MentorVIEW With Eleni Anagnostiadis,
Executive Director of the National Institute for Standards in Pharmacist Credentialing

Eleni Anagnostiadis is the Executive Director of the National Institute for Standards in Pharmacist Credentialing in Alexandria, Virginia. Prior to this position, she was Manager of Pharmacy Support Services for Giant Pharmacy in Maryland. She speaks candidly of her goal of achieving reimbursement to pharmacists for providing care to patients as well as of growing up in a family of hard-working Greek immigrants.

PNOW: The National Institute for Standards in Pharmacist Credentialing (NISPC) was founded in June 1998. Please tell us about the organization's priorities and objectives.

EA: NISPC was formed by the American Pharmaceutical Association, the National Association of Boards of Pharmacy, the National Association of Chain Drug Stores and the National Community Pharmacist Association. These associations came together to develop one nationally recognized disease state management credential for pharmacists. One of NISPC's priorities includes obtaining credentials for additional pharmacists. Currently we have over 1,200 pharmacists with credentials in four disease states - diabetes, dyslipidemia, asthma and anticoagulation. Some of our other priorities include promoting the new designation of certified disease manager (CDM) for pharmacists who successfully pass one of our exams. Credentialed pharmacists can use the CDM designation behind their name on business cards or for marketing purposes. We want to assist CDMs in getting included in pharmacy legislation both at the state and national levels, so that pharmacists can be reimbursed for services through Medicare and Medicaid programs. We would also like to assist CDMs in getting reimbursed for their disease management services by trying to inform, educate and increase the awareness of CDMs in the employer community and the insurance industry.

PNOW: What role do you play in the organization?

EA: I am responsible for marketing, communications, business development, and public relations and customer service. I also coordinate administration of the testing.

PNOW: What drew you to pharmacy as a career?

EA: As a high school student, I loved the sciences and anything that had to do with medicine. Therefore, entering college I planned to major in chemistry and perhaps go on to dental school. After my second year, I realized that I wanted to use my interest in the sciences within the health care profession. I pondered my role in a health care field where I could actually help people, utilize the knowledge and expertise I had gained and have a profession that would be conducive to the family life I once dreamed of having. I reached the point where I had completed all the prerequisites for a profession in the sciences. A decision had to be made for my chosen career. I talked to different healthcare professionals and reviewed the course book from the University of North Carolina.. Pharmacy seemed to have the qualities I was looking for. I thought it was a profession that had many different avenues in which I could go.

PNOW: How did you decide on community pharmacy in particular?

EA: It offered opportunities to deal with a variety of people. The most appealing characteristic was seeing and talking with patients when they came in to pick up their prescriptions. Here was the potential of answering health care related questions and having one-on-one contact with my patients.

PNOW: What would you say is most important to you as a professional?

EA: The thing I feel most strongly about as a professional is obtaining recognition for pharmacists as well as reimbursement for the patient care services they offer. Pharmacists are the only professionals of which I am aware of who do not get reimbursed for the services they provide. So many pharmacists provide patient care and offer their expertise on a regular basis that I feel that it is about time that pharmacists get compensated and recognized for their time. On a day-to-day basis, pharmacists catch drug interactions, may triage a patient, discuss their condition, answer their questions, and recommend products. Basically pharmacists are advocates for patients and professionals but yet do not get compensated for their time and services.

PNOW: What are some benefits, in your opinion, of pharmacist-directed care?

EA: There are many times when a doctor will write a prescription, but does not have time to explain what the prescription is for or what condition the patient has. Sometimes patients feel a lot more comfortable in a pharmacy setting verses in a room with a doctor in a white lab coat. Sometimes patients are afraid or intimidated to ask the physician questions and are a little more open to a pharmacist. In general, you can contact a pharmacist seven days a week whereas a physician may be available from 9 a.m. to 5 p.m. Monday through Friday. Therefore the patient may feel more comfortable in speaking with the pharmacist or asking questions. In addition, pharmacists are more likely to monitor compliance and explain in detail the use of inhalers, for example. Another benefit from pharmacist directed care is that the pharmacist can track multiple medications of a given patient who may see a variety of physicians.

PNOW: Does it present any challenges for a pharmacist?

EA: There are several challenges that come to mind. One is the shortage of pharmacists. Technology and utilizing additional technicians can help. Another challenge is altering physicians' perception of pharmacists. Most physicians see pharmacists as mere dispensers and when pharmacists become active in a patient's care, sometimes physicians feel threatened and might respond negatively. I have always found, however, that if you inform the physicians ahead of time of your goals for a mutual patient they have no problem with the pharmacist offering the patient care services. When I was at Giant and was working with our diabetes care center, when somebody enrolled in our program we actually wrote a letter to the physician. We stated what the goals and objectives of the program were and then we asked for his feedback. Every time we saw his or her patient, we would fax a summary of what went on during that consultation. The doctor would put that in the patient's folder and would cover the information with that patient the next time the patient was in. And of course, the lack of reimbursement to pharmacists for their time and services is yet another challenge. Although you may see a situation as a challenge, there are definitely ways to overcome it.

PNOW: You credit your ethnic background and culture with making you the person you are today. Can you tell us a bit about your fascinating family history?

EA: I was born to Greek immigrant parents. My father moved to the United States in 1957, when he was 27 years old. He came to this country for a better life. He started a restaurant business with his three brothers and subsequently went back to Greece and married my mother. My parents always spoke Greek in the home. Neither my sister nor I knew English until the age of 6 and I really appreciate being completely bilingual at this time. Once I started kindergarten my mother started going to a tutor to learn English so we were learning English at the same time! A lot of people who had come from Greece didn't take the time to learn the language the way my parents did. It meant a lot to me and showed me the importance of using the English language and adapting to this country.

PNOW: How did your family life influence you personally and professionally?

EA: The two people who influenced my life the most have been my parents. My parents instilled in me the importance of education, integrity, determination, and the work ethic. They also said you could be anything you want to be if you put your heart and mind to it. When my parents came to this country, neither of them had received a full education in Greece much less the advanced education we have here in the United States. When my father came to this country he only had $5 in his pocket. Through hard work and dedication and teamwork, he and his three brothers started a restaurant. The four of them went to a small bank in North Carolina and got a $5,000 loan on a handshake. They really had faith and felt like if they worked hard and were honest people they could overcome any obstacle. I admire him for what he has done for himself and for his family. I think the biggest benefit is not what we have materially but what my sister and I have learned from him: that you don't have to have money, you don't have to be educated; you just have to have the qualities of a good honest person to succeed.

PNOW: Did the restaurant play a big role in your family life?

EA: Yes, I think the restaurant played a major role in my family life. It is amazing to think that these four brothers, not knowing the language, not having an education, and with very little money overcame the obstacle of being immigrants and adapting to the American way of life. In fact, growing up, my cousins, my sister and I would take turns busing at the restaurant. I also remember when I was seven years old, helping in our catering business by setting tables at caterings for 2,000 to 3,000 people. It was truly a family run business.

PNOW: That is an inspiring and lovely story. Do you miss having that degree of interaction and cooperation with your family?

EA: Yes, I miss it but in addition to visiting regularly we stay in contact. More importantly, however, I now have a family of my own: my husband and two wonderful children. As a family, my husband and I try to instill in our children and our family life, the morals and ethics we learned. With them, I have the interaction and communication I had growing up in addition to loving support in all my endeavors. Our lives change as we grow and fortunately this has been real positive to me.

PNOW: You are 11 years into your career. What do you wish you would have known when you were first embarking on your career?

EA: Most importantly, I would have liked to have had a mentor. Having someone you trust, admire and respect with whom to discuss your profession I feel is extremely beneficial. Mentors can provide constructive criticism, positive reinforcement, and support to help you accomplish your goals. Some of my best mentors have entered my life in the last couple years. These are people who believe in me, have helped me get to where I am today, and still provide support and guidance.

PNOW: What other advice would you offer to young pharmacists?

EA: I would tell these young practitioners to get involved in a pharmacy association at the state or national level. I never realized how much we could give back to our community and to our profession by banning together with others. Sometimes you get wrapped up in going to work, filling prescriptions, taking care of customers and then going home. There really is a lot more to the profession. In these associations, you find a lot of people who have the same core beliefs and values as you do within the profession and want to do the same things for the profession. Multiple voices speak louder than a single voice.

Who do you most admire? Mother Teresa. She was one of the world's greatest humanitarians. Mother Teresa became a symbol of untiring commitment to the poor and suffering.
What is your favorite book? Charlotte's Web. E.B. White reminds us to open our eyes to the wonder and miracle often found in the simplest of things.
Favorite Quote? "Leaders aren't born, they are made. And they are made just like anything else, through hard work. And that's the price we'll have to pay to achieve that goal, or any goal." Vince Lombardi

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