Unbeknownst to some, doctors of pharmacy are responsible for more than medications.
Their accessibility to patients – they’re often right there when patients pick up medications and can meet with patients more frequently and for longer than many medical doctors – has created a pathway for health care teams to develop relationships, support efficient medication management, and find gaps within patient care. They’re also the only doctor who interacts with every specialist a patient may see throughout their treatment.
In the early days of Covid-19, pharmacists found new ways to connect with patients and maintain efficient health care management through telehealth medicine and meeting patients where they are.
“We talk to patients maybe three times more than their regular providers do, and we manage their medications,” said Nader Tossoun. “By the time their provider sees them again in three to six months, there can be tremendous improvements in their health outcomes.”
Tossoun is an ambulatory care pharmacist at Northeast Valley Health Corporation in San Fernando, California. During the pandemic, the community health center used funding from Direct Relief to hire patient navigators who work with pharmacists to engage patients. As providers became busier and short-staffed during the coronavirus pandemic, Tossoun’s team was available to meet with patients regularly to continue their care.
The pharmacist said the most critical part of his job is being present for his patients.
Tossoun’s parents were pharmacists. As a child, he watched them at work and how often they interacted with members of their community. He says their ability to help others is why he wanted to follow their professional careers.
“All you have to do is walk into a pharmacy and you have a health care professional right there ready to answer all of your questions,” Tossoun said.
But Tossoun’s team is a bit different from what a patient might find at a traditional pharmacy since they are embedded within the health center. His team uses patient navigators to engage patients on a personal level by asking about their daily routines and working with patients to create a feasible management plan. They consider the social determinants of health, like whether a patient has access to food, reliable transportation and a steady income to afford their medications, to be part of each patient’s medication management plan.
In San Fernando, California, where Tossoun’s team works, there is a large Latino population, and almost 40 percent of the population was not born in the U.S. About 10 percent of the community lives under the poverty level, and the median household income is just $60,655, compared to the national median of $67,521. Many of their patients lack reliable transportation, stable housing, and access to food.
“In society…they’re the invisible people,” said Tossoun. “They’re overlooked. They’re either looked down upon or they’re ignored and not really listened to. When they come here we try to reinstall that hope and let them know that we are here for you. We are accessible to you and we have the same goal, which is your wellness, which is your longevity, which is your qualify of life.”
Tossoun and his team say that working with patients and understanding their daily needs has fared better health outcomes. Patients are more willing to listen to them and work with them on their health and wellness plans. The patients feel like they have a shared interest in the medical decisions, not just a doctor telling them what to do.
“You’re the boss at the end of the day,” he said. “I’m here to help you, but you’re the boss.”
Share Our Selves, a nonprofit health center in Orange County, California, has a similar patient-focused mantra. Everything they do is for their patients, according to Mary Ann Huntsman, chief quality and innovation officer. She said their intent is to empower the patient by listening, meeting patients in their homes, and working with patients to determine a health plan that’s affordable and manageable.
“Acknowledge and meet the patient where they are, that’s what the pharmacist can do,” Huntsman said. “They understand medication therapy management, they understand and they see every day the struggles that patients have.”
Huntsman said that not knowing your pharmacist could be to the detriment of a patient’s health. She said the pharmacist is the “best kept secret,” that she wishes wasn’t a secret at all.
Like the Northeast Valley Health Corporation, Share Our Selves works with patients who lack reliable transportation and have lower incomes. They are redefining the roles of pharmacists to engage the community so that people feel empowered to take control of their health.
When coronavirus began to spread, Share Our Selves was forced to develop ways to better connect with the community. They pushed telehealth options and hired community health workers to ask patients about lifestyle needs to understand better and develop efficient health and wellness plans. The community health workers are also bilingual and bicultural, which has lessened communication barriers with the diverse population they serve.
Share Our Selves will bring medications and monitoring devices to patients’ homes and has a food pantry for vulnerable patients who don’t have regular access to groceries.
Nancy Dao, the clinical pharmacy manager at Share Our Selves, says the pharmacy team brings a unique view to patient care. There’s more to their work than most realize, she said. Pharmacists determine which medicines are safe and effective to take, figure out what’s cost-effective for the patient, assist patients in understanding their insurance benefits, and act as a resource for providers. Often, Dao also manages the administrative tasks of running the pharmacy.
“Everyone should have a relationship with their pharmacist,” Dao said. “We want to be so helpful and we can be the missing piece of their health (care plan).”
Since Share Our Selves added telehealth and in-home options, Dao said patients are more likely to discuss their needs. For Dao, it means she can be proactive about patient care rather than reactive.
“If I know a patient gets a delivery every first Wednesday of the month, I can plan ahead and reach out to her,” Dao said. “It’s more convenient for the patient and less headache for the pharmacy.”
Direct Relief, together with BD, has provided Northeast Valley Health Corporation and Share Our Selves grants totaling $420,000 each to expand pharmacist-led care for at-risk patients. The funding is part of the BD Helping Build Healthy Communities initiative. In total, Direct Relief has provided more than $1.2 million in grants and $420,000 in medical aid to Northeast Valley Health Corporation and Share Our Selves.