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Profile of a Pharmacy Innovator: Megan Friedrich

Dr. Megan Friedrich earned her Bachelor of Science in chemistry from the University of Illinois (Urbana-Champaign) in 2002, and received her PharmD from the University of Wisconsin Madison in 2006. She then went on to complete a post graduate year one (PGY-1) residency with Midwestern University and SUPERVALU/Osco Community Pharmacies. Dr. Friedrich has been an active member of several professional organizations including; American Pharmacist Association, American Society of Health-System Pharmacists, American College of Clinical Pharmacy, and Iowa Pharmacy Association.

Dr. Friedrich embodies entrepreneurial leadership through her commitment to the idea that any pharmacy practice can be clinical, and she incorporates this belief into her practice. As a pharmacist and a preceptor, Dr. Friedrich hopes to share this philosophy with students so they can advocate for positive change within the profession. Currently she is in the process of implementing several new programs in her practice to improve the level of patient care provided.

Dr. Friedrich shared these thoughts with DELTA Rx:

What is your background and how did that lead to your desire to pursue a career in clinical practice?
The value of providing clinical services to patients was instilled early in my career through experiences as a pharmacy student. During this time, I had the opportunity to participate in Operation Diabetes and provide medication therapy management (MTM) services at a free clinic. I was also exposed to several patient care service models at various pharmacies during my rotations. After graduation I decided to do a community pharmacy residency with Jewel-Osco/SUPERVALU Pharmacies and Midwestern University. I chose this program because Osco has several outstanding programs, some of which are more than 15 years old. It was an incredible opportunity to learn how to provide these services from true innovators.

At what point in your career did you decide to try something outside of traditional dispensing pharmacy?
Initially, I was planning to pursue a traditional staffing position in the community after graduation and develop clinical services along the way. I believe that all pharmacists no matter where their practice is can make their jobs clinical. However, I knew that would be a long and gradual path. When I had an opportunity to focus on clinical programs and learn from experts in the field through residency training, I jumped at the chance.

Was there a pivotal moment that brought you to your position as a clinical pharmacist and preceptor with Drake University?
After my residency I worked at a pharmacy in Chicago where I continued to provide clinical services such as health screenings, immunizations, and diabetes education consults and also provided MTM consults. The position at Drake University was brought to my attention by my faculty preceptor during my residency. Residency experiences offer networking opportunities that should not be overlooked! While I was happy in my role at Osco, I realized that the position at Drake was an excellent opportunity that would promote my growth as a professional.

How do you generate new ideas for new patient care services?
Ideas for the programs I am in the process of developing for Medicap Pharmacy have been generated from my past experience and also from the experience and expectations of my colleagues. The provision of services and involvement in the development of those services during my residency helped me set realistic expectations. I had to account for differences in staffing and develop programs based on the resources available vs. those required to initiate and maintain the service.

My colleagues also play a role in the development of these new programs. Pharmacy is a team profession, and I want to initiate programs that could be easily expanded to other Medicap Pharmacies. This means that I need to focus on programs in which other pharmacists are passionate. Because I was new to the area, it became vital to meet with other pharmacists to better understand patient needs and to get their feedback before developing programs. This was vital as they brought many new ideas to the table. It is essential that staff members are on board if a new program is to be successful.

Describe the development of your new initiatives
Programs under development at Medicap include diabetes education, medication therapy management, and immunizations. Diabetes education takes both time and money for development and implementation. We wanted to start small while generating interest for diabetes education in both patients and pharmacists. Beginning with group education classes, the format and topics were chosen based on ADA guidelines for diabetes education. We also incorporated common questions pharmacists routinely receive from our patient population.

The Medication Therapy Management program is based on NACDS/APhA Core Elements for Providing MTM Services. We are currently seeking reimbursement from a variety of payers including Medicare Part D plans, employer groups and Self-Pay. MTM services are provided by individual appointment and include a comprehensive medication review for each patient. A charting system is also being developed so that follow-up care can continue when the patient returns to the pharmacy to pick up his or her prescriptions.

Most stores offer immunizations already, but they do not always seem to run smoothly. My challenge is to help make operations more efficient and take some of the burden off the pharmacy managers.

What obstacles did you have to overcome to develop and deliver these services?
The two most significant obstacles were lack of experience and funding. Delivering services and actually developing them from scratch are two different concepts. Since my past experience involved a company with well established services, I knew going into this venture that it would be challenging—people would look to me for answers when I was used going to others for the same. Networking really helped me to overcome this barrier. New friends and colleagues at Drake, Medicap and the Iowa Pharmacy Association (IPA) were excellent resources when I thought I was stuck.

Early in the process, I developed a brief business plan and outline to determine the design of each program, resources currently available to support the initiative and resources needed. I sought feedback from as many people as possible in order to determine what was necessary versus desired, and to identify additional available resources. In February 2008, I received a grant from the Hartig Faculty Development Program that helped cover some of the start-up costs and I continue to look for additional grant opportunities. I also pooled resources from other stores which gave me access to additional items. For example, one store had a laptop they were willing to share; this was a costly item that we no longer needed to purchase for the diabetes classes. I am moving forward with what I have and trust that the rest will follow as long as these programs are successful and I am able to identify new opportunities and create enthusiasm!

How are you promoting change in pharmacy?
Implementing patient care services will ultimately change patients’ perceptions of pharmacists. As a result, patients will expect and ask for more from their pharmacists, which will ultimately change the way pharmacy is practiced. My goal is to help students understand this so that they can continue to move the profession to the next level.

You can already see this occurring with flu shots. 15 years ago patients would not have looked to a pharmacy for their flu shot. Re-education was needed to make patients understand that pharmacists are often trained and extremely competent in this area. Now many pharmacists who would not consider themselves “clinical pharmacists” are immunizers and training students is practically standard practice.

What is your professional goal?
To continue learning, to share what I know, to sincerely work with others and to help patients achieve the best outcomes possible.

What advice would you give to others in this area?
Don’t ever be afraid of a new challenge or opportunity! It is okay to bite off more than you can chew but think strategically and have a plan; you won’t choke—and others will come and help you! Ask for help when you need it and be a team player. Aim high, but also be realistic and realize that pharmacy is a business. If you are not able to stay in business, then you will not be able to help your patients!