Public Health Matters Video: Entrepreneurship, MedsPLUS Consulting, and Reaching Marginalized Communities

In this episode, host Dr. Christina Madison interviews Pauline K. Long, PharmD, DCES, pharmacist and co-owner of MedsPLUS Consulting in Birmingham, Alabama. They discuss Dr. Pauline's journey into entrepreneurship, her motivations for opening her own pharmacy, the impact of her consulting business on patient outcomes, and innovative approaches to community health and wellness services, including vaccination clinics and employee wellness programs.

Christina M. Madison, PharmD, FCCP, AAHIVP: Hello, everyone and welcome to another episode of Public Health Matters, part of Pharmacy Times Pharmacy Focus podcast series. I'm your host, Dr. Christina Madison, also known as the public health pharmacist.

We have another incredible guest with us here today, Dr. Pauline Long, who is a business owner, a woman of color, a force of nature, and [she is] doing some incredible work down south. I'm really excited to chat with her as someone who is as followed along the journey as another fellow women of color as well as a fellow pharmacist entrepreneur, I'm really excited to dive into some questions. So with that, Dr. Long, can you go ahead and introduce yourself and then we'll dive into some questions?

Pauline K. Long, PharmD, DCES: Yes, so hello, everybody. My name is Dr. Pauline Long, I am a pharmacy business owner in Birmingham, Alabama. I own an independent pharmacy, as well as a pharmacy consulting company. It's great to be here and I want to say thank you so much for the invitation, Dr. Madison. I along with thousands of other pharmacists have followed your journey, and it's an honor to be here with you today. Thank you very much.

Madison: Oh, my goodness, that was so sweet. Thank you so much, I really appreciate that. That's so kind of you. Again, when I'm looking and I'm going through and thinking about who to have on on the show, I think really the 2 biggest things that I look for are people that are making a meaningful impact in their community—and you definitely checked that box—and then also, I really like to amplify other women and then women business owners. So, thank you so much for that compliment. That's really kind of you.

So, tell me, because, obviously, entrepreneurship and owning your own pharmacy is definitely not for the faint of heart, can you give us a little bit of your background as far as what kind of motivated you to decide to open your own pharmacy, and is there anybody else in your family that is an entrepreneur? [Or] are you just this wonderful unicorn that has decided to go off on your own and blaze your own trail?

Long: Yeah, well, I'm definitely a unicorn. So my dad—an amazing man—actually is an entrepreneur in his own right, but not a legal entrepreneur. So I remember being in my early teens, my dad is a contractor, so all things contractor building things, painting repairs, he's done that my whole life. And so on the weekends, he will go out and do things like that, but he never had an LLC, he never had a formal business. But I learned a lot about business from him, even within that informal status. So, I'm definitely a unicorn in my family as far as being a full-time entrepreneur, you know, 10 toes completely in the pool of entrepreneurship, I'm a unicorn.

Madison: [I'm] totally gonna steal that from you, that is amazing...I love that, "full 10 toes." I will give you credit, Pauline, I will give you credit.

Long: But I mean, it's so funny...our business, MedsPLUS Consulting was actually founded in 2018, and prior to that, I worked for 1 of the big box chains for a total of 21 years, and just through that experience—I mean, most of the people listening to this will understand what's going on in big box chain pharmacy and can kind of understand what led me to kind of seek other opportunities.

But I went to pharmacy school, the number 1 reason people say [is] because [they] want to help people, but that is actually absolutely true. I wanted to be able to make an impact in people's lives and be able to help them change their lives, whether it's through coaching and education, or through medication, either 1. And so, when when things started changing in retail or community pharmacy, I started to get a little...my feathers were ruffled a little bit, I [was] just like, "I just don't feel like I'm making an impact." It started become monotonous, [as if] I could do this with my eyes closed. Every day—even though there were different people coming in and different situations—was seeming the same. And so, I started exploring other areas of pharmacy, other areas where I could use my degree, and I got on LinkedIn and that's how I connected with you...if anybody is struggling or feel stuck, connect with people on LinkedIn because you will be amazed at things that people are doing in pharmacy that has nothing to do with hospital, Walgreens, CVS, all the normal avenues.

So yeah, I got on LinkedIn, connected with y'all, and just my eyes were open, it was almost like bright lights [were] shining saying, "These are things you can do, there are things you can do with your degree, these are things you can do with your experiences, it does not have to be confined to this box in this store." So, we started MedsPLUS Consulting in 2018, with my partner, Dr. Jennifer Campbell, and our mission was just to find ways to partner with other health care providers so that we could improve patient outcomes. And so, we started looking for doctors to partner with, nurse practitioners, anybody who had a patient population that we could touch and offer things like medication management, diabetes education, diabetes prevention, those type of programs, because these are things that I learned through LinkedIn, through attending seminars and webinars, and things like that, and thankfully, we did find a provider who was kind of progressive-minded. She's a younger provider, so she didn't feel intimidated or like we were encroaching on her space, and the rest is history. We've been able to develop other partnerships from that particular partnership, and it's led us to where we are today, now 5 and a half years later.

Madison: That's incredible. I'm so glad that you listened to your heart, and you listened to your gut feeling that you weren't feeling fulfilled, and so you chose to look for other pathways. One of the things that I think is so great is that you have this consulting business, but then you also have the independent pharmacy, and there's so much that you can do [and] kind of cross-pollinate between the 2, because you have that access point for the medication—which is ultimately the thing that people are connected to us as a pharmacist for—but really what we bring to the table is our cognitive skills and our ability to really practice at the top of our license.

I'm curious, I know you also do these wellness services for businesses, [could you discuss] the genesis of [how] that got started, and now, [it's] more employee wellness, or if you want to talk a little bit through that because I think that that's really innovative. And 1 of the things that I often talk about when [discussing] public health, is a way to engage and actually think about employee retention by including those wellness type services.

Long: Yeah, and you're exactly right. Like I said, our business was founded in 2018, we were actually able to become full-time entrepreneurs in 2021, and what was going on at that point? COVID vaccines. I remember seeing you everywhere, talking about COVID and the vaccines, and I was like, "We have a pharmacist representing us!" So that's what happened...in early 2021, we had 1 toe in the pool. March, April 2021, we jumped in, put all 10 toes down, and that was the during [the administration of] COVID vaccines.

So, we received a phone call from a county official saying, "Hey, I know you're a pharmacist, I know you can immunize, we need help getting COVID vaccines into underserved communities. Can y'all help with that?" And we were like, "Absolutely." And so, I was ready to go—like, let me sign this resignation letter so that I can move on and do better things—my business partner was a little bit more apprehensive. She's like, "Ah, I just don't know." I said, "Jennifer, this is our chance. This is a could be a huge thing for us...Trust me, just trust me, this is what we need."

Thank God, she believed in us and she believed in the mission. And so, [in] 2021 we left and we started doing COVID vaccine clinics, all over the city of Birmingham and [in] Jefferson County—which is our greater area—and when I tell you from March 2021, probably until about April 2022, that's all we did. Anybody that called, we went [to] churches, community centers, senior centers...but 1 place that we did not expect was businesses. [The] businesses were like, "We want to vaccinate our employees." It was during the time where the mandate was kind of [up in the air], companies were like, "Should we do the mandate, should we not?" But a lot of employees were like, "You know what, this is convenient. I don't have to go out and wait in a pharmacy or my doctor's office."

So, we did several on-site vaccination clinics at large businesses in Birmingham and that's where the genesis of this employee wellness program came from, because we thought if we could collaborate more with these businesses and foster those partnerships that we had developed during [the] COVID [pandemic], we can now go back and say, in addition to COVID vaccines, we can offer all of the recommended vaccines on-site, as well as health screenings and consultations. And so, that's where the employee wellness problem came from.

Madison: Oh, wow, that's incredible. I always say the gifts of COVID. I think there's obviously a negative connotation when that happened, but I do think that there were some very positive things that came out of it, especially thrusting pharmacists, into this potential where we could utilize our skills, we can talk about testing, we can really provide access and equitable access to people in need. And I always say, it's all about the messenger, right? It's all about the person who's giving the messaging around health information and how important it is to have health care professionals that look and sound like the communities that they serve.

I don't know the statistic off the top of my head as far as the percentage of African Americans that live in your community, but I'm sure that they were so happy when they saw you and your partner rolling up. I mean, because I talk about it all the time. I do a ton of trainings—I actually just did a corporate training around vaccine competence—and that was 1 of the main things that I heard when I was doing these COVID clinics, was that we would go into these communities that were historically marginalized, and there would be no one that looked like them that was either providing the service, providing the vaccination, giving information, and it's like, we really need to create space for the ability to make sure that there are people there that have like-minded views, as well as [people who] have lived experience that can relate to the people that you're serving.

Long: Yeah, that's absolutely right. I mean, those shared lived experiences are so important, because—and this was probably [during] late 2022, early 2023—we had a project with the [Housing Authority of the Birmingham District], and we had a partnership where we they have 14 properties around the city—often known as the projects—but the Housing Authority members, the clients, would come into the clinics, and they would just have really sincere questions about this. You know [comments like], "I don't necessarily trust anything that's free...I'm afraid of vaccinating my children." And for me, Jennifer, and our team—which was primarily African American women—to be able to sit down with them across the table and say, "I understand your frustration, I understand your concern, but here is what the evidence says." It made a huge difference in whether or not they got vaccinated.

So we're hoping [that] because of these relationships that we built, now that we're going back out to the same communities, we're asking them about family history, because these are things that in a lot of these communities, it's not talked about. I mean, they know [that] "I see grandma giving herself insulin," but they don't know what that means, and that because grandma gives herself insulin, you're at risk for diabetes. So, it's just [about] taking those conversations and taking those relationships to the next level and hopefully improving public health, improving community health. And that's the phase of the business we're in now.

Madison: That's incredible. I'm curious, do you guys ever work with community health workers? Because I know that that's something that, for me, I'm like...telling all these people, you can contact your local health department and ask to see if you can have a community health worker come and be in your pharmacy to talk about Chronic Disease Prevention and Health Promotion (CDPHP). That's something that I often feel like is something that's missed by a lot of pharmacies—especially independent pharmacies—is having a collaborator. Every health department in the country has an office of CDPHP and they have resources dedicated to getting things out to the community, and what a better partner than pharmacy to get this information out. And so, I'm just curious [of] what you guys are doing with your community health workers, and sort of how you got queued into community health workers. Ws somebody who worked in the health department for 10 years, I knew about them, I think it's not something that's common knowledge, and so I'm hoping that the people who are listening are getting ideas for how they can maybe supplement workforce because we're all stretched so thin.

Long: Absolutely, absolutely. So, we were actually very fortunate. Early on during our jump into the entrepreneur world, we were introduced to 1 of our best partners now, this organization called Connection Hill—and it's actually a local organization here in Birmingham—but I'm sure organizations like it exists throughout the country. But [Connection Hill] is a nonprofit that actually recruits, trains, and deploys community health workers. And because of this partnership, at all of our clinics, we were able to have anywhere from 2 to 4 community health workers side-by-side with us in the communities, they had already been trained on vaccine hesitancy and the COVID pandemic in general, so we were able to walk side-by-side, 3, 4, sometimes we had 5 clinics a week. And you know, our pharmacists—along with Connection Health's community health workers—would go out into the communities and provide this service.

The partnership has been so great, now it's going on 3 years, that we actually are training our own community health workers. So, as of last week, MedsPLUS has hired 3 community health workers and we're going to be going into the communities of Birmingham, doing community-based diabetes education. So, we're very excited, they actually started training Tuesday, and they'll be training for several weeks, and then we'll give them diabetes-related training here at our pharmacy, and then we'll go on into the community starting in April doing-community based diabetes education. So, we are well aware of community health workers, we adore them, their strength as far as bringing peer support, because a lot of them come from the communities they serve, and then just their way to get down on the patient's level, they have the fundamental health knowledge that they need, but then they're able to speak with patients on their level, and serve as a peer support. And it's been invaluable to our business.

Madison: Oh, my goodness, that makes me so happy...and I swear, I didn't look anything up, I was, like, going with the flow. I honestly, I had no idea. But these are things that obviously I like to advocate for, and I like for people to be able to know more information about.

So, I'm curious, if you could wave a magic wand, what other services—as far as preventative care or public health-related services—do you think that you would want to offer in the future, or what things are you kind of looking towards as far as potential partnerships with [as an example], podiatry, or ophthalmology, or maybe even partnering with dermatology? Because these are all individuals that we kind of think about as maybe being specialists, but then when you think about diabetes care, a lot of the things that are considered "extra" or "elective", are really needed—like oral health, checking their eyes, checking their feet, all of those things. Are those things that you guys have considered looking into as far as strategic partnerships? It seems like you guys have a really great relationship with the physician and nurse community, and I'm hoping that that can be expanded.

Long: A large part of the diabetes self-management program…so we're accredited through [the Association of Diabetes Care and Specialists], and of course, they have a standard curriculum that you follow and a part of that is assessing the patient's [access to] specialty care. So, making sure that they've had a dilated eye exam, making sure that they've had a foot exam, all the other parameters, that's a part of the program. So, we'll be asking them—that's 1 of the things the community health workers will be doing, they have kind of a checklist to verify that all the patients have received the services. Now as far as us partnering with [them], that definitely may be another iteration of this, so that once they start our program, we'll have almost everything kind of in-house. So, if you have not had a dilated eye exam, we can make an appointment with, [as an example], UAB Callahan Eye Hospital, or something like that. I'd love to be able to do that just to close the gap, because 1 of the things we noticed—and we even knew this being behind the pharmacy counter—is that you can tell a patient [with diabetes] all day..."You need X, Y, and Z," but as soon as you hand it to them [as] their responsibility, it may or may not get done. And unfortunately, in marginalized communities, oftentimes it does not get done unless someone does it for them. So, I'd love to be able to just close those gaps, make sure we close that loop, and any patient that comes into our system gets everything they need from our system, I'd loved that.

Madison: Well, that sounds incredible. As far as your vaccination needs, right, so you [mentioned earlier], you started with COVID, you lead with COVID, but then you also have to talk about all these other required vaccinations. What is sort of the age range of the population that you're serving, and have you thought about looking into other programs like [Vaccinations for Children (VFC)] and [the 317 Program], and those kinds of things so that you can help with some of the programs that public health already offers that can supplement when maybe people don't have the means to be able to pay for some of these services?

Long: So, if I didn't know you, I would say you were psychic, because all these questions you're asking—from the community health workers to now VFC—because literally, we just had a conversation yesterday with the pediatrician who now works at 1 of the big research centers here in Birmingham.

And so, to answer your first question, our vaccine problem right now is primarily focused on adults, so people that come out to our community clinics, and I'd say about 60% of them are considered elderly, they're over the age of 60. So we go to the senior centers, we go to their exercise classes, and that's where we meet most of our patients. But we were actually speak with this pediatrician yesterday, just kind of letting her know what we do, and she was like, "Have you ever considered VFC?" And we said, "Absolutely." But 1 of their main requirements is that you have either a generator or a secondary place to store your vaccines in case of an emergency, and at this time, we don't have that, and that's what's hindered us from being in that program. And she was like, "Well, we have a generator, and we can store your vaccines. So that resolves that problem, when are you going to apply?" And we're like, "As soon as possible, because that's what we've been waiting on."

So, now that this will now be in progress, we will have the chance to serve children—underserved children, children on Medicaid—and get them up to date with their vaccines as well, which is amazing, because it's been hard to serve that population anyway. And if we can serve their grandparents and their parents, why can't we serve them? So I'm very excited, this literally just happened yesterday. We just got to get our application in and get that going.

Madison: Well, that's amazing. So 1 of the things that I did when I was at the health department was that we facilitated new applications for VFC and for 317, and so whenever I go to a new clinic facility, that's my number 1 thing, is getting them set up with those state programs because they are so beneficial and because it does make such a difference when you're caring for anyone who's 18 years [and] 364 days old, right? So, even though we consider an adult to be 18, vaccine system and when we get the vaccine paid for, it's up until your 19th birthday. So, there's that chunk of young adults—and especially when you think about things around sexual health and getting them up to date with HPV, hepatitis, Tdap, meningococcal, all of those [vaccinations]—it's great to be able to service that. And then also, if they're getting ready to go to college, you can do that whole assessment for them right there and then they don't have to pay these exorbitant price because they went to a minute clinic or urgent care, and now you've got access to vaccines that are really meant for them, and the whole reason why that program existed is because we want to get to herd immunity so that we avoid these outbreaks—which by the way, we're having a horrible measles outbreak right now in Florida...

Long: Shocker.

Madison: I'm gonna leave that be, I'm gonna leave that be. But again, I think it shows us that even a tiny difference in the percentage of coverage can make a huge impact when we think about outbreak management. I think they they said that the percentage of vaccinated children in that community was like 92%, and herd immunity is supposed to be 95%. That's only a 3% difference, but now we're seeing children who may have prolonged infections, God forbid they pass away, they could have developmental delays, they could lose their hearing, there's all these things that we're not familiar with because we haven't seen these diseases in so long.

And I always say, [when it comes to] public health, unfortunately, we're our own worst enemy, because when we do our job well, you don't know that we exist because we're behind the scenes [we're] not crisis management, like [we were] during the pandemic days. And so, I'm so grateful for the work that you're doing, and that you're really showing up in those communities and I'm excited to see where this goes. I'll say it now, if you ever need help, please let me know how I can support you and how I can amplify your message. You can see how my brain works, I'm not psychic, but these are the things that if I had a magic wand, every independent pharmacy would do and have, so you can see where my business planning would be. If you ever need help, please let me know.

As far as your leadership journey, because I do think that this is really a masterclass and on betting on yourself, and understanding that you may not have all the answers, but you saw an opportunity, and you really kind of went for it, and because of the need in your community, is there any advice that you would give to people that maybe only have 1 toe in the entrepreneur pool, or maybe that they're considering, leaving...corporate pharmacy, if they're considering thinking outside of the box [and] doing something different, what advice would you give, [if you knew then the things that you know now], what would you have changed?

Long: I mean, I'm a woman of faith, so God leads me and He guides me, He also encourages me because [when] you're an entrepreneur, you know that there are amazing days and there are days when you just want to lay in bed and cry. You have to be able to balance those and come to terms with both of those, and so, I will definitely say make sure that your mental health is in check, make sure that your spiritual health is in check, because this is just as much as a physical thing—I mean, I'm physically in here doing this work—as it is mental and spiritual. And so, all of those have to be in tip-top shape as much as [they] can be in order for this to be successful, because entrepreneurship can break people if you don't have yourself together. So, I would definitely advise people to make sure that you're able to get yourself together spiritually, emotionally, financially—if that's something you need to do.

But also make sure you have a tribe around you. I have an amazing family, I have an amazing church family that supports me, and helps lift me up and encourage me when things get kind of shaky. And so having a tribe and a family around you...I [also] have a business partner, so we're able to encourage each other. We have a colleague across town who has a similar practice and she's a solopreneur, and so, we've kind of locked arms with her—we don't consider each other competition even though we're doing the same thing in the same space, we're sisters—and we're like, "You're not going to do this by yourself." So, just having that that support is everything. Even when things aren't going well, you can have someone to lift you up and when things are going amazing, you have somebody to cheer you on. So that'd be my advice.

Madison: That's awesome. You know what they say, your network is your net worth, so you really need to make sure that you are surrounding yourself with like-minded folks and people that will speak your name in a room of opportunity when you're not there. That's a very, very, very big thing, especially for women of color, because oftentimes, we aren't able to get some of that like venture capital and getting some of that seed money to get started. I think [about] less than 1% of all VC funding goes to women of color. So yeah, if you're able to have people that will invest in you, invest their time, invest their faith in you, I would say go for it, and don't say some day, say today.

Long: And also, I just want to add, kudos to our city, the city of Birmingham. Look into your local municipalities, because there are...I mean, I know the city of Birmingham has an entire department dedicated to economic development, Small Business Administration, all of those organizations have programs, whether it's getting you capital ready...in the city of Birmingham, we actually received a grant called Bold, that's actually helping us do our community-based diabetes education, and who knew that the city of Birmingham will be interested in community-based diabetes education? They didn't know until we presented the proposal to them. So don't be afraid to think outside of the box, we've received grants from the state of Alabama to do work in diabetes prevention, so think outside of the box. It may not come from a venture capitalist or someone with huge amounts of capital, it may be your town, that's really suffering...We were in Chambers County [on] Monday, and they're having a big problem with cervical cancer, they're the number 1 county for cervical cancer death. [What if] there was a pharmacist that was right by the center where we were, [and] what if he did something surrounding cervical cancer, and he's able to get some funding from the county? It's things like that that I didn't consider before we started this journey. These are things that I've learned along the way.

Madison: Yeah, I would highly recommend reaching out to your Small Business Administration, you can go to something called Score, which offers free business training, think about joining your local chamber, your urban chamber, your City Chamber, your women's chamber—if you're a woman—and then the other thing, too, that I was going to mention, is that if you are a business owner and you're a woman or a woman of color, there's also certain RFPs and RFXs that you can apply for [where] you can get additional funding if you are a certified women-owned or minority-owned business. So I would highly recommend—if you aren't already certified women-owned or minority-owned business—to go through and do that.

And then make sure that you look into intellectual property law and [you're] doing those kinds of things so that you make sure that you protect your intellectual property. So those are my advices to people that are starting out. Because it's hard when you're establishing yourself in the beginning, but just keep on keeping on ..you never know where opportunity is, you never know who needs to hear what you have to say, you never know who's listening. I'm so glad that you brought those things up, because those are all things that I personally know, but it's nice to have someone else say that those are things that helped them personally.

Well, Pauline, this has been such a lovely conversation. Thank you so much for your time today. If people want to get in touch with you, follow you, ask for advice, where [and] what is the best way for them to reach out? I know you said LinkedIn, but I'd be happy to add any links, websites, social media handles in the show notes, but if you want to tell people how they can get in touch with you?

Long: Absolutely, absolutely. We're on all social channels, we're on Facebook, Instagram, TikTok, and LinkedIn, so the business is MedsPLUS Consulting. And my name is Pauline K. Long, so you'll find those on all the social media channels. And please reach out, I love to help any way I can.

And the number to our pharmacy is 205-650-4636, or you can email me at drpauline@medsplusconsulting.com.

Madison: Well, thank you so much again, and I look forward to seeing more exciting new things with your VFC program that you will ultimately get approved for—I'm gonna put that in the universe, I'm gonna manifest that for you—as well as your new community health worker training.

Long: Yes, thank you so much. We're so excited.

Madison: All right, well, again, my name is Dr. Christina Madison, also known as the public health pharmacist. And remember, public health matters.

Dr. Pauline K. Long can be found on LinkedIn.

To learn more about MedsPLUS Consulting, LLC, check out their website, call 205-650-4636, or reach out to Dr. Pauline via email at drpauline@medsplusconsulting.com. Check out MedsPLUS on their social media channels:

• Facebook: @Medsplus Consulting
• Instagram: @medsplus_consulting
• TikTok: @medsplus
• LinkedIn: MedsPLUS Consulting