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Pharmacy Residency Podcast

Dec 22, 2017

Dr. David Zgarrick of Northeastern University created a Facebook group that he writes " will serve as a discussion forum for topics of interest in PHMD 5250 (Pharmacy Care Management) over the summer semester." I reached out to him as a former faculty member from the Midwest and had a good discussion about strategies for improving your entrepreneurial and business acumen. 

Here is a link to his page at NEU.

Full Transcript:


Welcome to the Pharmacy Leader's Podcast with your host Tony Guerra. The Pharmacy Leader's Podcast is a member of the Pharmacy Podcast Network with interviews and advice on building your professional network, brand and a purposeful second income from students, residents and innovative professionals.

Welcome to the Pharmacy Leader's Podcast. I'm excited today to have Dr. David Zgarrick on. He invited me to his PHMD 5250 Pharmacy Care Management Group and I thought I'd get his thoughts on getting a little bit better at business and entrepreneurship from him. So we're going to take a very big view from the, you know, entirety of the nation with ASAP and down to how we should maybe add to our business training from pharmacy school and then talk about an individual course itself. So I hope you'll enjoy this episode with Dr. David Zgarrick and I'll let him introduce himself in his background in leadership road.

Hi, I'm David Zgarrick. I am Associate Dean for faculty at the Bouve College of Health Sciences at North Eastern University in Boston. I'm also a professor of Pharmacy in the school of pharmacy in the department of health, pharmacy in health assisting sciences. You're listening to the Pharmacy Leader's Podcast.

First, my leadership journey I guess. For me and like, for a lot of us it started in pharmacy school. I mean, in some ways it have started before but really I was, I got very involved in the academy of students at pharmacy and then I have to admit, I'm going to date myself here. When I was in pharmacy school, at least when I started pharmacy school it was still student APHA or SAFA.

Oh boy.

It actually made the change, you know, the APHA made, in the mid 80s started their academies and that's when SAFA became the Academy of Students at Pharmacy and I happen to be a president of the chapter at University of Wisconsin at the time. You know, that was my first, let's just say, my first national pharmacy meeting. Honestly  it was, actually my first time ever on an airplane was going out to the APHA meeting in San Francisco, I believe it was 1986.


It was a P-1 student first year pharmacy school that year and that, you know, and I'll say it like a lot of people say it, it really is what kind of hooks you in so to speak.


So when you go to that first national meeting and you start realizing that wow this is so much bigger. I mean I might not have even meet all these people who are going through a similar experiences than you are and you realize, oh, I'm not alone and then at the same time you begin to realize, wow, this is so bigger than just what we are in our own little classroom or our own little campus and all that kind of stuff. And particularly from a leadership stand point, you know, the ability to be able to get involved and help make things happen, again, beyond your classroom, beyond your campus. So I went from being president of my chapter at Wisconsin to running and winning a regional delegate. I was reaching for delegate for an APHA for my second year pharmacy school. I ran for a national office a, what was it, member at large, I actually ran for and there were 12 other people running that year. I was not successful, but it was still a good experience to get up on the national stage so to speak and, you know, work with the association, meet so many people. Well one of the things that I mean, I think about my leadership journey, you know, it's so tuned into the people that you meet and I have to say this is, you know, the days way before facebook and any of your instagram or any of that kind of stuff where, you know, my fellow regional or when I got involved on the national level with APHA. It was student APHA and ASP Michael Manalockas was president that year. Bethany Boyd and Tim Tucker were fellow regional delegates along with me, Kim Kruger was in a regional delegate along with me. So there were just a lot of people I got to know who honestly stayed friends of mine and I've stayed in touch with throughout the years. And we've all gone our own leadership journeys and we've all supported each other along the way on those leadership journeys and that's been really great. Got my pharmacy degree while I was in, at Wisconsin getting my pharmacy degree, I started getting active in our state association. We're still the Wisconsin Pharmacist Association at that time, it was before they made the combination of the community of the hospital groups but I got really involved in that group. Again it was great to be able to make connections within the states. Ended up working as a community pharmacist for a few years and then went to graduate school at Ohio State. You know, kind of focused on my academics and my research and that kind of stuff during graduate schools, a lot of people do. I mean I would, I still went to professional conferences but it was by enlarged to present my research and do what, you know, the scholars do when they go to these conferences.


But I did me keep me involved in APHA. Then I took my first position, you know, I got my PhD and I took my first position and I was at Mid-Western in Chicago essentially right when they were starting that program in 1992-93 and that's, I guess, that's really where probably one might say my leadership development really started to progress. You know, now, I'm in a full time job so to speak, you know, I'm getting involved in my research. I'm doing my teaching, not only did I stay involved in APHA but that was where AACP started becoming more and more a part of who I was and what I did. And I'll say, AACP has been very much part of my leadership journey, I got involved in their section of social administrative sciences, you know, the people that teach management, social sciences, that kind of stuff. I've kind of run the gambit through them, you know, I started by doing a lot of committee work and just volunteering wherever I could. Again, it was a great way to meet people, to network, to, you know, get to sit at different tables so to speak and learn from different people who are all doing things I was really interested in. I eventually, was fortunate enough to be elected as a chair of the social administrative sciences section. That actually resulted in my first opportunity to serve on AACP's board of directors because I was, actually that was then the nominee or the candidate who would serve on their council of sections and I served on the council of sections for two years and was on the AACP board with that. Few years later I ran for a chair at the council of faculties within AACP and I won that position.  Was it back in 2012, 2013, I was very fortunate, I was actually nominated to be president, ran against Sydney Boyle.

Oh oh.

Didn’t win that position.

I know her.

Sydney was again, a great leader and Sydney did a great job through her years as president. But, you know, as they say when one door closes another opens and for me that led me to as Chris Bradbury decided that he was going to step down from the treasurous role at AACP. It was, you know, I guess somebody is giving what I teach you what my interest is and I have to my father is an accountant so the apple doesn’t fall true far from the tree. At the, you know, the role of treasurer came open and I ran for that role and was fortunate to be elected and have been serving in that line for the last two years and it's been a great way to continue to be involved in AACP and, you know, particularly focusing on finding answers and making sure that our organization has the financial resources to be able to carry out our mission and do what we want to do. So, but all along, I guess, the leadership journey is very much focused on, I guess, I think of myself very much as a service leader and I serve in leadership roles so that I can help advance things that are either important to us as a profession and important to what we do and academic pharmacy, important to the people that I work with. Again, how can I create opportunities for others, you generate them getting involved, helping them, introducing them to people, you know, getting them to be able to do things that are going to advance their careers and all that kind of stuff. So, yeah, it's very much about what can I do to help advance, you know, what we as a group are trying to do through service to our profession and through service to others, so.

So when you're going back to AACP this summer. What's going to be the primary drive or what are you going to be working on as a board?

What are we working on as a board right now for AACP? We implemented a new strategic plan two years ago now and we're in the midst of that, it's, I'd say, it's got eight main points, eight-eight points but five of them that we really focused on and then I'll say that the top two are really right now, you know, what can we do to continue to enhance our applicant pool that end up our students in better applying to schools of pharmacy and what can we do to continue to forward the profession of pharmacy itself. To make sure that people realize that pharmacy is a great profession that has a lot of great opportunities. Actually I just did a presentation to our law school here at North Eastern and we did some comparison and contrasting of pharmacy and law. And one of the things where I get, I still I'm very bullish on pharmacy is that there are all kinds of opportunities for new graduates in pharmacy. I mean, employers really want what new graduates bring to the table especially in terms of their skills and their knowledge based about drug therapy and so forth and so, you know, that's very much what we as a board right now are working on is, how can we continue to put the profession forward in a positive light, how can we get students to want to apply to pharmacy schools to make sure that they're seeing pharmacy is all over the things that pharmacist are going to be able to continue to do in the years going in to the future.

So to take those two sides it sounds like you're working on the supply side with the students and.


And then the demand side and my job doesn’t require, it only requires the pharmacy skills, it doesn’t require a pharmacy degree. I teach chemistry at a community college.

Yeah, yeah.

So, I keep hearing over and over again about these people that are like, well, do you actually need to even pass the boards like, no I don’t really even need that. It’s just a skill set and I hear that.

And it's really interesting you bring that up because that was actually a part of the discussion we had with the law school faculty. I mean, law schools have been kind of going down this path for a while now where when you think about what needs a license to practice law for versus what skills does somebody who goes to law school has and how those can be applied in a variety of different ways. You know, the reality is that you don’t need a license to practice law to benefit from the skills one gets going to law school. And I think increasingly we're going to see that in pharmacy, I mean, you know, which is one thing that I'll point to is the growth of the pharmaceutical industry as an opportunity for graduates from pharmacy school. We have a, I'd say, right now of our classes of a 120, 130, we have roughly 10% of our students that go out and do pharmaceutical industry fellowships and then go work for the industry when they're done. And let's say nothing they do with the industry necessarily requires them to have a license to practice pharmacy yet the skills and the knowledge that they learn while they are in the pharmacy school are essential to what it is that they're going to do. So, again that's, you know, we're very much seeing that.

I've heard the same thing with the PhD track more recently that PhDs have the skill set that's, you know, it's surely innovation, like to get your PhD you have to create something that advances your field.


But a lot of times they don’t PhDs necessarily how to do that outside of the traditional academic role.


So taking that in to account, how do you bring what's going on at AACP which is now national level so let's go down to the.


To the college of pharmacy level and talk a little bit about the way that you've, I don’t want to say you structured the North Eastern curriculum but you were acting dean for a little while.

But I worked for a little while, yep.

Tell me a little bit about that.

Oh, of course, you know, I guess, one thing first of all that kind of helped placed North Eastern in to context with, you know, every other institution, you know, in many ways where our university like any other and in one way in particular we're very very unique. And that our entire university is structured upon something called co-operative education. I mean essentially it really means, how do we combine our students getting experiences along with the classroom education. And it goes beyond, you know, let's say the Eppys and Appys that most pharmacy, you know, that pharmacy students get where they're going to curriculum. We in essence, our students will spend a semester in the classroom and then they'll turn around and they'll work full time for semesters and then they spend another semester and then they go out and do a second co-op. And, you know, in pharmacy over the four years of the Pharm-D program our students do three, four month co-ops. They are on co-op for twelve months out of those four years and they do one co-op in hospital, one co-op in community and then they have an elective for a third co-op and they really learn the value of work and experience and they can tie, you know, what it is that they're learning in the classroom to how it's applied in the real world so to speak and then come back and take what it is that they apply in the real world or what's going on in the real world and honestly I think it makes them better students in the classroom. So to answer your question how, you know, how we at North Eastern are kind of taking what's going on at this national level and bringing it down to us. It's really just continuing to emphasize, you know, we are preparing practice ready pharmacist, we are, you know, our job is to take these students that come to us that tell us they want to be a pharmacist and not only provide them the classroom and lab experiences but also provide them with the real world experiences that's going to prepare them for what pharmacist do across a variety of settings and I know, the way we structure our curriculum and the type of relationships that we have with our various partners in the co-op world and that kind of stuff. We're really fortunate and that we can, you know, we really do a lot of good things to help prepare our students here at North Eastern.

And you're too humble to say it but you're one of the power five privates in this country, Southern Cal number one, North Eastern number two then Kraken number three Drake and Butler round out the top five. So with the number of pharmacy schools it's obvious also that your peers are also acknowledging that your program is doing what it's supposed to do and I've heard this kind of separation, maybe to make it clear to some people that if you're thinking about maybe that Spanish class, you took for four years in high school and you're thinking about somebody who went to Spain to learn Spanish and who remembers and then who can actually take on a conversation.


To kind of put that, you know, who can have the pharmacy conversation, who is practice ready.


In that way.


Well, let's take it down now to the classroom level so I kind of reconnected with you after, I actually remember you bought us dinner and this is not why I had you on the podcast but there's like a bunch of us, my wife was there, I was there, it was some kind of pharmacy meeting, probably APHA.


And you were part of Drake at that time and my wife and I were just getting married. We didn’t have three six year old daughters.


But so now we have this class that you're teaching. So tell me first, tell us first a little bit about the class but then how you incorporate social media into that class?

Ok, wonderful, yeah. You know, pharmacy management, I mean, it was definitely my way I got into academic pharmacy, I mean it all goes back to pharmacy school and probably even goes back before that. Like you said, my father, I mean both my parents are still with us, my father was an accountant and he was a business executive and my mother was a teacher. She taught special ed and when I went to pharmacy school I thought, oh, I'm going to be a health care professional. I'm going to be totally different than my parents and then look what happened.


I teach and I teach business and management, so there's nothing like, your parents getting your last laugh on their children. So, but I, you know, fast forward that to pharmacy school, you know, I was taking all my pharmacy classes and I was, you know, I was enjoying it ok. Interestingly enough probably in the mid 80s there were a number of us that went to pharmacy as a, you know, with the every intention of going to medical school, it was kind of like a pre-med type thing.

I got accepted to pharm school before I had made it to med school.

Yep, yep.

I tell people that all the time, yeah, sure.

Yep and my thought was is that, well god this is great, I mean, I'm going to learn about all these things that are help me going to be a better physician and worst case scenario if I don’t make it into pharmacy school, yeah, I'll be a pharmacist, no problem with that. Two things happened along the way, one, I realized being a physician wasn’t at all what it was cracked up to be, I mean, it's not like you get the keys to the BMW the day you graduate from medical school. But more importantly I learned that there were so much more to pharmacy then I ever imagined there was even when I started pharmacy school and it was, honestly it was through experiences like I had with APHA and also through just the inspiration I got from certain teachers along the way and one of them was the late Joe Wiederholt, he was our pharmacy management professor at Wisconsin or one of the people in the social administrative group at Wisconsin and I took his pharmacy management course. I mean it was required course for all of us and, you know, for a lot of students it was kind of like, ah, why am I taking this, I'm only taking it because I have to  and all that kind of stuff but for me for whatever reason it just clicked and I don’t know if it was because, you know, I grew up with this culture of, you know, businesses and management and that kind of stuff especially with my dad and parents and stuff or whether it just, you know, I understood very quickly or I was very comfortable with the fact that for any pharmacy to be successful it needs to be successful as a business and a business entity as well as a clinical, you know, care providing entity. I mean, they go very much hand in hand and I was very comfortable with that and, you know, just really enjoyed learning about the business and management aspects of pharmacy. I guess that continued, you know, that was when I was working for Shopco coming out of pharmacy school. Working at a, you know, chain community pharmacy, I enjoyed that, I enjoyed the business both the clinical and business aspects of that. Went back to graduate school when I was at Ohio State essentially I took all the courses that MBA students take. Again, continued to enjoy and think about how that was applied and I guess with time, you know, as I decided where my career was going to lead me it was like, I liked the fact that it was leading you to, you know, towards academia and towards the opportunity to be able to teach that. To be, I guess in some ways share that passion that I have for how do you combine the business in clinical aspects of our profession, you know, with, you know, future graduates, with future pharmacists and as well as the chance to research in these areas, you know, to all research is, when it comes down to it and you know, this is answering questions that make you ask why. And I mean, I like to tell the story I was one of these kids that always asks why, you know, I ask my parents why and they tell me to look it up.


And then you go to look it up and you know, what sometimes you don’t find the answer and you have to figure out the answer yourself and that's where research comes in. And learning research methods and all those things you do when you get your PhD and so, that was a bit, again, I guess being able to combine all of that was certainly what led me into academia. The pharmacy management course that I teach is, I guess in a lot of ways like, a lot of us that teach it's the combination of things we've learned along the years. Sometimes we've been in courses when we said to ourselves wow, that's really great, I want to, you know, share that with my students someday, you know, I want students to be able to understand that. We've also all probably had the experiences as well where we've been in with professors where things haven't been that great and you learn from those things as well and you also learn I don’t want to treat my students that way or I don’t want to teach in that manner.


And so, you know, I've taken all of those things that I have learned and I have tried to incorporate them in what I share with my students. I take very much of a building block approach, I mean I realize that for the vast majority of the students that are in my classrooms, this is the first exposure to business or management that they've had and so I guess one thing I've learned over the years is not to have too high of expectations to really recognize that I am in fact creating the building blocks for a lot of these students. And, you know, my goal isn’t necessarily that that every student's going to go out and become a CEO or anything like that after taking my course. My hope is that by the time they take my course and finish my course that they realize, wow, I've got a lot more to learn and then these are the places I can go to learn that and apply that and do those things and so forth and, you know, I think that approach has by enlarged works. It's being a professor and being an academia has allowed me to connect with a lot of other people at other schools of pharmacy that do the same thing. Probably one of the best collaborations or best connections in terms of my professional career that has resulted from that is with Shane Diesel who is the co-editor of the pharmacy management text. I mean that text started, you know, it's funny like a lot of text do, probably a conversation in a conference once upon a time where I had some ideas and he had some ideas and like a lot of us in academia, you were frustruated by at the time the lack of resources that you could have your students, you know, use and that kind of stuff and essentially you end up creating your own. And that's what we did Shane and I kind of put our heads together and decided, yeah, let's create this text book, let's get a lot of our colleagues along who've been, you know, experiencing the same issues or problems over the years and, you know, god that was, you know, we're talking about 15 16 years later, you know, we're on the fourth edition of the text and, you know, that's been a really important contribution for us to be able to help advance our field.

Let me actually ask you a little bit about that because when we think about pharmacy students going out there and creating these clinical service and making money, our practice lab guy or our practice lab professor was Fred Abrahamson, he was there over  50 years and.


His very first kind of thing was, it's not a sin to make money and I feel like pharmacist coming out feel that it is maybe, I don’t know what the word is but they feel very uncomfortable asking for money for their services and how do you maybe help create a win win as a maybe someone would say rather than this win lose?

I guess, I very much take the same view as your as Dr. Abrahamson, you know, I'll, you know, part of me gets really pragmatic with it. It's like, yes, the reason you got in to pharmacy is that you care about people and you want to see people get better using your knowledge and your skills that you have about drug therapy. At the end of the day, the only way you can do that is if you are actually paid for doing that. One of the things I try to help students recognize in, you know, in these classes, where does their paycheck come from, just like you, I mean, if you work at a community college you know very well where your paycheck comes from so do I working at a, you know, research university and everything, I mean, it's this combination of student tuition and research revenues and all those good things and it's the same thing, you know, in practice. There's a combination of different types of revenues that are necessary in order to make a practice work and then there's the expenses that have to be there in order to create those revenues and so, you know, I go back to helping students understand if you want to provide really high quality clinical services you need to be able to in essence create an argument and which is a fancy way of saying, you know, at the end of the day you're going to create a business plan that will help people understand why you and your services are worthwhile and there is absolutely no harm in having people understand that. As a matter of fact, at the end of the day, it's essential that people understand that they value what it is that you have to offer and value it so much that they're willing to pay what it's worth to them and that's, you know, whether we're buying drugs in a pharmacy or a clinical services from a pharmacist or coffee in Starbucks it's all about value and whether that consumer is getting that value. And, you know, pharmacist, we know add a lot of value to medications and their use and we haven't always been very good at explaining that to others even though we've done a very good job of doing it. We're not good marketers and that's one of the thing where I'm trying to help our students who especially through what I teach in this class, help them understand again just like making money is not a sin, marketing is not a sin, you know, talking a little bit about yourself, helping others understand who you are and what you do, how you add value to these wonderful things we call medications, you know. Why is it that people are better off because a pharmacist is involved in the process, then what would happen if a pharmacist wasn’t involved in the process, you know, again, the more we can help others understand that the better case we can make for ourselves and for our continued value.

Ok, so we've taken it from AACP nationally to the college to the course, I've asked you a lot of questions. Is there anything that you want to make sure that our group of students, residents and really a lot of the innovative practitioners that are out there hears from you?

Again, I continue to be very bullish on the future of pharmacy and the future of the profession, you know, particularly for the students that are coming out now. I think there is a challenge, you know, as we continue to see, you know, more schools of pharmacy be developed and so forth. There's also challenges to folks of maybe my health or so forth, people that have been doing this for 20 30 years to keep up our skills, to, you know, know that there is a new group of pharmacists coming into the market every year that really in many ways are trained and educated in a different way than we were trained when I went to pharmacy school. I mean, I learned my job was to get the right drug to the right person at the right time and while that's still an essential function of pharmacy there are so many more things now that pharmacist do to add value to the process purely over distributive functions and so I'm really excited about that. I do say that in order for us to be able to get the most out of these clinical functions we need to have an understanding of the business functions of pharmacy just as much as we do of the clinical functions. I think one of the things and I know you saw this on my social media feed about the article from Harvard Business Review that recognize that physicians by enlarge don’t get any training at all in terms of business and management.

That was a surprising article, yeah.

Yeah and to that end let's say, pharmacist, you know, yeah, most schools of pharmacy have their introductory of pharmacy management course. I'll argue though that, you know, and I'll argue not necessary that we need more courses but pharmacist need more background. First of all, they need to understand that, you know, business and management is more than just what they learn in that one pharmacy management course that they are going to take and then in a lot of ways just like, you know, no one would ever like, start taking pharmacology or organic or medicinal chemistry as their first, you know, pharmacy or chemistry courses. There's all kinds of courses you take before that so that you can understand those courses and then you apply it in your, you know, your Appys, on your clinical education. The same approach kind of needs to be used for business and management, I mean, there's all kinds of skills. I mean, a pharmacy management course really is just a collection of a whole bunch of business disciplines that we, you know, divided into units and teach over the course of a semester or two and we want students to learn more about each of those disciplines. And then once they take our courses they need to go out and figure out how do they apply that to pharmacy practice, how do they use marketing, how do they use finance, how do they use accounting, how do they use personnel management in terms of helping them be the kind of pharmacists and create the kind of practices that they want. And so, I guess I'll  put that out there as that's one of our big challenges moving forward is how can we make, you know, pharmacy management, how can we continue to make it relevant and how can we continue to provide opportunities for our students to learn and grow as they move forward.

Yeah, well, thanks so much for being on the Pharmacy Leader's Podcast.

Alright, thank you. Thank you, I very much appreciate it.

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