Honduras Mission Trip March 2006
"My goals for 2019 align with how I want to FEEL at the end of 2019 - Abundantly Blessed." My Big, Scary, Audacious goal is to have a successful business that will one day support my family and allow me to create a charitable foundation for medical missionary work. In this blog post from New Years Day waaaay back in 2017, I wrote about my 15 year plan to open a Mission Clinic in Central America. This year I've hit most of my top 10 goals...
Goal setting is important to me because it has allowed me to step away from jobs I don't love, charge what I'm worth and take chances on new ventures. Even though it wasn't on my "goal list" I created a new Planner based on the CORE FOUR Elements of the Healthy Business Helix. In my latest workshop, "Planning for 2019 Like a Pharmapreneur", I teach you the steps for choosing your:
The Planner, now available on Amazon, follows along with my latest Workshop. CLICK HERE TO REGISTER FOR THE "Plan Like a Pharmapreneur in 2019: Business Development" WORKSHOP!
Will you join me in setting your 2019 Personal Development Goals TODAY?
Click here to register for the free Business Development and Planning for 2019 Like a Pharmapreneur Workshop.
On the Workshop I share my process for goal setting and how I've come up with my 2019 Goals (listed below).
One of my "processes" is to choose a word to represent the year ahead. The word represents how I want to FEEL at the end of the year and throughout the year. It represents my focus. And as Tony Robbins says, "Where focus goes, energy flows" 2017 was a focus on VISIBILITY... 2018 was focused on INFLUENCE in order to create an awareness and evolution in pharmacy... In 2019 my focus is on ABUNDANCE. To me, abundance means having the freedom to pursue your purpose. It means bringing my message to more pharmacists, teaching about pharmacy consulting services and sharing my story genetic testing journey. My goals for 2019 align with how I want to FEEL at the end of 2019 - Abundantly Blessed. As you know, goal setting is very important to me. People who write down their goals are 42% more likely to reach them. I've been writing my goals and posting them on this blog consistently since 2016. And I've been writing my goals down in the notepad app on my phone consistently since 2014! Follow my entire journey here. However, the danger in focusing heavily on achievements, is that sometimes goal-oriented people (me) can get too wrapped up in the future and forget to enjoy the present. Hopefully focusing on abundance and gratitude for all that I already have will help me to be more PRESENT in 2019. Present for my family, my Academy members and myself. This year I want to add a "Lookback List" to my Annual Business Recap to celebrate things I am proud of and grateful for... Feel free to create your own and save it somewhere you can go back and look at it in the future when you're feeling down. Your notepad app on your phone is an EXCELLENT place to start this reflective practice. (If you need some help remembering all the amazing things that happened for you in 2018, go back and take a look at your paper planner or online calendar) Here's my "Lookback List" for 2018: January 2018 - Aven started dance lessons, first month post-partem, began shooting elevate summit videos, hung out with Ramit Sethi Feb 2018 - Family ski trip to St. Louis, took Natalie's e-course on strategic objectives, finished shooting summit videos March 2018 - threw myself a "Greatest Showman" themed birthday party, Elevate Summit launched, interviewed on Your Financial Pharmacist podcast April 2018 - rested after Elevate Summit, cancelled my whole life policy and upgraded my term insurance, went on a girls trip to Gulf Shores May 2018 - Began my NGx/PGx consulting business, on the Talk to Your Pharmacist Podcast, Started my health & genetic journey with MTHFR, Registered for PGx Certification course June 2018 - PioneerRx Connect event/CMA Fest in Nashville with my husband, 5 Ways to Take Your MTM Consults to the Next Level webinar, VIP day with sales coach Nikki Rousch, finished PGx certificate July 2018 - Jurassic Quest in Memphis for Aven's birthday, Elevate Adherence Mini-Summit, Weekend family trip to Mountain View, VIP day with speaking coach Carol August 2018 - resurrected my Youtube channel, special day with Mom and Aven, created 2019 Business Development Planner for Female Pharmapreneur Workshop and Mastermind Sept 2018 - VIP day and conference with business coach Shane, hosted the Female Pharmapreneur Workshop and Mastermind in Nashville for 8 amazing female pharmacists, completely changed pricing for Academy and added 50 new members, appeared on Rx Buzz Podcast with Ashlee Klevens Hayes October 2018 - NCPA conference in Boston with my husband, listed home for sale and made offer on a new one, (and looking forward to Halloween with the kids) November 2018 - Elevate Diabetes Care Mini-Summit, BizChix Live conference in Southern California, amazing massage, Harry Potter World, creating Lesson 12 December 2018 - Closed on new home, Pharmapreneur Academy Scholarships, Hoyt's first birthday, celebrating Christmas in our new house, taking time off My Top 10 Goals for 2019 (written in past tense as if it were December 2019)
The "word" that I've chosen to represent the feeling I want to have at the end of 2019 is ABUNDANT. Right now, I'm already feeling that way, but I know there's always room for improvement. Will you join me in setting your 2019 personal development goals? ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website.
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 What would your life look like if your "side hustle" was earning you an additional $1,500 a month? What would you do with it? Pay off your students loans faster, save it in your retirement, spend it on a new home, reinvest it into the business, take that Bucket List Trip in 2019... Now imagine: What if your business started earning $15,000 a month? $150,000 a month? It sounded crazy to me at first too, but I have plenty of entrepreneurial friends for whom this is a reality. That is the beauty of building your own business. There's no limit to your earning potential. This simply isn't the case in 99.9% of "normal jobs". When you build a business, especially one that doesn't require your direct involvement, you're no longer trading your time for money. Entrepreneurs can leverage their time to exponentially increase their income. And so can you! Not saying this isn't a LOT of WORK. The time you'll spend on the front end of building your business will probably take longer and require more investment of your time and money than an employed position. I've heard this called front-loading the sacrifice. The author, Doc Green of DiverseFi, was relating it to savings and investing, but I'm relating it to building a business.
I recently wrote about the Types of Consulting Businesses a Pharmacist Can Build. For example, say your goal is to build your health coaching business for women trying to conceive... There are some steps I recommend to go through BEFORE you ever start marketing yourself to potential clients. The 12 week goal-setting process:
Want my full training on this process? Join the Pharmapreneur Academy today and get INSTANT ACCESS! Imagine your Big Annual Goal is to make $25,000 in your new consulting business. Prioritize the TOP 3 Quarterly Objectives that you think will get you to that number. Break your Big Annual Revenue Goal into Monthly Metrics. ex) $25,000/12 months = $2083/month Each week, you know you have an extra 8 hours in which you can see these clients. Now, base your services around that number. ex) $2083/8 hours = $260/hour Perfect! Now do you want to see one client 4 times per month? 2 times per month? 1 time per month? This is will give you an idea of how many clients you are looking for and what packages you'd like to offer them. The example we're using for this consulting business scenario is with women trying to conceive, so lets continue with it. It would make sense to see this client twice a month, during specific times in their cycle. So you'll need to sign up 4 clients for say 6 months at a time. Thats 8 clients total for the year. Sounds doable right! Now, the million-dollar question, how do you GET SOMEONE TO HIRE YOU to do this? That is exactly what I will walk you through step-by-step in the How to Build a Pharmacy Consulting Business e-Course. Lesson 12 goes through an advanced training on building a cash-based service business. LESSON 12 - Cash-Based Services - Online and Off
We'll also be hosting a special January Members Only Q&A Call on Sales Training called "Warming Up the Cold Call" with The Sales Maven Nikki Rousch. Of course, you can figure this out on your own, but remember your 12 week goal? Investing in a program like the Pharmapreneur Academy will saves you dozens of hours, maybe even months of wasted time, money and energy. The Academy will give you exactly what you need and steer you away from spending resources on the things you don't. The e-Course is open again now, but only for a short time. If you want to save time, money and make progress on changing your life with that extra money each month, join us in the Academy and start your "side hustle" today. What would YOU do with an extra $1,500 each month? Join our next live webinar "Whats Working in Consulting for 2019" by clicking here to register! ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website. 
This is probably the biggest question on your mind if you are just finding my site, right?
If you have been here before, then welcome back my friend! But for those of you just finding me, I get this question alot so I've decided to construct an article that will hopefully answer this question. However, be warned, this information may cause the following symptoms: excitement, nervousness, insomnia, perma-grin, racing thoughts, irregular heartbeat and much more! In all seriousness, there are as many types of consulting businesses as an innovative pharmacist can imagine. With provider status knocking at our door, learning your options NOW can help save you time and money in the future. It can help you become THE pharmacist to call! Let me first start with my story. I started my business because I lost my job in 2014 when I was 6 months pregnant. At that point I was able to scrape together some “prn” work to make it through my maternity leave. After I had my daughter, I knew that I didn't want to go back to long hours in big box retail pharmacy. My family's finances depended on me so I knew I needed to make my relief and consulting business work. I began managing the MTM program for a local pharmacy. As I learned more and more about MTM, I began to share it on my blog and LinkedIn. Pharmacists began contacting me for advice about how they could begin consulting. I talked to so many pharmacists who were very unsatisfied and it broke my heart. Here I was loving my MTM business and trying to market my business to grow it locally when others obviously need my help globally. In September 2015, I put together a coaching program and took on three clients. I kept detailed notes of our conversations. I soon identified common barriers and similarities in the questions they asked. I began outlining all the information that I was sharing with them. In December 2015, I pre-launched the online e-course. 8 people joined the beta test group. Then launched again in March, 16 more joined. After working out some of the "kinks", I re-shot the entire course, increased the price and added more members. In June 2016, I launched Lesson 7 on CCM and PQRS. In September 2016 Lesson 8 on CPAs, pharmacotherapy MTMs and TCM. You see I never set out to build a community that has helped over 250 pharmacists learn about consulting services. If I had, it would have been too overwhelming. My unique point of view is that pharmacists need to prove their value by developing relationships and PROVE their value. This may not equate to a bloated six figure retail pharmacist salary (whoa, does she mean THAT?). Yes, it may be an unpopular opinion, but I feel that the high salary community pharmacists enjoy can actually hold them back. I've heard this called the "golden handcuffs", which is a fitting term. Many times those handcuffs are also connected to crushing debt (student loan or other). What peeves me the most is when people expect everything to be done for them. They want someone to create a dream job for them, then ask them to come do it. That is not the way it works. You must CREATE the Dream Job YOURSELF. Now, I am ready to help pharmacy take part in a larger conversation about innovation in healthcare. How can we do it better, cheaper, more connected and truly patient-centric. This, I believe, can only be accomplished through interoperability. The first step to achieving this interoperability is to connect pharmacies, clinics and acute care settings. This can be done through collaborative practice agreements and pharmacist led clinical services. Next we will do it with software, even AI, who knows. Which brings me to the innovative pharmacist who wants to start a consulting business. The options they have and how to get started. If you don't want to get stuck behind the wave of clinical pharmacy consultants, keep reading (it will be worth it). So What are Some Types of Consulting Businesses? 1. The implementation specialist This person would focus on helping community pharmacies implement sustainable MTM programs. They would focus on staff training, organization, setting up systems and automating the MTM process as much as possible in the pharmacy. They would help the store put in place protocols and procedures for all staff members to be trained in MTM. More information about organizational systems and staff training is contained in Lesson 4 of the e-course. 2. The program improvement specialist This person would consult with pharmacies to help them improve existing programs. These programs could include, but not be specific to MTM, CPAs or other clinical services. The consultant would conduct a SWOT analysis on the pharamacy and propose changes based on the assessment. Some areas of improvement may be to improve physician collaboration, improve patient adherence measures, complete more CMRs or add community services such as vaccination clinics. More information about how to improve clinical programs is contained within Lesson 5 of the e-course. 3. The management consultant This person may work closely with software companies, telehealth companies, diagnostic testing companies, etc. to help them improve collaboration with community pharmacies or patients. Check out my interview with Deloitte management consultant Sonal Shah to get a few more ideas. 4. The physician clinical consultant Many pharmacists are becoming increasingly interested in partnering with physician groups. It can bring personal fulfillment to the pharmacist and a valuable service to the physician group. A few ways pharmacists can help physicians is by coordinating a chronic care management (CCM) program for the clinic. By focusing on physician quality reporting system (PQRS) measures a pharmacist can put together a care plan that will help improve patient outcomes and prevent penalties from newly introduced MACRA legislation. Pharmacists can also offer services such as TCM, MTM polypharmacy consultants and PGx testing. More information about this can be found in Lesson 7 of the e-course. 5. The point of care testing services consultant This person would be an expert on collaborative practice agreements that would allow pharmacies to implement CLIA-waived point of care tests. Such test may include pharmacogenomic consultations, rapid diagnostic screening tests, preventative screenings or even narrow therapeutic window medication testing. More information about point of care testing services can be found in Lesson 8 of the e-course. 6. BONUS - The "Health Coach" This actually may be the first consulting business that comes to top of mind when thinking about consulting services. I intentionally placed this one last because I believe that it has the smallest chance of supporting a successful business model. UNLESS you know what you're doing. Creating a niche cash-based business models where patients would pay the pharmacist on a per appointment basis to be a "health coach" or anything like it. If you are interested in this type of consulting business, we've just released Lesson 12 in the e-Course at the Pharmapreneur Academy on Offering Cash-Based Consultant Pharmacy Services! This Lesson is perfect for functional medicine pharmacists, nutrition and weight management programs, genetic testing consultants and specific disease state specialties. So what else WILL you find inside the E-course and Community?
Still not sure? Email me and share your reservations. Or, if you think the Pharmapreneur Academy may help you accomplish your goals, click here to join our next Live Webinar! ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website.  "Lesson 12 is great for pharmacists interested in functional medicine consulting, pharmacogenomic and nutrigenomic testing, offering weight and hormone management programs!" After three years of building the Pharmapreneur Academy, I finally have created a step-by-step model for pharmacists who want to offer cash-based services.
I've been resistant to do this since cash-based services take a different approach, may be targeted at a different patient demographic and can be a tougher "sell" for a budding entrepreneur. As you'll see in the E-Course Lesson Outline below, our LESSONS start at the beginner level and build up to the more advanced consultation services. Cash-based services can be the most difficult to get off the ground, BUT these services can provide patients immense value and GREAT FINANCIAL rewards you without the hassle and oversight of insurance payers. Back in March, when I started my Genetic Journey, I created a Genetic Consults business that I launched as a cash-based program to see if patients would be willing to pay for pharmacogenomic and nutrigenomic testing services. I documented everything I did and everything I learned about offering a cash-based "health coaching" program. In LESSON 12 of the e-Course at the Pharmapreneur Academy, I share everything I've learned about what works and what doesn't about business, marketing and "selling" your cash-based services. Lesson 12 is great for pharmacists interested in:
LESSON 12 - Cash-Based Services - Online and Off
Can you see why I'm excited to release Lesson 12? You've never seen a business training like this in the world of pharmacy! Since we've gone through our most recent Lesson in the e-Course at the Academy, lets now take a look back at the first 11 Lessons. LESSON 1
LESSON 2
LESSON 3
LESSON 4
LESSON 5
LESSON 6
LESSON 7
LESSON 8
LESSON 9
LESSON 10
LESSON 11
As you can see, there is something for everyone in the E-Course at the Pharmapreneur Academy. All these trainings and much more are included for free with your membership. To join before December 31st, go to PharmapreneurAcademy.com and get INSTANT ACCESS for only $197! Still have questions? Join our next live webinar "What's Working in Consulting in 2019" on Sunday, January 6th at 8pmCST. ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website.
Normally every November we give away one scholarship to the Pharmapreneur Academy (value of $997).
But THIS YEAR is different. We've COMPLETELY CHANGED the pricing structure of the Academy because I wanted more pharmacists to be able to join and get access to information about consulting. Our members get RESULTS, but I hear from pharmacists everyday who are struggling in their careers and feeling "stuck". The Pharmapreneur Academy allows you to get "unstuck" and finally move forward with your consulting business. Because of my commitment to reach more people, I've decided to give away TWENTY FIVE Scholarships this year! That's right, it's the Holidays and I want to be generous with this valuable information. If you've been thinking of joining the Academy, but haven't been able to because of financial obligations, apply for one of our 25 scholarship spots. Here's what I want to know about YOU:
All you need to do is APPLY BY ENTERING YOUR INFO below. Remember, one of my 2018 goals was to HUGELY & UNEXPECTEDLY bless someone? Well, I've decided to bless 25 someones! The Scholarship recipients will have free access to the Academy for 30 days. This includes full access to:
We expect the Award recipient to participate and be an active member in the Academy.
If you have any questions about the Scholarship, email me at blairthielemier@btpharmacyconsulting.com ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website. 
"It's absolutely excellent! Did you decide to begin building a new career this year? Or finally start that business you've always wanted to? Or take that course you've been thinking about? For the past three years, I have been publishing articles about goal setting to kick off the new year. It has been a way to hold myself accountable, keep track of my successes (and failures), and because of it I believe I enjoy life more fully than some do in a lifetime and hopefully inspire others to do the same. Year after year, I stress the importance of creating goals for your life (personal relationships, financial, career and health/self-care). Goal setting has allowed me to step away from jobs I don't love, charge what I'm worth and take chances on new ventures. If we hadn't started setting some Family Financial Goals back in 2013, I don't think I would have as many opportunities and options as I do today. We'd still be "paying interest and not ATTENTION" in the words of Dave Ramsey. In fact, we've been using a combination of Mint, Betterment and the notepad app on my phone consistently since 2014 to successfully nearly double our SAVINGS AND EARNINGS rates. Some of those goals include:
Check out my 2016 Goals and my first year in Online Business here. Check out my 2017 Goals and my second year in Online Business here. Check out my 2018 Goals here. If you haven't yet, now is the time to start planning your Personal and Career Growth by setting your goals for 2019. I set Big Annual Goals in four areas of my life:
In our new Business Development Workshop I teach you my process for setting your Business/Career Goals and share my own 2019 Goals. Goal setting has allowed me to step away from jobs I don't love, charge what I'm worth and take chances on new ventures. Even though it wasn't on my "goal list" for 2018, I thought it would be fun...so I created a new Planner based on the CORE FOUR Elements of the Healthy Business Helix. The 2019 Business Development Planner, now available on Amazon, follows along with my latest Business Development Workshop: Planning for 2019 Like a Pharmapreneur. "You must plan ahead to achieve anything great. " This Business Development Workshop will introduce you to my Business Development Framework, designed to walk you through the Core Four Elements of Productive Planning to Achieve Your Career Goals. The Framework will walk you through the Core Four Elements of:
I love goal setting and I hope this Workshop will help you set some Personal, Career, Financial and FUN Goals for 2019! Click here to register for the free Planning for 2019 Like a Pharmapreneur Business Development Workshop. ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website. 
I haven't yet publicly shared the moment that caused me to begin looking into my own genetic variants, but I can tell you exactly when I had my "ah-ha moment".
December 28th, 2017 at 1:25pm My son was just born and the neonatologist was doing his assessment. Under the yellow light of the exam table, I noticed her looking closely at the base of his spine. I asked her if something was wrong. She said, "I'm looking to see if I can see the bottom of this hole, if I can't see the bottom we'll have to do an ultrasound." I told her that his sister had the same dimple and she was fine. This seemed to satisfy her. But when I looked at it, she was right, this was MUCH MORE than a dimple. You cannot easily see the bottom of the tiny hole at the base of my son's spine. The information about my daughter seemed to ease the neonatologists concerns, but it got me thinking...
So many things go through your head when you are caring for a newborn, but for me in the back of my mind I knew there was something I needed to look into further. I've been interested in Pharmacogenomic testing for the past few years, but I decided to start my precision medicine journey by testing myself. A few month after my son's delivery, I began my genetic journey by taking a 'direct to consumer' DNA test... When I got the results of the DNA test kit back, I was flagged for having a higher than normal risk of CV disease, Parkinson's and Alzheimers. In digging through the results, found out I can’t methylate folic acid - it’s approximately 7% of normal methylation capacity. I also learned that 40% of the population in the United States has some form of this mutation, but checking for it is not a standard of practice. The gene MTHFR codes for an enzyme that performs functions involved in building proteins and detoxifying cells. The mutation causes the enzyme to function inefficiently, causing inflammation in the brain and elevated homocysteine levels. This leads to inflammation throughout the body, circulatory system and especially the brain, causing higher risk for developing cardiovascular disease and neurological diseases like Parkinson’s and Alzheimer’s. This all pointed back to my genetic mutation causing dangerous nutrient deficiencies like the one that caused my son’s near-neural tube defect. As a result of the genetic test, I’m able to take the exact supplements my body needs to combat inflammation and hopefully decrease my risk of developing a neurological disease. My experience has motivated me to want to help others, especially young women trying to conceive. FOLIC ACID MAY NOT WORK FOR YOU. We are also seeing genetics linked to depression and ADHD, so my genetic consulting program focuses on testing children on psychoactive medications for a genes that impact how well the brain makes and clears dopamine, serotonin, and the neurotransmitters that affect memory and concentration. This provides a preventative option, offers potential alternative to stimulant medications and prevents “trial and error” prescribing. Shortly after I tested myself, I got certified in Pharmacogenomic testing. Then I became trained in Nutrigenomic testing. Then, I decided to start seeing if I could help others with my newfound knowledge. I took 3 beta testing patients, then the word spread. Friends and family began asking me if I could test them too. I worked with over a dozen 'beta testers' before I felt very confident in my services. I identified children with ADHD and on psychiatric medications as an area of interest of mine. I took on a few patients. After one of my recent consults, I had given the mother a list of about 10 things to try before starting the child on a stimulant medication. She was ecstatic. She told me she thought that I would tell her that nothing could be done and medication was their only option. If you've read my blog posts about starting my Genetic Consults business, then you know I was able to get the business up and running in just a few months. I didn't do it because I wanted to build a second business. No, my main focus is helping pharmacists build their career by building consulting businesses through the Pharmapreneur Academy. I treated the Genetic Consults business as an experiment so I could turn around and teach other pharmacists how to create a similar model. I'm working on putting together a wealth of information on cash-based services in Lesson 12 of the e-course at the Pharmapreneur Academy, which is launching December 16th, 2018. Lesson 12 is great for pharmacists interested in functional medicine consulting, pharmacogenomic and nutrigenomic testing, offering weight and hormone management programs! CLICK HERE TO LEARN MORE ABOUT HOW THE E-COURSE AT THE PHARMAPRENEUR ACADEMY CAN HELP YOU FULFILL YOUR CONSULTING DREAMS. ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website. 
Want to watch a video version of this post? I've got you covered!
What is Nutrigenomic testing and how can a pharmacist use it in patient wellness consultations and supplement recommendations?
Nutrigenomic testing is similar to pharmacogenomic testing except we are looking at genes that specifically have to do with nutritional deficiencies. What genes are you testing? Some commonly tested genes are MTHFR, MTRR and FOLR1. These three genes are directly related to the methionine pathway and can impact the patient's homocysteine levels and folic acid levels. Some other genes that we're looking at and testing with Nutrigenomics is GAD1, GSTM, interleukins and HLA-DQA1 which is an indicator of gluten intolerance. There are no CPT codes that code for nutrigenomic testing and testing is not covered by insurance. Most of the pharmacists offering nutrigenomic and health and wellness consults are charging the patients cash. The cash price to the patient would include whatever test you'll be running, plus the consultant pharmacist's consultation fee and then certain supplement recommendations. On top of the pharmacist's consultation fee some opportunity for pharmacists to impact patients in nutrigenomic testing is to offer supplement recommendations as part of a health and wellness consult that identifies what nutritional deficiencies. The consultant may need to address any changes in diet that the patient may need to undergo as well to help impact and improve their genetic makeup by modifying gene expression (epigenetics). How could a consultant pharmacist offer nutrigenomic tests? In addition sometimes a nutrigenomic test can identify opportunities for pharmacogenomic testing. For instance some nutrigenomic tests, will test the COMT gene and the MTHFR gene which we also see on many pharmacogenomic panels. Pharmacists are seeing an opportunity to help patients through offering them high quality supplement recommendations and by using natural products like CBD oils. As more and more patients are looking for a more natural and holistic approach to medication therapy and preventative medicine, consultant pharmacists who are interested in functional medicine can use nutrigenomic testing to identify and remedy nutrient deficiencies that the patient may be experiencing. How can you put a program like this together? A consultant pharmacist in an off site setting such as a community pharmacy or independent consulting firm could provide nutrient deficiency consultations, microbiome and food sensitivity testing, nutrigenomic testing and weight management as part of a holistic health and wellness consultation program. If you are interested in building your clinical services... Join us on our next LIVE webinar to learn more about Pharmacy Consulting and the Pharmapreneur Academy. We'll discuss Protecting Yourself From Career Climate Change with Consulting as a Side Business Register now! ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website. 
Want to watch a video version of this post? I've got you covered! What is Pharmacogenomic (PGx) Testing? Pharmacogenomic testing is identifying genes that may affect enzymes responsible for hepatic metabolism of certain medications. Remember back in pharmacology and genetics you may remember learning about the Cytochrome P450 enzymes. Those enzymes are some of the ones that we look at in a pharmacogenomic test. What Genes Are Tested? In addition to the CYP450 enzymes, we also look at HLA-A and HLA-B, which indicate the presence of alleles linked to hypersensitivity to carbamazepine or phenytoin. We also look at OPRM1 which in our mind geotag specifically shows a decreased sensitivity to analgesic but it could go either way. We also look at the COMT which indicates whether or not the body is producing enzymes that can clear dopamine norepinephrine from the synapse. We also look at SLCO1B1 which tells us if the patient is more at risk for statin-induced myopathy. And finally for thrombosis risk we can look at genes that code for Factors 2, 5, and 10 Leiden. How Do You Bill for Pharmacogenomic Testing? As far as CPT codes go, there are no CPT codes that code specifically for pharmacogenomic testing. The patient can be referred to the pharmacist or to the physician for pharmacogenomic testing based on the medications that they're on and based on their diagnosis. Some impactful activities for pharmacists wanting to offer pharmacogenomic testing either in their community pharmacy setting or in a physician's office setting are:
To refer back to the incident to billing criteria, check out our last video on incident-to billing. How can you put a program like this together? A consultant pharmacist in an off site setting such as a community pharmacy or independent consulting firm could integrate pharmacogenomic testing and consultation into an MTM visit Lesson 9 in the E-course at the Pharmapreneur Academy is ALL about Pharmacogenomic and Point of Care Testing Services! If you are interested in building your clinical services... Join us on our next LIVE webinar, Sunday, November 18th at 8pmCDT Learn how to Protect Yourself From Career Climate Change with Consulting as a Side Business and how the Pharmapreneur Academy can help you build the Career of Your Dreams! Register HERE. ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website. 
Want a video version of this post? What is comprehensive medication management and how does it differ from continuous medication management? Comprehensive Medication Management is a program created by CMS to be included in the new Comprehensive Primary Care Plus (CPC+) clinic model The CPC+ model was created by MACRA as part of an advanced APM. Now remember in MACRA, there's two different payment tracks that clinics and providers can choose the MIPs route or the advanced APM route. The CPC+ model is application-only and it's only available in certain states and regions. "There are 2,900 primary care practices currently participating in Comprehensive Primary Care Plus (CPC+) in 18 regions: Arkansas, Colorado, Hawaii, Greater Kansas City Region of Kansas and Missouri, Louisiana, Michigan, Montana, Nebraska, North Dakota, Greater Buffalo Region of New York, North Hudson-Capital Region of New York, New Jersey, Ohio and Northern Kentucky Region, Oklahoma, Oregon, Greater Philadelphia Region of Pennsylvania, Rhode Island, and Tennessee." There are two different track models a CPC+ clinic can opt in to. In Track 2, there's an option mentioned to improve care through comprehensive medication monitoring. The idea behind comprehensive medication monitoring is to develop a plan after discharge or for those patients receiving longitudinal care management. There are four primary "change tactics" mentioned in Track 2 of the CPC+ model:
My thoughts for a program that includes a clinical pharmacist like this could include services like:
Providing comprehensive medication management programs and a CPC+ model is an opportunity for consultant pharmacists to help providers and focus on patient care outcomes. If you are interested in building clinical services like comprehensive medication management... Join us on our next LIVE webinar, Sunday, October 21st at 8pmCDT Learn the TOP 3 Mistakes Pharmacists Make in Their Careers and how the Pharmapreneur Academy can help you build the Career of Your Dreams! Register HERE. ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website. |
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