Learn from it. Try not to repeat it,” he said.

The best advice Stiens ever received was to follow his passion. “If you’re in it only for the money, please change your profession. Find what you love to do, and do it with passion. If you are good at what you do, the money will come.”

In conclusion, senior care pharmacy offers many amazing career choices for the pharmacy student or practicing pharmacist who wants a new challenge. All 4 stories shared throughout this series show that senior care is a strong area of growth, opportunity, and professional reward for the pharmacist.

If you missed our first 2 Pharmacy Careers® interviews in this series, with Dee Antimisiaris, PharmD, CGP, FASCP and Erica Estus, PharmD, BCGP, they are available at PharmacyTimes.com. Keep an eye out for our next featured senior care pharmacist.

Erin Albert, PharmD, JD, MBA, PAHM, is a writer, pharmacist, and consultant based in Indianapolis, Indiana. View her website at www.erinalbert.com.