INDEPENDENTS HAVE MANY CAREER CHOICES?SPECIALTY PHARMACIES ONE OPTION

SOME CAREER CHOICES AREobvious, some are not. Lois Adams, RPh,MBA, president and chief executiveofficer of HHCS Health Group inOrlando, Fla, has made some importantcareer choices in pharmacybased on her own life experiencesand those of the people who work forher. For instance, she set up a cysticfibrosis (CF) pharmacy in 1985because a friend named BeverleyDonelson "came to work with us andgot interested in cystic fibrosis whena grandchild was born with the disease," she said.

The child, now 21, became a cross-countryrunner in high school andcontinued the sport in college and isabout to graduate from college andget married.

"She had excellent care from birth.The disease is well under control," explainedAdams. "She had meconiumilueus and had a portion of her bowelremoved when she was 3 days old. It's adifficult disease forthe whole family."

Donelson, knownas "Grandma Bev" to CF patients onthe Internet and allover the world, hasworked at HHCSHealth Group for 24years. She is on thelistserves of the CFpopulation, and patients often askher for advice on issues other thanmedical questions, says Adams.

Today, the CF pharmacy sendsmedicine all over the world. "We cancompound products and make itmore economical for patients," saidAdams. "And it all started with thisyoung lady. One of the insurancecompanies would not provide herwith a medicine (a vitamin E formulation)because of cost. I went to themanufacturer and asked them toreduce the cost and they refused. Ireformulated it for her and gave theformula to Duke University," becauseshe attended Duke and went to theDuke Clinic, Adams explained.

Other pharmaceutical manufacturerswere more generous. "When wefirst started the CF pharmacy, we gotfree medications from pharmaceuticalmanufacturers for those withoutmoney to pay," said Adams.

When she decided to change thestructure of the pharmacy's business,Adams got a revised pharmacy permitfrom the Florida Board of Pharmacyfor her operation. In addition to beingan infusion special permit pharmacy,HHCS also converted to a communityspecial permit pharmacy. "The permitenabled the pharmacy, which has 2000to 3000 patients from all over thecountry, to send medications such ascapsules and noninfusion medicationsto patients," she said.

Patients learn about the pharmacyfrom physicians, other patients, on theInternet, from CF organizations,health fairs and education days, andmedia advertising, says Adams. HHCSHealth Group is the umbrella namefor the corporations, with several otherwholly owned corporations as offshoots.These include the CysticFibrosis Pharmacy; Freedom Pharmacyand Wellness Centers; a DiabetesShoppe; a Center for Memory Disorders;the HHCS Research Institute;Freedom Specialty Division for specialtydrugs; International PharmacyCorp; HHCS Inc, a wholesale company;and Medipaws, a pet pharmacy.

Adams also has Florida AmbulatoryInfusions Centers where patients cancome to be infused if they do not wantto go to a hospital, and the centers havedisease management for other respiratorydiseases, women's health,autoimmune diseases, and oncology.Adams, a pharmacist for over 40years, set up the Center for MemoryInc, a 501(C)(3) not-for-profit corporationwhich is located in the samefacility as the pharmacies. It wasestablished as a legacy to her motherafter her mother's death fromAlzheimer's disease. Her mother, age92 when she died, "had the finestcare," said Adams. "She outlived it[the disease]."

The Center for Memory Disordersconducts clinical trials and evaluates,diagnoses, and treats patients withmemory loss, with a staff thatincludes primary care physicians, aneurologist, a psychiatrist, a clinicalneuropsychologist, a clinical coordinator,a social worker, and pharmacistAdams.

In addition to her busy schedule atHHCS Health Group, Adams mentorsstudents from the University ofFlorida School of Pharmacy inGainesville, which has a branch inOrlando, and the High Tech Institute.

Located just blocks away from thepharmacy, the High Tech Instituteprepares students to enter the alliedhealth professions. "Students comeinto the store and we show themwhat a pharmacy is and what a pharmacistdoes," said Adams.

She also conducts clinical trials forpharmaceutical manufacturers at theresearch institute. "We had a lot ofpatients with HIV disease in Orlando,Tampa, and Miami," and the clinicaltrials focused on drugs for treatingHIV/AIDS. "We are getting readyto do [clinical trials] for memory disorders," she said.

Asked what advice she would give topharmacy students who are close tograduation, she said, "keep youroptions open, and think outside thebox. Many options are open." Pharmacists"need to be well rounded andunderstand that pharmacy can be avery rewarding field." She added,"there is more for you than a $100,000salary and an expensive car."

Pharmacists should consider gettingan MBA, she continued. "Thefield is changing all the time. Theyneed to understand reimbursement,money, and health care in general." Pharmacists have to become familiarwith the basics of both the Medicaidand the Medicare program, includingMedicare Part D, because "it's animportant part of ultimate successin the profession."

Students also should learnabout the legislative process, sheemphasized. "They must beproactive and work with legislators.They can't sit back and letthings happen." She urges pharmaciststo back candidates whowill help the profession andstresses the need to work withinpharmacy associations, as she haswith the Florida Pharmacy Association,the Florida IndependentPharmacy Network, National Associationof Compounding Pharmacists,and the American PharmacistsAssociation.

Community work also isimportant to Adams, as is the timeshe commits to the University ofCentral Florida, where she hasbeen inducted into the College ofBusiness Hall of Fame. She is therecipient of the Wyeth Bowl ofHygeia Award, the RQ RichardsPublic Relations Award from theFlorida Pharmacy Association,and the Elan Innovative PharmacyPractice Award.

"You must be involved. Thereare many opportunities in theprofession. If you have a passionfor something, it affects yourlife." She urges graduates "to carrythe banner. We're a very trustedprofession."

She has worked hard to getwhere she is. As a single mom, shewent to graduate school for herMBA, had 2 jobs, and raised 3 children.She has 2 sons?Dr. Bo Evanswho is a family practitioner andByron Evans who is a recruiter?anddaughter Marlo Moore who is a full-timemother.

Adams says firmly, "I love what wedo." In fact, she finds the field sorewarding that she has no intentionof giving it up. "I have been askedabout selling, but I don't want to. Ihave wonderful employees, and Idon't want to retire." Besides, sheasks, "If I retire, what would I do?"

Ms. Rosendahl is a freelance writer basedin Fort Lee, NJ.