All in the family: Two generations in pharmacy

With this article, a group project from reader Pete Kreckel, RPh, and his wife, daughter, and son-in-law, Drug Topics launches a new series that will present your stories: how you came to pharmacy, how your path unfolded, and where it led you. Our goal is to show new pharmacists how many choices and opportunities appear to those whose minds are open to new possibilities. Here's your chance to share what you have learned through your life in pharmacy! Send your contributions to drugtopics@advanstar.com today.

My Dad was a welder. My Grandpa was a blacksmith. Our family background is full of men with callouses on their hands. So how did I end up in a white lab coat in pharmacy school in 1977?

Not sure I can tell you, but there I was. Next to me was a very cute and charming lab partner, Denise Kubitsky, who eventually became Mrs. Kreckel. No healthcare background in this guy’s pedigree. But it sure was the start of something.

Independent retail practice

The first position I landed upon graduation was in a small town in Clearfield, Pa., for a large major chain. The district manager was thrilled that I was interested in working there since this was such a difficult store to staff.

Most pharmacists there were “doing their time” until an opening was available in Pittsburgh.  After I was licensed and hauled in the big bucks ($12.85/hr), I quickly realized that the low staffing level did not lend itself to patient consultation.  I remember telling Denise, “If this is retail pharmacy, I made a serious mistake in choosing this career five years ago.”

Fifteen tech hours per week was not enough, but my district manager said to me, “Pete, I’ve watched you practice and, if you quit spending time with the customers, you will have plenty of time to do our paperwork.”

I was ready to apply for a graduate program at Pitt, and get a PhD. so I could teach.  Then the phone call came. My mother inlaw called and said there were two openings in the Altoona area; one was the store Denise interned in, the other in a newly opened location in Tyrone Pa.

When I called the owner to ask about the opportunity, ready to send him that impressive resume, he answered, “Anyone married to Denise Kubitsky has to be all right. Can you start next week?”  All my years of “resume building”--class president for three years, president of the student council for two years--meant nothing in comparison to my wife’s reputation.  We moved into the community and became part of it immediately.  We got involved in our church, nursery school, and our parochial school.

For the first 20 years or so, it was the same old, same old…dispensing, counseling, managing inventory, the same gig all “bench” pharmacists know so well. My lab partner and I “compounded” three offspring together, the oldest of whom eventually revealed her ambition to follow in our footsteps.  The store grew into a hugely successful business, all along allowing me to build relationships and connecting to my patients.  Working for an independent “chain” was much enjoyed.

From bench to podium

A phone call came from a colleague (actually the guy who brought us to Central Pennsylvania in 1981) letting us know that a teaching position at St. Francis University had opened up. Teaching pharmacology sounded easy for a seasoned retail pharmacist. I was interviewed by the eight faculty members and two students. Two other candidates also interviewed.  I really connected well and landed the job.

Then the work began.  No text book, no previous notes, my didactic coordinator would hand me a list of goals/objectives and drugs to be covered.  I remember that even “Cognex/tacrine” was on this list.  Heck, I even had to update the list!

My Lab Partner and I spent every evening for a whole year down in the basement, creating lectures on subjects ranging from antibiotics to estrogens. To call the process “overwhelming” would be an understatement.

About that time, Gretchen, my oldest daughter, was accepted into our alma mater’s pharmacy school. Dr. Patricia Kroboth, the dean, pointed her out to the class of 100. “I had Gretchen’s mom, Denise, in my first clinical assignment at Pitt.” Dr Gary Stoehr, assistant dean (currently Dean of D’youville School of Pharmacy) did the same, but said, “I had your dad as one of my clinical students, I hope you are more like your mother!!”

Clinic management, continuing education

After 25 years, Denise left the independent chain and headed to Geisinger Health System to manage a retail pharmacy in the clinic. A year later, I left and joined a four-store independent owned by Bill Thompson.

The previous 25 years were great, but when the owner allowed non-pharmacists to make decisions that involved dispensing and work flow, and the focus became on giftware rather than prescriptions, I became dissatisfied.  I tell every student that I precept to remember that your license hangs on the wall by a nail; it is not bolted there and is rather portable. Use this to your advantage.  When attitudes in management change and don’t allow you to practice in the way you desire, take your license off the wall and find a new nail!

My new employer loved the profession of pharmacy and assigned me to a 1,200-square-foot store that has been there since 1932.  I often feel with the indifference the major chains show for this profession, they would be as happy selling roofing nails, cars or sump pumps…they just see the profession as a way to sell the product they offer, that being drugs.

At my first interview, I asked Bill about his comfort level with me precepting students, and he told me he often wanted to get involved but most of his pharmacist staff was unable to do that, due to store volume or layout.

Bill encouraged me to precept students, and my wife and I decided to “refill” our empty bedroom with out-of-town students who want to experience “rural pharmacy.” While in pharmacy school our daughter Gretchen told us that one of the biggest challenges the 6^th-year students face is finding housing for the 5-week rotation period.  We allow students to live with us for free, we charge them nothing for room, board, and, heck, we even pack their lunches for them.  We have hosted student health care professionals that are pharmacists, physician assistant students, and even two optometry students; to date we have provided over two years of free housing and board.  Talk about developing inter-professional networking!

Through my connections with St. Francis University, I create online webinars for FreeCE.com. The first presentation was about HIV medications (my weakest subject at the time). I really stepped out of my comfort zone with HIV and was offered opportunities to do more.  I cover most “retail” topics of interest from outdoor first aid to medication adherence.  The “bench” pharmacists appreciate my passion for this profession. I cover topics from OTC meds to HIV; I never filled an HIV med my first 26 years; now I have 5 patients and a real passion for treating this disease state.

At-home MTM, university teaching

Just before starting her P3 year, Gretchen attended a Kappa Psi Pharmaceutical Fraternity convention in Boston, where she met a Pitt alum named Mark. He happened to be a cousin of two of our best pharmacist friends.

Gretchen completed a community pharmacy practice residency at Virginia Commonwealth University in Richmond; Mark left CVS after climbing their ladder for a decade, and began performing medication therapy management (MTM) for Humana Healthcare in the work-at-home setting.

Gretchen was able to work anywhere. Anywhere became Morgantown WV, where she accepted a dual assignment as clinical professor at West Virginia University and clinical pharmacist for a local independent pharmacy. She shares her Mom’s passion, looks, and smarts. Sometimes, people are blessed with more paper than a degree when graduating or a certificate when finishing a residency, like say, a marriage license, otherwise known as, true happiness.

Random addition: To say that our profession is a “small world,” is an understatement. If precepting a student pharmacist today, s/he may even be your boss within a decade (this literally happened to me).

Giving back to the community

Current events include my lab partner’s stepping down to flex time at Geisinger so she can serve as a clinical pharmacist at Centre Volunteers in Medicine two days a week. Denise really steps out of her comfort zone, and works on formularies to benefit these most needy patients.  With an amazing support staff, they are able to get medications from the generous manufacturers who give free meds to the indigent. Although this is a paid position, she spends countless hours developing protocols, formularies, and collaborative practice agreements. There she reviews charts and uses her smarts and charm to provide the patients and physicians with the benefits of evidence-based cost-effective prescribing.

I also work half a day at the Altoona clinic for the uninsured, doing the same stuff as Denise. Dr. Zane Gates (a pharmacist and physician) wants to change our role in healthcare and wants this clinic to be a future model. I implore you to see his “TED talk” on YouTube. This guy has vision.

All four of my “phamily pharmacists” have been instrumental in developing a formulary for this clinic. Last Easter, after a delicious dinner, we got out the formulary, and using everyone’s expertise we finalized the formulary and handed it off to Bill Thompson for his expertise in cost management. Truly a team effort where everyone shares their toys.

We often hear comments about how disgruntled many retail pharmacists are, and about the apparent lack of opportunities in this amazing profession. My advice to my final-year students (I’m up to my 25th final-year class this year) is to make connections, follow your passions, and do what you love to do.  Remember your license hangs by a nail, it is not bolted to the wall!

In an evaluation for a webinar, one retail pharmacist wrote a diatribe charging that I wasn’t a real pharmacist - that I practice “fantasy” pharmacy.  I’d have to agree with him - times four!

Pete Kreckel and his lab partner live in Altoona, Penn. Contact him at pharmcanoe@aol.com