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Pharmacy Residency Podcast

Mar 19, 2018

In this episode, Jackie Boyle of blog hosts Carrie J. DeKorte, PharmD, FACHE, Deputy Network Director of the VA Desert Pacific Healthcare Network, VISN 22.  Carrie oversees eight healthcare systems and is responsible for operating a $4.8b budget through 30K staff serving over 500,000 Veterans via 6.6m outpatient visits and +3,000 beds across 72 sites of care in Southern California, Arizona, and New Mexico. Her love for service and patient care has allowed her to leave a tremendous impact on her team and her patients. Carrie describes leadership development training she has participated in and the urgent need for clinical pharmacists to be exposed to administrative scenarios within their career development. 

Full Transcript:


Welcome to the pharmacy leaders podcast with your host Tony Guerra the pharmacy leaders 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 well welcome everyone to the pharmacy leaders podcast my name is Jackie Boyle from the pharmacy girl and today we are so excited to have with us Carrie DeKorte she is the deputy network director of the Veterans Affairs desert Pacific health care network vision 22 where she oversees of she oversees eight healthcare systems operate the four point eight billion dollar budgets serves over 30,000 staff and over 500,000 veterans across 72 sites in the states of Southern California Arizona and New Mexico so Carrie we are so excited to have you on the pharmacy leaders podcast Thank You Jackie I appreciate the invitation it's a great opportunity to visit with others about leadership and pharmacy and healthcare so thank you for the opportunity well we're excited to have you so can you tell us a little bit about your professional trajectory or journey how did you get to where you are a journey is a very good way of describing in a pretty unique path I would think I applied for pharmacy school and medical school I couldn't make up my mind at the time and finally it came down to I think I'll go with pharmacy because it's a little bit more flexible when you're a doctor you're always a doctor no matter where you go and it's really hard to have a part-time physician job so in my mind I was really thinking about a future with family and maybe going part-time at some point in time and so I entered pharmacy school pretty much naive I would say to the potential of pharmacy and pharmacy leadership and  I started my career at the Tucson Medical Center as a pharmacy intern and it was incredible experience and I'm so grateful to Tucson Medical Center for giving me the opportunity to work there while I was in pharm school and really learn about the potential of being a pharmacist and all the different opportunities and some great mentors there at Tucson Medical Center and some not great ones that I learned from as well and decided what I would want to do in the future and it really opened my eyes to clinical pharmacy so I applied for and was accepted to a clinical pharmacy residency program at the Phoenix VA and the reason I chose the VA is primarily to serve veterans it's really a passion of mine like being involved in service to others especially those who have served our country and especially those veterans who maybe are down on their luck they don't have the social or economic support system and to help them get back into a state of health so that they can move forward in their lives my grandfather was a veteran and he went to the VA several times when I was in high school he passed away when I was a senior in high school and I've always just really felt drawn to serving veterans and it was very fortunate at the time the Phoenix VA was one of the most competitive residency programs in the nation and really enjoyed my time there and had incredible mentors just some of the most brilliant women I've ever met in pharmacy and they really encouraged me and if not inspired me to be a little bit more competitive and really go for the gusto when it comes to knowledge and pharmacy and so I stayed on there after my residency and I was there for about four years and obtained my board certification pharmacotherapy specialists which wasn't necessarily something everyone was doing at the time and I was really really trying to pursue excellence for our veterans but I did tell you and I just got to be honest sometimes it can be a little frustrating working for the federal government and I love teaching so I left the VA and took a position as an assistant professor of pharmacy practice at the Midwestern university here in Glendale Arizona and I love teaching I really enjoyed it but I really missed the clinical practice of being with the veterans had a clinical practice site as a consultant pharmacist at an extended care facility but really missed my veterans and so I took a transfer to Salt Lake City VA that's one of the things I've been very blessed by working in the VA we have 140 sites across the nation that's not including all of our clinics you start counting up all the clinics and it's a great opportunity to move across the nation and really network and build your skills so I was the director of pharmacy education and training and the clinical pharmacy management at the Salt Lake City PA and that was my first supervisory position and I'll tell you that's a lot of on-the-job learning and I really enjoyed my practice there I worked in the ICU I covered all of my different pharmacy teams as they were out but really opened my eyes up to the entire health care system you know Pharmacy is such a small piece of what happens in the healthcare system and I was involved with the quality management officer and doing some root cause analysis and they put me in a different stretch assignments I ran prosthetics department for a little while and then I completely switched over to administration so I went a hundred percent administration and not only a hundred percent administration but in the VA central office in Washington DC and really learned about what it means to be a federal entity and how to work with office of congressional legislative affairs and office of the medical inspector and more integration with Joint Commission and a variety of processes up at the central office level but again there I was missing my veterans I really loved being around the veteran patients you know they can just make me smile and they remind me of why I work as hard as I do so I tip it down great to come back out to the field and I was in Tucson for about four years and again went back up into administration I was the assistant director there for a little while and then I transferred over to Los Angeles where I was the associate director there and and again these are Healthcare Administration positions so we think of a more like a CEO of the hospital and had oversight of acquisition and material management facilities management finance management really seeing the healthcare system from the 30,000 foot level and then I had an opportunity to come here where I'm now at in Gilbert Arizona so I'm the deputy Network Director and we have eight facility or healthcare systems so hospitals plus all their clinics in Southern California Arizona New Mexico and I'm very fortunate right down the hall for me is our pharmacy benefits manager and actually we were talking earlier today so I'm still involved in pharmacy in some of the nuances related to pharmacy and we have a good time talking about these different leadership challenges and pharmacy Wow thanks so much for sharing it sounds like you've had a fascinating and phenomenal journey ups downs and right turns and left turns yeah and it sounds like too that you  always had an aspect of your job role that was directly touching or interfacing with those veterans that you cared about as well yeah it's one of the things I noticed early in my career and I'd encourage everyone to think about there's several different assessments that you can take online whether it be personality assessments and one of the ones I did was motivators what motivates you what drives you what brings energy to you at work and my primary motivator is service and it goes along with the idea of serving veterans I've never heard of that one I'll have to check it out and link it in our show notes if I could that motivators assessment but I'm a I'm a nerd for assessments I find it that's great I highly recommend them and I recommend doing them throughout your career I think we do change as we go throughout our career just based upon our experience and other life factors what's going on at the time and it I think first and foremost we have to know ourselves before we can lead others that's a great point so Carrie through your leadership experiences what do you think are some misconceptions about leadership or what makes a great leader I think some of the challenge that we have is we take individuals who are highly technical competent and what I mean by that is they may be great clinical pharmacists they may be great outpatient pharmacists they may be great inpatient pharmacists and then we put them in a supervisory position which is a completely different skill set and I think that's a key misconception for folks and they're thinking about going into leadership or once they get in leadership it's not the same skill set I think another misconception or learning point would be its not increased Authority you know several people think that well once I become a manager I'll have the authority to make this happen and what you quickly find out it's not about Authority it's about influencing people to change behavior and that happens one on one when we're trying to change behaviors that's not an issue of memorandum and everyone must follow the memorandum that doesn't change behavior and that doesn't change culture and so leadership really is about being an influencer and being a leader obviously there are times that we have to be a supervisor or manager and I have to tell you those times are not the fun times nobody really wants to come down hard on another person yeah you believe the best in people and people do come to work to do the best that they can and always taking a look at the system how did the system fail and that's one thing I see time and time again is that we put new individuals into new leadership roles and we don't match them up with a mentor we don't put them through training which provides true exercises where they can walk through a scenario and talk about what they would do and then receive feedback on how they might want to handle it if we do training it's usually online and here read this and it's just not effective training I think for leadership and that's one of the things that I've been very blessed with is a natural curiosity so I sign up for everything all kinds of training avenues and kudos to folks listening to this podcast clearly they're interested in becoming the best people that they can be and so keep up the good work with podcasts sharing the information and building a community and I think that's probably my main message is just being grateful for the community that I've been a part of and been blessed to be involved with yeah that's those are some great points and there's nothing like learning by being a part of something versus reading it you know enough unless you're faced with either some sort of simulation or a real-life experience that is certainly challenging to learn those difficult situations absolutely it's those crucial conversations you don't really know how well you'll do until you're in it but as much as you can plan ahead or practice with someone else I highly recommend it and just talk through it with someone else I'd say this is what I see and I do love the Crucial Conversations trainings I think they're highly valuable and we also do some transformational coaches trainings and facilitation trainings and grid bends does some advanced facilitation that I think has been excellent that's one thing we don't do in pharmacy school really we have a communication class but it's more focused on how to communicate with patients and really we need to talk about how to communicate with other healthcare professionals and or people that you supervise and how to handle when things go wrong it sounds like the VA has a really great leadership development program over there I have been blessed we do have an executive leadership program that I went through in about 2004 and but there's several opportunities online including things like this podcast you know it's just about getting out there and being part of your community whether it be local regional or even national be part of a community build those relationships those safe people that you can go to people that will share our stories and people that will share their mistakes we can learn from each other's mistakes definitely so Carrie where do you see challenges for women leaders in pharmacy or could you share some challenges that maybe you've faced yourself absolutely and so I've had a couple as I mentioned great preceptors and mentors and some that I've learned how I don't want to be one of my mentors was the pharmacist in charge and she came to me one day and said you just killed a patient you sent the wrong drug down to the IDI and she let me go home that night thinking I killed someone and I came in the next day and I was a mess and I went to the manager I said what's going to happen to me he said what are you talking about and I said well so-and-so told me I killed a patient because I sent the wrong medication down there like Carrie you didn't kill a patient the nurse noticed it was the wrong medication and they sent it back and asked for the right one I think that's one challenge in female leaders and that that dog-eat-dog world you know trying to impress upon someone the importance of double-checking yourself there's a way to do it and there's a way not to do it I've had some excellent mentors who just are real kind human beings they have the knowledge but they're not so insecure that they need to flaunt their knowledge and I think that's a challenge for female leaders in pharmacy you know we're very driven to be technically sound and have that knowledge and then to prove that we have the knowledge and be able to back it up with studies and p-values and all those great things we learned about but it's more about being confident in yourself enough to know that you don't have to prove yourself that way that you can have a conversation with someone and ask more questions than you tell the answers to so I had some great preceptors and mentors who had just asked me questions and it was non-threatening it was just well where did you come up with that idea well what do you think about X Y & Z or an alternative then we would talk through it and I think that's really important for female leaders in pharmacy is just to be emotional IQ and understand how to work with people the awareness of how we present ourselves at work and how we come across I think it's sometimes difficult for women who are trying to balance that natural nurturing and still trying to make a point that we need to be very detail-oriented and we do need to be correct and we do need to put patient safety first I think another thing for women leaders and is correct business attire I see it a lot some women leaders dress in ways that would be less modest than their position and so just being aware of that and for goodness sakes if we see each other doing that we need to say something to each other you know talk to me don't talk about me help each other just say hey do you realize that you might want to consider a skirt that's a little less short or hey do you realize you might want to consider buttoning up one more button on that blouse and then just being honest with each other so often I see women leaders talking about other women leaders and their attire in the business place and I think the third thing I would think about for women leaders that's the challenge is to understand that we are set apart when you get in leadership you can't continue to have the type of relaxed atmosphere that you may have appreciated before and an example is I have a female leader in a new leadership position who went to the holiday party everybody's there everybody's enjoying it and she had a little bit to drink and you know said some things that were inappropriate and now you know she may lose her job and so just understanding that there is a higher expectation in leadership well we are held to a higher standard and we are on stage 24/7 you don't get to go to the the grocery store and behave differently because you do represent your organization and leadership is 24/7 and just having that awareness of being set apart thank you for sharing all the great advice I am so glad you brought up the emotional intelligence topic we were actually just discussing that at my institution today we're thinking of incorporating emotional intelligence since we're residency training so really yeah absolutely I would say every residency training needs emotional intelligence and servant leadership I think that's one area you know because again in pharmacy it's very competitive to get into pharmacy school so it naturally draws that tendency for competition to be technically sound and where we usually don't focus is on the relationship based interpersonal communication skills absolutely so I know you mentioned a little bit about how women can help each other and maybe even give each other some nice advice sometimes where do you see if where would you see other opportunities for women to help support each other or even grow I think this podcast is a great example of cultivating community and how we work together to help each other share our stories first get comfortable in our story and then share our story and have the conversation take the time and energy to have the conversation it's carefully cultivating that community and building connections not competition I mentioned Ingrid Benz earlier as a facilitation training and that's really where I learned a lot of my coaching and mentoring skills we also have a transformational coaching certification program so it encouraged folks to look at coaching and mentoring in how to be an effective mentor or coach I like to think of more talking and less typing too often today we put things in text or an IM or an email if we're trying to document and it's just really thinking about it from a human perspective how often do we misunderstand text or email and how much better it would be if we would just pick up the phone and talk to each other and I think that's a something that we've really lost in more recent years it's really easy for me and my own time it's convenient for me to send you an email and in my mind I can justify it thinking well it's convenient for you because you can read it when you get to it but really what we're missing out is that community and that connection and really talking with each other so I'd encourage more talking and less typing especially if you've gotten to the second reply on the email by golly if you can't clarify it than two replies it's time to pick up the phone and stop you know that's a great point I know personally sometimes it takes me way longer to write an email then tips talk with someone and it's amazing - I think sometimes I send emails and it's part of my process of thinking through it I want to say but I could also just stop and not hit the send button and then pick up the phone and be cohesive and what I'd like to share with that person and also it's more about dialogue and building dialogue it's not about us telling the doctor what they need to do or us telling the other pharmacists are subordinate what they need to do it's about having a dialogue absolutely alright I'm going to switch gears just a little bit so Carrie if you can think back what would you tell your younger self about leadership for pharmacy or anything career related what would be the biggest piece of advice you would give your younger self oh that's a great question I love that one um don't be in such a hurry again Pharmacy tends to attract people who are driven right who are task oriented who are details and I think for me and my younger self I was so driven and hungry for that next promotion that next achievement my BCPs and then I wanted to move up into the next role and and really just don't be in such a hurry you have 30 years to work pace yourself if you want to make it you know and just really enjoy the journey it's not about the destination it really is about the journey and you'll know it's time to move on when you've absolutely learned everything you possibly can from the current situation that you're in don't be quick to run just because it's uncomfortable don't be quick to run just because you can because you're highly skilled for example I received a call just on Friday from a facility asking me if I'd come out there to be their Associate Director and I thought about it over the weekend I thought no I'm not done learning where I'm at I'm not done growing where I'm at and so really just don't be in such a hurry for the next opportunity that you miss out on enjoying the journey and build that stamina you know create anchors in your life remember to nurture yourself and nourish yourself so often pharmacists and particularly the female pharmacists were very driven and we have lives at home and family and just really need to think about taking care of yourself it's okay to disengage it's okay to turn off your phone for a day you know I think the other thing that I would offer my younger self is to accentuate the positives and really focus on your strengths and here's another one of those tests for you if you haven't done it already the strengths identifier and I've done this twice and each time I get a little bit different so it's interesting we're really identifying your strengths and then play into your strengths and don't worry about your weaknesses for the longest time I had it on my list of things to do I need to refresh my Spanish and I finally just said to myself Carrie you don't need to it's not something that you need to do right now and that's not something that needs to be on your list because it creates a sense of unfinished business or not achieving my goals so I'm not saying don't make goals I'm just saying don't forget to play to your strengths and really focus on what is your expertise and not worry so much about everyone else in the race that they're running everyone runs their own race and we're only responsible for our race in the end yeah great great points again I know one of my mentors told me once that their career is a marathon not a sprint and that's always stuck with me absolutely absolutely and that's so true and yet we come out of school sprinting because we've been sprinting right it's all about ranking high enough on the PCAT to get into pharmacy school ranking high enough in class you know it's always competition who's doing the best and that's just sort of how we're training if you think about it in school I know in one of my classes in high school they used to see this quarterly according to our rank in the class so it was all about competition and somewhat that's in bred in us and so then how do you maintain the competition with yourself can you be the best you and how do you bring the best you to work every day and maintain that competition but give up comparison with other people because I'll tell you the quickest way to lose your sense of peace is to start comparing to other people you know they talk about Facebook Facebook is sort of your highlight reels compared to what you know is going on in real life and it's very damaging to some people in social media because they compare themselves to what everyone else is doing so I think it's really resiliency having self-confidence suing your own competition with yourself being grateful and gratitude for the opportunities given to you and optimism for the future that it is a marathon and you have what you need today to succeed today and keep running that marathon every day great points so I know we would like to keep these episodes under about 30 minutes so Carrie can you tell us what do you think it's the one best way that women can help support each other in pharmacy leadership I think the one best way women can support each other in pharmacy leadership is sharing information and communicating with each other I think building that connection in that community whether they are your supervisor or not whether they're your colleague at the same office or not if they're in a different manufacturing business if they're in any different setting it doesn't really matter what setting you're in and I think people limit themselves you know comfort is people who talk like us and people who can appreciate our current roles I'd encourage people to get outside themselves you know get outside your tent and look up at the sky and see all the stars and really recognize that we have many women leaders who are stars and what can we learn from each other and support each other through sharing information and communication and connection thank you so much Carrie I know I learned a lot from you today so thank you for being on the pharmacy leaders podcast thank you appreciate the opportunity Jacquie support for this episode comes from the audio book memorizing pharmacology a relaxed approach with over 9,000 sales in the United States United Kingdom and Australia it's the go-to resource to ease the pharmacology challenge available on audible iTunes and in print ebook and audiobook thank you for listening to the pharmacy leaders podcast with your host Tony Guerra be sure to share the show with a hashtag hash pharmacy leaders