Maine’s Pharmacy Experts #164

Catherine Cloudman:

What drives our economy on a national basis is entrepreneurism. And there is no question that here in Maine it's an even greater extent, right? I mean, you have to be creative and entrepreneurial for the most part here in our state. I mean, that's really what drives our economy here.

Greg Mitchell:

We couldn't be happier to see business cooperate and collaborate and be seamless between their business practices and the educational opportunities. We continue to strive to do that.

Dr. Jim Krebs:

We are considered the drug information expert, so our patients really should count on us for that information. So that's something we rely on heavily. In pharmacy education is a lot of time in communication and how they can communicate directly with their patients and in a simple language that the patient feels feels comfortable with so they can retain that information and hopefully improve the outcome.

Dr. Kayla Stewart:

I started looking for other opportunities for me to still use my science background but actually meet patients and make a difference. So I looked into pharmacy school and I just knew that pharmacy was going to make a lot of sense for me professionally and personally. So once I finally started studying pharmacy, I realized that it was exactly where I needed to be.

Dr. Lisa Belisle:

This is Dr. Lisa Belisle and you are listening to Love Maine radio show number 164, Maine's Pharmacy Experts, airing for the first time on Sunday, November 2, 2014. Pharmacists do much more than dispense medication. As pharmacy science experts, educators and community liaisons, they are important members of the healthcare team. Today we speak with guests who have a special interest in the education of Maine's pharmacy Katherine Cloudman, principal at Apothecary by Design, Portland's economic development director, Greg Mitchell Dr. Jim Krebs, assistant Dean of Experiential Education at the University of New England and newly minted pharmacist, Dr. Kayla Stewart of Apothecary By Design. We know that you will enjoy getting to know these members of the healthcare team. Thank you for joining us. Here on Love Maine Radio. We think a lot about the wellness of our communities, and not simply from an individual standpoint, but really from a collaborative standpoint. These individuals that I have with me today have been thinking about this quite a lot themselves. We have Katherine Cloudman, who is one of the founding partners of Apothecary By Design, and also Greg Mitchell, Portland's City Economic Development Director. Both of you have some thoughts on what's making Portland a healthier place to live. So I'm glad you've come in to talk to us today. Thank you.

Greg Mitchell:

Thanks for having us.

Dr. Lisa Belisle:

And we're going to talk more about the University of New England and the Pharmacy school, which is really a big interest of Apothecary By Design. But first, I wanted to talk to you about why it is that we need to have new businesses coming into Portland and doing things that are slightly different and taking risks because this isn't something that we always think about as we're going through economics challenges.

Catherine Cloudman:

We closed on our financing for our business the day before the stock market crashed in October of 2008. So it was a very scary time to be starting a brand new business. But myself and my four business partners, we were well on our way and we opened our doors almost six years ago. And it has been a very interesting ride. And we wouldn't be sitting here today without the help of a bunch of other community partners. Portland, the city of Portland, and Greg in particular have been very supportive of our business, as have Fame and Bangor Savings Bank. And we have a terrific working relationship with the University of New England and their Pharmacy school. And a lot of those things have come together in such a way that have allowed us to grow the business and find great people and fund our business and fund our growth. So we've grown to having 70 employees and 80 million in revenue this year.

Dr. Lisa Belisle:

This must be music to your ears, Greg. You must really enjoy hearing about businesses that took a chance, started something new sort of at the deepest part of the recession, and then have found success. And actually, I want to say you were recently recognized, Inc. 5000. You are one of the top growing businesses, I believe, across the United States. That's correct.

Greg Mitchell:

One of the most gratifying aspects of my job is watching businesses grow and prosper. And in the case of Apothecary by Design, the city really works hard to Basically create the environment to support growth. And while the company partners were risk takers on their business, I want to point out they were risk takers in where they decided to invest. They're located down in Bayside, which is the new front door to downtown Portland. This is an area that the city concentrated on extensively with an area wide plan to support the kind of retransformation of an industrial area that had scrapyards, warehouses to repopulate it, repurpose it for businesses like Apothecary. So they were risk takers in where they invested. They were one of the first, I call them a pioneer in terms of supporting a redevelopment effort in Bayside. And you can see the results of that today with Trader Joe's and Whole Foods, more housing, more commercial investment. So it's enormously gratifying to set the stage for investment, to make sure that the city's doing what it can in a supportive role. Everything from roads and utilities. But also in the case of Apothecary, we ended up with direct financing relationship to help support one of their phases of growth. And they've grown beyond their initial location to a second location. So having those kind of anchors in our community that are creating significant high wage job employment and taking advantage of the programs that are offered, for example at UNE creates the full circle for making an economy work.

Dr. Lisa Belisle:

Well, as we think about health and wellness, we think about the ability to find places to run or find places to walk or have clean air or have clean water, and some very basic health fundamentals. But what we also need to think about are have places for people to work. We need to have places where people can get health insurance. And there are so many different layers of need when it comes to wellness. What is it? I guess I think I just read a statistic about unemployment and how it really impacts families. And I believe the statistic was something like families who deal with unemployment are more likely to go through emotional turmoil like divorce. So on the opposite side of that, having jobs available, like the 70 jobs, apothecary by design, or the pharmacy jobs through UNE, that's a really important thing.

Greg Mitchell:

Absolutely. I couldn't agree more. We've got to have a pathway for employment, kind of an economic ladder, starting at entry level positions and working your way up to support growth. So we're striving for that in terms of supporting growth in our economy with a very diversified base and creating that environment. Again, you talk about health and wellness. We're proud of the fact that in the area in Bayside, the city Planned, designed and invested in the Bayside Trail to interconnect a hardscape trail system through Bayside all the way around the peninsula to Back Cove. So we're taking advantage of our water views, the picturesque views, but also people mobility. We're a very walkable community. So we're trying to be full service, not just in the type of businesses that we attract, in the type of employment, but also to create the right environment to move people from housing to work or just taking a break during the day.

Catherine Cloudman:

And I'll just speak to that a little bit at the Apothecary by Design level. Some of what you're speaking to, Lisa, is stability and creating stability for people. And you know, despite whatever their background might be. And I think one of the things that we feel really proud about is having created jobs across a real economic spectrum. So whether it's a cashier or someone in shipping and fulfillment, or a nurse care coordinator, or a clinician, one of our pharmacists, it's a really wide spectrum. But we are also really dedicated and committed to providing a full spectrum of benefits for these folks as well, so that there is some stability and safety to them coming to work each day. So whether it is a flexible workday or health insurance that we pay a very high percentage of, or our 401k plan where we have a mandatory contribution that we make to people who are qualified to participate in our 401k plan, we're really focused on trying to do a lot of those things that provide them the stability because if they're feeling stable, they're going to be more productive at work. And that's part of what makes us more successful in what we're trying to do for our patients.

Dr. Lisa Belisle:

Wellness is very important to Apothecary by design. I know that a lot of the work that you do focuses around specific areas like for example, hepatitis and fertility and other issues that are more disease specific or more problem specific. But at Apothecary by Design, you actually are focusing on also keeping people getting people before they get to a place of disease. You have supplements, you have educational sessions and you really have people who understand. You have a naturopathic doctor who works with you. You have people who understand what is necessary to keep people on an even keel.

Catherine Cloudman:

That's true. And I think that is very much our focus and we're very much an integrated pharmacy across all aspects of pharmacy. So the nutritional, health and well being is a very big component of that. I mean, part of what we're trying to do is look at how to help people manage side effects of medications that they might be on. And to the extent that we can support them in such a way that keeps them healthy and keeps them from getting more sick than they might be, then that's good for everybody in the healthcare system.

Dr. Lisa Belisle:

Craig, it must be interesting for you. You were born and raised in Maine. You went to Cheverus. You went to not too far away to Vermont to get your undergraduate degree. It must be interesting for you to come back and see what has happened because you spent some time in Boca Raton and you've been all around the state working with municipalities and also as a private consultant. But Portland's changed a lot.

Greg Mitchell:

The landscape has changed dramatically over the last 30 years. I remember growing up here in the late 70s, and the old port was not what it is today. I remember my parents telling me, that area is off limits. That's not an area that you should be going. And so what a dramatic change to see that kind of hub of activity, that vitality, which is serving as a magnet and really is selling Portland's lifestyle nationally and internationally. We continue to make a number of short lists in terms of, you know, safe place for people to raise their kids. You know, a very hip place, a foodie place, of course. And it has to do with just the feeling and the buzz of what's going on in the community. Very metropolitan experience at a very small scale, and it's very intimate that way with, you know, the old adage, six degrees of separation. I say in Maine and Portland, it's two degrees of separation in terms of people's connections and overlap. So it's an easy story to tell, and it's one that we're working very hard on, not just from a visitor experience in arts and entertainment, but also from a business experience. Hence the reason we're here today. You know, we're a good place to start a business. We're a good place to grow a business. And apothecary is evidence that you can just survive, but you can really thrive in Maine and attract the talent that you need to support, you know, a workforce of 70 jobs in a relatively short period of time. So it's phenomenal for me to be a part of the experience and to have a hand in trying to shape and direct the economy. It would all be for naught without business investment, I'll say that.

Catherine Cloudman:

Well, piggybacking on that. I mean, one of the things that really important. I know this is an initiative of the city, and it's Something that we're certainly benefiting from. And that is the sort of hip vibe that Portland has makes it a lot easier to attract and retain qualified young professionals to the community. And it's a reinforcing kind of thing. So, you know, here we have this fabulous partnership with the University of New England, and we provide a great experiential education for the students that are, you know, within our, that come and visit our pharmacy. And we probably have six plus students in our pharmacy at any given time. It's a great opportunity for us to get to know them and them to get to know us. But, you know, if they were all graduating from pharmacy school and then moving out of the city of Portland because there's no jobs to be found here, or they don't love the community, then we'd be in a very different place. But that's not the case. You know, the students that come here and attend University of New England or Husson or many of the other schools in the area fall in love with Portland and fall in love with Maine. And they want to try and figure out how to be creative and how to stay for all the reasons that Greg talked about. And so that's a pretty fun thing to be able to segue them out of their graduate degree program into a position enabling them to live in a city that is really a fun place to be right now.

Dr. Lisa Belisle:

Here on Love Maine Radio, we've long recognized the link between health and wealth. Here to speak more on the topic is Tom Shepard of Shepherd Financial.

Dr. Jim Krebs:

Wouldn't it be great if we could spend our days doing all the things we dreamed of while gazing up at the stars on a crystal clear night? Yet for most people, and I include myself in that group, the realities of

Dr. Lisa Belisle:

daily living prevent it from happening.

Dr. Jim Krebs:

We all have responsibilities to our employers, our families, people who rely on us to be there for them. But what if you could get to a place where you were able to

Dr. Lisa Belisle:

reinvent yourself and start a new journey

Dr. Jim Krebs:

that was more fulfilling? What if you could define what true north meant and find your star and start walking towards it? What if you had the money to embark on a second life because financial worry had fallen off your radar? This, my friends, is what I call the seventh state of your financial evolution. And while I'm certainly not there yet, I'm here to help you get there. It's time to evolve. Get in touch with Shepherd Financial and we'll help you evolve with your money.

Dr. Lisa Belisle:

what's interesting to me also is that what you are doing in offering an educational alliance with the University of New England is something that required you to be able to have some vision when you first started creating these plans. We know that we've needed more pharmacies, more pharmacists. We know that we have an aging population. But the type of education that you're offering at Apothecary By Design I think is unique for these students.

Catherine Cloudman:

I think it's very unique. For one thing, you don't find a lot of pharmacies out there that have sort of the breadth and depth of services that we provide. So they're seeing both alternative therapies in our nutritional, health and well being area. They're seeing compounding, both non sterile and sterile compounding. They're seeing sort of the more traditional retail pharmacy environment and they're also seeing specialty pharmacy, which is a up and coming, fast growing area of pharmacy where they're really getting ingrained in a special specific disease state and learning about it in an in depth way from a clinical perspective. So seeing that range of services is a unique experience for them. And we don't just have them, you know, in our store or in our specialty pharmacy, you know, doing mundane tasks. I mean, we have them doing research and presenting to our clinical team on a particular topic. That's really educational for our team. And it's a great experience for them to stand up and present in front of a group of clinical people who are going to ask them difficult questions, but probing questions. So it's a great experience for them and it's a great experience for us as well.

Dr. Lisa Belisle:

It must also be helpful for them to be able to have this, I guess this front row seat in a business, in a new business. Because I'm thinking, Greg, of your situation and economics and medicine for quite a long time were not necessarily talking to one another and now we can't help but talk to one another. So to have students who are going through and to remind them that yes, this is a business like all businesses and for us all to be able to develop our Brains in such a way so that we are cognizant of that.

Greg Mitchell:

Absolutely. Kathryn talked about capturing that student population that's graduating and that's a targeted audience of ours. We find that once people experience Portland and Maine, they fall in love with it. And the next step is we've got to find them an employment opportunity, a professional employment opportunity that's challenging, that they feel is the right next step from school so they can support themselves and their family.

Dr. Lisa Belisle:

So.

Greg Mitchell:

So we couldn't be happier to see business cooperate and collaborate and be seamless between their business practices and the educational opportunities. We continue to strive to do that from the city perspective in terms of making those connections, but to actually have relationships that are working to give those students a different experience, a business experience, hand on experience that they can now capitalize on that. Our hope is that they stay in Maine. We continue to see employment growth in this sector to employ them. But even if they leave the state, they have skills that are very marketable that will make them much more attractive in the workplace. So it's the wave of the future. I think all schools are recognizing that to be successful there has to be a pathway to employment beyond a degree. And so those business relationships are critical and so important from my perspective. So we're continuing to try to find ways to create matches. It happens organically and naturally. But if there's ways that we can collaborate and support our educational institutions, providing a trained workforce to businesses and then them offering those kind of high quality experiences that Kathryn's describing are invaluable to really get that person committed to Portland for the long term. It's helping drive down our average age in Portland, which is below 40, and it's driving up our educational attainment. Our Portland residents 25 years and older. 45% of our resident population 25 years and older has a bachelor's degree or a higher level of education. That is a phenomenal statistic that compares well across this country with major metropolitan areas, including, including Boston. So we have some phenomenal assets to capitalize on if we can just support an economy to grow business, grow jobs and capture that youth, attract that youth here.

Catherine Cloudman:

To Paula, what's really valuable in terms of that experiential education is that they do see all aspects of the business and they're not isolated to just some of the clinical activities. They really do understand, you know, what are the economics of dispensing a particular medication all the way through to counseling the patient and all aspects of how that works and what drives our economy on A national basis is entrepreneurism. And there is no question that here in Maine it's an even greater extent. Right? I mean, you have to be creative and entrepreneurial for the most part here in this. Here in our state. I mean, that's really what drives our economy here. So to the extent these students can come out of their graduate degree program, not just with the clinical expertise, expertise, but with the business skills to be able to thrive in an entrepreneurial community, that's a real benefit to us as business owners, but also to themselves because particularly in health care, we've seen the importance of developing the business skills side of the equation as we move through all of the changes that are happening in healthcare.

Greg Mitchell:

I totally agree with those comments. From my perspective, this company was a startup in 2009 and here we are today with a company with 70 jobs and 80 million in revenue from the inside, looking at that kind of growth and expansion. For the youth to see that, to see how that's managed, in addition to the services that are provided, it's a phenomenal education. It doesn't get any better than that. I've seen that with my boys and some of their employment. I've encouraged them to take those kind of risks. With startup companies, I think against older and more established and mature companies, but companies with startups, you stand to gain so much more insight, so much more, much more knowledge by watching the growth, the identification of market opportunities and their ability to capture that opportunity and be successful. Six years is a very short period of time in a company's evolution to achieve the level of success this company Apothecary has achieved. So I've been doing this for 30 years and I've seen business evolution from start to finish. And so again, that educational interface with the workforce and the training. But to reinforce in Kathryn's comments on entrepreneurship training, it doesn't get any better than living it.

Dr. Lisa Belisle:

I'm also struck by the necessity of communication skills and the ability to communicate across a broad spectrum. If you are a pharmacy student, you need to be able to talk with other pharmacists, you need to be able to talk with physicians and healthcare providers, you need to be able to talk with patients. And this is really no different than any other successful business where if you're a business person, you need to be able to talk sales and you need to be able to talk numbers. And I think that this is. We're heading away from that siloed approach to education, which is very specialty driven and we really are starting to understand that communication is key I think that's true.

Catherine Cloudman:

And I know you're going to be speaking with one of our new hires who's a pharmacist and she does a wonderful job presenting and has given a number of presentations to our clinical staff. So I think you'll enjoy your time with her. And that's been one of the things. In fact, we had her present when we had the URAC Accreditation Committee come in for our on site visit. And so that was an example of a newly graduated student. In fact, I don't even think she had graduated by the time she came. By the time Urek actually came in to visit, she had to be able to have the wherewithal and the comfort to stand up in front of these on site accreditors and speak to some of our quality initiatives that we were working on. Our clinical staff needs to have the ability to go out and be on a sales call with practitioners and talk to them about the range of services that we provide. Provide. But also that's sort of the business angle of that visit. But also they need the credibility around the particular clinical topic that they're speaking to so that they have the respect of the person sitting across the table. So it's exactly what you're speaking to, Lisa. They really need both one hand on the clinical dashboard and the other hand on the business dashboard so that they can really bring those two things together in a way that makes them credible and confident in a variety of different settings.

Dr. Lisa Belisle:

Well, I'm very excited about the work that you're both doing. I think, you know, also having grown up in Maine and seeing all of the shifts and transitions. And I believe that when we moved here in 77 Marginal Way and where Apothecary is in the Bayside area, it just looked incredibly different. And it's so gratifying to see all of this shifting. And I know at Maine Magazine and Old Port magazine, we're excited to see what's coming up. We get to speak to a lot of people who are doing interesting things and to know that the same types of interesting things are going on in health care, it's really wonderful. It's really a great thing. Well, we've been speaking with Greg Mitchell and Katharine Cloudman. Greg is Portland City Economic Development Director and Katherine Cloudman is one of the founding partners of Apothecary by Design. I encourage people to learn more about what Apothecary by Design is doing in this area and also to learn more about the city of Portland. Greg, is there a website or a way that people might learn more about what's happening economically in the city.

Greg Mitchell:

Absolutely. We've got a couple of websites we can refer people to, city of Portland, Maine. And another website that's worth a visit is called liveworkportland.org that is an arm of the city, a nonprofit that we've established that's focusing on marketing and branding us outside of Maine and internationally. And the emphasis of those programs are people recruitment, people attraction, entrepreneurship support. So both those websites people can contact me directly at City hall and would love to interface with folks that want to learn more about what's going on in Portland.

Dr. Lisa Belisle:

And Kathryn Apothecary By Design. How can people learn more?

Catherine Cloudman:

Apothecarybydesign.com is a great place to visit and also follow our Facebook page. We have ongoing posts happening regularly about wellness activities that we're working on, events that people are presenting at, and just updates on what's happening with our business.

Dr. Lisa Belisle:

Well, thank you very much Kathryn Claudman and Greg Mitchell, and we appreciate your doing all the wonderful work you're doing for the City of Portland and beyond. And keep it up.

Catherine Cloudman:

Thank you.

Greg Mitchell:

Thank you.

Dr. Lisa Belisle:

As a physician and small business owner, I rely on Marcy Booth from Booth Main to help me with my own business and to help me live my own life fully. Here are a few thoughts from Marcy

Dr. Kayla Stewart:

when was the last time you took a break from what you were doing, from the work that was piled up on your desk and just looked up? I know that during the course of my days I often forget to take a moment or two to just breathe, look up at the sky and dream. Terrible that I have to remind myself to breathe. But when I do, I feel energized because in those moments I'm able to let go of the daily grind and think more about what I want to accomplish, how I want my business to grow. Sometimes those are the aha moments. If we all took a few moments out each day to stop what we are doing and dream a little about our business futures, not only would we feel a great sense of calm, but we may come to realize that these dreams can, in fact, come true. I'm Marcie Booth. Let's talk about the changes you need. Boothmain.com

Dr. Lisa Belisle:

As a family physician for many years, I have had the good fortune to interact with pharmacists in lots of different ways in the hospital setting and also in the community. Today I'm going to interact with two pharmacists who are far more than just your average pharmacist. I believe you'll understand as you get to hear more about them. We have Dr. Jim Krebs and is it Dr. Kayla Stewart at this point? Dr. Kayla Stewart.

Dr. Kayla Stewart:

Dr. You can say that again if you want. Sounds really nice.

Dr. Lisa Belisle:

Dr. I'm sure. Dr. Kayla Stewart, Dr. Jim Krebs is a UNE is UNE's assistant dean for experiential education. Dr. Kayla Stewart is a University of New England graduate and now an Apothecary by Design pharmacist. Thanks so much for coming in and taking time out of your busy schedule and talking to us about this really interesting collaboration that the University of New England has with Apothecary by Design and also about pharmacy education in Maine.

Dr. Jim Krebs:

Great. Thank you.

Dr. Kayla Stewart:

Dr. Lisa thank you.

Dr. Lisa Belisle:

Pharmacy has really come a long way, I think, since probably since you, Jim, were studying this at the University of Rhode Island.

Dr. Jim Krebs:

Absolutely. Traditionally we were in a dispensing role which as most people are familiar with, we're at a community pharmacy and they just kind of see us behind the counter in a white coat to really now we are direct care providers. So, you know, having a provider status is we can meet with our patients one on one, 15, 20 minutes an hour and chat specifically about their disease state and the drug therapy with the goal being to really reduce hospital admissions, decrease healthcare costs and just have better outcomes for our patients. So I think a lot of people will be surprised to see that they can find to go to their pharmacist to get immunizations and, you know, have changes in the drug therapy in collaboration with a physician or a PA or nurse practitioner now. So it's greatly changed.

Dr. Lisa Belisle:

And I can attest to that. I think that when I as I was saying when I first started in medicine, the way that I understood my relationship with pharmacy was much different than I understand it now as I'm seeing a patient now. If I have somebody that I know is going to need more counseling on a medication, I actually have said to them before, look, here's some basics on this medication I'm prescribing. But the pharmacy really can give you a lot of great information and sometimes it's more user friendly. They don't feel quite as intimidated as sitting there with their doctor.

Dr. Jim Krebs:

Absolutely. I mean, we are considered the drug information expert. So our patients really should Count on us for that information. So that's something we rely on heavily in pharmacy education, is a lot of time in communication and how they can communicate directly with their patients in a simple language that the patient feels comfortable with so they can retain that information and hopefully improve the outcome.

Dr. Kayla Stewart:

I think that's incredibly important. There are so many different walks of life that come through. You know, you may even counsel a nurse on a medication that they're not as familiar with. But, you know, as far as the patients go, making sure that they can understand what you have to explain to them is incredibly important. I think that's an awesome thing that I really enjoy doing is relating to different kinds of people and making sure they feel comfortable with all the medications that they take.

Dr. Lisa Belisle:

Now, Kayla, you are originally from Windom. You went to the University of Maine, and you were part of the second graduating class at the University of New England's. Is it the School of Pharmacy? Is that what it's officially called?

Dr. Kayla Stewart:

Yeah, College of Pharmacy.

Dr. Lisa Belisle:

College of Pharmacy. How did you decide that you wanted to go into this field?

Dr. Kayla Stewart:

I got my undergrad at U Main in biochemistry. I really liked science. I started kind of practicing and studying for my master's in biochemistry. And I realized that I didn't really enjoy working alone in a lab with test tubes and with no one to interact with. And so I started looking for other opportunities for me to still use my science background, but actually meet patients and make a difference. So I looked into pharmacy school and I did a tour at une, and it was everything I was looking for. I mean, the faculty was incredible, and I just knew that pharmacy was going to make a lot of sense for me professionally and personally. So once I finally started studying pharmacy, I realized that it was exactly where I needed to be.

Dr. Lisa Belisle:

Jim, you also have a Master of Science in Medical Education leadership from the University of New England College of Medicine. So for you, education and communication has been very important for quite a while.

Dr. Jim Krebs:

Yeah, I think even from the beginning, I think our pharmacy education teaches us about the importance of educating our patients and other healthcare professionals. So early in my career, I was involved in brown bags series in the Mid coast area. And then at each hospital, we're responsible for educating physicians, nurses, pharmacists, various healthcare professionals on drug therapy. So that even led me to go to Saudi Arabia, where I was a part of a program with the Royal Family, where we were there to educate the Saudi pharmacists and Saudi students to help take over the pharmacy. And this was in many disciplines. So eventually the Saudis could run their own healthcare system instead of having the western run their healthcare system. So that led me eventually to une. So UNE has been in a wonderful experience where I really felt it was like my time to give back. So starting at the college in 2008, as a founding member, I was greatly involved in hiring faculty and recruiting the first class of students. And it's been wonderful to educate the students. But that led me to think, you know what, I need a few more skills. So I did complete a master's in medical education at the University of New England at the college, College of Medicine. And that was an amazing actually online program where there's anywhere from eight to 10 students in your cohort. So I worked with physicians in many disciplines all over the world. And being the only pharmacist in there, it was incredible dialogue between us on how we're going to educate the next generation of healthcare professionals.

Dr. Lisa Belisle:

I'd like to back up and learn a little bit about what it takes to become to get your doctorate in pharmacy, because this is something that I think people don't. We think about people who have medical degrees or people who are doctors, who are dentists or vets, you know, veterinarians. But it's a lot of work to become a doctor of pharmacy. And it must require not only time spent in the classroom, but also hands on time.

Dr. Kayla Stewart:

We absolutely spent a lot of time in practicum, in labs. We had an incredible opportunity at, at UNE to really work in a real life setting. We had this incredible laboratory, Hannaford. The Hannaford lab. Right. And you know, we had labs where we would practice counseling patients. We had actual patients come in for some of our, some of our classes so that we could counsel them practice, really become more immersed in the actual practice of pharmacy as opposed to just the lecture and the didactic portion. And along with, you know, the things we did in school, we had a number of rotations outside of school that allowed us to really expand ourselves as professionals.

Dr. Jim Krebs:

To elaborate on that, you know, at UNE, it's a four year doctorate degree. So students can come in either with two years of prerequisites. But most of our students come in with a four years bachelor's degree already. So the curriculum is a total over four years. Where the first three years involves primarily work in the classroom with a little bit of internships we call experiential learning. And then the whole final year, the fourth year, is experiential. So every six weeks our students have a new experience. So they work under the leadership of pharmacists throughout Maine, the country, throughout the world, to complete those internships. And they can be anywhere from an institutional rotation at a hospital to a community pharmacy like Apotheir by design. They can be in Thailand or Spain for global education, which is programs that Kayla and I both have participated in.

Dr. Lisa Belisle:

Now, what types of things can you learn in Spain, for example, about pharmacy that you couldn't necessarily learn in Brunswick?

Dr. Jim Krebs:

So I'll let Kayla answer that. She was really ingrained in it there.

Dr. Kayla Stewart:

That was by far one of the most incredible experiences, and I think that it really has made me a better pharmacist as a result. I think the importance of studying not only another culture, but their healthcare, how they practice providing for their patients, how they practice, how they practice pharmacy over there, is really incredible. They have a universal health care system that we are moving towards now. And it's really important, I think, for us to learn from people that have already established this kind of healthcare system so that we can improve upon our own. And I think one of the other things that I really took from my experience was understanding what it's like to not be understood. And I think that that translates everywhere. But, you know, especially in pharmacy, I've met a number of patients that don't speak English as their first language or aren't, you know, aren't as able to understand medical terminology, so really understanding what it's like to feel as if nobody understands you. And I think that that has really opened my eyes to the kind of patient care I need to provide for my patients, and it needs to be very individualized.

Dr. Lisa Belisle:

As you're talking about this, I'm thinking about some of the work that recently they've been doing with doctors, really, across the country, and trying to help them understand the importance of medical literacy, of health literacy, and terms that doctors think about like congestive heart failure. You know, when you say that to a patient and they're thinking, oh, my gosh, my heart's failing, you know, what does that mean? Some of the things that have long been held have made sort of doctors into gods. These things are kind of falling, you know, that we now know that we can't just be throwing out terms just because the vocabulary sounds kind of specific and good to us. We need. People need to understand what's actually going on with their own bodies. They need to participate in their own career.

Dr. Jim Krebs:

Absolutely. And something that you may not be aware of, Dr. Lisa, is that something we work diligently on at UNE. UNE is one of maybe seven schools in the nation or Universities in the country, I should say that, have an interprofessional education collaboration. So that means we are really fortunate, uni, that we have a college of medicine, a college of pharmacy, a college of dental medicine. We have social work people, PAs we have so many healthcare disciplines that we work together as a team to work on interprofessional education. A lot of that has to do with educating our patients together in terms that they understand. And one way that's really amazing, that UNE I think is really proud of, is our simulation lab. I think it's a new trend in medicine where we have, in a sense, a controlled environment where we have a patient. It could be alive, or it could be a mannequin where we can go in and educate on challenging or difficult cases. It could be a language barrier, it could be maybe a complicated delivery, or it could be education for a patient with diabetes. So it gives us a chance to really practice that role in a safe environment, to not feel threatened. And me as an instructor is really wonderful to go in there and say, they don't know what congestive heart failure means. How are you going to explain it to them? And the student's like, what do I do? I'm like, you got to figure it out. You have this patient right in front of you. What are you going to say to them? And they figure it out. It's pretty amazing, actually.

Dr. Lisa Belisle:

This whole thing is also wonderful to hear from you because, Jim, because you obviously have quite an extensive educational background yourself, and you were able to be there. Ground floor. Let's create a pharmacy school. Let's do it in a way that makes sense for today's students, like Kayla, when she was going through. I mean, that's a really exciting opportunity and one that I think doesn't exist everywhere.

Dr. Jim Krebs:

It does. And I felt really privileged to be a part of that system. When I joined UNE in 2008, I really felt it was like my time to give back. And I still believe passionately that what we are doing for our profession is amazing. And what we're doing for the state of Maine is equally important. For many years, as most people know, we had, you know, the brain drain. There was no college of pharmacy in Maine, so our students would leave to go to Boston or Rhode island or Connecticut and then not return. So I thought that was really, really important after being a pharmacist in the 90s, where we had a huge shortage. So it's been really invigorating. And I think the thing we really focused on is our commitment and our relationship to our student, that we are student focused. One of the things that we find really important from our students is their engagement with the faculty. They feel that it's a really nurturing environment for learning. They're just not a number. So I think we are a family and I think Kayla can attest to that, that our faculty have an open door policy, that we are committed to our students and to our profession in Maine.

Dr. Kayla Stewart:

Yeah, I would absolutely agree. I established a number of relationships with faculty that really do transcend the relationship traditionally seen between a student and a professor. You know, you really have the opportunity to speak with them about not just the test you took last week or the questions you got wrong. But hey, I'm applying for a job. You know, I need help. I don't know, you know, what salary to ask for, I don't know what job I need to look for, you know, those sort of guiding, you know, mentorship type relationships. And I've met quite a few faculty members that have definitely influenced my career and how I practice and given me somebody to look up to and really interact with even after school has ended.

Dr. Lisa Belisle:

kayla, I would think that it would also be very interesting for you to as a student have experienced, say the Hannaford Pharmacy, the Walgreens, the Apothecary by Design and to really see that there are different business models, there are different patient provider interaction models and have the opportunity to decide where you best fit.

Dr. Kayla Stewart:

I think that's where the experiential education became extremely crucial in understanding not only pharmacy, but myself and where I wanted to practice, I went to a number of incredible sites. I was in Norway, Maine, at a small hospital, Stevens Memorial. And it was a beautiful, beautiful commute. It was in the fall, so, you know, all the leaves were changing. I was. I was in Spain. I went to Apothecary by Design, and I saw pharmacy practice in so many different lights. And it was incredible to glean a little bit from each of those sites and really incorporate that into how I practice and really how I wanted to continue my career. So I think it was absolutely the experiential education that, you know, showed me. The parts of pharmacy that, you know, I didn't necessarily knew existed or knew were so amazing.

Dr. Jim Krebs:

Thank you, Kayla. I think what we do is really, really important. I mean, as I said earlier, our students have to complete six, you know, internships or rotations, and they do gain us something a little bit from each of them. And it's pretty amazing. Now we're in autumn, and they've just been doing this for three or four months, and they're still a little nervous. And for me to see where they're gonna be in, like, February, March, April, it's amazing. Just the maturity and growth that comes along. So May comes around. It's like, wow, they're ready to practice. And it makes us feel really good.

Dr. Kayla Stewart:

And you don't. You would think that, you know, after all the school that you have completed, you know, those first three years before you go off, that you would, you know, be fresh and ready to go and know everything. And then once you get into practice, you realize that nothing is. Is like the book. So, you know, it's really a different kind of learning altogether. And there definitely is a transition between your first rotation where you're nervous and you don't even know where to start, and everything that you've practiced in your books. No, this doesn't really apply here. Clinically, that's really not relevant. And it definitely is a huge transition as a. As a person, as a professional, to start at week one in your first rotation and then actually finish your last rotation and think about sitting for your boards and taking care of patients. There's an incredible evolution in that last year.

Dr. Jim Krebs:

It's really wonderful. Nothing makes me happier to have a student say, In September, October, Dr. Krebs, I don't know what I want to do. I'm like, great, because you're going to figure that out by May. So then I'll see them in April, and they'll be like, you know what? I've taken a position here. Or I've got accepted to a residency. It's like, it's amazing the growth that occurs in the last nine months of the education.

Dr. Kayla Stewart:

And it's terrifying too because you go out, it's your last year of school, you should be thinking about getting a job, you should be thinking about applying, residencies, interviews, and it becomes very daunting. And when I, I know when I first started my first rotation I went to Spain and I thought, I've been doing everything wrong. I should be living in Spain. This is amazing. I love it here. And I almost tossed my passport in the river and stayed. But I knew I had to finish school and I came back and I was so lucky to have had Apothecary as my first American rotation. I didn't realize how incredible pharmacy could be as much as I loved it before I came to Apothecary. And I realized these people are on the phone for an hour with insurance companies to get a paid claim to go through. They are talking to patients, they're on call on the weekends to make sure if patients have problems or questions, they are available to answer them. And I was very lucky because I thought, you know, I came back from Spain and had that sort of post Europe depression kind of deal, like, you know, what am I doing with my life? And Apothecary was incredibly inspiring. Denali became, she was my preceptor at Apothecary, one of the pharmacists there. And you know, she became, you know, an inspiration to me, a mentor and a friend. And I knew after the first week that I needed to work there. So I finished the rest of my rotations and I loved them. I learned a lot at every one and always in the back of my mind, I knew Spain was not an option at this time. So I thought, you know, if I'm going to stay here, I would just love to work at Apothecary. I would be just so lucky to have that opportunity. And a position opened up and I snuck right in there and I haven't had any regrets.

Dr. Lisa Belisle:

The main thing I think is, I mean, the main connection I think becomes more important than we realize. And I know that, Jim, you've worked up at Midcoast and now you're at UNE and you've you. Apparently you and I knew each other unbeknownst to, to me at a time when I was prescribing medicine while I practiced in Yarmouth.

Dr. Jim Krebs:

It was all appropriate.

Dr. Lisa Belisle:

Dr. Yes, I'm sure I'm assuming I did a good job with my prescriptions. But it really is interesting to me that especially in Maine, people are more connected than we realize. You can meet somebody, and then 10 years later, you can actually put a name to a face and the relationship becomes important. Especially, you know, Jim, you are in South Freeport now. Is that where you live?

Dr. Jim Krebs:

Yeah. The connections are incredible. I mean, you know, I came to Maine in 1994 when I had my BS in pharmacy, and I worked for Mid Coast Hospital, but I also worked per diem for Hannaford Pharmacy, and I traveled throughout the state because there was a huge pharmacist shortage. So I got to meet pharmacists and people from all over the state, and it's amazing, 20 years later of who knows who. So I think that's been part of my.

Dr. Kayla Stewart:

It's scary.

Dr. Jim Krebs:

It is scary. It's part of my success at UNE is that it's the connections. And I think that's. It's part of. Part of UNE's branding is about our connections. But it is really important, especially in Maine. You know, I think old school is. It's who you know, but I think it's more about the relationship you build with them. But the connections are amazing. Yeah.

Dr. Lisa Belisle:

And I would think also, Kayla, with you having been raised in Wyndham, I mean, you work at Apothecary, there's got to still be people that, you know

Dr. Kayla Stewart:

from all the time. I run into people who knew my nanny or lived next door to my uncle, and it's an incredible, you know, I bring up, hey, yeah, I work at Apothecary. Oh, you know, really? You know, I just know somebody that works there. Yeah. You know, my friend writes prescriptions, and they send them over there all the time, and it's just. You never can escape it. And it's one of those beautiful things that you kind of always have support no matter where you are. I mean, in Maine, anyways. I've always felt like anywhere I turn, I'm going to run into somebody who knows somebody, and it's just. It's incredible. I mean, I have. I did a lot of traveling in Maine for my rotations. I did one in Calais, and I reached out up there. A friend of mine who went to Calais before me for a rotation had said, hey, there's this really great girl, you know, this lady Edith. Like, she's Edie. She's awesome. You're gonna love her. You should stay with her, you know, reach out to her, see if you can't stay with her. Because, you know, I had to find a place to stay. For that four weeks I was up there and I reached out and made a great friend in her. And it was all because I knew a guy who had gone there before, who had met somebody and made a friend and, you know, connected me with them. And it was, you know, I feel like a lot of my rotations have all been about reaching out to people that I know, hey, I'm going to be in your area for the next six weeks. I need a place to stay, and everybody has always been happy to take me in, even if it's a friend of a friend.

Dr. Lisa Belisle:

I've also found, you know, I just saw a patient yesterday who I was in girl Scouts with, you know, 30 something years ago. You know, I used to deliver babies of people that I went to high school with. And, you know, I have found also that, you know, it really contributes to the sense that you really, you do want to care for these people in your community, in your life, because they're important. You know, they are your nanny's friend or they're somebody that went to school with your brother. I mean, that this is our community and that, you know, being able to offer advice as a pharmacist or, you know, care as a doctor, it's something that you really want to be able to do.

Dr. Jim Krebs:

Absolutely. You made me think, Dr. Lisa. You know, students, you know, as we chat about career options, and they're like, you know, you know, Jim, I'm not sure if I want to be a hospital pharmacist. I don't want to be on call and I don't want to work holidays. And I always say, you know what, I never got frustrated when I had to work Thanksgiving or any other holiday because I was like, I'm taking care of my community. Yeah, it's stinks. I'm not home with my family. But you know what, it's important that I'm here. And we try to share that with our students. So I hope they're getting it.

Dr. Kayla Stewart:

Yeah, I absolutely agree.

Dr. Lisa Belisle:

Where can we find out more, Jim, about the University of New England and their pharmacy school?

Dr. Jim Krebs:

Yeah, you know, the best thing to do is go to www.une.edu and link on the College of Pharmacy. But I really encourage people to drop by the college themselves.

Dr. Lisa Belisle:

And Kayla, can you remind us how we can learn more about Apothecary by design?

Dr. Kayla Stewart:

Yeah, you can definitely stop by. We love to meet new people and you can always find kind of cool stuff at our retail location. But you can visit us online at www.apothecarybydesign.com well, this has been an exciting conversation for me.

Dr. Lisa Belisle:

I always learn things when I sit down and talk to people about what's going on and I think what's happening here with pharmacy in the state of Maine is exciting. It's exciting for doctors and healthcare providers, but also for patients and community members. We've been speaking with Dr. Jim James Krebs, who is the University of New England's assistant dean for experiential education, and Dr. Kayla Stewart, who is Yay. Congratulations on that doctor. I know you worked hard for it, who is a University of New England graduate and now an apothecary by design pharmacist. Thank you for the work that you're doing and for the education that you're bringing to our community.

Dr. Jim Krebs:

Great. Thank you.

Dr. Lisa Belisle:

Thanks Dr. Lisa, you have been listening to Love Maine radio show number 164, Maine's Pharmacy Experts. Our guests have included Kathryn Cloudman, Greg Mitchell, Dr. Jim Krebs, and Dr. Kayla Stewart. For more information on our guests and extended interviews, visit themainmag.com Radio Love Maine Radio is downloadable for free on itunes. Follow me as DrLisa on Twitter and see my daily running photos as bountiful1 on Instagram. We love to hear from you, so please let us know what you think of Love Maine Radio. We welcome your suggestions for future shows. Also let our sponsors know that you have heard about them here. We are privileged that they enable us to bring Love Maine Radio to you each week. This is Dr. Lisa Belisle. I hope that you have enjoyed Maine's pharmacy experts. Thank you for allowing me to be a part of your day. May you have a bountiful life.