Abstract
For Jeannie Collins Beaudin, responding to patient needs has been key to the development and success of her community consulting practice in hormone replacement therapy and specialty compounding.
Ms. Collins Beaudin, who owns Keswick Pharmacy in Keswick, New Brunswick, has enjoyed pharmaceutical compounding since her graduation from Dalhousie University in the late 1970s. But it wasn't until 1998, when a patient asked her to make a commercially unavailable product, that she began to develop her specialty compounding practice. “A woman was looking for a progesterone cream similar to one that had been available from the US,” she says. After spending considerable time researching formulae and sourcing the ingredients, Ms. Collins Beaudin decided it would be advantageous to join the Canadian branch of Professional Compounding Centers of America (PCCA). Doing so allowed her to save time and ensure that her patients would receive the best possible products.
Once she completed PCCA's basic compounding course, she found that word of mouth and referrals from a variety of sources, including health food stores, helped get her compounding business off the ground. In the wake of several years of controversy about hormone replacement therapy, Ms. Collins Beaudin found that many women were looking for alternatives to conventional HRT, and she focused her professional development in this area. “Especially since the release of the Women's Health Initiative study results in 2002, I find that doctors and patients are receptive to compounded hormone formulations which may offer several advantages over commercially prepared products,” she reports.
Consultative approach
After several years as a staff pharmacist in both community and hospital settings, Ms. Collins Beaudin had the opportunity to open her own clinic pharmacy in a Fredericton, NB, suburb in 1995. “I was anxious to spend more time with clients and put my clinical skills to use.”
She credits her previous experience working with Eleanor Murray, owner of the Riverside Pharmacy in nearby Oromocto, with providing the confidence to develop a more consultative approach to patient care. “Eleanor set a great example for excellent service and patient-focused care. Once in my own store, I started holding regular clinic days for diabetic and asthmatic patients.” Ms. Collins Beaudin then sought feedback from patients and staff at the local hospital. “They indicated that my community-based programs were unique and were, in fact, complementary to the educational efforts provided by hospital staff. I was encouraged to continue and advertise the events.”
‘Flexible health spending accounts are not common in New Brunswick yet, so I often provide information to third-party payers to ensure they understand the value of my services’
Jeannie Collins Beaudin: Women are looking for alternatives.
After opening a second pharmacy in Keswick, NB, in 1997, Ms. Collins Beaudin found that she was often invited to make presentations to local community and government groups. These talks generated so much interest in her skills that she had to suggest making appointments in order to meet the demand. Her first consultation client was a woman (not a regular patient at the pharmacy) seeking a medication review. “I was somewhat unsure of what to charge her for my time — I finally came up with a fee of $30, which was approximately what a pharmacist was paid per hour at the time,” she recalls. The woman was so pleased with the service that she offered more, saying “it was worth more than that!” and paid Ms. Collins Beaudin $40.
She now routinely schedules two appointments per week — charging $150 for a typical menopause/HRT consultation. “I usually spend one hour with the client, taking a complete history and then spend two to three hours preparing a report with recommendations.” Ms. Collins Beaudin first sends the completed report to the client, and then to the client's physician with recommendations. She says, “I aim to make the reports as useful to physicians as possible. I try to limit the report to one page and deliver it to the physician prior to the patient's next medical appointment, so the doctor has an opportunity to review it.” She finds that providing supplementary abstracts or published articles lends credence to her evidence-based recommendations.
Ms. Collins Beaudin has found that physicians in the greater Fredericton area are appreciative of her efforts, particularly the detailed histories she compiles for HRT patients. “The doctors tell me they wish they had the time to do such a thorough screening,” she says. She is very gratified that some physicians are now referring menopausal patients to her, saying, “it builds confidence to have them recognize my knowledge.”
Ms. Collins Beaudin's consultative practice is greatly appreciated by the patients who pay for her services. She will often assist patients in dealing with their employer's benefit department or insurance company to obtain reimbursement for clinical services or specialty compounds. “Flexible health spending accounts are not common in New Brunswick yet, so I often provide information to third-party payers to ensure they understand the value of my services,” she reports.
Ms. Collins Beaudin was recognized as “My Favourite Pharmacist” in a professional periodical a few years ago by a patient with pancreatitis, who wrote glowingly of her efforts in providing transdermal formulations for the patient's medications, liaising with the prescribing physician, and even obtaining government drug plan coverage.
Staff retention a bonus
Providing innovative clinical services can have a beneficial “side effect” — making your pharmacy a more attractive practice site. In 2001, after experiencing pharmacist staffing difficulties, Ms. Collins Beaudin and her husband (a teacher, who assists by managing the business elements of the pharmacy) decided to merge their two stores into the Keswick location. “It was literally carrying my clinic idea into a community store,” she says. She has since hired a staff pharmacist who also performs consultations by appointment and participates in community outreach activities. Ms. Collins Beaudin reports that she finds pharmacy technicians are also very happy to work in this environment. “Having an attractive working environment makes it easy to keep good staff.”
She now finds herself in demand as a speaker for training sessions aimed at pharmacists. “I find it very rewarding to help others develop and advance their clinical practices.” She was recently featured on Dalhousie University's PharmaSea Educational Cruise and participated as a panellist at CPhA's annual conference in Quebec City. The speaking engagements, along with her recent term as President of the New Brunswick Pharmaceutical Society, are providing Ms. Collins Beaudin with the opportunity to pursue her latest goal — increasing recognition for pharmacists. She is also looking forward to expanding her practice to include more patient follow-up activities, as well as monitoring and lifestyle management for cardiovascular patients. She enthuses, “the work I do is very gratifying. There are many opportunities for pharmacists to demonstrate their value to patients and other health professionals.”