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Pharmacy Residency Podcast

Apr 27, 2018

UIowa P4 Ahamed Ahamed, who has a strong interest in patient care and entrepreneurship, interviews Mike Case-Haub Pharm.D. 

Case Haub Consulting (CHC) is a Clinical Pharmacist Services firm dedicated to transforming the future of pharmacy. We believe that pharmacists have unique skills and training that can make a significant difference in improving patients’ overall health care, and our team of more than 100 clinical pharmacists is passionate about engaging with patients, finding solutions to medication-related issues, collaborating with local pharmacies and physicians, and delivering high quality patient-centric care that improves overall health outcomes while managing costs.The CHC model of clinical services is based on reviewing patients’ overall medication therapy needs with a broad, unbiased outside perspective. We provide effective, high quality comprehensive medication reviews (CMRs) with economies of scale. We work with local pharmacies to improve their operations with training and customized solutions. We partner with MTM vendors, health plans, and health systems/clinics to address all varieties of medication related challenges.

Better health outcomes, higher quality of care, lower health care costs: the future of pharmacy starts today.

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 from building your
professional network brand and a
purposeful second income from students
residents and innovative professionals
so welcome everyone to the pharmacy
leaders podcast my name is Ahmed Ahmed
and I'm actually a third year pharmacy
student at from the University of Iowa
College of Pharmacy and today I will be
interviewing my case hub who is the CEO
and founder of Kay's hub consultants and
basically this company is a consulting
business that he started a few years
back and so we're just gonna ask him a
few questions about his company Mike how
are you doing good thanks Abed how are
you today good good so the first
question I have here for you is when was
your aha moment and when did you start
your business
so our aha moment well let's see we we
started the company back in October of
2014 so we're still a fairly fairly new
company kind of a start-up still in that
kind of category really my aha moment
was I had been working as a pharmacy
manager is a kind of a store manager for
a local pharmacy and we actually were
robbed so we got robbed at knifepoint
and then a couple weeks later we got
robbed at gunpoint and at that point I'd
already started the consulting company
but I was kind of just doing that on the
side you know my wife was a stay-at-home
mom at that point had three small small
boys and you know really I was the sole
breadwinner for the house and but you
know it was just kind of this consulting
company going and and I kind of felt
like well maybe the universe was telling
me something that maybe it was time to
get out of a retail pharmacy and if I
was really gonna make this consulting
company you know hopefully get off the
ground I kind of needed to put on my you
know eggs in that basket and that's
pretty scary to be very honest but you
know at least from my perspective if I
was really gonna make it go and
hopefully be successful with it I really
again put on my chips in and really to
really focus on that full-time and so
really after after that had happened I
put in my my notice to my current
employer at that point and and then it
kind of just fell into place after that
so it was a that was kind of my aha
moment was like I I really need to kind
of focus on this company and and then
you know throw caution the wind and and
kind of take on some risk there and go
from there
absolutely absolutely and just to kind
of spend on what you said about the
whole putting all your eggs in one
basket so what did it take for you to
ensure your business would be successful
so you would be comfortable basically
leaving a normal revenue stream behind
and allowing yourself to take this new
one on as an entrepreneur there is no
level of comfort from my perspective it
you you never know I you know and so
many businesses you have to be willing
to fail and there's very few businesses
out there that you know the founder or
the CEO or whoever's kind of got that
company up and going likely they've had
numerous unsuccessful companies before
that so I think it's it's a little bit
of faith it's you know of course belief
in your company and your model and what
your vision is I think that's really
important but you also have to
understand that you may fail and you
have to be okay with that and I know
that's probably not so people really
want to hear but it is something that
you know to make your company be
successful you have to be willing to be
flexible and you're going to fail on
certain parts but but hopefully you know
kind of like the old adage goes if you
may have lost the battle but you haven't
lost the war kind of mentality is that
yeah there's gonna be time to lose a
client or there's many times that you're
gonna be financially really struggling
with certain things and then there's
other times that you're gonna be doing a
great job but and so it's more of a you
know I always tell people it's more of a
marathon than a sprint so we have to
kinda what's our long-term strategy and
knowing that there is going to be a band
flow and you just have to be comfortable
with that and if you're not comfortable
being an entrepreneur is probably not
what you need to be doing you need to
probably find a more stable you know
profession and you know if you just want
to clock in and clock out and do your 9
to 5s or whatever kind of job you want
to do that's great that's generally not
the mentality bills people want to be an
entrepreneur though you got it and just
in terms of successes and failures
because we are all taught that we're not
shaped by our successes but rather our
reaction to our failures so what was
your worst entrepreneurial moment since
you so this happened not too long after
I decided to quit my stable full-time
job so we had a number of clients at
that point and but our largest client at
that point this was probably about three
or four months after you know I again
quit my full-time job and was doing this
full-time our our largest client at that
point was acquired and so through that
acquisition they pretty much had to say
well we weren't gonna work with certain
client or you know certain vendors any
more of that type of stuff just trying
to figure those things out so so
unfortunately right after you know I
decided to put all my eggs in this
basket that you know those eggs kind of
got scrambled up pretty well so we we
were struggling there for a little while
to try to figure out what the next steps
were going to be and we had other
clients in too and so we were okay but
it definitely that definitely hurt now
that actually that client did come back
to us so we were really happy with that
it's just you know in this you know in
this world of healthcare as you know
we're all pretty much aware there are a
lot of acquisitions and mergers and that
type of stuff then too and and so you do
have to be willing to kind of write out
that wave a little bit and and that's
something that we've we've definitely
learned firsthand for sure okay got it
no absolutely and so say we went back in
time to when you first started your
business case help consultants what
would you say your mission at the outset
was yeah I would really say you know the
mission or kind of what the
vision is for the company is that I have
personally felt like the practice of
pharmacy is definitely moving in a
different direction than where it's been
at traditionally my vision was to really
move us away from product distribution
and really try to focus on cognitive
services and I wanted a model where I
didn't have to dispense a product or get
paid or reimbursed for the product per
se but to actually pay pharmacist and
have a model where we are getting paid
to to use our brains I mean I'm not
saying I'm using your brains if you're
dispensing but that's all that we're
doing we're mostly focusing working with
patients directly and and how do we get
pharmacist really involved in those
types of models and I think it's pretty
challenging because as we know the most
part pharmacist aren't reimbursed
directly by payers you know for the most
part I mean there's some some exceptions
and that kind of stuff but in general
that's a very challenging model so what
we've tried to do is really focus on how
can we collaborate and work directly
with physician clinics and health plans
and health systems and really show the
value of what pharmacist can do the
other big component that we wanted to
focus on is I really wanted to move the
needle I wanted to have scalability and
I wanted to not just have hey I've got
four pharmacists that can do this work I
wanted to have the ability to say hey
I've got 400 or I got 4,000 or who knows
I've got four million but I'd be able to
scale that up because I feel like
there's a lot of pharmacist out there
that want to do this kind of work and
there's a lot of patients out there that
need this kind of work or you know these
kind of services to be provided to them
so what we really want to do is create
that almost turnkey solution where we
can plug those pharmacists into that
model I kind of tell people where I can
feel like we're Buber for pharmacy and
if we're we you know we've
to create this model where we're
connecting patients with pharmacists
that want to do this kind of work and I
think that the cool thing is is that
since our pharmacists are doing this
kind of work all the time just like
anything you know if you don't do
something very frequently you're
probably not going to be very good at it
so our folks because they're doing this
kind of work all the time they're really
good about how to have those
conversations with patients and how to
identify drug therapy problems and
resolve those drug therapy problems and
have conversations with the decisions
and you know how to kind of get those
things going and it has been really it's
been really interesting and I think
there's a lot there's a ton more that we
can be doing to advance the you know the
the practice of Pharmacy and I think
something I started with and I think we
struggle with as a profession is that I
think we as firms just really good about
patting ourselves on the back and say
hey we're doing such a great job but
outside a pharmacy nobody really knows
what pharmacists do or there's this
mentality of oh well they just fill
prescriptions or they're you know in the
basement of the hospital and that kind
of stuff that as well - and so by us
directly trying to interface with
physicians and and other you know
leaders within healthcare I think
there's a lot of value to that because
we can help start shaping or changing
the practice of matches Pharmacy but how
our patients manage within the
healthcare spectrum and I think if you
think about how many patients are
hospitalized or have readmissions or
have to go to the ER or you know have
all these chronic conditions most so
those patients are going to be managed
by using medications and we as
pharmacists are met the medication
experts and so how do we get plugged
into that team and get reimbursed for
that service is something we struggle
with every day but I think we're
starting to crack through some of those
barriers and I think we've had some
pretty good success on trying to create
those kind of models and have them be
scalable absolutely and just to expand
on that a big thing that people do not
think about is marketing your business
or marketing well
we do as pharmacists even so how do you
market yourself to the I don't know
doctors offices or just other pharmacies
insurance companies to tell them like I
have this value that I will be able to
give to your company or give to your
office and therefore like how do you
basically market yourself and case up
consultant at school yeah marketing it
is it's a challenge because you know of
course we have our our website and we
have marketing materials and that kind
of stuff then as well too but a lot of
it is I would say pharmacy our family
our family treaty has very few branches
on it so it's kind of it's kind of who
you know and you know I feel like we're
pretty well known in the industry or you
know I know different folks and they
know different folks and you kind of
have those collaborations and you never
know what conversations gonna kind of
open up that door for the next you know
the next potential client that kind of
comes down the road so you know we
haven't really done a ton of you know
direct consumer advertising or that kind
of stuff it's really more focused on
again connecting with the right the
right folks within the industry and I'm
just kind of be on the lookout for
different opportunities as they come up
now we have looked at doing direct to
consumer advertising and we feel like
there is there's a model like a
concierge model where we can work
directly with patients to help them as
you know as advocates we could help them
you know because do medication reviews
or you know we've even looked at a model
of kind of a virtual pharmacist on
demand or when a patient is at their
physician's office while they're waiting
for the doctor to come in we can
actually virtually pop in do whatever a
med review or a met rack or you know
do whatever we need to do with that
patient and then have that conversation
with the physician when they come in the
room that is well - so it's kind of a
model where we could have pharmacists in
a clinic but they're not physically
there they're virtually there and
there's a lot of scalability and I think
as technology continues to improve
I think telehealth and tell
Pharmacy and you know tella fill in a
blank is going to become an even huger
part of what we are doing in healthcare
not just what pharmacist can be doing
but I think it's we're just trying to
think about different models and how can
we fit into that in a model that's
pretty pretty innovative if possible for
sure for sure and just also something
that we wanted to ask you was in terms
of employees that you have at Cates of
consultants because you did mention a
few numbers earlier but how many
pharmacists technicians and do you have
employees that aren't pharmacists or
technicians yes so right now I mean our
model is really we're contracting with a
lot of pharmacists to do this type of
work so we've got probably around 300
about 300 contracted pharmacists that
work with us and then as far as
employees go we have 25 employees right
now that work for us the vast majority
yeah we do have some pharmacists sort of
work for us as you know management to
that type of stuff as well too
and then we do have pharmacy technicians
and pharmacy students that's the vast
majority of the folks that work for us
we do have a you know a business
analyst that works for us as well too
but but for the most part is you know
pharmacists pharmacy students and/or
pharmacy technicians that they're
working for us you got it okay that's
pretty awesome you definitely employed a
lot of people it's like that's great
keep going just great
awesome awesome and so now a lot of
students listen to this podcast and
people who might be interested in the
business so maybe you can tell us a
little bit about how many hours are just
like day-to-day how many hours you put
into work maybe have to start your
business when back in 2014 compared to
now have you been able to slow down and
have some fun or is it just work work
work one of the main reasons I wanted to
start this company as well - to try to
figure out more work-life balance you
know I was working very hard at lots of
different companies that I worked at
before and
which is great I mean I think working
hard is really important than two but
you know as I mentioned before I get
I've got three three boys and a lovely
wife and you know I like being married
and I'd like to stay being married so
you know those things kind of we're
trying to kind of balance some of those
types of things out then to it and so
you know what I do like about our
company is that we do we do have that
flexibility and so you know if one of my
boys has a you know who got a soccer
game today we've got baseball or there's
a play or student-teacher Congress's or
whatever we need to do I can you know I
can go to those types of things where
before if you know if I'm working the
bench and I'm scheduled that day I have
to you know I have to I have to go to
work and so it's just a different
different type of model or kind of a
different structure than what we you
know traditionally think about from
pharmacists do it as far as time the
hours we work you know there's kind of
this old saying you know I in the
entrepreneurial world of I work 80 hours
a week so I don't have to work 40 and
I'm sure you understand what that means
but you know in a nutshell is just
saying that you know I'm willing to work
a lot hours for myself so I don't have
to work 40 hours for somebody else every
week then - and it's you know it isn't a
balance because it's exhausting I will
not I will not sugarcoat it at all it is
very exhausting I mean I'm going in
directions at all times but it's also
it's also rejuvenating a little bit as
well too because you know I love what
what I do I love what we're what we're
trying to do I'm passionate about it you
know but I'm also burning the candle
from three different ends on two and so
I think you know just trying to find
that balance and as we keep growing
we're able to bring on you know
additional management to help with all
the day-to-day operations and all the
different stuff that we have to do and
focusing on strategy and you know sales
and all the things that have to happen
within a company and you know it's a lot
of work I mean I'll be very very honest
it's a it's a very challenging thing
that we've activated here but
but again if it you know if I wasn't
challenged I'd probably get bored and I
wouldn't want to really really do it
much longer than as well either and and
it's for me it's it's fun because you
know we get to talk about our profession
and I get to talk to and work with
students and pharmacy techs and
pharmacists and talk to health plans and
talk to physicians and all these
different groups that we talk to and you
know I could have a conversation with
somebody this afternoon and we love what
we're wanting to do together and we
could start doing it tomorrow and that's
the the big advantage that I've liked
about the company is that we can be very
nimble we can make changes you know on a
dime for the most part if we need to and
if there's something cool we want to try
out well then we can try it out and it's
not a well well this is going to take a
year for us to you know figure out the
all the ins and outs and the nuances and
that kind of stuff there's something we
truly want to do we can do that pretty
quickly without having to go through a
lot of red tape got it for sure
and you did mention so you're working
about 80 hours a week maybe it may be a
little more just to not work 40 hours I
thought that was a pretty powerful
statement and just you feel like it's
actually let's see like more
significantly significant significantly
more fulfilling to be a business owner
in the field of pharmacy as opposed to
you know working as a community
pharmacist hospital pharmacist and in
terms of not only flexibility but
revenue and things of that sort as well
um I think for me it's more fulfilling
but I definitely not say everybody would
you know want to do this or like to do
it as well either so you know for me it
was I just kind of had this itch that I
had to keep scratching that I wanted to
kind of push the boundaries I wanted to
try something different
that's just kind of been my personality
you know for as long as I can remember
is that yeah when I was in pharmacy
school for example I worked at a lot of
different types of pharmacies I worked I
worked full time and I was in perm and
she school as well too and so you know I
worked in you know hospital work with
investigational drugs
worked with yeah iowa medicaid worked
with you know a lot of different retail
settings try to do a lot of different
things I wanted those experiences to try
to figure out what did I want to be when
I grow up and and kind of every day I
asked myself that same question what I
don't want to do when I grow up then too
and so trying to create that you know
create what I want to do when I grow up
and not necessarily have to have
somebody else create that and me kind of
fit into that I want to be the you know
I want to be the molder and I want to be
the one that kind of creates that and
figures out what that is and that
doesn't mean that I know exactly what
that looks like it what it needs to be
because I think a lot of input from a
lot of different people that I trust in
the industry that are able to feed me
information or say hey have you thought
about this and you know so I want to be
really open minded to that because I
think those are the kind of companies
that are very successful long-term that
have that ability to be a little bit
pliable you know be able to absorb
different different ways of thinking and
and I think surrounding myself with
those kind of folks is really important
as well too I want people that question
and people that they think may hate
saying think outside the box is that
such a cliche but I think having those
people that are willing to you know
question and question authority or
question why is the institution set up
the way it is right now I think that
there is a lot of value to that and
trying to to break some of those molds
and shift some of those paradigms that
are currently in place oh my god and
just to go off what you said with the
whole thinking outside of the box and
being cliche I heard the saying that
they got the secrets in life are hidden
behind the word cliche just workout to
lose weight or you know thinking outside
of the box to come for new ideas they
are cliches but I feel like that's what
we really have to go that's how we have
to go about things is do the cliche
things to become successful at whatever
you want to do
it's exactly yeah and just lastly here
Mike in terms of just people are
aspiring to be entrepreneurs in the
field of pharmacy or just entrepreneurs
in general what would you what so what's
some advice you can leave us with for
student pharmacists that are currently
and they they're not sure what they want
to do when they grow up and you know
other people who are interested in just
entrepreneurship or the entrepreneurial
route yeah I think you know when I talk
to students I think something that I
always try to instill in them a little
bit is that what you're learning in
pharmacy school is really important and
clinical skills that you're getting and
and those types of you know value-add
skills that you're getting are really
really valuable but on the flip side
don't expect the second you get out of
pharmacy school that there's gonna be
all these amazing clinical opportunities
for you and whatever job you're gonna go
to they're gonna be it's gonna be
exactly what you learned in pharmacy
school that's not the case and you're
kind of diluting yourself if you really
think that that is the case and so you
have to have the mindset of this is what
I want to do you're gonna have to go out
and create those positions you're gonna
have to go out and create those programs
because they're it's unlikely they're
gonna be there for you yeah there's
gonna be some out there but for the most
part you're gonna have to create that
yourself so that's really it's important
to understand what what does that look
like and and how from a business
perspective what do I even start
so you know if you're working in a
hospital and you're like I want to start
this new fill-in-the-blank program
you're not just gonna be able to go to
the CEO the CFO of a kind of the
hospital and say yeah I wanna you know I
want a million dollars to create this
program and they're gonna say okay well
you know I'm gonna need you there you're
gonna need to have some business
experience without it and when I say
this is experience that doesn't
necessarily mean that you have to have
an MBA or you have to go to business
school and that kind of stuff I feel
like there's a lot that you can learn
because I don't I don't have an MBA I
didn't go to business school I've just
kind of picked up stuff as I've gone
along and I think having that
mind that kind of questions what's going
on and try to absorb that kind of
information I think it is really really
important so you know I would really
just encourage students that maybe kind
of get out of your bubble a little bit
and know that when you get out in the
real world you need to you're gonna need
to create your own space you're gonna
create your own types of programs and
you're gonna have to kind of push the
push the envelope a little bit and if
you're not willing to that's fine but
you you may not be happy with the
position that you're in because that
position was created by somebody else
and it's it's probably not the ideal
position for you so you know be willing
to get uncomfortable be willing to not
just do what everybody else is doing I
think that's really important you know
there's nothing wrong with you know I
graduated from farm to school and I I
went and worked at you know Walgreens
for two years or whatever or you know or
I wouldn't work at a hospital or
whatever you wanted and that's great if
that's what you really want to do
I also encourage people not to just
settle of just you know throwing up
their hands and say well this is just
what I have to do and you know I think
that there there's everybody can be an
entrepreneur I think it's really just
about what do you want to do and and no
don't settle
I mean don't just do what everybody else
does anything that's really really
important all right you guys heard here
first everyone can be an entrepreneur
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