Please describe your clinical and administrative practice site and the position you hold. What about your job do you love the most?

I am a professor and head of the Department of Pharmacy Practice at the University of Connecticut School of Pharmacy, and my practice site is in the cardiac intensive care unit at Hartford Hospital in Hartford, Connecticut. Depending on the year, my responsibilities can vary greatly; about one-third of my time is devoted to administration of the Department of Pharmacy Practice, and another one-third of my time is split between teaching various courses, such as the cardiac module. I have some students for a few months out of the year in the cardiac ICU at Hartford Hospital. I meet with students at the end of the day to go over aspects of the core curriculum, patient cases, and presentations. I make sure they are ready for the next day to go on rounds and be good contributing members of the health care team. Since becoming department head, I no longer do direct rounding in the cardiac ICU; however, from time to time, I am asked by the pharmacist or cardiologist to go on the floor and see a specific patient with a specific need. The other one-third of my time is devoted to research and review articles. What I love about my job is that I have flexibility to do different things during different times of the year. It does not get repetitive and is always changing.

How did you earn the title of Department Head & Professor of Pharmacy Practice and why did you decide to go into academia? Please give an example of your research.

I love the ability in academia to take time out to think in greater depth about things that are unknown. You have time to think about the nature of information and can research what currently exists to answer the question of whether the evidence is good enough to make a recommendation or if there is something you can do to make it better. This is important for somebody to do, but it can’t be the typical clinical pharmacists because then they don’t have enough time to take care of their patients. I was given the opportunity to look more closely into some of these areas to package the information so that it can empower front-line clinicians to make more informed choices, better understand the choices they make, and even create new therapeutic alternatives. An example of the research I do involves clinical trials, meta-analyses, and systematic reviews. Sometimes I write narrative review articles on topics where I feel the literature needs to be bolstered. For example, I look at drugs for potential abuse and the adverse effects of those drugs. By studying the basic science, I try to determine the mechanisms by which the adverse effects occur.

You recently spoke at the ACCP Annual Meeting in the Cardiology PRN focus session. Please describe your experience and how your involvement in ACCP has supported your professional career growth.

ACCP is a wonderful pharmacy organization that has an intimate setting where the presenters and attendees have very close contact with each other. I engaged in a therapeutic debate of whether people who had drug-resistant arrhythmias should be treated with continued drug therapy or ablation therapy. My opponent and I made passionate cases for why one was better than the other, but in the debriefing, we took time to discuss that, in reality, patients are somewhere in between, and there will be other unaccounted variables, such as the location and funding of hospitals, the expertise of surgeons, and the technical infrastructure. I must thank both ACCP and ASHP for having major positive impacts on my career. Becoming ACCP Young Investigator of the Year helped me receive tenure at the University of Connecticut School of Pharmacy. I also received the ASHP Drug Therapy Research Award for my first project in cardiothoracic surgery, which helped me obtain further funding for research. I think other health professionals need to see pharmacists as not just consumers of new discoveries from physicians, but also creators of new information to help move the health care field forward, which goes hand in hand with the clinical practice strides we are starting to make.

Briefly explain the articles you’ve recently published. How did you encounter this topic and why do you believe it is a critical issue?

The articles I recently published discuss how generic drugs are not as safe as the FDA wants you to believe, in part because of NDMA contamination, data falsification from manufacturers, and pre-announced foreign inspections by the FDA. In 2010, I talked on the “Ask the Pharmacist” segment of NBC-30 and Fox61 about Ranbaxy Laboratories Ltd., which showed the lengths the company was going through to hide poor manufacturing quality. At first, I thought this was an isolated incident, but after looking into it, I discovered that companies were repeatedly not meeting FDA regulations and that the FDA was allowing the companies to do so. I was very shocked, and it ended up getting a high enough priority that I felt I had to get it out there so that health care providers could be aware of it. Given that 80% of all active ingredients are made overseas, this poor manufacturing quality and contamination is a national issue.

How do you believe this issue can be resolved? What changes must be made?

Ideally, I imagine that after the article comes out, there will be a greater awareness among health care providers. With that awareness, I hope that the organizations representing them, such as ACCP, APHA, and ASHP, among others, will try to convene a group among themselves with medical representatives to be part of a statement saying that they are very concerned about the lack of assurance that our prescription drugs are meeting FDA quality standards. I think if pharmacy and medical associations do that, it will put a lot of pressure on legislatures for grants for funding to make drug safety a priority and to close the vulnerability that we have by doing more unannounced inspections of foreign facilities.

What advice would you give to students who are pursuing careers in clinical pharmacy, research, or academia? Advice for those aspiring to be published?

Regardless of the practice site they go into, the first thing I tell all students is that you need to find something you are passionate about and in which you think you can make a difference that is also something other people care about. In a clinical setting, you need to include the patients in the health care team decision process. They are much more likely to adhere to a treatment if they help choose it. In academia, research, and aspirations for being published, you need to find an area and know everything there is to know about it. You don’t have time to become an expert in everything, but you should be an expert in something. The ability to be flexible is important to adapt to new research ideas and to differentiate yourself or else you will be outmoded. In addition, do not abandon clinical practice if you want to be a researcher because, very often, you will be faced with real patient dilemmas. Furthermore, you shouldn’t take on too many commitments because you feel obligated to; if you do, they will begin to feel like burdens instead of blessings. Instead, do what is most important to you and then steer the other opportunities to fellow colleagues who want to take them on.