Over the past five years, the pharmacy industry has sustained significant strain. We witnessed a mass exodus of pharmacists and technicians from retail pharmacy stores due to added pressure on an already worn-out workforce, including increased demands, budget cuts and unsafe working conditions that bred medication errors.1 Collided with plummeting stock prices and widespread store closures,2 the consequences of this environment have devastated the industry and its workforce and negatively impacted patients’ access to lifesaving medications nationwide.
The role of pharmacists is critical in helping patients take their medications safely, and although there is great adversity in the industry today, there continues to be tremendous opportunity, innovation and growth in other sectors of pharmacy.
Three female pharmacists who have followed unique career paths that help to drive innovation and change in the industry, beyond the retail pharmacy setting are highlighted below.
A Specialty Pharmacy Career Path Shaped by a PGY1, PGY2 Pharmacy Residency and Board Certification in Ambulatory Care
Maria Wuerch, PharmD, BCACP, a clinical specialty pharmacist at Clearway Health, says she fell into the specialty pharmacy realm by luck. In 2023, she and her husband moved to rural Wisconsin from Indianapolis, and she was fortunate enough to find a position as an ambulatory pharmacist.
“I love specialty pharmacy,” Wuerch said. “It’s the perfect place for an ambulatory care pharmacist.”
The goal of an ambulatory pharmacist is to help optimize care and be involved start to finish in the medication process.
“That’s very valuable in specialty pharmacy with high-risk, high-cost medications. There are a lot of places for possible intervention, from the very start with prior authorizations all the way to when I counsel a patient on how to give an injection for the first time,” Wuerch said.
Wuerch is an integrated member of the health care team at the five specialty clinics she supports at Aspirus Health in Wisconsin. She builds relationships with the providers and serves as a medication expert on anything from adverse effects and formulary coverage to strategies to optimize 340B medication savings for the hospital. She provides counseling to patients on their treatments, ensures their labs are up to date, checks for drug interactions, and ensures that every disease state is being treated appropriately.
“The initial counsel is when I have the most time with the patient. It’s always an exciting time for me,” she says. “The patient is a little nervous when they come in because they aren’t sure what to expect, but it’s great to talk to them, help them understand their diagnosis and walk them through what to expect from their medication.”
After graduation from pharmacy school, many pharmacists choose to practice in retail or outpatient pharmacy care. Other pharmacists choose a different direction which may require them to pursue a residency or additional certifications. Wuerch underwent a PGY1 pharmacy residency at Indiana University Health, a PGY2 pharmacy residency in ambulatory care at Community Health Network in Indianapolis, a fellowship in rural telemedicine, and became a board-certified ambulatory pharmacist.
Wuerch decided on the PGY1 residency because she was undecided whether she wanted to work in inpatient internal medicine or outpatient ambulatory care.
“The PGY1 residency training was hospital based and was at the very start of the pandemic. I think that was incredibly influential for me to start my career in such a unique position,” she says. “It’s taught me to be flexible and the importance of following guidelines in patient care. Specialty medication is one of the fastest growing areas in pharmacy, so you need to be up to date and flexible with the changes thrown your way.”
After completing her PGY1 residency, Wuerch pursued a PGY2 residency so she could specialize in ambulatory care. Her PGY2 residency shaped how she practiced, how she counseled and managed her appointments with patients, and gave her a better understanding of where patients are coming from so she can tailor her approach to their needs. Having this background enhanced her clinical understanding, identified areas for clinical growth, and taught her business fundamentals, like how to utilize data and metrics to navigate the business needs of health systems.
“Without my PGY2 residency, my current role would have been more difficult,” Wuerch said.
Wuerch’s additional pharmacy training has also allowed her an opportunity to pursue research. She recently presented a poster at the National Association of Specialty Pharmacy meeting and expo that tracked specialty pharmacy interventions.
In Wuerch’s intervention tracker, she traced the types of interventions she had with patients and the estimated cost avoidance. Some of the types of interventions she tracked included medication indication/dose appropriateness, adverse event management, pre-treatment health maintenance review and immunization recommendations. Maria found that for 232 patients, she had more than 450 interventions within a four-month timeframe, equaling over $1 million in cost savings and avoidance from just one clinical pharmacist.
For anyone interested in pursuing a similar career path in specialty pharmacy, Wuerch suggests being persistent and advocating for yourself.
“You are the person who knows what’s best for you. Being a younger practitioner, I faced barriers when I first started. There was pushback from doctors—they didn’t necessarily trust a young female pharmacist questioning their patient’s treatment plan. But, after a few months, these same doctors started saying to patients, ‘Just do whatever Maria says.’”
Utilizing Clinical Outpatient Pharmacy Experience to Build, Design and Optimize Specialty Pharmacies at Hospitals and Health Systems Across the Country
Loan Nguyen, PharmD, manager of pharmacy operations and accreditation at Clearway Health, was drawn to a career in specialty pharmacy after a family member had diabetes and died from the disease at a young age.
“There weren’t a lot of resources in place to support him,” Nguyen said. “He wasn’t adherent to his medication, diet, and exercise, which could have improved his outcome. There was a lack of education on how important medication and lifestyle are. This experience got me interested in how care could be improved. It motivated me to want to be more educated on medicine and find a way to make a positive impact on patients.”
Nguyen began her career at Boston Medical Center (BMC), assisting medical staff as an outpatient pharmacist and then as a specialty pharmacist. Years later, she joined Clearway Health where she is responsible for specialty pharmacy operations and accreditation, leading the building, optimization, and accreditation processes for Clearway Health’s clients nationwide.
“While working in the outpatient pharmacy, especially servicing the underserved patient population in the Boston communities that BMC serves, I saw huge barriers with medication access and personalized care,” Nguyen said. “Working in specialty pharmacy, I am able to eliminate some of these barriers and help them gain access to medications and improve their overall outcomes.”
Nguyen said her role is particularly important for health systems without their own pharmacies.
“There are many health systems that don’t have a pharmacy at all,” Nguyen said. “This is where I come into play. We partner with our health system clients to provide expertise to build and operate their own specialty pharmacy. I bring my clinical experience and operational expertise to ensure the new pharmacy has the correct infrastructure in place, meets the needs of the patient and the business requirements of the health system, all in a compliant way.”
“I also help our client sites become accredited for [the Utilization Review Accreditation Commission] and [the Accreditation Commission for Health Care]. Having these types of accreditations allows our hospital and health system partners to offer a higher standard of care. We work with them to address any operational gaps and ensure they are complying with all required policies and procedures,” Nguyen explained.
Nguyen’s clinical background allows her to envision optimally-built pharmacies, and her experience working in the day-to-day pharmacy has given her a greater understanding of the gaps.
For others looking to pursue a similar pathway, Nguyen recommends a career in specialty pharmacy operations and accreditation.
“There are more jobs in pharmacy than providing direct patient care, and other functions we can support and make a difference in while improving patient outcomes and care at a broader level,” she said. “Overall, the people I work with and the positive impact my work has on patient care is what I love most about this job.”
A Pharmacist with a Clinical and Operational Background Uses Her Experience to Become a Software Product Innovator
From an early age, Leandra Battisti, PharmD, senior director of product management at Clearway Health, displayed a strong affinity for chemistry and mathematics. Guided by her interests and the advice of a high school counselor, she pursued a career in pharmacy.
"I knew I wanted to work in health care, but I wasn’t certain which path to take. Pharmacy seemed like the right fit,” Battisti said.
After graduating from pharmacy school, she began her career in retail pharmacy, valuing the direct patient interaction.
"I enjoyed being the final touchpoint for patients, helping to ensure they understood their medications.”
Leandra then moved on to a position in a health system specialty pharmacy in an outpatient role. While in this position, she embraced an opportunity to help launch a hepatitis C virus (HCV) treatment program.
"I was the first clinical pharmacist managing the HCV program in primary care, and this was a turning point for me, I realized how much I enjoyed specialty pharmacy," she says.
Battisti's career then took her in a different direction than she originally envisioned. She joined Clearway Health where she could help to improve specialty pharmacy programs on a national scale, beginning first as a specialty pharmacy site director, then moving on to a role in the operations side of specialty pharmacy. Battisti finally transitioned into a product management role, where she is today—a position she says has proven to be another natural fit.
"Moving from operations into product management was a significant shift, but it allowed me to leverage my understanding of the clinical and operational sides of health care," she said. In her current role, she serves as the critical link between end users, clients and development teams.
"What I value most is the ability to translate user needs into solutions our developers can build, ensuring the best possible outcomes for both our employees and the patients they serve," she said.
Battisti’s background as a pharmacist has equipped her with a deep understanding of the challenges faced by health care professionals.
Leandra’s expertise extends beyond clinical insight; her experience has given her a comprehensive view of the reporting and analytics required to drive efficiency across the business. Her firsthand knowledge of the patient experience allows her to envision and develop features that improve both operational workflows and patient outcomes.
"The biggest challenge was stepping into a new space where I wasn’t the expert," Battisti said. "Moving from an area where I knew the answers to a field where I had to learn quickly was a daunting transition. But I’ve always believed that growth happens when you're outside of your comfort zone, and I pushed myself to make that leap."
Today, Battisti’s work in product development touches every facet of Clearway Health’s operations.
"Although I’m no longer on the clinical frontlines, I remain deeply connected to the teams that are. Being part of something so integral to how we operate as a business is both fulfilling and rewarding," she said.
Her journey from clinical pharmacist to senior director of product management has provided Battisti with a unique perspective on the business of pharmacy.
"Exposure to the business side of pharmacy offers insights you wouldn’t gain otherwise. It's a rewarding career path, and women, especially those with clinical backgrounds, bring an invaluable perspective when they transition into business roles," she says.
These three career paths exemplify the importance of the role of the pharmacist and showcase some of the ways this role can be stretched to make a significant difference in lives of patients. Although the retail pharmacy space is struggling from decades of stagnation, there is a glimmer of hope for radical positive change in this industry in the future. Pharmacists with career paths like Wuerch, Nguyen, and Battisti show us what can be possible.