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MentorView with Deborah Milito

"You need to constantly challenge yourself. You will end up being a better person and professional 
if you do."

Deborah Milito is the director of clinical and operational services for the Department of Pharmaceutical Care at Monsour Medical Center.

PNOW: Can you tell us a little bit about what you do at Monsour Medical Center?

DM: I have very busy days here. I am, of course, the clinical pharmacist who takes care of all issues on the floor, such as Vancomycin consults, all drug usage evaluation, adverse drug reporting, and also, our very active IV to PO switch program. I am also a smoking cessation specialist as well as an anticoagulation specialist. I am on many different committees such as discharge planning and the geropsychiatric treatment team. In addition, I am the coordinator of all the grand rounds that we have most Thursdays at noon.

Do you have a lot of direct patient care?

Yes, I do. We do a lot of patient teaching with Coumadin, estrogen therapy and things like that. We personally go and talk to the patients. I am also a preceptor for three different universities so my PharmD students get a lot of practice doing that as well.

Do you have any advice for ways to improve communication with patients?

You have to be approachable. I think it is inherent to the pharmacy profession that we are like that. I always remind my students that they have to be relaxed and open and able to answer the questions. If you don’t know the answer, you need to know it is OK to say you do not know but will find the answer and get back to the person.

Have you been at Monsour for your entire 23-year career?

For the first year out, I was at a retail community pharmacy in the city.

Your family background is very interesting. Can you tell us a little bit about that?

I have an identical twin sister who is also a Pharm.D. She used to be the director at Monsour, but had a baby five years ago. I have two boys and we live a door apart from her. She works as a part-time pharmacist here at the pharmacy so I see her at work and then we get to see each other at home, too! (She also has a set of 16 year old twin boys; it’s a myth if you think it skips a generation!)

Have you always done things together?

Actually, when we were getting ready to go to college, we thought it was time to be apart because we had been together so much. We did not tell each other where we were applying or where we got accepted and we both got accepted at Duquesne University in the pharmacy school! We thought, why fight it; it was meant to be.

You are a single parent. Do you have any tips for other single parents?

The one way I have succeeded is that when I am at home, I am at home. When I am at work, I am at work. I try to keep the two separate. That is not to say that sometimes there is not some overlap with phone calls to check on where my children are, especially in the summer time, when they are off of school and at home, but I really try to keep them separate. If at the end of my day I can say that I learned something or that I helped somebody and my kids have a smile on their face, then all is good. Also, I have a support system in place with the children’s father, relatives and friends.

What advice would you give to the young pharmacist who is first entering the profession today?

I would advise them to be flexible and to understand that everything is not cut right down the middle. I know as a student you want to say, "this is the way it is supposed to be," but it isn’t like that in real life. Also, you have to always have the desire to keep learning because the minute you think you know everything, you don’t.

Who has been the most influential person in your life?

That is a hard question. One person is my father. He has stood by me no matter what and always has the best advice -- sometimes not subtle, but sometimes very subtle. I have always respected him for that. He has always encouraged me to do what I thought was right and to not take no for an answer. The other person was the first pharmacist I worked for, Marc Goldberg. I worked at his pharmacy before I came to the hospital. I got some really good business instincts from him such as leaving your problems at the door, keeping a smile on your face and knowing that the customer is always right!

Is there anything you know now you wish you would have known when you first entered the profession?

I wish I knew how many people rely on your expertise. I never would have thought that. Because pharmacists are so approachable, everyone will ask your opinion about everything.

Professionally or personally?

Well, they really respect your opinion when they know that you are a pharmacist. People I run into at the supermarket, family members, people at a party, my CEO, you name it. It is incredible to me how many people appreciate the expertise that I have. I have always thought pharmacists have a very well rounded education, not just in the medication arena but also in a lot of different areas. I didn’t realize that when I entered the profession. We have been the most trusted professionals for many years.

What do you feel is the most important quality for success?

I think it is to not sit back and think you have learned everything you can possibly learn. You need to constantly challenge yourself. You will end up being a better person and professional if you do. You cannot rest on your laurels and think that this is where I am and this is where I am going to be. I just don’t see that as being successful.

How do you personally challenge yourself?

I am always asking the next question. I received some information back in January asking if I would like to be a faculty member for Allegheny County Community College. They needed someone to teach Pharmacy Law and Ethics. I didn’t feel I knew much about Pharmacy Law and Ethics, but I found it intriguing. So, I called. To make a long story short, I am now a professor for Pharmacy Law and Ethics, and other courses as well, at the Community College. I have also been asked to speak for different drug companies on a myriad of topics. It forces me to learn more about certain disease states that perhaps I didn’t know. I think you have to toot your own horn sometimes. Who else is going to do it? I think you have to grasp at opportunities and keep asking yourself, "what if I did this?"

What would you say has been the biggest challenge you have faced in your career and what did you do to get to the other side of it?

I used to be serious all the time, and then I let a new person into my life for the past three years. He has taught me to relax and enjoy life a little bit and to realize that everything gets done in its own time. I’ve learned that it is OK if I do not get everything done today. It will get done tomorrow. One of my sayings that I use a lot is that if it is not life or death, and I do deal with that in the hospital, then maybe it really doesn’t matter.

What has been the greatest joy you have experienced professionally?

Here at my hospital, I get such tremendous respect and support from the physicians. That has just been wonderful. I talk to my peers who say they cannot get over certain hurdles because the physicians want to continue doing whatever they do and do not let the pharmacist do it. The support that I have received, and I will say that it hasn’t happened over night, has been incredible. I have had to earn their respect, but once you have it, it is a great thing to have. From a professional standpoint, it has been wonderful for me.

What would you say has been the best advice you have ever received?

When I was trying to decide if I should go back to school to get my doctorate, my children were only 2 and 5 at the time and I really just could not make a decision if it was the right thing to be away from them. A very good friend really helped me out. She said, "Think about this, your children will see you working very hard for something and when you achieve it, that could be the best thing that they could ever get. Such a lesson learned: If you work hard you can get something you really want." That was the best advice I ever had: to go ahead and do it!

What final words of wisdom would you like to share?

You have to love what you do. I still can say that after 24 years, I actually look forward to coming to my job every day because I know that we are an acute care setting in a small community hospital and you never know what is going to happen the next day. You really have to enjoy what you do. If you don’t, then maybe you need to do something else. Don’t complain about it, just move on.

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