Saving Lives: The Role of The Pharmacist in HIV

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About Dr Garrett

Dr. Anna Garrett has been a clinical pharmacist for over 20 years and has worked in a variety of practice settings. While traveling her career path, she discovered that working with women in midlife is her true passion.

She offers a variety of services including hormone balancing, weight loss and health coaching designed to help women in perimenopause and menopause escape from hormone hell and feel amazing in their bodies so they can rock their mojo through midlife and beyond. Dr. Anna is passionate not only about helping women get their hormones balanced but also about teaching women how to advocate for themselves in the healthcare system.

Dr. Anna received her Bachelor of Science and Doctor of Pharmacy degrees from UNC-Chapel Hill and is a Board Certified Pharmacotherapy Specialist. She is also a Certified Intrinsic Coach®, and has studied through the American Academy of Anti-Aging Medicine. Dr. Anna is the author of Perimenopause: The Savvy Sisters Guide to Hormone Harmony which was published in April of 2019.
Dr. Anna works with her clients virtually and locally. Please contact her at info@drannagarrett.com.

“BE THE CHANGE”

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Transcription

Michelle:
We’re so happy to have on the conscious pharmacists podcast, Dr. Anna Garrett from dr Anna garrett.com who’s a pharmacist who’s been practicing for many years, has changed the trajectory of her career and started dr Anna garrett.com. She’s written a book and I’m so happy to have you on our show today and thanks. Thanks for joining us.

Anna:
Well, thanks for having me. I’m really excited.

Michelle:
Oh, absolutely. So can you let our listeners know what your current field of practice is and how, how you ended up on dr Anna garrett.com from being a pharmacist in a hospital and several different avenues of pharmacy through your,

Anna:
Yeah, it has not been a linear path by anybody’s stretch of the imagination. So as you mentioned, I now have an online business. Dr Anna garrett.com. And I work with women on hormone balancing, especially from the lifestyle and supplement aspect. As a pharmacist, I can’t write prescriptions in this state unless I have a collaborative practice agreement, which I don’t currently have. So there’s so much that can be accomplished just by changing lifestyle and supplementing nutritionally. But to answer your question about how I got where I am pharmacy actually is my second career. I have an accounting degree that I’ve never used. And so I, I worked for Domino’s pizza and marketing and did all those sorts of things until I was 27. And then I decided to go to pharmacy school and completed a residency, did kind of a traditional path.

Anna:
My residency project was creating a clinical coordinator position in infectious diseases. And as you and I were talking about before we started the recording, we both share experience in the HIV world. Because that was one of the things that I did. I worked for industry for a very short time. And then when I was sort of trying to figure out what to do with my life after I left my industry job and met a physician when I was working at a small community hospital that asked me if I wanted to start clinical pharmacy services for their big outpatient physician group. And I was like, well of course, why would I not? And so he said, well, the first thing we want to do is start a Coumadin clinic. And I said, of course, why would I not having zero experience in a managed management of anticoagulation?

Anna:
So that was something that was sort of baptism by fire. But I grew that practice to let’s see, we had pharmacists in three cities and we ended up doing diabetes management. Poly-Pharmacy I had a nutritionist and then I moved to Asheville because that was the deal my husband and I had made when we got married cause he lived here. Then we decided that we would move back here when my daughter got out of high school. And so I was the manager of the disease management program at mission hospital, which is our local hospital here, as well as the COAG clinic and medication assistance. And so in order to help our care managers and disease management become more efficient and effective at working with the patients they serve, we decided to offer them a coaching program that they could take to learn how to work with people in basically 15 minute chunks of time.

Anna:
And so I said, well, you know, if I’m, if they’re going to learn that and I’m the manager, I probably need to know what they’re learning. And so most of them took level one, a couple took level two, but I decided to finish the entire certification. So that was where I got my coaching experience from. And I knew I wanted to have more freedom and flexibility in my life. And so at the end of 2011, I decided to leave my full time job and start my business. And my intention had been to just work with midlife women doing life coaching essentially. And I was like, lamb, I have this pharmacy degree, so it would be really dumb to give that up. And so a friend of mine has a compounding pharmacy in North Carolina and she said, come shadow me. I’m doing these hormone consultations. And I did. And so by the time I left there, I knew that that was the piece that I needed to add so that I could take my pharmacy experience, combine it with my coach training, and then create my business. So that’s the, that’s the short version of my career. And so I started in October of on my birthday in 2012 I started my business and I’ve never looked back. And it’s been great.

Michelle:
No, that’s, that’s amazing. It’s, it’s just so fulfilling and like enlightening and to show pharmacists out there how you can go from like traditional pharmacy, go to pharmacy school, become a traditional pharmacist, whether it’s in a chain or a hospital. And if you have vision for something, you can do anything. I mean, I find it to be extraordinary. And the path that you’ve traveled. Like you said, it’s not linear and tribulations all along the way. But to find one’s niche like, like you have is, is really quite extraordinary. And you know, to any pharmacist listening out there who are maybe still in pharmacy school like trying to navigate these like shark infested waters if you will, there’s always a way. And what you’ve done is like really extraordinary and found your niche with women because you know, sometimes I think women don’t know where to turn.

Michelle:
You know, people go down the traditional ma, I don’t know, I don’t want to really call it Western medicine path. But you know, as women start going into menopause, feel like they don’t really have much place to turn except go to the doctor, get on hormone therapy and the many other avenues that you can take with like what you do through supplementation, just coaching and trying to get people on like a holistic path to like wellness. So can you tell our listeners a little bit about like what you do? Like, how, if, if I, if, if I was a woman who, who found you on, on, on your website and said, you know, I feel like I’m going through menopause. I’m stressed. What’s going on in the world is, is so depressing. I have no energy. I have no strength. You know, I feel sick, I go to the doctor and they just tell me everything’s in my head. How do you, how do you approach a client like that? Cause it’s clients we see like all the time, right?

Anna:
Right. So what I do first is to have a consultation with them and make sure that I’m clear on the symptoms they’re having and what they have as goals for themselves. Because I may have a goal for them that doesn’t align with what they want, but that’s usually rare. And, and I just want to make sure that I’m a good fit for their situation. So after that we figure out the path. So since starting my business, in fact right now I’m currently enrolled in the school of applied functional medicine because I want to be able to help my clients in a deeper sort of way so the path can look like hormone testing and I use a, a drag urine test called the Dutch test for that. And then I also use the GI map test if there’s gut issues that I think might be going on because that’s very intricately related with hormone health as well as neurotransmitter health.

Anna:
I have a food sensitivity test that I use because that may be an aspect of, of the issues that are going on. And then I have a SpectraCell test which looks at micronutrients. And so we decide, you know, what is the past going to look like, what are the steps going to be? And then we start with some testing. And people can either just have me create a plan based on their test results or I also offer ongoing coaching to help them implement that plan if they need more accountability and support. So it really is customizable based on what that particular client’s needs are.

Michelle:
Oh, that’s fantastic. Because you know, each person, you know, maybe overall a lot of people have the same symptoms, but everybody has a different story. And I think we have to customize clients or patients care to them specifically and not just like a blanket thing like across the board.

Anna:
Well, and one of, one of the things I also do when I’m working with them is try to teach them how to advocate for themselves within the healthcare system because I’m obviously not going to be their primary care provider. And I want them to know the questions to ask and to have thought about what they’re willing to do as far as their hormone or any aspect of their health actually. What are they willing to commit to? Because the most frustrating thing would be for me to create some elegant management plan, but you know, they have no intention of giving up alcohol or making major dietary changes or things like that. So it’s important for everybody to be on the same page and for them to have a clear vision of what they want for themselves.

Michelle:
No, absolutely. And it is, it’s extraordinary how little changes in diet and maybe giving up alcohol, giving up, smoking, just simple things that people don’t even think about can really like not only change one’s life but actually saves somebody’s life. You know, I, I, I’ve seen that working with HIV patients, just little tiny tweaks that you can make in their diet exercise. And that’s kind of how I approach my HIV patients as well. The antiretrovirals are like, I call it the bullseye of everything. It’s right in the middle. Everything they do on the, on the, on, around it makes a difference if they don’t live well and do things like, you know, lifestyle changes, diet, exercise, things like that. The rest of it doesn’t really even matter. And I think it applies to everything. And I think that in the work that you do, a lot of times women w we’re the, we’re the people that do everything last. We take care of our families. We don’t take care of ourselves, we take care of everybody else first. So I think it’s just amazing that women have a place to go and someone who can help them where it’s all them.

Anna:
Well, and I think, you know, as you were talking about your HIV patients I had a client recently who is a nurse and we did the dried urine tests on her and saw that she had this massive cortisol spike at about eight o’clock at night. And of course she’s not sleeping well. And I said, what are you doing at eight o’clock at night? And she’s like, well, you know, I’m not really doing anything out of the ordinary. And then she texted me the next day and said, I figured it out. She was reviewing oncology patient cases at night as a side, as a sad job. And she would start doing that, you know, oncology, it’s not the kind of case review and you really want to be doing before bed. And so that was, that was the stress or that, that we identified, which is really, really interesting. And people think that when they’re doing things like that, it doesn’t matter because they can feel the stress in their head, but yet their bodies feel that stress. And it makes such a difference when you know when your head and your body aren’t on the same page, it’s a mess.

Michelle:
Oh my God, it’s extraordinary. I mean, when I do my living, well I’m talked for four patients. I have it like in six, six different sessions. And when I talk to them about thoughts and like the tiger chasing you, it’s always like, what do you do before you go to bed? Like what? I always tell them, first of all, don’t watch the news at night. Start there. That’ll kill you for sure. And you know, what are you watching? Like some violent movie or you know, having all the lights on in the house and being, yeah. You know, I think if we could go back to the way it was 10,000 years ago and when the sun went down, we all went to sleep, we’d all have much better like existences. And it’s funny because since we’ve all been on this lockdown, everything, the world seems much calmer and much slower on an energetic level.

Michelle:
I found, you know, it’s, it’s just really quite extraordinary. Okay. As long as you stay off of social media. Oh, you cannot, I mean, not Facebook or die. I mean, which place to end up. Totally. Totally. Got to go outside and listen to the birds for sure. So I see you’ve written, you’ve written your book, your, your perimenopause, the services described to hormone harmony. That’s, that’s like amazing to, to, to have published a book. And I’ve, I’ve bought the book, I’m waiting for it to arrive from Amazon. Yay. I can read it during my lockdown. So tell us a little bit about your book and tell people that they, you know, everybody thinks I want to write a book. Like what was writing a book? What was that whole experience like for you? Gosh

Anna:
Well I threatened to do it for three years so it can start there. And so when I wrote the book, I wrote it sort of in what to expect when you’re expecting format. Because you know, when, when those of us who have kids got pregnant, that was the first book you went and bought and you got to see kind of what went on through the whole sequence of pregnancy. And I was like, somebody needs to write that for peri-menopause because women have no idea what to expect and they get blindsided by perimenopause and they think that there’s something wrong with them or that they’re weird or they’re alone and they’re not. So I fortunately had a lot of blog content that I could use as sort of a starting place for the book. The smartest thing I did when I decided to write it was to hire an author coach to keep me accountable because she basically helped me outline it and then said, okay, I want you to give me a chapter every two weeks.

Anna:
So I did that and she was great and helped me navigate the whole editing process, the whole distribution process. And so it took me about a year from the time we did the outline to the time it was published. And you know, it, it was a real learning experience. People keep asking me what my next one’s going to be yelling. I’m like, I haven’t recovered from the first, so I’m not sure. But people do say they want to write books and there are a million different ways to do it. There are people out there that will help you write it in a weekend. I wanted something that was a little more solid than that. And so I went the self publishing route just because I don’t have the patience to try to shop it out to agents and this and that.

Anna:
So I just cell phone. But yeah, it’s been great. It’s it’s helped with getting, getting more clients. It has definitely been helpful for women in my group. I have a private Facebook group called the hormone harmony club, and there’s about 6,000 people in there right now. And so it’s been a real asset to people who are just starting to learn about peri-menopause. And my biggest challenge with this book is that I wrote it for a group of women who probably don’t know they need it. So women who were in their late thirties who are maybe starting to experience a little something that feels off but they don’t think about period menopause because they think I’m too young and their doctors say they’re too young, but they’re not. So anyway, that’s just me kind of going on and on about marketing. But I’m not, I mean more

Michelle:
To the pharmacists out there, when you are starting your own business and you’re going down this entrepreneurial Rose, you’ve left the jobs behind you and, or you want to leave the jobs behind you. Having a book is, it’s like, I think it’s the greatest marketing tool ever. I mean, I have my book saving lives the role of the pharmacist in HIV and it’s a great marketing tool. Not only is it extraordinary information for your patients or your readers or whoever your target is, but haven’t you found that when you are trying to get clients or you, you’re trying to work with other businesses and you just give them your book, it just, everything. I mean in today’s times I find that a book is better than any brochure or marketing piece you can have. It’s just like, here’s my book. Yes ma’am.

Anna:
It does lend a definite extra level of credibility.

Michelle:
And you, you brought up a good thing marketing, I mean to, to the pharmacists out there who are, you know, stuck in the rat, stuck in their jobs or people coming out of pharmacy school who have gone a traditional path, who are thinking of, you know, wanting to do something more or I don’t want to be stuck behind the counter forever. I mean, how, how do you, what tips would you give somebody who, who’s wanting to diversify or even on the side do some kind of gig, like start a website, start, you know, I’m doing consulting or tele-health or consultations. I mean in a marketing aspect, where do they even start? Cause I think some people just like, Oh my God, where do I begin?

Anna:
Well, I can tell you what I did. So when I started, I basically said my first client was my trainer and she had had a hysterectomy. He was having terrible trouble with hot flashes. And I said, look, if you buy the test kit, at that time I was using saliva testing. If you’ve added the test kit, I’ll do the interpretation and tell you what to do for free. I don’t encourage people to do things for free normally. But that was how I started. And then it was my best friend. And then once I got past those two, I started charging and I have ramped up the price as I’ve gone. And I would say, you know, pharmacists tend to get stuck in the perfectionist mode where everything just has to be just so, and everything, how all the pieces have to be in place before they’ll start.

Anna:
And sometimes you just have to start. So it’s important to figure out who you want to work with cause it’s not everybody. You can’t market to everybody and have message land clearly with the people that you actually do want to work with. And sometimes figuring out who you want to work with is a process. So I started out with women in midlife and women, midlife has now shrunk itself so that when I’m doing my marketing, I am marketing to women in peri-menopause because they are the easiest people for me to help with the bag of tools that I have. So as a pharmacist, if I can’t write prescriptions and women in menopause are probably likely to need a prescription for estrogen or testosterone, I certainly will work with women in many menopause, but I’m unlikely to be able to do as complete a job without having to interface with their physician as I can in perimenopause.

Anna:
So I’ve narrowed the field down. So when I narrowed the field down, that was when I decided to write the book. And so Monday, which is pretty squarely in perimenopause now. You know, pharmacists are like, I, you know, I don’t want to charge people money for what I know. Well, honestly, I was on a functional medicine panel. We did a webinar a couple months ago and there was a woman on there who, who has a compounding pharmacy and she has a weight loss program. And she said, I had to go to therapy before I was able to charge people money for my weight loss program. And you know, we get this program to us in school because it’s like, Oh, you know, we want to use our knowledge and give away your brain for free. And I’m like, no, no, no, no, no.

Anna:
We don’t need to be doing that. Doctors don’t give their brains away for free and they have student loans to pay. Physical therapists, you think about any other healthcare professional, they’re not, they’re not giving it away for free. So one of the things I’m doing now based on my experience with starting a business is on coaching pharmacists who were in startup to help them build their businesses to talk about the marketing and the setup and you know, that they want to do online. Do they want to do bricks and mortar or what? So that I can help people avoid making some of the mistakes I made.

Michelle:
Oh absolutely. And you know, and that’s, that’s like so helpful when people can come to you because you’ve already gone through all the trials and tribulations and the trauma and if they can follow the pathway that you set for them, then it does make it easier for them. And as a profession, we all, Oh, the worst pharmacists are never standing on the roof rooftop screaming like what extraordinary healthcare providers we are. And I think that’s what’s made it so difficult for us to get nationally recognized as the magnificent healthcare providers we are. I mean, as far as I’m concerned, pharmacists or the most important member of the healthcare team, when you think of all these drugs and the catastrophes that are occurring every minute of every day regarding meds, you’d be able to fix this in the pharmacist. And we just meekly sit back and let the whole healthcare system run over us.

Anna:
Well, and we have the knowledge. I mean, I can’t tell you how many people I’ve talked to who ask me, well, should I go get a master’s degree? I’m like, why do you need a master’s degree in nutrition? I mean, you can’t get pharmacy degree. Exactly. And it’s about acquiring letters and degrees before they’re, before they’ll step out and feel comfortable. Like, well, an additional degree doesn’t increase your comfort level. Actually practicing and starting increases your comfort level and your competency. So you know, sometimes I get a lot of pushback about that, but like you have the tools that you need, you don’t need a coaching certification. You talk to patients all day long. Yeah. I missed that.

Michelle:
How many patients lives did you change today? Just by consulting somebody in the OTC aisle.

Anna:
I mean if you start nowhere else, you can start with drug, nutrient depletions and doing consultations on that. So for instance, if, if you’ve got a patient that’s on birth control pills or hormone replacement, those both deplete B vitamins. So you can help people with that recommend B vitamins if they get put on that. So there’s a book called drug muggers by Susie Cohen. She’s a pharmacist. America’s most trusted pharmacist is how she brands herself. But anyway, she’s got a book called drug motors and it has all of the drug nutrient depletions that, that there are. And so that’s a really easy place to start if somebody’s looking for a little bit of a way to step out of the box.

Michelle:
And there’s always a way, you know, I think some people I know just personally, I mean, being a pharmacist, standing behind the counter, just doing traditional pharmacy was like so boring. I, you know, I thought I am just going to give up pharmacy and just, I can never do this again. And then I just started consulting and it’s like people thought I was insane. Yeah. And here we are like 25 years later. So no, there’s always a way. And you know, I feel so fortunate that you were able to be on the show because I think it gives like so much hope to a lot of people out there and a lot of our, our women pharmacy colleagues who sometimes are just like want to the and don’t know where to, where to turn on how to make their careers go the path they want or just how to, how did feel better and not go here.

Anna:
And working in retail right now just sounds like a special brand of mail. I mean, you throw in the pandemic on top of what was already going on and it’s just like, Oh my gosh, I can’t even imagine it. God bless those people.

Michelle:
They, they working so hard. And just, just as you mentioned earlier, all we want to do is try and take care of our patients. And they are under the harshest, most extreme circumstances with the Pentair make. And with the PBMs and you can just go off for hours in that direction. But no, there’s, there’s always, always away. And what, what can you tell the FA, the pharmacists out there who are on the front lines. We are frontline healthcare workers and who are just exhausted and worn out. And how do, how do we as pharmacists take care of ourselves so we can take care of our patients, put on our oxygen mask first before we helping anybody else?

Anna:
That is a really good question right now. You know, I would say be willing to ask for help. So that could mean you know, if your partner can your partner car help you carve out some time just for yourself. You know, it’s, it’s tough to enlist help from childcare workers and that kind of stuff right now just because of the pandemic. But you know, even if you can just find five or 10 minutes to do some sort of thing that centers you. So even breathing exercises are helpful. I, you know, it’s been so long since I’ve been in a retail pharmacy that was the one area where I very intentionally did not a good practice did some PRN work. But that’s, that’s pretty much it. So I don’t really understand the demands that are out there right now.

Anna:
You know, I think as a, as a profession, we’re going to have to figure out what our collective oxygen mask is and push back against what, what is going on, on the corporate level. And, you know, sometimes it feels to me like it’s going to take just a major disaster, you know, deaths for, for the message to get clear. But I know I’m rambling cause I don’t know what the answer is. That’s, let me just put it that way. You know, carving out as much time as you can for yourself, making sure that you’re eating well. So even if you’re taking food to work, to eat making sure it’s nutritionally danced, taking supplements if you need to do that to help support your nutrition

Michelle:
And your immune system. So, I mean, there are a lot of little things you can do. Sleeping, avoiding alcohol, all those things that we typically think of. But you know, what, if I knew what the answer was overall, I’d be very wealthy. Right. And, but you make like a great point is to take time out of your, out of your day for yourself. I know you know, I’ve been working here at home and doing all these tele-health consultations and working like, today’s probably will be probably the 38 today in a row, but you’ve got to take time out for yourself. I was on a call yesterday with a colleague and I was actually on my exercise bike and she said, what are you doing? You sound out of breath. I told him I met my therapist. Exactly. Exactly. So, you know, we’ve got to do those kinds of things and like you say, eat well, get sleep and just, you know, cut it off.

Michelle:
Just stand for two minutes and just take a breath. Literally just breathe. It’s really very helpful. So no, it’s fantastic. And I know by the time the show is published, you will have already had your resilience reboot webinar cause that’s tomorrow will that weapon or be recorded and available for people to either purchase it or attended. If they, if they want to. Anybody who’s listening today it will be recorded. And it’ll be sent out to people that register the day after the webinars. So this week, but that’s actually a really good point. I will do something to make it available on my website. Oh, that’ll be great. So for everybody out there listening, by the time that you hear this episode, the resilience reboot will have been the webinar will be over, but dr Anna will have it at some point on a website for you to register and maybe listen, listen to that.

Michelle:
And w we going to put all your links on the, on the show notes, a link to you and to your website. And if for any of our listeners who want to try to get ahold of you, what is the best way to get ahold of you? The best way is info@drannagarrett.com. That’s G, a, R R, E T, T, two R’s and two T’s. That’s the best way to to get me. Or you can go to my website and fill out the contact page and that’ll, that’ll get me to, so those are the best two ways. Oh that’s fantastic cause it could be a lot of pharmacists on here. I’ve been thinking of that going down this path and don’t know what to do. So dr Anna would be available to help you with coaching, help steer you in the right direction and help you, guide you on the path that you want to take. So and it’s been an absolute pleasure having you on the show and thank you so much for your time and thank you. And you know, I will share all your work on, on, on the show or on the show notes and thanks so much for being on the show. Well thank you so much for having me. It’s been great to actually meet you in person after knowing who you were for a good 20 years. So my pleasure to and to all the pharmacists out there, remember be the change.

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