On July 1st, current CPNP President-elect Rex Lott, Pharm.D., BCPP will become president of CPNP. We were fortunate enough to sit down with Dr. Lott at the CPNP annual meeting and discuss his plans and vision for the direction CPNP is going in the coming year and beyond.

Before getting to the pressing interview questions, we'd like to share some information about our incoming president. Dr. Lott has been a practicing psychiatric and neurologic pharmacist for nearly 40 years, having received his BS in pharmacy from Washington State University in 1972. He later received his Pharm.D. from the University of Minnesota in 1977. In the time that followed, Dr. Lott has practiced in multiple settings, including a state hospital system as a consultant clinical pharmacist, a clinical pharmacist and pharmacy director for two different institutions for developmentally disabled adults, a consultant pharmacist in the long-term care setting and a private practice pharmacotherapy consultant. Since 1997, however, Dr. Lott has been a full-time faculty member with Idaho State University (ISU), with a practice site at the Boise VA Medical Center. He practices in both the inpatient and outpatient psychiatric settings. His academic activities include didactic lecturing at ISU, precepting APPE students, teaching 3rd and 4th year Psychiatry Residents from the University of Washington, and precepting pharmacy residents on elective psychiatry rotations in their residency program. He also counts epilepsy as a practice interest, in addition to psychiatry. Professional affiliations in addition to CPNP include the American Epilepsy Society, The Epilepsy Foundation (National) and the Epilepsy Foundation of Idaho.

How did you come to be involved in CPNP?

I was not a founding member of CPNP. I actually missed the founding meeting by 20 minutes, and at that time chose not to become a founding member. What really pulled me in, however, were the educational programs specific to psychiatric pharmacy, which were at the highest level of any pharmacy organization. I also had known the other people in the organization for years and felt a great sense of camaraderie with them.

How were you able to move from being involved at a lesser level to being involved with CPNP in a leadership capacity?

I was able to become involved at a higher level by volunteering for a committee, which was the Recertification Committee. I was also asked to serve on the Task Force on Residency Programs which evolved into the Resident and New Practitioner Committee. I served on these committees for several years before being selected as a Member-at-Large on the Board of Directors and finally, as President-Elect.

It's interesting you should mention volunteering for a committee, as this is one of the overarching themes that was mentioned at the Town Hall Meeting, by outgoing President Jerry McKee. Perhaps you can comment on these (listed below for reference):

  1. Advancing existing and establishing new relationships with various organizations (i.e., NAMI, ASHP, and other consumer and pharmacy organizations),

  2. Maximizing the visibility of existing CPNP resources, and

  3. Nurturing a culture of volunteerism to grow future leaders.

I am most enthusiastic about nurturing volunteers for our organization. This year, we hope to greatly increase the opportunities for volunteerism. Increasing our volunteer efforts will help us to meet the first two objectives, specifically building our relationships with other organizations and making our resources more visible. The other factor that will help our organization (and our profession in general) to be more visible is to work toward being reimbursed for our services as pharmacists.

How do you propose to increase the volunteer capacity of CPNP?

We are and should continue to be open and inclusive regarding our membership. The more open and inclusive we are, the more people will feel comfortable with volunteering. In addition, development of “ad-hoc” opportunities and projects may give members an opportunity to get their feet wet with volunteering.

At this year's meeting specifically, I'm sure you've noticed a number of students and PGY-1 Residents in attendance. How do you engage this group that might not yet have decided upon a career path specific to psychiatric pharmacy?

I think the things that stimulate engagement of student and resident members are the opportunities to become involved in CPNP and the open nature of our organization that results in their having ready access to “veteran” members. Being a volunteer-driven organization is also helpful because they can be more involved right from the start. Good communication is also important, especially from leaders within the organization. This helps to foster a culture of “mentorship” which is important to development of new practitioners into fully engaged members and future leaders. We've already seen this with establishment of student chapters of our organization. Finally, I think the poster session is a great opportunity for students to be involved. Where else can student and resident members present their projects in the same forum as veteran members and leaders of the organization? Most other organizations have separate sessions for students and residents which, in general, are not well attended in comparison with the general poster sessions and are less conducive to student and resident growth.

Where do you see CPNP in five years?

Growth. CPNP is definitely a growing organization. However, we want to keep the same character, where newer members can be mentored by our more experienced members and where our veteran members and leadership are approachable by anyone. So there are advantages to being a smaller organization. I think we will also be a lead player in advancing our profession as a whole as well as our specialty. As was mentioned at the Town Hall meeting, “It's time for us to step up.”

One of the themes I keep hearing (and was alluded to earlier in the interview) is that of obtaining payment for services in order to advance our profession. Could you elaborate more on this for those members (myself included) who practice in settings where this is less of a concern (such as the Department of Veterans Affairs)?

Even in the VA setting, where you and I practice, there is a great degree of variability. Some facilities treat clinical pharmacy specialists similar to mid-level providers. At other facilities, the scope of practice for clinical pharmacists is less broad. It's about recognition of the value we add as pharmacists, whether in a federal facility or in a setting that is more dependent on reimbursement from third-party payers. One of the most important things we can do is to develop a Standardized Practice Model, which was also mentioned at the Town Hall Meeting and in the Pre-Meeting Workshop. If we can have a high-quality, consistent definition of psychiatric clinical pharmacy practice, the recognition will come from employers and payers alike. Being paid for services rendered gives instant legitimacy and allows others to see the value of what we offer as clinical pharmacists.

Finally, what closing advice would you give to New Practitioners?

It's all about involvement. That's not to forget skills, abilities and talents. Rather, we have to use these in our involvement with consumers and their organizations, such as NAMI, to become more involved in the community and advocate for consumers. I think a good example of involvement of members is the fluphenazine decanoate shortage. We had individual members remark on how the current multiple dose packaging system is prone to excessive waste and is a disservice to consumers, since there has already been a shortage of this product. This lead to our organization's leadership drafting a letter to the manufacturer, who has promised to take this into consideration going forward. So we can help to make a change. But this doesn't happen without grassroots activity from everyday members.

Editor's Note: The Editorial Board of the Mental Health Clinician thanks Dr. Lott for taking time out of his busy schedule to sit down with us and make this article possible.

The authors of “Augmenting Antidepressants With Triiodothyronine: An Underutilized Strategy” discuss how T3 may be underutilized and how it may improve response rates in depressed patients.

A reminder that a special subscription price is available to Current Psychiatry, a monthly peer-reviewed publication, and the leading source of practical, evidence-based information for healthcare professionals treating psychiatric patients. Thanks to the CPNP partnership with Current Psychiatry, CPNP members can receive a year of Current Psychiatry at a cost of $24, over 77% less than the normal subscription rate.

Ray Lorenz, PharmD, BCPP

AltaPointe Health Systems, Mobile, AL

In order to highlight the wide variety of attendees at the CPNP Annual Meeting, the MHC conducted interviews of different types of practitioners who attended the meeting. We hope their perspective will encourage others to attend future Annual Meetings. If you have your own opinions about the meeting, please feel free to share them with the MHC editors.

The interviewees:

  • Stephen R. Saklad, PharmD, BCPP: veteran attendee and Saklad Award winner (SS)

  • Roger Sommi, PharmD, FCCP, BCPP: veteran attendee, CPNP Past President (RS)

  • Leiha Gavin, PharmD: PGY-2 Psychiatric Pharmacy Resident and first time attendee (LG)

  • Kristen Gardner: Student attendee, poster award finalist, student grant award winner, PharmD Candidate 2013 from University of Michigan College of Pharmacy (KG)

  • Kalyn Hendrix, PharmD: Student attendee, poster presenter, and student grant award winner. Recent graduate of Auburn University, Harrison School of Pharmacy (KH)

How many annual meetings have you been to?

SS: I have attended all of the CPNP meetings, with the exception of the first meeting in Orlando in 1998. I had a bicycle accident a few weeks before the meeting and broke my shoulder, right hand, and a few ribs so I wasn't able to travel.

RS: All 15 of them

LG: This is my first meeting

KG: This was my second annual meeting. I attend the 2011 annual meeting as well.

KH: This is my first meeting.

Why did you decide to come to the CPNP Annual Meeting?

RS: There is really no choice. These are my people.

LG: I'm a PGY2 psychiatric pharmacy resident and the psych focused programming.

KG: Originally, I wanted to attend to present a poster and network within the specialty in which I was interested. Additionally, the continuing education sessions are really great, especially for students because we have a lot of learning to do!

KH: Because I wanted to learn more about psych pharmacy, network, and learn about residency programs.

How have you been involved with CPNP as an organization?

RS: I'm a Founding member and Past President and I currently serve on the Business Development Committee as the Past Chair

LG: While I haven't been formally involved other than participating in the list-serve, I presented a poster at the Annual Meeting and attended the patient education networking roundtable. I am interested in becoming more involved by serving on a committee and potentially publishing in the MHC.

KG:I plan to continue serving on the CPNP Student Committee this year and maintain my involvement as I transition from a student to practicing pharmacist.

What has been your favorite part of the Annual Meeting and why?

SS: I enjoy all of the meeting. However, my favorite part of a CPNP meeting is seeing so many of my colleagues and friends, as well as meeting other members with similar interests. I find the discussions of the programming and thinking of the ways for CPNP members to implement these ideas or suggestions to be very exciting. I always leave the CPNP meeting with a long list of things that I will need to do in the next week, month, and over the following year.

RS: Poster session and networking

LG: The poster session was my favorite part because I learned a lot about presenting a poster and I grew professionally. I also enjoyed the networking opportunities.

KG: Honestly, my favorite part of the meeting was getting reacquainted and re-enforcing those connections with people I met last year. Similarly, I was able to meet so many new people this year too! A few pharmacists were really great and just kept introducing me to other practicing pharmacists. I really appreciate that as a student pharmacist because it makes it easier and more comfortable to speak with others.

KH: I really enjoyed the pain management presentation and getting to meet like-minded people.

What will you change about your practice after attending this meeting?

SS: I think that the new CPNP Movement Disorder DVD is a needed tool that we can use to help train the staff at our practice sites to perform these evaluations more consistently and with greater accuracy.

LG: I learned about more ways to do patient education.

If you could have dinner with one of the presenters from the annual meeting, who would you choose and why?

SS: I think that I would like to have dinner with Linda Strand. She presented a great discussion on providing primary care services. I would like to hear how she thinks that we can provide specialty consultation services in the Patient-centered Medical Home.

RS: Judge Steve Leifman because he was inspiring.

LG: Dr. Kimberly Arlinghaus, MD because she has experience working with veterans and I would talk more with her about assessing traumatic brain injury and the next-steps in treatment.

KG: I would have dinner with Dr. Barbara Wells because her talk was very inspiring. I believe she is an amazing example of the difference we can make in our career by upholding integrity and exemplifying kindness in all facets of our life.

KH: John Tovar, PharmD, to be able to get more information about metabolic syndrome in psychiatric patients.

How is the CPNP Annual Meeting different from other meetings you've attended?

SS: The most obvious difference is that all of the programming is very interesting and almost always can be applied to patients that I work with routinely. The meeting is also still small enough that most of the attendees are familiar. It is also in much more interesting locations than the giant meetings that seem to be stuck in Atlanta, New Orleans, or Las Vegas.

RS: It has high quality programming from start to end and it's focused on my areas of interest.

LG: It has programming specific to psychiatric pharmacy.

KG: It focuses on my favorite area - neurologic and psychiatric pharmacy! It represents the heart of my interests and passion. Also, the pharmacists at the meeting are so welcoming to student pharmacists by freely discussing their practice, providing advice, and interacting on a social level with students. It is nice to speak with pharmacists/residents outside of an academic setting.

KH: This meeting has more quality programming and is more focused on psychiatric pharmacy.

Why did you decide to present your poster at the Annual Meeting?

LG: To grow professionally and as part of my PGY2 program

KG: One of my mentors, Dr. Vicki Ellingrod, advised that I present my research project from a summer program last year, which is how I was presently aware of the opportunity. This year, I decided to present again on my Pharm.D. Investigations Research Project (at the University of Michigan, we are required to complete a research project to graduate from the program). However, she encouraged me to apply/compete for the Research Trainee Award. I was selected as a finalist; therefore, I was required to not only present a poster but deliver a 15 minute platform presentation as well. It was an amazing experience, and I am so thankful that Dr. Ellingrod encouraged me to apply!

KH: I wanted to get exposure and experience in presenting posters and to help me network with psychiatric pharmacists.

Why did you apply for a student travel grant and what does it mean to you to have won?

KG: I chose to apply for a student travel grant because receiving complimentary registration to the annual meeting would provide financial assistance to attend the conference and would also be an honor I could list on my CV. I can only imagine the competition among students for the 8 available grants; therefore, being a recipient of the student travel grant meant the world to me! What meant even more was that the grants were the direct result of donations from CPNP members. This is evidence that CPNP members make conscious decisions to invest in the development of students.

KH: I applied because I needed financial support to attend the meeting and it meant a lot to me to win because it reinforced my desire to pursue psychiatric pharmacy. It also showed me that this was the right path for my career.

By Joshua Holland, PharmD

Cox Health, Springfield, Missouri

I recently attended the CPNP annual conference in Tampa, Florida. While I sit in my chair and stare at the medication orders on my computer screen, my experiences at the conference seem almost surreal. This is the first time that I have ever felt this way after a conference. Despite only practicing as a pharmacist since 2008, I have been lucky enough to have the opportunity to go to other national, regional, and local conferences. This conference was by far the best one I have ever attended.

First and foremost, I noticed that almost every member of CPNP that I talked to during the conference was excited to be there. There was a passion that came through that each person had for the job they performed and the people that they helped. The desire to learn more through attending presentations and by networking with others was apparent as well. Everyone I spoke with was more than willing to share what they have learned through successes and through failures. This passion and desire was infectious, and I left the conference feeling energized and ready to go to work on making my position at my facility better able to serve the patients' needs.

The second thing I noticed was unexplainable humility which some members of CPNP displayed when I had conversations with them. There is a saying that kept coming to mind as I had these conversations with people whose names I have seen in publications or on the CPNP email list: “Leave your ego at the door.” I was amazed at how many conversations I had with members who I viewed as “Super Heroes of Psych Pharmacy.” Not only did they take the time to talk with me and answer my questions, but they even took into consideration any ideas or thoughts that I had about psychiatric pharmacy practice. I appreciated the fact that they were willing to pretend to be “Clark Kent” for a few moments to inspire and guide me in my practice.

And finally, the third thing I noticed was the sense of unity at the conference, which is probably a result of the previous two. I could not help but feel comforted about the future of being a psychiatric pharmacist after attending the conference. For two and a half years, I have had to fight at my facility to be able to have even a few opportunities for patient contact. It is encouraging to know that others have fought and are fighting the same battles and that there are plenty of people to help. I felt after the conference that I didn't just have a few individuals, but a whole organization that I could use for support.

In regards to the positive experiences I explained above, I would also like to mention a few wishes I have for CPNP and its members. My first wish is that you find as many ways as possible to share the passion and desire that I saw at the conference. I hope that everyone who comes into contact with you knows how much you care about what you do. My second wish is for you to accomplish as much as you can as an individual, but to keep in mind that the accomplishments of the whole far surpass the accomplishments of the one. Great things can be done when each member does something for the benefit of organization. My third wish is that as the membership increases the feeling of unity and community doesn't diminish. Relationships take time and effort, but it is always worth it in the end.

In closing, I would like to thank all of those who helped make the conference happen. You did a great job. I appreciate all of you who took the time to have conversations with me. I look forward to working with you in the years to come. Also, I would like to thank those of you at the pool who shared your sunblock with me as I would have been in trouble without your help. Well, I better wrap this up as the orders on my computer are piling up. Maybe I will get to go to the unit to see some patients tomorrow….