The Future of Healthcare with Dr. April Segal of Remedy

More coverage of well-services. I would love to see more insurance companies offering options where people can choose more of the well-services that individuals might benefit from, such as gym memberships, supplements, and nutrition classes. If you are healthy, you typically cost the insurance company very little, I would love to see some of those funds […]

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More coverage of well-services. I would love to see more insurance companies offering options where people can choose more of the well-services that individuals might benefit from, such as gym memberships, supplements, and nutrition classes. If you are healthy, you typically cost the insurance company very little, I would love to see some of those funds being applied to reward people for staying healthy!

Asa part of my interview series with leaders in healthcare, I had the pleasure to interview Dr. April Segal, PharmD, BCPS, APh. April is a traditionally trained clinical pharmacist who is passionate about combining western medicine with more natural approaches, a self-proclaimed ‘Integrative Pharmacist’. She is passionate about community, health and environmental sustainability. She opened Remedy Holistic Pharmacy in order to empower her community with more choices leading to a better health and a healthier world.

Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?

Iwas inspired to become an integrative pharmacist after seeing the consequences of medication overuse. I always wanted a career that would enable me to help others and I loved that pharmacists were in a unique position to get to speak with so many people within a community. It was after practicing in a role where I was tasked with sorting out complicated medication regimens that it became clear to me that trying to fix chronic health conditions with medications alone often leads to further medication use and inadequate results. That is when my passion for integrating more natural approaches and specifically herbal medicine began.

Can you share the most interesting story that happened to you since you began leading your company?

Hmm well, we are still pretty new, but when we were first opening we got some interesting (and ironic) pushback about what bringing a pharmacy to the neighborhood would mean and if residents would be negatively affected. The main concern was regarding if we would be filling prescriptions for opioids. I found it ironic because a big part of what we are doing is helping people find more natural options, including for pain syndromes. I get where the concern came from and now that we have been open for a few months, I think people see Remedy as an asset to the neighborhood and I often get comments from locals that they are glad that we are here.

What makes your company stand out? Can you share a story?

When you walk into Remedy you can tell it isn’t like any other pharmacy you have been in. Most people that walk in off the street have no idea that we are a “real” pharmacy, meaning that we fill actual prescription medications. People are just so used to a pharmacy experience being a de-personalized nightmarish affair that they just try to get through as quickly as possible. What makes us unique is that we created a peaceful and uplifting space, it is modern-fresh mixed with a traditional apothecary, which matches our philosophy- integrating traditional herbal medicines with modern pharmaceuticals. The best of both worlds!

Can you share with our readers about the innovations that you are bringing to and/or see in the healthcare industry? How do you envision that this might disrupt the status quo? Which “pain point” is this trying to address?

People are making more intentional and educated choices on the way that they do everything. From the food that they put into their bodies to the brands that they purchase and support. We feel this should apply to the pharmacy space as well. If you had an option to go to a pharmacy that gave you more natural options, was incorporating more environmentally-friendly practices and was a bright and beautiful place, wouldn’t you prefer that? I am hoping that most people would and that slowly we will see more pharmacies like Remedy, and in turn, less overprescribing of medications, less plastic waste and more engaged communities. We describe Remedy as ‘A New Kind of Pharmacy’ but in a lot of ways we are bringing back the old school model of community pharmacies, like the traditional “Mom and Pop” drug store. Do you feel good about the pharmacy you use? Most people don’t. We are offering a pharmacy experience that you can feel good about in more ways than one, from biodegradable prescription vials, to herbalists and pharmacists that you know by name, the future of pharmacy is here!

What are your “5 Things I Wish Someone Told Me Before I Started” and why. (Please share a story or example for each.)

1. Don’t wait until it’s perfect. I am a bit of a perfectionist so I typically prefer to have all my ducks in a row before proceeding with anything. If you wait until things are exactly the way you want when you are running a small business, you might never start. I envisioned that we would have all of our services up and running on our opening day. If that was the case I STILL wouldn’t be open! We have had to phase in many of our services, including our compounding service and herbalist custom formulations. Things always take more time than you originally plan, and that is OKAY.

2. Networking is more important than ever. Networking makes great business sense as it helps with building connections that can be financially beneficial. It becomes very hard to get out of the store or to make it to networking events when you have so much on your plate but I always feel much more encouraged and energized after these events. They are not just beneficial for the business but on a personal level they provide emotional support, or should if you are networking with the right people, it is important to make time for it.

3. You can’t please everyone. Just don’t even try. Be courteous and grateful always, but don’t take everything to heart. There are so many people that will have suggestions and critiques (even back to back contradicting ones). Stay true to your mission and your passion and in the end, it will all work out the way it is supposed too.

4. Go with your gut. There can be so many decisions to make daily and so little time to make them. Don’t fall into an analysis paralysis trap, go with your gut. The extra cost or time that you might be second-guessing is often worth the extra investment if your gut is calling you to it.

5. It gets easier! I found the most stressful and challenging part of opening Remedy to be at the beginning when we were making big financial decisions but still didn’t have anything officially announced. It was like all the downside without any of the fun. I was worried that it was going to be harder once the doors opened but now, 3 months since opening our door, I find each week more enjoyable than the last. I wasn’t sure if it would take years to feel this way, but I am happy to say overall each day is already so enjoyable.

Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?

Quick Fix American Culture

In the US we want quick, easy fixes- NOW. Enter the popularity of taking a pill and expecting a short cut to health. Medications ARE great at making us feel better, at least in the moment or that day or even that year — but most of the time they do not address the root cause of why we started taking them in the first place. You can’t add in a daily pill for diabetes and think that means you don’t have to make 30 daily decisions about consuming healthier foods. I think other cultures understand what we still seem to struggle with, that there are no short cuts; not in life and not in health either. We are still learning that and I think it is becoming more evident that our health system is failing to improve the quality of life for many people. For the first time, we are also starting to see that not only are we not improving the quality of life, but we are also seeing a decline in life expectancy as well, and when you start to look at the causes of death in the US it is very telling, drug overdose and suicide are growing rapidly.

Payment models that de-value individuals

We have created a health system that is based on efficiency and value; which is good. The problem is that we have focused on the value and efficiency primarily from the perspective of the insurance company and lost the ability to add value directly for individual patients. If you happen to be an average person with a textbook case of illness for an acute health issue, then, for the most part, our health-system can provide you with the care you need. The problem is when you don’t fit into that box. Insurance companies allow providers only minutes to address health concerns, the only thing there is time to do is match symptoms with algorithms, algorithms with diagnosis, and diagnosis with medications. For acute conditions, this generally works out okay, but we (health-care providers) tend to miss the larger picture of how constellations of symptoms might be related in this model. The real tragedy is that many times there isn’t reimbursement for the time needed to go over education and treatment plans that are more involved than taking a daily pill.

Vertical Integration and Healthcare Monopolies

There has been a disturbing elimination of checks and balances with the vertical integration of health-care systems. When large national insurance companies are allowed to also own pharmacy benefit managers (PBMs) and retail pharmacy networks they have a huge amount of power. It does not create an environment that is beneficial for anyone except for those at the top of that monopoly. If we don’t have an open-market economy, we aren’t protected from predatory practices. First, pharmacies and doctors will feel it, and they will have to make tough decisions (this is already occurring). Next, the average consumer will feel it, most likely in the form of reduced access. Do you want broader coverage of medications? Do you want to use the pharmacy of your choice? Do you want more time with your doctor? Do you want the treatment that your doctor suggests for you or do you want the treatment that your insurance tells your doctor to use? For-profit private healthcare giants like the new Aetna-Caremark-CVS merger, in my opinion, have too much power and I am concerned about what the consequences will be.

You are a “healthcare insider”. Can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.

1. More coverage of well-services. I would love to see more insurance companies offering options where people can choose more of the well-services that individuals might benefit from, such as gym memberships, supplements, and nutrition classes. If you are healthy, you typically cost the insurance company very little, I would love to see some of those funds being applied to reward people for staying healthy!

2. Broadening access to other health-care professionals- There is only so much benefit someone can get out of a 20-minute visit with their physician. When you look at the prevalence of chronic conditions and how much of chronic disease is healed with hard daily lifestyle changes, you start to realize 20-minute appointments once a month are inadequate. There are so many amazing professionals out there that can provide more ongoing support and different skill sets. I would love to see a model that supported more ongoing care that incorporated health coaches, dieticians, acupuncturists just to name a few!

3. Making healthcare more local- when healthcare is local it is better for the individual and the community. Individuals are more likely to be engaged and in control of their health and well-being, and feel better cared for. Individuals in different areas have different needs and different values. I think making healthcare more local and the creation of ‘Health Neighborhoods’ makes health more enjoyable for all involved, it builds community which can have long-term benefits in many ways.

4. More focus on social determinants of health and coverage of services that address these needs. You can’t focus on getting healthier if you aren’t having your basic needs met first. Social determinants of health have been ignored for a long time and I love that new models are being created that include these considerations, such as safe housing, social support, educational opportunities. We must aim to keep not only the body healthy but also the soul.

5. Decrease vertical integration and healthcare monopolies. To my previous point, I am very nervous about the long-term impacts that large mergers in the healthcare arena will cause. I hope that we do not see a continuation of this trend.

Thank you! It’s great to suggest changes, but what specific steps would need to be taken to implement your ideas? What can individuals, corporations, communities and leaders do to help?

I think the best thing we can do as individuals is to educate ourselves on the financial inner workings of the healthcare system. Yes, it is confusing…. and some would say that is intentionally this way, but if you can invest the time to understanding it, you can start making more informed choices that reflect your values. I am shocked by how many patients I encounter daily that might not even know what a copay or deductible is. It is obvious that healthcare is political, complex and affects everyone. Don’t wait until you have a catastrophic medical event to educate yourself. Inform yourself now so that you can spend your healthcare dollars in a way that makes sense for you and vote for people that have a better plan for the future.

What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?

I wish I had more time for this! Unconventional Medicine by Chris Kresser, Natural MD Radio by Aviva Romm and The Body Keeps the Score have been recent favorites. I love reading things where I can learn a different perspective on health treatments that what I may have learned in my traditional training as a pharmacist.

How can our readers follow you on social media?

Readers can follow Remedy Holistic Pharmacy on Facebook @remedyrxsd and Instagram @remedy.rx

Thank you so much for these insights! This was so inspiring!

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