Curiosity and Asking ‘Why Not’ Is Helping Avant Pharmacy Rethink Healthcare

Amina toured us through the pharmacy before the majority of her staff and customers arrived that morning. Walking through the front door, the space had a look and feel unlike many other pharmacies, with the sound of falling water and an uncluttered, serene area that gave a sense of calm.

Workout gear, like resistance bands and athletic socks, lined the wall leading to the out-patient infusion space with big comfy chairs and blankets draped over the back.

When we sat down with Amina, she helped us understand why her pharmacy was different.

After learning more about her story, she said, “I had this crazy idea, because I live by the concept, “Why not? What am I waiting for?”

She told us about being born and raised in Kenya, East Africa, and as a teenager moving to the U.S.

She explained that her sense of curiosity has been with her since she was young, noting that “I grew up with two uncles that were both traditional herbalists in Africa. And I just wondered, all these things that they gave people, do they really work? How come my parents gave me conventional medicine? And so, I was really curious. It all came from curiosity of, what really is ‘medicine’ and how do you prescribe medicine to different people? And so, I chose to be the western expert in our family because we already had the traditional experts.”

That led her to pharmacy school and her start as a community pharmacist working for a well-known national pharmacy. She recalls, “I loved being in the community. I loved patients who came in. I loved knowing everyone's dogs and where they were headed on vacation. And it just...Those relationships in the community, made my job so much easier and fulfilling knowing that I’m part of everyday life for these patients.”

And over the last 15 years, she’s brought this love to her very own pharmacy with the inspiration to “create what I haven’t found...to solve every obstacle that I think exists in patient care.”

How Did We Get Here? Reversing Our View of Healthcare

“Our first mission was to really be in our community and be able to be a place where patients felt empowered, patients got the knowledge they needed, and they got an advocate on their team to help them navigate the complexities of healthcare. And then over time we got more courageous. We started solving bigger problems. With that I realized, why are we always taking care of patients at the end? How did they get here? What happened? Why are we now dealing with the complexities, things that are un-reversible?”

She reflected on the ever-increasing cost of healthcare and how it was an insurmountable challenge for some patients. “That bothered me a lot,” said Amina.

And it prompted her to ask, “How do we catch people? And be that place where people can come in not because they have prescriptions, but how do they prevent needing a prescription?”

That became her vision for all that followed—including the intentional placement of products that support a healthy lifestyle.

“You see yoga bands and you see running socks and you see kind of like that athletic feel. And this gets people asking us, ‘are you guys a pharmacy?’ And we get to have conversations about preventative care.”

Where There’s A Gap—We're Going To Fill It

Amina is currently opening her fourth pharmacy in the greater Charlotte area. The locations are intentional, she said, either near bus lines or public transportation or rural areas, making it easy for patients to access the care and wellness resources at her pharmacy.

She said it’s “why community pharmacists are very important because we are able to easily identify a gap and we can actually close it.”

“We were finding that a lot of patients may not need hospitalization, but they need some medications to be administered in IV, as simple as after a bad case of flu or diarrhea, they need extra fluids. Our local physicians are not set up to do it. So we wanted to solve that.”

“We were able to get a nurse to lead our infusion center. And so we do get referrals for ambulatory infusions. It really started around COVID when we wanted it to be available for the monoclonal antibodies, that led to people needing fluids, that led to people needing more things, and now it's a permanent place for us.”

“If you follow our trends, it’s about closing a gap.”

Partnering to Fill Care Gaps Also Helps Curb Burnout

Facing her own challenges owning an independent pharmacy, Amina’s curiosity struck yet again, she remembers, noting, “I was curious how my physician colleagues were feeling when they own[ed] their own practice.”

“When I started connecting with the physicians human to human, forget our professions and looking at it in terms of the business, what they struggle with, we had so many similarities.”

And it’s the relationships she built with these physicians that is a model to be replicated.

“We all went to school to serve patients, [are] very passionate about patient care, but there are a lot of things about business that was challenging. We thought [that] a collaboration would be ideal because things that were creating a lot of burden for them [doctors], were actually things that pharmacy could do happily to take care of their patients.”

These conversations became practical questions related to how pharmacists and physicians could effectively work together based on North Carolina’s policies and were solidified by the partnerships that Amina secured.

She explained, “we are not there to replace primary care, but we are really there to extend their reach. We’re there to be a safety net for the patient so they don’t get lost to care. And one very, very important lesson that I learned is that patient won the most when we collaborated.”

“We actually found that by teaming up, it’s reducing burnout on both professions, because when our medical providers can work at the top of their license and focus on the patients that really need them the most and move their population health contracts to a pharmacist who is able, capable, knowledgeable to actually serve those patients, counsel those patients, close those gaps, whether by them directly vaccinating, giving the appropriate education, smoking cessation, you name it, it’s actually brought a lot of relief.”

She added that providers are happy because they feel like they are practicing at the top of their ability instead of feeling bogged down by administrative tasks and “patients get seen, heard. They feel like everyone is really there to take care of them.”

“Everyone is really rising up. Our pharmacy technicians are rising up, our pharmacists are rising up, our medical providers are rising up, and that to me is a dream team in healthcare.”

The Future of Pharmacy is Now

Innovative technology and advances in health intelligence sharing are key to the success of the pharmacist-physician collaboration and ultimately, better care for patients. 

Amina said, “technology is improving access [to healthcare]. Access to information that we need in real time to make decisions for patient care.”  

“Back in the days it was okay to work in silos,” she added. “You are on a fee-for-service model. When you saw a patient, you got paid. But now you’re getting paid when the patient improves on outcomes. And that becomes not a one-person responsibility. Therefore bringing in a pharmacist care team with services that a pharmacist can do to actually compliment, it’s a win for both the physician, it’s a win for the patient, it’s the win for the health plan because you’re now diversifying your care team because not only can the pharmacist make sure the medications are cost-effective, appropriate, patients can afford them, they're not increasing side effects.”  

“So you’re having that component, but also everyone is working at the top of their license because our patients need to see the physicians for diagnostic to kind of find out the complexities of their disease, while the pharmacists are really playing the role of coaching...helping you identify the care gaps and solving them by all the solutions that are available within the community.”  

She points to an example of a patient’s blood pressure that is not well managed and how it’ll take more than just one visit to a physician to help this patient. She tells us that this is where pharmacists can come in and provide lifestyle coaching, help with remote patient monitoring of blood pressure checks and the pharmacist is able to intervene and educate the patients along the way.

Amina added, “you’re now allowing another higher-level clinician that can counsel this patient and be able to guide the patients in the correct care plans.” 

And as for the future, Amina’s outlook is positive.

“Pharmacy will be here a hundred years from today. It will look different. And it’s starting to look different because we have to think of ourselves as part of a value-based care model with solutions that no one else can bring to the table but us [pharmacists].”

“Team-based care is here to stay and pharmacists play a vital role in this team-based care. And it needs to be recognized,” she said.