Lisa Catall of Rite Aid sees room to help patients more through medication therapy management
When Bhavesh Dhabliwala walked into his neighborhood Rite Aid last November, he just wanted something for his gas pain. But if he hadn’t met pharmacist Lisa Catall, “What would’ve happened? Who knows? Maybe I wouldn’t be talking to you,” Dhabliwala says.
Dhabliwala expected the pharmacist to simply point him down the right aisle, but he didn’t know who he was dealing with.
“One thing I always do is come out from behind the counter, go out into the store with them, and ask questions,” Catall said.
That night in November, when Dhabliwala told Catall what he wanted, she immediately asked, “What makes you think you have gas?”
“Because when I burp, I feel better,” he told her frankly. But when he described his symptoms, Catall was concerned. A man in his 60s with pain in his chest and a strange sensation in his shoulder – Catall couldn’t just let him walk away. She asked him about his heart.
“I check my blood pressure, and it’s fine,” Dhabliwala said.
When Catall told the patient that even people with normal blood pressure could have heart trouble, he was alarmed. Handing him the product he had come in for, Catall said, “This should work if you have gas, but if not, promise me you’ll go to the doctor.”
A couple weeks later, after an abnormal stress test and a catheterization that revealed a blocked artery, Dhabliwala was having a stint placed.
A personal culture change
Catall, who is soft-spoken and describes herself as reserved, never would have imagined interacting with the public in the way she has with Dhabliwala and many others in the six years she’s been in retail – much less enjoying it so much.
“What I enjoy most is the patient service. It’s one of the more gratifying things that I do at my job.”
A hospital pharmacist for 25 years, Catall didn’t expect to particularly enjoy anything about a job in retail. During her 20 years at Atlanta’s West Paces Medical Center, Catall rose through the ranks to ultimately become director of pharmacy. When the hospital closed in 1999, she moved to the neonatal intensive care unit at Northside Hospital, also in Atlanta. The new job required Catall to leave at 5:30 every morning to make the 25-mile drive from Alpharetta, a suburb north of the city. Still, Catall found it fascinating to work in one of the largest NICUs in the country. She never planned to leave the hospital. But when she divorced and became a single mother in 2003, her early-morning commute meant her four kids would have to see themselves off to school every day without her.
“It was a big challenge to keep my family [in our house in Alpharetta] because everybody knew my kids on the street. I felt really fortunate that at least if I had to leave them, they could go knock on a friend’s door if they needed something,” Catall told Pharmacy Today.
Making a move
One day, Catall’s youngest son, Tony — nine years old at the time — missed the bus and had to ask a neighbor to drive him to school. Catall was crushed that she hadn’t been there for him. At the same time, a pharmacy student who had been doing rotations at Northside was set to start a job at Eckerd (now Rite Aid) upon completion of her degree. Seeing Catall long to be closer to her children, the student suggested that Catall look into Rite Aid as well.
“Even though I loved the hospital, it felt so much better to imagine being just a couple minutes from my kids versus down in Atlanta with [highway] 400 between us.”
So Catall took the job, but she took with her all the preconceived notions she had about retail – that the job was less clinical and the patients would be a hassle.
“And maybe it isn’t fun to work with some publics, but I happen to have a wonderful patient base. They all live right around here. I see them in the grocery store, and at the mall, and it feels like we’re friends.”
Friends in the community
Catall does her part to make work fun.
“I’m the pharmacist that wears ankle weights and wrist weights every day at work. When my daughters tell their friends’ parents where I work, they ask, ‘Is she the one that wears the weights?’” Catall keeps the lavender-colored weights – one pound for the wrists and two and a half for the ankles – under the counter and puts them on every morning before she starts her 12-hour shift.
“People always say, ‘What are those?’ And then we get into a discussion about easy ways to work out. It’s good for a pharmacist to represent fitness.”
Catall values the relationships she’s built with longtime patients – relationships she never would have had in hospital pharmacy. She recalls an elderly couple who had been coming to the drugstore for years until the husband passed away. The wife recently came in on her own, and Catall simply asked how she had been doing since losing her husband.
“I knew she was just devastated, and she said, ‘Thank you so much for asking. You don’t know how much that means to me.’ Things like that make it more than just a job.”
The once-introverted former hospital pharmacist credits the drugstore with giving her skills she otherwise never would have developed.
“I can just talk to anyone anywhere now,” she said.
Now a well-known member of her community, Catall didn’t immediately feel so at home behind the counter at Rite Aid. The move from the hospital to the drugstore came with its fair share of culture shock.
“One of my first encounters after leaving the NICU and coming to the drug store was with a guy who came in, took off his shoe, and put his foot up on my counter to show me his toenail fungus.”
Catall was shocked at the time, but now, she says, each day brings a new stranger who shows her, without ceremony, an ailing body part and asks for a remedy. That’s when Catall launches into her characteristic line of questioning.
“It’s kind of like being a detective. Because they’ll tell me they need something for a cold, but that can mean a lot of things, so I ask questions. What are the symptoms? What are we treating here?”
Their symptoms aren’t always as simple as coughing and sore throat though. Often Catall gives patients like Dhabliwala the product they think they need in exchange for the promise that they’ll see a doctor if symptoms persist.
Looking to the Future
Increasingly, patients are seeking over-the-counter remedies in lieu of seeing a doctor.
“They’ll say, I just lost my job, or I don’t have insurance, which brings a whole other dynamic into it, but you try to help them as much as you can.”
Helping as much as she can includes letting patients know when they are spending too much. Dhabliwala had no idea he was overpaying his medications. “A couple of my medications were cheaper with my Wellness+ card than with my insurance, and she took the trouble to find that out,” he said.
In the face of drastic changes in health care and the economy, Catall wants to be able to do more for her patients.
She has just become an immunizing pharmacist and is looking into MTM training. “It seems like MTM is the natural next step for me – with people not being able to afford to go to the doctor, losing their health insurance, and with health care changing so much.”
Catall predicts that as health care reform gives more people access to care, pharmacists will become a more cost-effective means than physicians of managing medications, and she wants to be a part of that new landscape. At the same time, as mail order drug companies are hurting the drugstores’ bottom line, Catall knows the mail can’t offer the interaction and advice that a pharmacist can. She hopes MTM will help drugstores and their customers.
Finding her niche
When she came to Rite Aid six years ago, Catall thought she’d be back at the hospital pharmacy in no time. Now she wants to expand the services that she and her drugstore offer.
“I expect to retire here,” she says.
And until that happens, Dhabliwala says he will be a patient. Every time he goes into Rite Aid, whether for a prescription or to shop, Dhabliwala heads back to the pharmacy to say hello to Catall. She never fails to ask about his health, and he always gives her an update.
“She always encourages me not to take any chances. It’s nice to talk to someone and get a straight answer,” Dhabliwala says.
Recently Dhabliwala complained of foot pain and Catall explained that even that could be related to his heart and that he should mention it to his cardiologist at the next visit.
“I want to be more than just someone pointing people down the right aisle,” Catall said.
Patients like Dhabliwala would say that she already is.