In this episode Bryana Gregory shares a compounding pharmacist’s perspective on healthcare. She brings the viewpoint of the millennial generation (Generation Y) to the Perspectives on Healthcare Podcast with Rob Oliver. Bryana lives and works in Texas.
Here are 3 things that stood out as Bryana Gregory gave a compounding pharmacist’s perspective on healthcare:
· Quality healthcare means leading with a servant’s heart
· Healthcare should be about keeping people healthy, not keeping them sick
· Medical professionals need to listen to their patients with an open mind
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Here is the transcript of Bryana Gregory: A Compounding Pharmacist’s Perspective on Healthcare:
Introduction to be Bryana Gregory
Rob Oliver: Thank you and welcome. I appreciate you being with me today. Today’s perspective comes from Brianna Gregory. She is a pharmacist and physician liaison based in Texas. She is a millennial, a member of Generation Y. Welcome to the show.
Bryana Gregory: Thank you, Rob. I appreciate it. It’s an absolute pleasure to be here with you today. Thank you so much for having me.
Rob Oliver: You bet. So tell me a little bit about yourself and about your role in healthcare, please.
Bryana Gregory: Yes. So as I mentioned, I’m a pharmacist. I’m a compounding pharmacist, which means that I work in a less common sector of healthcare in pharmacy. And then also as a physician liaison, what I really do is I help to facilitate the relationships between our providers or prescribers and the pharmacy. So because compounding pharmacy is sort of a niche, I help to educate providers basically on how to write the prescriptions for their patients so that it’s more customized so that the patients can receive customized treatment. So you know, so much of my inspiration really in healthcare actually came from my dad. He always had a really big influence on me, but he was a dentist and he spent several hours in the office even after work, just such a hard worker, which always had an impression on me. But at the same time as a child, I spent a lot of time in his office. So I was watching what he was doing as a medical professional. I spent time with him. I was kind of like his shadow as a kid, watching him look over x-rays, watching him treat patients and make moles in his lab. And several years later in 2009, actually he was diagnosed with prostate cancer, which more or less is generally a pretty slow moving cancer if treated correctly. But when he was finally diagnosed at stage four, it became evident that something had been missed along the way during his routine checkups. And so throughout his treatment journey, he saw several doctors, several specialists, several oncologists, and he started taking several medications. And this was a guy that really never took medication. In fact, we really didn’t have exposure to what pharmacists did, honestly, I really didn’t have a clue. By the time that he reached his third year of treatment, he was on 15 plus medications. So that’s something that in pharmacy we refer to as polypharmacy. And I remember that when my dad was in hospice, one of the things that had the biggest impact on me is his hospice pharmacist came into the home and reviewed his medications and actually slashed that number of medications by about half. And that’s just not what I expected. That really stuck out to me as he came in, not to add more medications, but to heal some up. So he was really trying to actually lighten the pill burden for my dad to make it easier on his body and only keep him on the medications that he truly needed. I think that this is initially what pulled me to the field of pharmacy because that was so impressive to me. But in the midst of all this, I was dealing with my own health care problems. I went to several doctors, had several referrals to many specialists, but still nothing was getting fixed. And eventually I visited with a functional medicine practitioner, someone who was finally willing to look at the entire picture of my life, everything from what I put in my body, what I put on my body, what I was doing every day, my habits, because I was really struggling with my gut health and I was spiraling downhill fast. So functional medicine is not a common area of healthcare, but once I experienced it for myself, it really actually shifted my perspective of what that area of healthcare looks like. So I think as most people get into healthcare, it’s something personal or it’s something that has to do with their family and that’s exactly what led me to do what I do today.
Rob Oliver: Okay. You’re so correct. I think that a lot of times there’s a personal connection there that draws us in and not only does that personal connection bring people in, but it also motivates them to do better with healthcare because they’ve seen that there are areas of gap, areas where there are things missing. So excellent.
Defining quality healthcare
Rob Oliver: What does quality healthcare mean to you?
Bryana Gregory: To me, quality healthcare really always means leading with a servant’s heart and the reason I say that is because like you just said, Rob, a lot of times it’s personal and if we can just be there to serve others and meet the patient where they’re at, we’re always going to be keeping the patient’s best interest in mind and that should be the point. So if you treat them like your family, they pick up on that very quickly and from a pharmacist’s perspective, what this means to me to deliver quality healthcare as a pharmacist is that you’re delivering the right medication to the right patient at the right time, but only if medication is necessarily required and it isn’t always required. Quality healthcare as the term suggests really should be quality over quantity and it should also focus on getting people healthy rather than keeping them sick and for whatever reason this seems to be a very novel idea in the modern healthcare system. So for that reason, I think our health system appears to be very broken in some aspects, broken in such a way that there’s a lack of communication between hospitals and pharmacies, about patient centers, insurance companies, in a way that it keeps the whole system very muddy for the patient, difficult to understand, it doesn’t appear to be streamlined or simple and because of that, patients tend to fall through the gaps and they feel that and then they fall off of their healthcare treatment regimen, they’re not compliant and for that reason they don’t reach their healthcare goals. So their treatment generally becomes very segregated because it’s happening in several different places at once. So quality healthcare is really about bridging those gaps and providing the best possible experience for the patient because it is an experience, it’s a journey, healthcare is a journey, it’s not the same every day and if we can help patients reach their individual healthcare goals, then I believe that we’re actually delivering quality care and this is why the area of functional medicine is so effective, especially when there’s not a lot of communication because it’s an integrative practice, you’re looking at everything and just like I said, when I was seen by a functional medicine practitioner, she was looking at everything, she was looking at my whole body, the whole picture and this is what helps to bridge those gaps but true functional medicine is about also finding what the underlying causes of the illness but it requires a whole team of healthcare professionals, it’s not just the pharmacist, it’s the physician, it’s the nutritionist, it’s everybody, right, but they have to be willing to listen and to empower and to encourage and to care enough to dig beyond what seems like it’s obvious, what generally happens in that 15 appointment window and patients deserve more time than that. Patients deserve to be held accountable and to have an adequate support system which they don’t always have at home, that might come from a pharmacist, it might come from a physician but functional medicine is not about overloading people with medications that only offer a temporary fix, it’s about replacing what you’re deficient in because it’s important to recognize people don’t get sick because they have a low level of pharmaceutical drugs in their blood, they get sick because they’re deficient in something or their body is out of balance and so as a compound pharmacist, once the doctor identifies what that root cause is, we can customize the medication for the patient if the medication is necessary and we can replace it in the dose that’s appropriate for that patient and when I say deficient in something, I mean the most common one could be hormones, it could be vitamins, nutrients, antioxidants, enzymes, anything like that but it’s different than traditional treatment because traditional treatment aims at covering up the symptoms and masking them with yet another medication but in functional medicine and compounding pharmacy, we aim to replenish what the body is deficient in so this is restoring both health and wellness and Rob, when it comes to medications, the reason quality is so important is that the quality of the medications that you put in your body directly affects the way you feel, right? It’s just like the food that you choose to put in your body so I think that quality healthcare really is the commitment to health and wellness all around.
An example of quality healthcare
Rob Oliver: You’ve done this a little bit, can you give me some examples or give me an example of quality healthcare? You’ve provided some but if you don’t mind.
Bryana Gregory: Yeah, so quality healthcare is customized healthcare. I think that customized healthcare is key because we are all very different which means we’re all going to be on a very different healthcare journey so compounding pharmacy is actually a really great example of this. For listeners who aren’t familiar with what compounding pharmacy is, a compounding pharmacy is a pharmacy that makes or compounds medications on site in their laboratory right there at a customized dose for the patient based on his or her individual needs so for compounding prescriptions, when you go into say a retail pharmacy and you see all those bottles on the shelves, those are medications that have been FDA approved but not everybody is going to fit inside of a box where they’re going to be able to take those medications and it’s going to get them to where they need to be. Sometimes people have a sensitivity or an allergy to a medication, maybe they’re allergic to an inactive ingredient or a dye or something like that so in the compounding lab, we can make those medications free of those offensive or problematic ingredients that bother people. This way they’re able to attain and achieve their healthcare outcomes in a way where they can still receive the same medications but in a way that works for them or for example we have an elderly person or a child who can’t swallow a tablet so we can adjust that dosage form, putting it into something like a topical cream that it gets absorbed still into the body but basically we’re just finding a different route of how we can do that. Traditional medications are not designed for everyone because we’re not one size fits all and that means that we deserve more than a one size fits all treatment so I always encourage my patients that if they’re not feeling their absolute best then they should consider talking to their doctor and talking about having the medications customized, compounded and tailored to their individual needs but not all compounding pharmacies are created the same either and they have to be sure to specialize in compounding medications and they need to not dabble in it just by adding a flavor here or there, they need to have strict quality standards implemented because that means that the medications are measurable and repeatable which means that the patient’s response will then be measurable and repeatable and that’s something that we can count on getting the patient where they need to be.
What should people understand about compounding pharmacy
Rob Oliver: Got it. You’ve kind of led me into the next question which is what do you wish people understood about your role in health care?
Bryana Gregory: Yeah, so did you know that pharmacists are considered to be the most accessible health care professionals and yet at the same time we’re probably the most underutilized? You can call up the pharmacy and just speak with a pharmacist. Pharmacists are medication experts which means that we are the most highly trained and best to advise on the safe and appropriate use of medications, when to take them, how to take them and we’re experts in pharmacology which means that we’ve been trained in depth about the science of how these medications are working in the body and affecting every single system in the body and because every person’s body is unique this means that they need unique types of medications and doses of medications and then also debunking the myth that pharmacists are drug pushers instead a great pharmacist honestly should set realistic expectations with the patient about why he or she is on the medication, how long they should be on the medication, why they’re on medication and when they can come off of the medication because again it’s not about overloading and adding adding adding without taking anything off and even more so in functional medicine you know we believe that prescription drugs are commonly over prescribed treating symptoms only rather than actually addressing the underlying conditions so many prescription drugs are only offering that temporary fix but they don’t solve the root cause of the problem and this is why we focus on replenishing the body rather than masking the symptoms again people don’t get sick because they have a low level of pharmaceutical drugs in their blood to get sick because they’re deficient in something or because their body is out of balance so it’s necessary to replenish these things that we’re deficient in and set realistic expectations of the patient along the way about the length of treatment too and this is really is the responsibility of the pharmacist. What excites you about the future of health care? There’s so much opportunity for education and for empowerment and from my perspective I’m actually blessed to have the opportunity to educate both patients and providers and what I do so that’s a little bit unique I kind of closed the triad there between the patient the pharmacist and the provider but what really excites me is when a patient comes to me and they’re excited about taking charge of their own health if we can help patients be more informed by educating them about health care and allowing them to make more informed decisions about their own health and then I believe we’ll actually have better health outcomes overall because the patient has more say in their own health care treatment they know what to look out for and they can also be more proactive in reaching out to their health care team in a timely manner to get what they need if they’re more informed so when a patient comes to me and they’re excited about learning it’s an opportunity for me to feel like I’m not only helping them but improving the whole health care system too.
Rob Oliver: An excellent point and having patients be empowered and patients be included as part of the care team is essential.
A suggestion to improve quality healthcare
Rob Oliver: What is one thing medical professionals can start doing today to improve the quality of health care?
Bryana Gregory: Listen and do so with an open mind. I really think it’s so important to take time to remember that it’s a privilege to be invited along someone’s health care journey and that journey is different for everybody. I believe it’s important to honor that by listening and sometimes we may take that for granted if someone’s diagnosis is not terminal but when it is it sits a little heavier with us and even if we’re involved in keeping people healthy well we still have to remember that they’re letting us into many details of their personal lives that they don’t share with anybody else sometimes even their own spouses and for that reason it’s important to remember that we have the opportunity to cultivate genuine relationships with our patients and just look like any other type of relationship people want to be heard. What’s amazing to me Rob is it so frequently I mean I think even on a daily basis this happens and counseling patients whether it’s over the phone or in person and the patient will finish up the conversation saying thank you so much for listening I know that you’re so busy and I just can’t believe you took the time and I’m taking back I’m taking back every time because I’m sitting here just thinking I’m doing my job you know and I love my job but they’ve taken the time to open up their lives and share those personal details with me and I really believe that people will tell you everything that you need to know and oftentimes give you the key to their treatment plan and the answer that you need if you just be present and listen.
Rob Oliver: Yeah what you’re saying makes so much sense especially when you have this you know what I’m doing when I’m speaking to medical professionals one of the things that I try and remind them is that people are generally coming into the office because they’re in a time of crisis okay that you know they don’t feel good and so they can’t get to work or their child doesn’t feel good and their child can’t go to school and if their child can’t go to school that interfere and so their world isn’t a is in a place of turmoil and crisis and by listening to them helping them to find what the solution is you’re helping them get some sense of normalcy back in their life so I think what you’re saying is as far as listening is imperative so thank you very much thank you very much for sharing that listen Brianna Gregory you have been phenomenal I appreciate you sharing today thank you for giving us your perspective on health care.
Disclaimer: All opinions expressed by guests on the Perspectives on Healthcare Podcast are solely the opinion of the guest. They are not to be misconstrued as medical diagnoses or medical advice. Please consult with a licensed medical professional before attempting any of the treatments suggested.