Carl Maronich (Host): Welcome to the Kirby Connection Health Podcast, where we help to nourish your wellness journey with Kirby Medical Center. I'm Carl Maronich. And on this episode, we're going to be talking about how the pharmacy can enhance a patient's visit to the doctor. Kirby Medical Center Pharmacy Director, Dan Burkybile. Dan, welcome to the podcast.

Dan Burkybile, PharmD: Hey. Thanks, Carl.

Host: And let's just jump right in to that question and start the conversation there. How can the pharmacist's expertise really in medication management help the patient's experience with the doctor?

Dan Burkybile, PharmD: Well, like a number of ways, at Kirby, we can either be in the background or we can be in the foreground. So, we have a great relationship with our docs here. I have a great relationship with the other docs in the community that aren't Kirby docs. So, just that relationship allows me to make endways, whether it's a trend I'm seeing. I've got certain issues, if people are having trouble paying for things, I can let the doc know and we can get that adjusted. So, just having my pharmacist having those relationships with the community and with our physicians and providers, we can kind of go that extra mile that you won't necessarily see at other pharmacies.

Host: Yeah. And when we talk about the pharmacy in a hospital situation, there's really two elements, the hospital stay itself and the pharmacy related to that. Then, post discharge, if you will, when the patients are out of the hospital and having to deal with medications. Can you speak a little bit to those two elements of it and the role that you play in that?

Dan Burkybile, PharmD: So, Kirby's been great. When I came on, there wasn't much of a pharmacy presence. They were trying to get into it. So now, we have an inpatient pharmacist at least that works for me. So, she rounds with patients, she'll round with the doctor. So if the doctor's got issues, she's right there to provide that answer, to provide that support. So, we have that on the inpatient side, and she's seeing you as you are sick and trying to get better or recover. And then, on the outpatient side, we get it. We understand like you've had pneumonia, you're trying to recover, you've been through all the x-rays, you've been through all the machines, the last thing you want to do is continue to have medical care. You want to go home. So, my team, we've got years and years of experience, so we understand that. We want to get you in and out of the pharmacy, we want you to get the right drugs, the right dose, and all that. But we're going to make it as efficient as we can for you and have that continuum of care that maybe you don't see everywhere else. You know, we'll get you your drugs and get you home is the idea.

Host: Yeah. And then, as a post discharge, when folks are at home and they've got some scripts, they get them filled. There are aspects to that as well that I'm sure from an education standpoint, you help them with before they leave the hospital.

Dan Burkybile, PharmD: Yeah. So, we try to give them everything they need to be successful. But I mean, we get phone calls all the time like, "Hey, doc said this, but I'm looking at this." And just having our staff so familiar with the community, people will text me, people will text staff. It's just kind of how it is in a small community.

So, recently, I had, anecdotally, a mom that was concerned about a flight for a kid. And she's like, "I just don't want to give him this drug. He's not going to do well." And I walked her through it. I double checked the dose, and she texted me afterwards. She's like, "He was the life of the party on the plane." Like, he did perfectly fine. He is afraid of heights, but she's like, "That drug did the trick." So, sometimes we're just there for reassurance too. Like, the doctor's done everything right. We're just there to be that final "Yeah, it's going to be okay."

Host: That's got to be rewarding when you hear those stories coming back that your interaction really helped the family. Let's talk a little about education. Not only educating patients on their drug's interactions, those kind of things. But for you, you know, we hear all the time, there are new drugs coming out. There are different procedures and things. How are you able to keep up with all that you need to related to pharmacy updates and drug updates?

Dan Burkybile, PharmD: The beautiful thing about having a pharmacy job is you learn every day. You learn new things. So as things pop up, you got to do some research. Once again, I go back to my physicians, I've got good relationship with Dr. Huang and Dr. Mandhan. So, I can ask them questions like, "Hey, what trends are you seeing?" So, it's a handful of things. You use a handful of resources, but that's what Kirby's for, is we all help each other out. So, it's been great.

Host: Do you run into many misconceptions that patients may have about the drugs they're taking or things they may have heard? I mean, the internet, it's a blessing and a curse, right? There's a lot of information out there, but I'm sure folks come to you with something they may have found in some odd corner of the web. How do you navigate those issues?

Dan Burkybile, PharmD: So, the biggest ones are the vaccines is people have questions on. So, I'm giving them the information and kind of letting them decide I'm working with them. Just what do we need to do here? What's in your best interest? Once again, we'll pull the doctor in as needed. You know, when you have that relationship with patients, they're free to be honest with you and you're honest with them. And typically, you know, we can come to an agreement that works for everybody.

Host: We'll now detour a little bit and ask a little about your background. What brought you to the pharmacist world?

Dan Burkybile, PharmD: I originally wanted to be a veterinarian, and the job market wasn't very good at that time. My mom was a nurse. She pushed me into pharmacy, and it's a great career because I get to interact with people. And I'm the high school soccer coach. So, that's like another bonus, is the pharmacy careers let me do that too. So, just working with people has been right up my alley and I love that. So, it's been a great career for me.

Host: So, you have coaching in your background. How does that affect your ability there at the hospital to kind of work with your team there? I'm sure there's some overlap.

Dan Burkybile, PharmD: Yeah. You know, even when I interviewed for this job at Kirby, like I gave examples of lessons I've learned through coaching and you're trying to get your staff to do something that you want them to do, or your team, let's do this. And so, I've learned so much from coaching. My wife teases me, I'll go to the grocery store and she's like, "You know everybody" because you've either coached them or you've worked with them, you know, in the pharmacy. Once again, it's the people connections and being able to just use that for a win-win for everybody.

Host: Sure. Well, that's great for local healthcare to have that knowledge of the community and have that trust of the community, which is what it really comes down to. We don't do a podcast around healthcare when we don't talk about prevention. Even with the pharmacist and the work that you do, I'm sure prevention plays a big part. You talked to patients about that there are medications that I'm sure can be used to help prevent certain things. How does that affect your world? Or what's the role that you play in prevention for patients?

Dan Burkybile, PharmD: Kirby's always been kind of at the forefront of this, of like how do we get our patients well? How do we keep them out of the hospital? So, we have the CrossFit gym and you interviewed Jordan Barney. So, I try to do that and set an example, but also with my soccer kids, like I try to run with them. I try to condition with them. One, you try to set the example, but two, it's working with people. You know, the weight loss drugs are the big thing right now. We've had just lots of success with it. People are losing a lot of weight. My concern is, is are they getting enough protein? Are they getting enough vitamins? So, that's just stuff, if you're going to go that route, it's been great, but there's just things we've got to counteract or counterbalance just to make that the most efficient use possible of going that route, which has been great for a lot of people.

Host: If a patient does have an issue, what do you advise is the best thing to do, reach out to your team directly? Go to their primary care provider? How do they navigate that if they're having an issue?

Dan Burkybile, PharmD: Historically, it's easier to call your pharmacist and get your pharmacist on the phone than it is your doctor. So, that's the route a lot of patients go. Whether that's right or wrong, that's how it is. So, I've always been glad to field those calls and do what I can to help, but there does come a point where it's like, "Okay, we need to get your doctor involved." we're always welcoming for questions, but that's just how the healthcare systems worked out. And, you know, when people catch on like, "Hey, these pharmacists kind of know what they're doing. They become their best friends." So, you know, when you don't have a hospital system with a good pharmacy staff, you kind of see it. And so, that's what we're trying to bring to Kirby, is that extra layer of knowledge and service.

Host: Now, you mentioned it before, so I'll back up a little bit to vaccines, as the school year starts if you have questions that come to you from a parent about vaccines. What advice do you give related to that in kids?

Dan Burkybile, PharmD: So, I'm going to look in their database and kind of see what they've gotten. Of course, the flu shots are coming up September, October. The latest COVID is kind of awaiting FDA release, but I expect those soon. So, Kirby, we'll do flu clinics. We'll go into the schools and provide those for the teachers. They'll bring my pharmacy staff along with them. So, we're able to kind of add that extra layer of service to service the community for these vaccines.

Host: Great outreach to the community and provide that support. Well, Dan, we've covered a lot of different things. Any other aspect you want to make sure patients know related to how the pharmacist can help their physician experience?

Dan Burkybile, PharmD: It's interesting to me. The pharmacy world is ever-evolving. We used to have 24 hour pharmacies all over the place. You don't see that anymore. Pharmacies are having a tough time with reimbursement. Some of the PBMs are kind of pinching pharmacies, so that's sad to see. But what Kirby's done is when we have a quick care open, we're going to have a pharmacy open. So, we are doing our best to service every hospital service that we have. I'm thankful for that. And I think Kirby's doing a great job in that realm.

Host: Stan Burkybile, Director of Pharmacy at Kirby Medical Center. Also, Coach Burkybile, the soccer season's coming up, Coach. Any predictions for us? How's the team going to do this year?

Dan Burkybile, PharmD: We're strong sophomore, junior, so we kind of got this strong middle class as far as numbers go. So, you know, we always compete for the top of the conference. So, that's my hope this year. But we've got a great stadium. We got turf and we got lights and we got music. And so, we're a little spoiled here, but we definitely have pride in our soccer program. So yeah, we look forward to fun year.

Host: It is going to be a great experience if folks come out to a soccer game, it sounds like.

Dan Burkybile, PharmD: Absolutely. And we got concessions this year, so we'll have out hot dogs and popcorn and all that good stuff.

Host: And at halftime, you'll answer any drug related question they have, right?

Dan Burkybile, PharmD: Well, maybe, yeah. I try.

Host: All right. Dan Burkybile, Director of Pharmacy Kirby Medical Center. Thanks so much for joining us. And for more information, go to kirbyrx.org. And if you enjoyed this podcast, please share it on your social channels and check out the entire podcast library of topics that you may find of interest. This is Kirby Connections Health Podcast. Thanks for listening.