Category: Student news

Living with little-known disorder Ehlers-Danlos sparked Miss Virginia’s love of science

The little-known disorder that inspired Miss Virginia's love of science

One month ago, VCU Pharm.D. student Camille Schrier won the title of Miss Virginia with the help of her science-related talent. Millions have seen her story. But not many people know about the genetic condition she lives with that inspired her career in science. Watch our exclusive video to learn more and read Camille's full story at blogs.vcu.edu/pharmacy. Music courtesy of https://www.bensound.com Photos courtesy of Cheryl Schrier

Posted by VCU School of Pharmacy on Monday, July 22, 2019

By Emiley Bagalawis
VCU School of Pharmacy News

Camille Schrier won the title of Miss Virginia in June with the help of her science-related talent exhibition — a demonstration of the catalytic conversion of hydrogen peroxide that created a dramatic burst of colored foam on the pageant stage. 

That win and the video of her demonstration led millions to see her story on TV news reports, social media and websites. She has been hailed for breaking stereotypes and as a role model for young women.

But most people have no idea of the disorder that helped inspire her career in science. 

Camille is living with Ehlers-Danlos Syndrome, a genetic condition that affects body tissue, joints and blood vessels. She was diagnosed when she was 11. 

“It definitely got me interested in science and medicine because there’s no treatment for this right now,” Camille says. “There was a lot of genetic information regarding EDS and genetics was something I was always really interested in. This was a further interest, in terms of genetics, for me to look at and think about how that could help us diagnose people.”  

Camille’s family noticed something was wrong as soon as she was born: Camille was born with her hips dislocated. She also fell a lot as a child and was prone to injuries because EDS can make people less stable. She found out she had EDS when she went to see an orthopedic surgeon for scoliosis, which her family learned was caused by her EDS. 

She lives with pain from the condition. Her level of pain varies in intensity from day to day, sometimes making her feel like she has the flu. 

A photo of a woman in a white lab coat.
Camille Schrier learned she had Ehlers-Danlos Syndrome at age 11.

“It’s not like shooting, burning or electric pain. It’s kind of a dull chronic achiness that I get frequently,” she says. “It … rarely interferes with my everyday life. But it’s definitely a reminder that it’s there.”

EDS affects about 1 in 5,000 people. There are 13 different types, classified based on the symptoms and signs that patients show. Common symptoms include loose and unstable joints that can lead to frequent dislocations, joint pain, fragile skin that can bruise easily, and poor wound healing. EDS can cause early onset osteoarthritis, scoliosis, musculoskeletal pain, arterial/intestinal/uterine fragility or rupture, poor muscle tone and gum disease.

Camille has classic EDS, which affects the genes in her type V collagen. Symptoms include joint hypermobility, skin hyperextensibility and skin fragility that leads to scarring and bruising.

It is a genetic condition. Camille and her mother, Cheryl Schrier, were both diagnosed at the same time. Cheryl Schrier says she would get injured frequently as a teenager but was consistently blown off as being “overdramatic.” 

“Camille was experiencing some of the same [experiences I had],” Cheryl says. “Her swim coach told her she was ‘trying to get out of the hard work’ when her shoulder dislocated repeatedly during backstroke practices, and field hockey coaches told her to ‘walk off’ ankle subluxations and hand injuries.” 

The Schriers’ experience rings true for Tahnee N. Causey, a genetic counselor and assistant director of the VCU Genetic Counseling Program who has worked with many patients with EDS.

Friends, co-workers and even physicians often do not understand a disorder like EDS that has few visible signs but that can cause real injury and pain, Causey says. Common symptoms of EDS include migraine, joint pain, gastrointestinal distress, poor wound healing and postural orthostatic tachycardia syndrome, or POTS, a circulatory condition in which people become lightheaded and dizzy when they stand up.

It is not unusual for EDS patients to struggle for a long time to convince doctors that their symptoms are real, Causey adds: “For some of our patients it’s a real validation that they have a diagnosis.”

Causey, who says her office evaluates about 10 patients a week who show signs that may mean they have the disorder, suspects it is more common than even many experts think.

Starting in September 2019, VCU Health is beginning a twice-monthly clinic with practitioners from different medical disciplines to help treat patients with EDS.

Camille Schrier says she hopes that speaking about her condition helps people, particularly healthcare professionals and pharmacy students, understand that EDS is “wildly misdiagnosed” and more common than people realize since there are many different strains of the disorder. 

“I have something that causes me pain constantly and causes me injury and chronic fatigue sometimes,” she says. “That’s something I deal with, and there are many other people that have illnesses that are not obvious.” 

Camille has taken a one-year leave of absence from her Pharm.D. studies. She is currently travelling the state, sharing her STEM platform as Miss Virginia. She will compete in the Miss America pageant in September. 

To learn more about Ehlers-Danlos Syndrome visit https://www.ehlers-danlos.com


Note: This article was edited on Aug. 8, 2019, to add information from an interview with Tahnee Causey.

‘I’m trying to be like Bill Nye’: How Camille Schrier’s interest in science helped her become Miss Virginia

A woman wearing a gown and tiara stands in a laboratory. A sash over her shoulder reads "Miss Virginia."
Miss Virginia Camille Schrier in the lab in which she took pharmacy classes earlier this year.

By Emiley Bagalawis
School of Pharmacy News

Camille Schrier’s science and medical education led her to stop taking part in pageants. That same education helped her become Miss Virginia 2019. 

Schrier, 23, a doctor of pharmacy student at Virginia Commonwealth University, was awarded the statewide title in Lynchburg on June 22. She was one of 24 contestants. As Miss Virginia, she will represent the commonwealth in the Miss America competition.

Instead of dance or baton twirling, Schrier’s winning talent presentation featured her in a white lab coat and safety goggles mixing chemicals to create spouts of colorful foam that shot far above the stage. 

A few days after her win, Schrier stopped by VCU. 

“It’s been crazy,” she said. “It’s been a wild ride.” She recalled being escorted from the competition after her win by guards who ushered her into a waiting car. “I felt like the president,” she added with a laugh. 

Schrier is in the process of moving into a Roanoke apartment provided to her as part of her reign. She will take a year off from her studies at VCU to tour the state and share her campaign platform of STEM awareness and drug safety. 

“I’m trying to be like Bill Nye [the science guy],” she said. “That’s what I’m going for. I want to get kids excited, but I don’t want it to be boring.” 

Graphic of pullout text that reads: The VCU pharmacy student donned a lab coat and safety goggles and turned the talent portion of the Miss Virginia competition into a science experiment."

Schrier, a Pennsylvania native, said she was an athletic kid, never a “girly-girl.” She attributes her love of science and nature to an eighth-grade science class. When she was 14, she became interested in pageants as a creative outlet. 

The process taught her more than she expected, she said: “It taught me a lot about being professional … in terms of just being able to prepare a resume, go into an interview confidently, and how to prepare for something like that.” 

Schrier participated in pageants from age 14 until she started college four years later. She graduated cum laude from Virginia Tech in 2018 with degrees in biochemistry and systems biology. She entered VCU’s Doctor of Pharmacy program last year.

Lauren Caldas, Pharm.D., an assistant professor in the School of Pharmacy, taught Schrier in a challenging first-year pharmacy foundations course. 

“In a class where a lot of students can become very stressed, she shined and was just a wonderful person to be around. She was always an example of professionalism,” Caldas said. 

Around the time Schrier started pharmacy school, she learned that the Miss America pageant had been revamped — eliminating the swimsuit competition and emphasizing professionalism and social impact. That, and the possibility of scholarships, reignited her interest. The Miss America organization says it is the nation’s top provider of scholarships for young women. 

Building on her pharmacy education, Schrier decided she would make her platform “Mind Your Meds,” focusing on drug safety and abuse prevention. Since Schrier did not have much experience in performing, she realized she would have to find a way to highlight her talents that was entertaining on stage. 

After looking online for science experiments for kids, she came across an experiment sometimes called “elephant toothpaste” that demonstrates the rapid decomposition of hydrogen peroxide using potassium iodide as a catalyst. The result is a dramatic burst of foam.

She acquired some industrial-strength hydrogen peroxide and practiced the experiment in the driveway of her apartment complex, adding food coloring to the foam. When she tried it in an outdoor car wash, the foam shot out so violently it hit the ceiling, staining it. (She scrubbed it clean with bleach.) 

A woman in a lab coat watches a spout of green foam shooting from a flask.
Schrier during the talent portion of the Miss Virginia pageant. (Courtesy Miss Virginia)

Her science experiment helped her win a regional title, Miss Dominion, making her eligible for the Miss Virginia pageant. Because the Miss Virginia competition would be held in a large space, she made her experiment bigger, with larger flasks and even more dramatic jets of brightly colored foam. She won the preliminary talent award.

“I expected to hear some feedback saying that my talent wasn’t really a talent,” Schrier said. “But I will tell you, I was overwhelmed with messages saying how cool my talent was, how refreshing it was and how everyone was impressed that I was able to tie education and science into something that was also entertaining.”

David Holdford, Ph.D., a professor in the Department of Pharmacotherapy and Outcomes Science in the VCU School of Pharmacy, worked with Schrier on her research fellowship. 

“After finding out she was competing for Miss Virginia, I was really happy for her,” Holdford said. “To me, it seemed her focus on medication safety and science were very innovative and would give her a chance to win.”

After her year as Miss Virginia, Schrier plans to return to VCU to complete her pharmacy degree. She had applied to three pharmacy schools but said VCU “blew every other school out of the water.” 

“It’s a community of people that help each other and that’s something that immediately drew me to want to be a student here,” she said.  

Schrier is not the only VCU pharmacy student to participate in the Miss Virginia competition. Taylor Reynolds, Miss Arlington, is a rising third-year Pharm.D. student and was one of the top 12 contestants who competed with Schrier on June 22. Last year Reynolds was second runner-up, winning $4,000 in scholarships.

In 2007, then-School of Pharmacy student Traci Poole, now founder and CEO of Apothecary pharmacy in Nashville, was second runner-up in the pageant. “I’ll forever be grateful for the years of experience in pageantry with the Miss VA USA system as it honed so many essential skills such as public speaking, networking, advocating for something I’m passionate about, and thinking critically on my feet,” Poole wrote in an email. “All of which have enabled success for my career no matter the opportunity that arises!”

Schrier said her education in the sciences has not always been easy. 

“I didn’t have that kind of role model who had gone through the same experiences that I had of being an undergrad in a science career,” she said. “And now I’m in a graduate program. It’s not easy [getting a science degree] and I want to be that person to go out there and encourage and show them that I did it. And so can you.”

_____

Watch her winning science experiment on stage at the Miss Virginia pageant in this home video: 

High school students get a closer look at pharmacy as a career 

A student checks another student's blood pressure.
High schooler Maysoon Daw-el-beit, left, has her blood pressure checked by a fellow program participant.

Emiley Bagalawis
VCU School of Pharmacy News 

On the tables of a gray classroom sit red buckets with hazard signs, latex gloves, cotton balls and black zippered bags. Twelve students, all teenagers, are seated at the tables. The scent of alcohol rises from opened packets as they nervously wipe their fingertips, trying to be brave. 

One student takes out a meter from the black bag and inserts a small test strip. Her hand shakes as she aligns a needle with her finger, but she can not go through with it. She asks the instructor to do it for her. 

“OK,” says instructor Mason Bader, a third-year pharmacy student. “On three. One —” A small snap rings out. The girl flinches, then sighs in relief. She massages her finger until a small drop of blood appears. 

The students are taking part in the first year of the Pharmacy Summer Scholars program for high schoolers who are interested in a career in pharmacy. The program ran from June 17 to 21. 

Most of the students are from the Richmond region; one is from California. Jasia Redmond is a rising junior from Hanover High School and heard about Pharmacy Summer Scholars through her school’s pharmacy program called The Specialty Center. 

“I decided to do this because I was interested to learn more about pharmacy,” Redmond says. “It seemed interesting.” 

The program is a part of VCU Pipeline Programs. Participants are charged $50 to cover food and materials, with waivers available. These programs aim to educate students on different health-science careers and diversify the health-care workforce and are offered to middle, high and college students. Middle schoolers can participate in a program offered called Pharmacy Explorers that is similar to the Pharmacy Summer Scholars.

Taryn Hayes, assistant director of recruitment and pipeline programs at VCU School of Pharmacy, is in charge of the Pharmacy Scholars program.

“I want students to have an understanding of pharmacy and the other career pathways that you can go into with a degree in pharmacy,” Hayes says. “I also want them to know about social determinants of health and why culture is important when administering care. Like how you create treatment plans based on a person’s culture. I want them to understand what culture is and how that impacts the way they treat patients.” 

The five-day program features activities, discussion and lessons. Jordan Gray is a rising junior. He says one of his favorite parts of the program has been tic-tac-toe. The students play a variation of the classic game to test what they have learned so far.  “It was fun,” Gray says, “it was very competitive and it opened us up to each other.”

The program also offers plenty of  hands-on activities. On a recent day, in addition to a lecture about blood pressure, blood glucose

two young women in a lab
High school students Traci Turpin, left, and Jasia Redmond measure coconut oil. The two are making lip balm as part of a Pharmacy Scholars compounding lab.

and body mass index, third-year pharmacy students Mason Bader and Nick Suarez show students how to take blood pressure and test glucose levels — the purpose of that scary needle prick. 

“We take blood to measure glucose because glucose likes to stick to our red blood cells,” Bader says. “Glucose levels are measured in millimeters of glucose per liter of blood.” 

Pharmacists are trained to take vital signs such as heart rate, breathing rate and body mass index in addition to blood pressure and glucose levels, the instructors explain. Suarez demonstrates how to take someone’s blood pressure using a blood pressure cuff and a stethoscope. 

“After pumping up the cuff, you deflate it slowly while watching the needle fall back down,” Saurez says. “You listen for the first ‘glug,’ which is the blood rushing back in your arm, and keep a note of what number the needle passes when doing so. Then you listen for the last ‘glug’ and see what number the needle passes.” 

He takes Bader’s blood pressure. The first glug is at 172, Suarez announces, the last at 72. “So his blood pressure is 117 over 72, which is normal,” Suarez says. 

Two tubes of lip balm on a table
Two tubes of finished lip balm.

Another hands-on activity is led by Wylie Crane, a fourth-year pharmacy student. She gives a short lecture on compounding. Compounding is when pharmacists prepare medicines by combining or mixing ingredients. 

“I call it pharmacy cooking because you take the ingredients from scratch and you make something new,” Crane says. 

To get experience in compounding, the students head into a lab where they work in pairs to make lip balm—think ChapStick—out of coconut oil, cocoa butter, beeswax and a flavoring. A glass beaker is placed in a water bath to heat the ingredients after they are carefully measured. After the ingredients are melted and mixed together, the students pour the solution into molds to cool. 

It’s the same process a doctor in Lynchburg, Virginia, used to invent ChapStick almost 150 years ago, and basically the same process taking place by the millions less than 20 miles away at the country’s only ChapStick factory. 

The students take part in other activities such as creating a suspension of medication particles in liquid that can be taken by mouth or rubbed on skin. 

And, of course, blood tests for glucose. 

“Your glucose level is 105,” instructor Bader tells the student who was so anxious about pricking her finger. “Which is normal.” 

The student wraps her injury with a Band-Aid. She looks pleased. 

Archambault Scholarship recipient Hess on public health: “You just feel so welcome at VCU”

A woman stands in front of a laboratory.
Danielle Hess, photographed in front of an observation window of the school’s compounding lab, recently received a prestigious national award for students pursuing careers in public health: “I knew I needed to put public health into pharmacy during my career.”

Danielle Hess, a third-year Pharm.D. student at VCU School of Pharmacy, received the prestigious George Archambault Scholarship at APhA’s annual meeting in Seattle earlier this year.  The scholarship is awarded to a student who demonstrates leadership and professional experiences that align with the United States Public Health Service core values of service to the underserved, integrity, leadership and academics.

We spoke to her about her passion for public health and how the School of Pharmacy has helped her pursue it.

What got you interested in public health?

I grew up on a Christmas tree farm and my parents and grandparents always said, “You’ve got to work really hard for what you want in life and nothing’s going to be handed to you.”

Then on every mission trip I went on, I saw a lot of people working really hard, but still not getting what they need to survive or to be truly healthy. These people are doing all they can; they just don’t have the resources to get where they need to be. I really loved supplying those resources and going into a community and trying to empower them rather than just, “Here’s a bunch of free stuff, good luck.”

When we went to Honduras with HOMBRE [the Humanitarian Outreach Medical Brigade Relief Effort, a nonprofit organization at VCU] after my first year, we took water purification systems. In years past, they had given them out and said, this is what you can purify your water with. And when they came back the next year, they were being used as flower pots. That’s when they realized something was missing.

When I went, they did it again, and I said, “How about we go to the homes and ask them, can you show me how to use this right now?” We realized a lot of them still didn’t know how. So we spent the rest of that day going around and making sure they all knew how to use the system. That was more empowering them and making sure they could use it in their life.

Talk about your formal work in public health.

I earned a global health certificate in undergrad, and with the mission trips and the research that I did in Thailand through that, I saw a lot of what public health can do in different communities, especially in underserved ones. With that certificate, I had an opportunity to apply to the WHO in Switzerland. I completed an internship at the World Health Organization before starting pharmacy school. It was amazing to see what different people are doing all across the world.

After that internship, I knew I needed to put public health into pharmacy during my career. Then, the U.S. Public Health Service came up my P1 year through a recommendation by Dr. Peron [faculty member Emily Peron, Pharm.D.]. I reached out to a pharmacist who had worked at the Gallup Indian Medical Center, and we spoke for about 45 minutes about it and she encouraged me to apply to their externship.

Through working at the Indian Health Service, I saw that what they’re doing in the community is an awesome way to put public health into pharmacy. You’re seeing patients all day, but then you are going into the community and helping them with things that supplement their medicines. Because if they don’t have the things they need at home, medicines aren’t solving everything.

It gives you the opportunity to see someone’s life as a whole. If they come into clinic you might say, “OK, let’s increase your metformin and let’s get your diabetes under control.” Whereas in public health, we are looking at all aspects of their life, making sure that they have food security, making sure that their life as a whole is optimal to make sure their health can be as well. That’s what I like about it. You’re seeing the bigger picture of people’s lives and then the population as a whole.

How has the school helped you pursue your passion of public health?

At the beginning, it’s intimidating because you don’t exactly know where to go. I just paid attention to what all my professors were doing. That’s why Dr. Peron was the first one I reached out to after I heard that she goes on HOMBRE trips, she’s interested in global health, and she’s out in the community doing things. I contacted her and asked, “Can we sit down and talk about how you got to where you are now?”

She shared many global and public health ideas with me and then it led to reaching out to Dean O [Associate Dean K.C. Ogbonna]. I heard about his work with the Richmond Health and Wellness program and was encouraged to go talk to him. He showed me how he helped set up that whole program and much of the behind the scenes work. It’s amazing how willing everyone is to help you find your path.

– they truly dedicate themselves to students.

Anybody else in particular you want to shout out to?

Dr. [Abigale] Matulewicz wrote my letter of recommendation for the scholarship, and she has been very instrumental in helping me improve my leadership skills through APhA-ASP throughout my time at VCU.

Because ambulatory care has great opportunities for incorporating public health into pharmacy, I reached out to Dr. [Evan] Sisson and Dr. [Dave] Dixon this past year. They took me on as an elective student for both semesters, where I was able to see patients at the Center for Healthy Hearts every week and complete a research project. With their mentorship, I was able to witness many ways a pharmacist can go above and beyond to make sure patients are receiving optimal care, including finding access for those uninsured and making sure that patients are able to afford the medications they are prescribed.

Auxiliary Label: Meat juice, the cure-all that built a Richmond fortune

A small bottle labeled "meat juice" and a drawing of a cow.
Each 2-ounce bottle of Valentine’s Meat Juice was made from 4 pounds of beef “exclusive of fat.”

Victoria Hammond
Auxiliary Label Staff

Richmond, home of VCU, is known for its excellent pharmacy and medical programs. But the city holds another legacy in health care: as the birthplace of a product that once was famous around the world as a source of health and nutrition.

That would be Valentine’s Meat Juice.

Meat juice was created in 1870 when Richmond resident Anna Marie Gray Valentine fell extremely ill, possibly with a form of stomach cancer. Her husband, businessman Mann S. Valentine Jr., prepared a drink from meat and water and gave it to her. After drinking this “meat-juice,” she felt better.

News spread quickly of her improvement. People wanted the juice, and the Valentine Meat Juice Company was born. Though Anna Marie Valentine died from her condition three years later, the public remained convinced the product had helped.

“It didn’t save her but it was a way to get her eating and gaining nutrition,” observed MckenZie Walker, volunteer programs manager for the Valentine Museum. The nonprofit Richmond history museum was founded by the Valentine family and has an extensive collection of meat-juice artifacts.

Valentine’s Meat Juice was advertised as a way to prevent nausea and promote digestion. Each 2-ounce bottle of meat juice contained the juice from 4 pounds of meat “exclusive of fat.” Patients were instructed to drink the juice “frequently and in small quantities … in preference to large draughts administered at longer periods of time.” The juice was said to be most effective when taken an hour before a meal.

The manufacturers also suggested using meat juice as an enema or to prevent seasickness. President Garfield used meat juice in his recovery from an attempted assassination. Many testimonials to use meat juice in medicinal practice can be found including this from J.B. McCaw, M.D., a well-known Virginia physician and namesake of VCU’s medical library who died in 1906: “Having used the ‘Meat Juice’ in many obstinate and almost hopeless cases of disease, I can confidently recommend it to the favorable consideration of the medical profession. … I am more and persuaded that we have gained by it a valuable dietetic.”

“It was a cure-all for everything, so whatever you were sick with you could buy meat juice for,” Walker said.

Valentine’s Meat Juice was popular not only in the United States but also in Europe. Valentine received awards at the 1876 International Exposition in Philadelphia, 1878 Paris Exposition, and the 1881 International Medical and Sanitary Exposition in London for his creation.

The product is similar to some being sold today as ways to improve health, Walker added. Bone broth, for example, is a popular tonic sold in health-food stores.

This product was available until 1986 when the company closed its factory doors after years of declining sales. The introduction of widely available over-the-counter vitamin supplements probably played a role in that, according to the Valentine Museum’s web page on meat juice.

The public’s taste changed too, Walker added: “Most people that I talk to say that just the name sounds repulsive to them.”

Today there are Richmond advocates who want to bring Valentine’s Meat Juice back to market. Why not? It made a fortune once before. Maybe it can again.

_______

Auxiliary Label is a student-created blog examining pharmacy life, education and research at the VCU School of Pharmacy from a student perspective. It is overseen by Greg Weatherford, the school’s director of communications. Contact him here.

Sources include:

  • Southern Planter and Farmer (1867-1881); Oct 1881; 42, 10; American Periodicals pg. 612
  • Valentine, M. (1873). A Brief History of the Production of Valentine’s Meat Juice Together With Testimonials of the Medical Profession. Richmond, VA: B.W. Gillis Steam Pressors.
  • Taylor, W H
 American Journal of Pharmacy (1835-1907); Jul 1873; American Periodicals pg. 325

 

 

How to Be an Entrepreneur, Lesson 3: Go Where You are Needed

Woman stands in an empty office. She is framed in a window.
Pharmacist Shantelle Brown stands in the space where her in-construction pharmacy will soon open.

By Nicole Carter
Auxiliary Label Staff

Hope Pharmacy is a new independent pharmacy inside a new independent grocery store, The Market @25th, that is projected to open March 28 in the Church Hill neighborhood of Richmond.

Shantelle Brown, Pharm.D., is Hope’s owner and operator. The 2003 graduate of Howard University College of Pharmacy believes she will be the first African-American female to open an independent pharmacy in Richmond. Auxiliary Label had the opportunity to speak with her and tour her pharmacy while it was in the final stages of construction.

Auxiliary Label: How did you decide on the name Hope Pharmacy?

Shantelle Brown: Well, I didn’t want to do last name. I think hope is so pivotal. It’s something that we all have or hope to have. I think it’s just encouragement. [The pharmacy’s logo shows the word with a second P superimposed over the first.] This stands for “helping others physically prosper every day.”

The Hope Pharmacy counter under construction.
The Hope Pharmacy entrance under construction.

What’s your pharmacy’s mission?

I would definitely say education. I think that’s what’s missing with the disparities that happen with the East End. And my prayer is that I’ll be able to bridge the gap between the residents that have been here for years and the new residents that are now coming into Church Hill. I had the chance to go to a town hall meeting and the longstanding residents expressed their concern that they were being pushed out, that maybe all the change is not for them. So, hopefully, with working with the grocery store and their promotion of good, healthy foods with affordable fruits and vegetables, and me being a mouthpiece for African-Americans in this area, I can relay the message to the residents that you’re wanted in this community. We want everyone to come together.

What has been the biggest challenge you’ve faced thus far?

Financing has been my challenge. For me, it was important not only to do this as the first African-American female [pharmacy owner] in Richmond but to be able to do it with just myself and my family. I told my husband that we need to be able to do this on our own. Thankfully, I closed on my loan at the beginning of January with Virginia Community Capital. They saw the vision and they do a lot of work with the community. Right now, for banks to give money to startups is unheard of.

What are you going to use your startup loan for?

I did a term loan for the store buildout and a line of credit for my inventory*. With any pharmacy, you’re going to be responsible to pay that bill from the drug distributor at least once or twice a month. It’s quite often. But you don’t get reimbursed from the insurance company for 45-60 days so you need to have a line of credit in order to bridge that gap.

I have a term loan for my build out and a line of credit for my inventory.

How did you figure out what kind of drug inventory your store needs?

We haven’t pinpointed exactly what we are going to start off with yet, but I’ve spoken with the old district manager for Ukrop’s [Super Markets Inc., a longtime grocery chain in Richmond that closed in 2010] and I spoke to a couple of independent owners. I learned that there are quite a few brands that skyrocket your inventory numbers, but you don’t really need to start with all those brands. Most of the time I end up sending them back. So, of course, there are exceptions. For example, you have to pay brand for your insulins. Most people say the norm for starting inventory is $60,000, but you should be able to almost cut that in half by utilizing more generics.

What advice do you have for future pharmacist entrepreneurs?

Do your research. Get the feedback from the residents. You want to be in an area where you’re needed.

Auxiliary Label is a student-created blog examining pharmacy life, education and research at the VCU School of Pharmacy from a student perspective. It is overseen by Greg Weatherford, the school’s director of communications. Contact him here.

[*This sentence has been updated and clarified.]

P-3 David Doan inaugurates an inspiring new Aux Label series

David Doan stands at a rostrum with the V-C-U logo.
David Doan speaks to alumni of the VCU School of Pharmacy at the Jefferson Hotel during the school’s annual Galen Society banquet.

By Christian Ruiz
Auxiliary Label Staff

From the author: Each person in my class is remarkable in his or her own way, especially to have come this far in pharmacy school. However, a dozen of them have inspired me in one way or another, and I wanted to share their secrets to success because I believe that we all can, and should, grow immensely as people and as pharmacists in this school.

So for each article in this series titled “OTC Advice” I will interview and write about a classmate who has inspired me over the past three years, whether it was inside the classroom, outside the classroom, or both. I consider their advice OTC — “over the counter” — since no prescription is necessary; just open a web browser and spend a few minutes reading.

I learned so much from these classmates over the years. I hope you enjoy what I learned. — Christian Ruiz

David Doan, a third-year pharmacy student at the VCU School of Pharmacy, has amazed me in numerous ways. He has served as class president for his first two years in pharmacy school and is now the student body president, and he has served in other leadership positions in various student organizations. Above all, he consistently embodies professionalism and friendliness, always offering a smile, a laugh, or a refreshing conversation even on our roughest days.

If I could summarize his following advice in a few words, it would be this: We all want to see each other succeed, whether it be through learning through mentors, learning a variety of different skills, or learning how to solve problems.

So say “yes” to each challenge that the faculty, staff and your own classmates offer as learning opportunities. You might be impressed with how much you can grow as a person and as a pharmacist.

Auxiliary Label: Why did you apply to pharmacy school?

David Doan: I chose to apply to pharmacy school because I had great respect for one of my mentors when I was working at the NIH [National Institutes of Health] who happened to be a pharmacist. I saw his job and what he was doing, and I wanted to do that. He had a Pharm.D. and an MBA and he ran a research lab at the NIH, and it’s something that I could see myself doing.

What did you like most about what he did at the lab?

I liked the variety of things that were going on at the lab, whether it be support for clinical trials, his own research in prostate cancer, or learning leadership techniques. It really taught me a lot.

What is your favorite thing about pharmacy school so far?

I just love to learn. Every single day you walk through these doors, you can learn so many different things, connect with so many different people, and build relationships. The school allows you to do that, and you walk out of these doors when you finish as a better person and a great pharmacist.

If you could be any faculty or staff member in the school, who would you be and why?

Dr. Gravatt. I think she’s amazing. She’s so well-rounded, she provides all of her students with the knowledge and skills, and she shares her experiences us and tries to make us better. She challenges us. She’s a great mentor. And she genuinely wants to see all of us succeed.

How do you think you have grown as a student and/or a pharmacist over the last three years?

Outside of the clinical aspects — learning pharmacy itself — it’s really about the ability to interact with people and with patients. It’s more about the soft skills. Being a pharmacist is more than just medications – you’re a professional problem-solver. Whether it be logistics, medication issues, or clinical situations, you’re the go-to for being that problem solver, and I think that’s what I’ve learned most.

If you could give your P1 self the most important advice or lesson you have learned so far in pharmacy school, what would it be and why?

Don’t be afraid to take on new challenges. Be someone that always says yes. The more opportunities that you seek out and go for, the more doors will open. And cherish the time you have here; it’s short, and after this, it’s real life. So, take advantage of it, and take advantage of the opportunities that the School gives you because they provide so many.

And don’t be afraid to step outside your comfort zone. Try to grow as much as possible. The more that you grow here, the better pharmacist you’ll be and the better care you’ll be able to provide your future patients.

Auxiliary Label is a student-created blog examining pharmacy life, education and research at the VCU School of Pharmacy from a student perspective. It is overseen by Greg Weatherford, the school’s director of communications. Contact him here.

Auxiliary Label: The ancient, mysterious history of pharmacy show globes

Pharmacy show globes: a tradition, a mysterious history

Show globes — large glass urns or vases filled with colored liquids — are found in many traditional pharmacies. What do they mean? Well, that depends. Victoria Hammond, Pharm.D. Class of 2020, investigates for the School of Pharmacy's Auxiliary Label blog of student life and research.

Posted by VCU School of Pharmacy on Thursday, December 6, 2018

By Victoria Hammond
Auxiliary Label Staff

Unless you have been to an apothecary museum or know someone who is a pharmacist, you probably have not heard of a show globe, but you may have seen one. Show globes are pieces of glassware that are often vase shaped and filled with colorful liquid, often seen in apothecary’s front window displays.

Show globes are ancient and have been symbols of pharmacy for a long time. They still are used today; in fact, in Pennsylvania it is illegal to display a show globe at a place of business that is not a pharmacy.

There are many theories about the purpose of show globes but nothing definite about their purpose is known.

One theory is thought to date from around the 16th century. Apothecaries needed a symbol to grab the attention of a mostly illiterate population. In this time period streets were crowded and needed a symbol that was bright, unique and easily recognizable to draw in business.  

Another theory suggests that show globes date as far back as Julius Caesar’s invasion of Britain around 53 B.C.  According to the story, an apothecary was located across from a dock for boats. The apothecary would place lanterns behind multiple show globes which would guide boats carrying troops safely to shore.  When the troops arrived safely, the story goes, Caesar allowed all apothecaries to keep show globes in their front windows.

It has also been hypothesized that show globes were used to relay messages to travelers about the health in the town.  Red liquid in a show globe meant that there was an epidemic and to stay away from the town. Green liquid in a show globe would mean that all is well in the town. Another theory also hypothesizes that show globes were used to send messages but to sick individuals during the Great Plague of London. It is thought that the colored liquid would show where individuals could find medical care.  

The final hypothesis of show globes involves maceration. Maceration is a process that involves softening or breaking up solids through soaking into a liquid. It was thought that directions of maceration involved the process to be done in light in a container that could hold 2 to 3 gallons.  This process would normally be done in an area with the best light: the apothecary’s front window.

Not much is known about the purpose of show globes, but they continue to be a symbol of the profession and are a unique piece of pharmacy history.

Auxiliary Label is a student-created blog examining pharmacy life, education and research at the VCU School of Pharmacy from a student perspective. It is overseen by Greg Weatherford, the school’s director of communications. Contact him here.

Pharmacists as part of medical team make patients healthier and reduce costs, study says

A hospital bed.
How can doctors keep patients healthier and out of the hospital? By having pharmacists on the medical team, a new study says.

By Christian Ruiz
Auxiliary Label Staff

Pharmacists working in collaboration with other health-care providers can improve the quality and cost of care for patients, according to a recent study.

A recent article in the American Journal of Health-System Pharmacy makes the case that pharmacists working as part of the primary-care team can be crucial life savers for their patients. In the case of the study, having pharmacists on the team reduced hospitalizations by 23.4 percent and reduced costs by approximately $5 million.

The study — of six hospitals from the Carilion Clinic health system in southwest Virginia in conjunction with 22 patient-centered medical homes associated with Carilion Clinic — was led by VCU School of Pharmacy’s Gary Matzke, Pharm.D.; Leticia Moczygemba, Pharm.D., Ph.D.; Karen Williams, Pharm.D.; Michael Czar, Pharm.D., Ph.D.; and William Lee. The study took place from January 2013 to June 2015. Funding sources for the study included the CMS Center for Medicare and Medicaid Innovation and the Carilion Clinic health system.

A total of 2,480 patients in the study had two or more of these seven chronic health conditions: heart failure, high blood pressure, high cholesterol, diabetes, asthma, chronic obstructive pulmonary disease (COPD) and depression. In addition, the patients were taking at least four medications and had a primary care physician in the Carilion Clinic health system.

The researchers studied the difference between collaborative care, in which pharmacists were members of the primary care team and worked closely with physicians, and “usual care,” in which pharmacists were not part of the primary care team, on the progress of their patients’ chronic health conditions and on their patients’ use of hospital resources.

The collaborative-care pharmacists called patients within 72 hours after their hospital stay to see if those patients had any medication-related problems or issues. Additionally, these pharmacists met the patients face-to-face or by phone to address patient-specific problems or concerns, which encouraged patients to self-manage their medications and health conditions.

Patients in the usual-care group did not interact with pharmacists in these ways.

Patients in the group working more closely with pharmacists showed better improvement in each of their health conditions compared to the usual-care group in terms of their diabetes, high blood pressure and high cholesterol.

In addition, the number of patients who were treated with the collaborative-care group experienced a 23.4 percent decrease in hospitalizations, from 1,675 hospitalizations before treatment by the collaborative-care group to 1,283 hospitalizations after treatment by the collaborative-care group.

The usual-care group, in comparison, experienced an 8.7 percent decrease in hospitalizations, from 355 hospitalizations before treatment and 324 hospitalizations after treatment.

Along with the health improvements, pharmacists in the collaborative-care group helped reduce the cost of hospitalizations overall by $5,156,675 — $2,619 less per patient than standard procedures would have been expected to cost. In comparison, the usual-care group recorded a cost reduction of $475,071, or $241 less per patient than standard procedures would have been expected to cost. This means that pharmacists in the collaborative-care group helped save $4,681,604 more than the usual-care group — or $2,378 more per patient than standard procedures would have been expected to cost — over the course of the study.

This study demonstrates that pharmacists can contribute far more to health care in the community than just serving as “pill counters” – a perceived role that immensely underestimates and undervalues the impact they can have on both the health of their patients and the cost of health care. Additionally, when health care providers work together as a team, our jobs as life savers can be worth so much more to our patients.

Auxiliary Label is a student-created blog examining pharmacy life, education and research at the VCU School of Pharmacy from a student perspective. It is overseen by Greg Weatherford, the school’s director of communications. Contact him here.

How to Be an Entrepreneur, Lesson 2: Find a niche

A rooftop sign reads "fountain."
A sign on the roof of Midlothian Apothecary. The restaurant inside the pharmacy acts much like advertising, says pharmacist Janet Darby. Photo by Nicole Carter.

By Nicole Carter
Auxiliary Label Staff

Midlothian Apothecary is an independent pharmacy in Chesterfield County, just outside Richmond, that has survived under the same management since 1990. Auxiliary Label’s Nicole Carter met with Janet Darby, a VCU School of Pharmacy alumna, to talk about the business of independent pharmacy today.

Auxiliary Label: What is your biggest revenue source?

Darby: It’s not drugs any more. With generics, I almost have to give them away for free. Brand-name drugs are still profitable. We do vaccinations and they pay well on those. Also, home health-care products such as durable medical equipment, but we don’t bill Medicare for that. Medicare has a designated location for patients to buy DME [durable medical equipment] but a lot of people don’t want to go through the hassle so we just sell it straight to the customer.

What do you think has the biggest growth potential out of all the services you offer?

We’re starting to do point-of-care testing for flu, strep throat, cholesterol and blood glucose. We can charge for that. The problem is, though, in Virginia I can’t write a prescription if I find out somebody is positive for flu. … We are setting up a collaborative practice agreement so that after I get the test result, I can call the doctor and then get the prescription.

How do you bill for the point-of-care testing?

It’s out of pocket. In Virginia we can’t bill insurance unless we are the one who writes the prescription. Last year, with the big flu epidemic, no doctor could see anyone [because they were too busy] — people were having the flu and couldn’t get any medications. The doctors are looking for help too because they can’t see everybody.

How is having the fountain in the pharmacy an asset to the business?

It’s always busy. It’s kind of like paying for advertising: A lot of people come in here [for the fountain] not knowing about the pharmacy, and some people come in not knowing about the fountain. So it brings in people and kind of keeps things hopping all the time. You can’t say it’s a moneymaker because you have to sell a lot of food to make money. But we see the money that goes toward the fountain as money we would have otherwise spent on advertising.

What is the biggest threat to independent pharmacy?

PBMs, the processors for insurance companies, right now they are ruining pharmacy. They mandate how much we get paid. And the insurance company pays them one thing and then they pay us something else. Now for generics they are using the average for the year. So if they think they paid us too much for the first six months of the year then they take money back. But they don’t give us a reason. It’s really crooked.

Competition isn’t a threat because I offer something entirely different. We provide individualized care that other pharmacies just don’t.

What is the biggest opportunity for independent pharmacy?

There is a niche. You got to want to do customer service. You’ve got to want to do a lot more than just fill a prescription. And you’ve got to answer question upon question. There are people out there that want that individual service.

What advice do you have for pharmacy students?

You’ve got to want to work. And you’ve got to want to work hard. If you can’t multitask you can’t be a pharmacist. And you’ve got to want to work long hours. It’s a great profession if you like people. You’ve just got to know what niche you want and what you want to do.

Auxiliary Label is a student-created blog examining pharmacy life, education and research at the VCU School of Pharmacy from a student perspective. It is overseen by Greg Weatherford, the school’s director of communications. Contact him here.

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