Delivery of Care

On the job with Ashley LaFerriere, pharmacist

A busy clinic pharmacy manager shares her views

Photo courtesy of Ashley Laferriere

Ashley Laferrire is the pharmacy manager at Blackstone Valley Community Health Care at 39 East Avenue in Pawtucket.

By Richard Asinof
Posted 9/30/24
An interview with the pharmacy manager at a busy community health care clinic opens up an important dialogue that CEOs need to listen to.
What will be the result of the FTC lawsuit against three of the largest pharmacy benefit managers over alleged illegal increases in the prices for insulin? When will the concept of “step therapy” for drug prescriptions be banned in Rhode Island? Does there need to be more state and federal regulation of infusion practices for drug delivery? How will the major corporate pharmacies resolve their ongoing labor problems regarding workplace practices with pharmacists?
The McKee administration has convened a number of working groups to put together their own plans for how to improve the delivery of health care in Rhode Island, including a group that meets virtually to come up with solutions for the lack of primary care physicians in the state. The primary care group is co-chaired by Elena Nicolella, the president and CEO of the Rhode Island Health Center Association, which is grappling with its own problems – including the financial crisis at Thundermist, which has resulted in layoffs of more than 100 health care workers. At some point, there needs to be a discussion around the apparent malfunctioning of accountable entities under the current Medicaid payment structure.

PAWTUCKET – Too much of the news reporting about our disrupted health care delivery system tends to be about asking questions directed at the CEOs and honchos in charge of the decision-making, the people at sponsored health care summits who seem most comfortable talking to each other.

Take, for instance, the health care summit held on May 28 sponsored by R.I. House Speaker Joseph Shekarchi. There were lots of CEOs and elected officials who spoke and but few patients. [See link below to ConvergenceRI story, “Bang the gavel slowly.”]

Indeed, often left out of the conversation are the worker bees – the community health care workers, the nurses, the technicians and the pharmacy managers – those who are the ones who actually deliver care to the patients, the ones who make their systems function despite the flailing bureaucracies.

For instance, when the U.S. Senate Health, Education, Labor, and Pensions Committee held recent hearings on the Steward Health Care bankruptcy debacle, it was a nurse from St. Elizabeth’s Medical Center in Brighton, Mass., Ellen MacInnis, who delivered some of the most damning testimony – while Steward Health Care CEO Ralph de la Torre declined to testify.

Anyone who is a patient attempting to navigate their way through the maze of health care delivery often has to confront the difficulties of purchasing the necessary prescriptions to keep them healthy, despite increasing prices and changing drug formularies and questions raised by health insurers about the efficacy of prescribed drugs which are deemed too expensive.

In turn, ConvergenceRI has marveled at the competence of the pharmacy manager at the Blackstone Valley Community Health Pharmacy located at 39 East St. in Pawtucket, owned by the community health center but open to customers in the community.

Here is the ConvergenceRI interview with Ashley LaFerriere, pharmacy manager at Blackstone Valley Community Health Care pharmacy.

ConvergenceRI: How long have you been working at Blackstone Valley Pharmacy?    
LaFERRIERE: I will have been here seven years in February. I’m at six and a half years right now.

We were owned by Cardinal Health for the first four and half years and we have been owned by the clinic since April 2022.

ConvergenceRI: Every time I go in to pick up my prescriptions, I am amazed at how busy your pharmacy is. It seems as if you are managing the pharmacy demands for all Blackstone Valley facilities. Is that true?    
LaFERRIERE: Yes. It’s not just for patients of Blackstone; we can use other providers as well.

ConvergenceRI: What do you find is the most rewarding part of your job?    
LaFERRIERE: That’s a good question. On a personal note, I enjoy the work/life balance that this job offers me. Because I have two daughters, one is four and the other is 11. I am able to spend nights and weekends with them.

When I worked for corporate places, like Walgreens, I wasn’t able to have much of a work/life balance.

Also, on a professional level, the praise I get from patients and also from the clinic staff is very rewarding. Not to toot my own horn, but a lot of times, they thank me for the solutions I come up with and the extra mile I go for the patients.

One of the nurses today told me: “You always come up with something…” Not always, but I try. I try and see what we can do if there is an insurance issue, or something.

ConvergenceRI: How important is the team approach in your work.  
LaFERRIERE: Oh, it’s incredible. I have one part-time pharmacist and one per diem pharmacist. The part-time works about 20 hours; the per diem works one-fifth a week, so I can try and focus on my managerial tasks

I also heavily rely on my three techs. And, obviously, I utilize them for their bilingual skills. They all speak Spanish. That’s extremely important.

ConvergenceRI: What do you feel are the most challenging aspects of the current helath care landscape, from your perspective.  
LaFERRIERE: That’s a very good question. Working here [at the clinic], it is a lot different, because I have direct communications with the providers for the patients as part of the clinic. I think that helps ease our workload. I know that at other places, it’s hard, because of the communications aspect. We’re able to talk or see someone and not [deal] with a robot or an AI [link].

At times, outside providers can be kind of chippy; given, you know, all of the formulary battles we run into with health insurers. That’s part of the struggle as well.

ConvergenceRI: If you could sit down and talk with someone and share your opinion about changes that could be made to improve things with the current health care landscape, what you would suggest? If you could sit down, say, with the president of of Blue Cross? What do you think they need to hear – and to listen to you about how to improve things?    
LaFERRIERE: They’ve tried to make it with a lot of things more than just phone calls; now, you can go online. A lot of the insurance companies have their own web portals, where if you need a vacation override, you can do it that way, rather than waiting on the phone. So, that has helped decrease the wait time. But, obviously, that could always be more efficiently tuned.

Also, the formularies are all posted on their individual websites, for Blue Cross and Neighborhood and Optum. But, I mean, honestly, they are like 115 pages and sometimes, it is hard to find which drug class you are looking for, based on the way they sort it, so that can be kind of tricky. I wish there was an easier way to find the drug class you are looking for; that way you can get right down to it.

Sometimes, they make it kind of like a maze to figure out – about what is covered, about what needs prior [authorizations]. They need to make it more user-friendly.

ConvergenceRI: What questions haven’t I asked, should I have asked, would you like to talk about?    
LaFERRIERE: Your questions are great. I think you hit most of the main points.

 

 

 

 

 

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