March 19, 2021
DeLon Canterbury, Pharm.D., BCGP, (Class of ’14), is President and Chief Executive Officer of GeriatRx, Inc. in Durham, N.C., and is a Certified Community Pharmacogenomics (PGx) Consultant. Canterbury has dedicated his career to serving low income and rural socioeconomic populations across the Triangle, aiming to give his patients healthier lives by supporting them in their health journeys.
Q: Please describe your practice setting. What makes your career path unique?
A: I work as a consultant pharmacist at GeriatRx, which uses a patient-centered approach to holistic care. We implement telehealth, Comprehensive Medication Management and Pharmacogenomics to provide cost-effective solutions for patients. GeriatRx provides invaluable health care consulting services and demonstrates the unique skillset pharmacists have in improving health care outcomes while managing our patients effectively with precision medicine and evidence-based Practices. GeriatRx deprescribes unnecessarily written medications and we work to reduce costs for our patients while removing the side effect headache from our patients’ providers. Our job is to find complex solutions to really complex health barriers for our patients, such as assessing the social determinants of health (food, shelter, community resources, health education) that are linked to positive health outcomes. It’s about the interdisciplinary team-based approach to care that health care needs.
Q: What led you to this career path? What steps did you take?
A: It’s kind of two stories in one. I’ll start with the very real, raw side. I was a retail pharmacy manager for about six years. I just kept seeing the very same patients who were either minorities or elderly coming in with the same medication errors. It ended up being such a theme that I thought, ‘how can we avoid this all together? How can we stop them from coming in with duplicate therapies and drug interactions that are causing harm?’ Time and time again, I saw the same issues. And you think, ‘this is broken. Health care is broken.’ It struck a chord with me to have to tell patients their co-pay was $1,200, even after I checked the coupons four times and did everything I could. Their heart is breaking, my heart is breaking. I felt like I wasn’t truly helping people. That led me down a dark road of depression and unfulfillment in pharmacy. I felt like I was a part of the problem and I was another cog in the wheel. So, I tried to pull myself out of this depression by remembering why I got into pharmacy in the first place, which was for community service. It started with volunteerism. So I found an amazing group – Senior PharmAssist, led by Gina Upchurch who’s also a Tar Heel alum. She runs the nonprofit called Senior PharmAssist that focuses on helping older patients with Medicare assistance and Medicare enrollment in Durham. I started working on their formulary committee and started researching medications we should put on or take off the formulary, and that was so fun! It got my fire back; it got my passion back. We were able to give that extra help outside of the four walls of a pharmacy and it encouraged me to see how pharmacists can tremendously influence the way health care is delivered and change the impact with have.
Story number two, my grandmother suffered from dementia in her later years, and that encouraged me to get that Board Certified Geriatrics Pharmacotherapy Certificate. We had to move her from New York to Atlanta because she was declining so poorly in her care and her dementia was worsening. Come to find out, when we went to refill her prescriptions, a pharmacist realized she was on an inappropriate medication that was worsening all of her symptoms. Preventable. My parents suffered for months in trying to figure out the cause, with countless medical bills and expenses wasted on a condition that was due to an inappropriately prescribed medication. Imagine how many other caregivers and family members are suffering just like this without a pharmacist to guide them along their medication management journey? Her side effects completely subsided after the pharmacist talked to her doctor and changed her medication. Health care shouldn’t be so plug and chug that those errors slip through the cracks. That also inspired me to continue in pharmacy, but to also specialize in geriatric care.
Q: What does a typical workday look like for you?
A: Day-to-day, I’m following up with providers as well as patients to make sure we are keeping up with patients’ health care goals. For patients, I’m checking in to make sure they are keeping up with their goals, asking questions such as, “are we checking our blood sugar and blood pressure every day?”
Each day varies based on patient needs. Some days are about motivational interviewing and talking about medication adherence and compliance. Some days we are talking about financial barriers to be able to adhere to those medications. Other days, we are talking about new therapies and pharmacogenomics, or health literacy.
We are able to do assessments and customize patient needs like falls risks, or anticholinergic toxicity burden. We look at the social determinants of health that impact health outcomes for our patients while providing medication/therapy management and pharmacogenomic testing if needed.
With us, you’re getting a full medication/therapy review. We provide that record to patients and their provider(s). Once a patient comes on board, we also go through each disease state they have and educate on each disease. We are teaching our patients everything we can about their body as if we are presenting a patient case from pharmacy school in a fun and easy to follow manner. We’re educating and empowering our patients. With education we hope comes change in behavior.
And when we communicate with the patient, we also consult their doctor and identify any barriers that we can address as a team. Everything is team-based and patient-centered for us. This is why we stress the need for a holistic and public health approach model to care.
We serve a mixed demographic of patients. So right now, during COVID-19, the majority are skeptical of the vaccine. But they know they can reach out to us at any time and ask their questions. I make myself readily available for anything COVID because of the misinformation. That’s been at the forefront of our practice. I’m offering free consultations to our patients, and to anyone who has questions about the vaccine. It’s led to me being in town halls, speaking on church panels, being a part of media interviews, and being hosted on several news channels and radio features which has given us much traction. I’m on the Executive Board of the African American COVID Task Force (AACT+) here in Durham and it’s been amazing because we’ve helped to provide testing, resources and community connections so people can get the support they need in these tough times. We’re here to educate and advocate so our patients make the best decisions. Through media interviews, I’ve also been able to speak to some of the power pharmacists can really have in this time of need and figuring out vaccine logistics. I’ve also been able to address COVID-19 and systemic racism that’s in play and the lack of equity we are seeing in the vaccine rollout across the state. At the time, 8 or 9 percent of African Americans had gotten the first dose and 80 percent were white. It speaks to the fact that systemic racism, or medical racism, has always been there, but COVID has now shed a mirror to the gaps in health care especially within our Black communities.
Q: Describe the most exciting or rewarding aspect of your role?
A: On a day to day, I leave every speaking engagement knowing someone has peace of mind. Each day, there are people who leave understanding and trusting the science is there. That’s especially important for me as a Black pharmacist. That barrier still hits home today. We still have the blemish of the Tuskegee experiment fresh in our minds. We still have the North Carolina eugenics program fresh in our minds that sterilized black females for population control, funded by our state government. So with the COVID-19 vaccine, there’s a need to address that hesitation. And when you start hearing it from your own family members, you think ‘ok, I’ve got to do something. I’ve got to speak up.’ I can’t let my loved ones who are high risk just play the misinformation game. We must never downplay the history and ugliness of the medical past towards people of color, but we cannot conflate half-truths in the midst of a global pandemic where Black, Latino, and Indigenous people are dying at rates 2-4 times more than white Americans.
Q: Describe the most fulfilling moment of your career?
A: Honestly, one of my most fulfilling moments was working with an 80-year-old patient. The poor thing was prescribed 36 medications. Completely ridiculous. I’m seeing she’s on five different drugs that will contribute to anticholinergic toxicity, she’s on two other sleep meds. Her caregiver described her as a “walking zombie.” She’s was barely responsive, she was depressed, she was dying. After we reviewed her case and managed her meds, we were able to reduce her down to 8 medications, which was amazing. If it wasn’t for our Comprehensive Medication Management, this patient would have been thrown into a nursing home costing over $150,000 annually. As a consultant pharmacist, GeriatRx was asked to serve as a medical expert on this case and provide the evidence behind our pharmacy interventions. I stated in court that it’s not her, it’s the medications. We were able to save her family hundreds of thousands of dollars, because her family was battling to seize all of her assets, including her home, independence, and access to grandchildren. GeriatRx not only worked with her provider on developing an efficient deprescribing plan but we were able to get our patient her life back. She got back to normal. That was the most humbling and rewarding moment in my career as a pharmacist and that solidified my calling and purpose to advocating and empowering my patients against a broken health care system.
Q: Describe the most challenging aspect of your role?
A: Some people are still new to the idea that pharmacists can even do consulting work. It’s a relatively minor barrier when you share the great stories GeriatRx has accomplished, but patients may be hesitant. The traditional lens of how people look at pharmacists is something we need to change, as its outdated and ineffective. Pharmacists have to be loud and be our own champions in demonstrating our invaluable services to the health care team. People don’t know much about pharmacogenomics, but pharmacists are leading this charge, which is another service GeriatRx includes with our Comprehensive Medication Management.
Q: How can someone learn more about this unique practice setting and the career opportunities it presents for pharmacists?
A: You’ve got to get exposed to know what you’re getting into. Joining a pharmacist association has been extremely beneficial for me such as the Student National Pharmaceutical Association and American Society of Consultant Pharmacists. Join the ones that speak to you. Build relationships with your faculty and staff. If you really wanted to break out of the traditional roles, find mentors in untraditional roles. Follow people that are entrepreneurs within the pharmacy space and gain the tools to be your own entrepreneur. Go to conferences and network. Networking has been so valuable. And invest in yourself with coaching or conferences.
Q: What advice would you give to a current student pharmacist who is interested in pursuing a similar type of practice role in the future?
A: It’s really the ones who think out of the box that are going to do well. And remember to go into pharmacy from a place of passion and a place of servitude. Don’t do it for the money or the prestige. Do this because you know someone else is going to benefit from your education. If you are considering pharmacy, go volunteer in a pharmacy. Get into the hospitals. Start from the ground up. And if you don’t know where to start, start with your teachers because they can guide you. I was extremely fearful to ask for support or letters of recommendation. You don’t learn or realize that until you’re out of school. Traditional pharmacy is not very pretty right now, so don’t feel confined. Show up. Think outside of the box.
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