PLEI Perspectives: Why Pharmacists Should Embrace Holistic Health

My heart was filled with mixed emotions as I left the American Pharmacists Association (APhA) Annual Meeting & Exposition in Baltimore, Maryland, earlier this year. As a clinician—scientist throughout my career, the many sessions on integrating science into practice made my heart soar. To hear firsthand about the progress being made by so many passionate women and men across the country was energizing.

I felt a bit like a proud parent, lovingly watching my “baby” grow into an adult, while at the same time shaking my head over what it continues to do in suboptimal ways. There were 2 presentations—1 very public and 1 rather hidden—that demonstrated how wonderfully futuristic the profession is becoming. What was not presented, however, suggests that we have a much longer growth phase ahead of us.

The healing power of touch and relaxation

The general session attendees were “edutained” by Dr. Abraham Verghese’s presentation, “The Healing Power of Touch: The Embodiment of Health Care.” This keynote was as uplifting as it was saddening, as lulling as it was energizing. Similar to his other talks, Dr. Verghese’s mesmerizing voice wove together numerous historical and personal stories that clearly illustrate how our health care system has deviated from the personal and healing touch on which all medical professions were founded into our current reality of big data, an unhealthy dependency on technology, and a system that commoditizes livelihood and well-being. His challenge to us, both individually and as a profession, was to take our learning into our own hands—literally—by going out into the world and healing with our hands as much as with our minds. To have this as one of the keynote talks at APhA was hugely encouraging to me. Hopefully the tide of discussing this, as well as implementing it, is turning in the right direction.

Complementing the presentation by Dr. Verghese was a phenomenal but rather intimate poster presentation by Dr. Lisa Appeddu; Emma Leffler, PharmD candidate; and their colleagues from Southwestern Oklahoma State University College of Pharmacy.

Nestled among some other interesting posters, their studies on the acute impact of relaxation techniques on student psychological and physiologic health analyzed pretreatment to posttreatment measures (perceived stress, anxiety, and evaluation of techniques) between intervention (relaxation) and control (nonrelaxation) techniques. Although this was a preliminary study and the number of research participants was small, the results are interesting and the topic important.

The researchers found that body scanning, mindfulness, and power poses (à la Dr. Amy Cuddy) were beneficial even in subjects unfamiliar with the techniques. Thus, nearly no-cost treatments (ie, no need for special equipment or formal training) can reduce psychological symptoms of stress in pharmacy students. Why is this so important? Well, because studies show that stress is a major factor in pharmacist turnover and burnout. If students are able to develop stress-relieving habits early on, then the negative impact of stress not only on them but also on their patients will be diminished. Oh, and if students can learn how to handle stress, so can seasoned practitioners, right?

Holistic wellness counseling

Walking away from Dr. Verghese’s talk, I thought about my own professional experience that is rather nontraditional yet something I believe is the future of our profession: holistic wellness counseling. Holistic wellness counseling means embracing and providing the widest possible definition of medicine to our patients: Western/allopathic pills, creams, and more; Eastern/naturopathic preparations; mind—body practices such as yoga, meditation, and others; and nutrition counseling. Although it is a significant change from the profession’s current model, there is one more critical aspect: The driving force of holistic wellness counseling is on health maintenance versus treating pathologies.

In my mind, this last point is similar to the shift that took place in the field of psychology from treating pathologies to using positive psychology based on sound scientific foundations, rather than intuitive thinking that was often incorrect (thank you, Dr. Marty Seligman, for paving that road!). More than 4 years ago, my wife and I opened a business that combined yoga, meditation, positive psychology coaching, and what the profession would consider medication therapy management (MTM). However, our MTM is offered in a nontraditional way. It includes medication reviews with in-person interviews lasting a minimum of 60 minutes (but often going to 90 or more), followed by a week or more of research on my part, and then a second meeting during which we review patients’ current status and I provide immediate, intermediate, and long-term recommendations on how to build up their mental/physical practice (yoga and life coaching or some other appropriate combination) in hopes of diminishing their dependency on medication.

The results are incredibly successful for the customer and wildly satisfying for me. I feel our experiment/research is similar to that of Drs. Verghese and Appeddu and their colleagues and represents a small start to a massive change in the profession.

Over in Ohio, a “futuristic pharmacy” recently opened in a collaboration between Ritzman Pharmacy and the Northeast Ohio Medical University (NEOMED). In this model, patrons have access to a membership-based medical fitness facility, primary care services, physical therapy, and MTM—in other words, whole-person health.

There are a few other examples of pharmacy practices that have taken basal prescription (Rx and OTC) services well beyond the traditional boundaries of the past 50 or so years and into territories I believe a few brave souls have been exploring for years. Congratulations to Ritzman and NEOMED, as well as to the other visionaries of the profession.

What was not presented at the meeting, however, were a few proposed sessions around the broader theme of holistic health—the impact of stress and trauma on the profession, pharmacists, and patients. In addition, the meeting missed how certain business leaders are breaking down the metaphorical walls of the profession and building new practice settings, as well as breaking down the literal walls and taking the profession virtual. Perhaps this is just a matter of timing, and the historical fringe discussions and practices will be coming into the mainstream in the near future.

Why do I think this? To start, the incoming APhA President, Kelly Goode, spoke eloquently about the power of community, and President-Elect Nancy Alvarez is a seasoned leader—development specialist with a longstanding history of facilitating a whole-person approach that recognizes a person’s mind, heart, body, and spirit and how each plays an important role in leading within and beyond the profession.

Looking to the future

The next few years for the profession will be incredibly exciting ones and will usher us into a new phase of our evolution. How well prepared we will be to handle the newly granted authority and gravity of provider status, as well as the ever-increasing pressures and stresses, will depend on the discussions and practices we begin now. I’m fully confident I will be prepared because I’m espousing the belief that Peter Drucker so beautifully captured: “The best way to predict the future is to create it.” I’m doing my part. Are you doing yours?

Gary Keil, PhD, RPh, is a board member of the Pharmacy Leadership & Education Institute, national program co-director at Beautiful Mind Strong Body Center, LLC, and coowner of Evolutionary

Health.