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Justin Cole:
00:04
Welcome to DISRxUPT, a podcast of the Cedarville University Center for Pharmacy Innovation. Today on the podcast, I am talking with doctor Kelley Carlstrom. Kelley is a board certified oncology pharmacist and the CEO and founder of KelleyCPharmD, an education company dedicated to bridging the gap in clinical oncology training for pharmacists.
Justin Cole:
00:29
Thanks again for listening to DISRxUPT. I am very pleased today to have doctor Kelley Carlstrom on the podcast with us. Kelley earned her doctor of pharmacy degree from the University of Colorado and completed her postgraduate residency training at Beth Israel Deaconess Medical Center and the Dana Farber Cancer Institute in Boston, Massachusetts. Her diverse carrier spans traditional and nontraditional pharmacy settings, including large academic medical centers, small community cancer centers, and she's also consulted for electronic medical record implementations, creates digital products for oncology clinicians, and creates content for patients in the health care technology space. With a passion for expanding oncology pharmacy education, Kelley's even developed a unique learn oncology framework, which is a unique approach designed to help pharmacists build their knowledge and confidence in oncology. She's also a prolific content creator and a member of the LinkedIn Top Voices program, sharing valuable clinical insights and motivation advice with her audience. So you can see, Kelley's got a lot of unique experiences, and so we're excited to have her on the podcast today.
Justin Cole:
01:37
Kelley, thank you for joining us.
Kelley Carlstrom:
01:40
Thanks so much, Justin. I'm thrilled to be here.
Justin Cole:
01:43
Yeah. So, I am not an oncology guy. I most of my listeners know that, I'm in pediatrics in terms of my background, and I've covered a whole lot of different services as a pediatric pharmacist, but I haven't done oncology. So you're gonna fill a lot of knowledge gaps for me even today. So as we get started, I'd love for you to just kinda share your journey about how you ended up in oncology pharmacy and what inspired you to specialize in the field.
Kelley Carlstrom:
02:10
Well, maybe I can convince you that oncology, even in peds, is the way to go for you, Justin.
Justin Cole:
02:14
Hey. I'm open. I'm open.
Kelley Carlstrom:
02:18
So I actually never liked oncology in pharmacy school. It was not my favorite topic. It's really difficult as we all remember, and, you know, nobody really graduates with any kind of depth of oncology knowledge because there's just too much for the curriculum in pharmacy school. So what happened was in my final year of school, my grandmother developed acute myeloid leukemia. And at the time, I was the only person in the family with with a health care background, so I kind of did the deep dive into what's going on with this cancer diagnosis and educating my family, and that really took a hard pivot in what I thought I was gonna do.
Kelley Carlstrom:
02:54
I had planned to do postgraduate residency training, and once I got there, I, you know, started moving more in the oncology direction, ended up doing a PGY two in oncology. And it's really my grandmother's treatment and, of course, her whole experience that drove me into this field because I just saw so many gaps in her care. You know, she was receiving world class care at a very large academic medical center, but there were still a lot of gaps. We didn't meet a pharmacist on her journey, which I thought was, you know, not great. And so I really wanted to make an impact in patients like her.
Kelley Carlstrom:
03:29
So that's how I got into this crazy specialty, and, it's been a wild ride, and I've loved every minute of it.
Justin Cole:
03:35
Well, I'm always struck by how often people have unique experiences in life that drive them in a particular direction or specialty. And, of course, you're not unique in that in that way. So thanks for sharing the story about your grandmother. So before we dive into some of the innovative stuff that you get to do, maybe we could tell our listeners a bit more about your role as an oncology pharmacist. So what role do pharmacists play in an oncology care team, and how can they advocate for their patients more effectively?
Kelley Carlstrom:
04:06
There are a lot of roles for an oncology pharmacist, and I think a lot of people don't expect kind of all the different avenues you could work in. Certainly, patient care is the most common, and even within patient care, there are a lot of different kind of buckets or areas you could work in. A very common one is in an ambulatory infusion center. So this could be attached to a larger hospital. It could be a stand alone independent center.
Kelley Carlstrom:
04:31
It could even be a small private practice that does infusions in there in that oncologist practice, whether it's one oncologist or, you know, many. So at the high level, what an oncology pharmacist does is ensures that the patient is getting safe care, that the dose and the medication and the timing is all correct. Just like across any other specialty in pharmacy, that is our role to ensure safe care, but also efficacious care. Is this the best treatment? Is there anything we need to optimize?
Kelley Carlstrom:
05:04
What are the patient unique factors we need to consider? You know? Should they be getting this particular chemotherapy with a comorbidity? Is there something else we need to consider? Of course, drug interactions, infusion reaction risk, you know, all the typical things that we're looking at.
Kelley Carlstrom:
05:18
We, as an oncology pharmacist, are just looking at it with incredibly complex drugs, you know, not just, our traditional cytotoxic drugs, but, you know, we have so many drugs approved in oncology, and they're getting more and more complex, not just in administration, also compounding them, and, of course, monitoring for toxicities both during treatment,
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nd and some toxicities happen even when the patient is off therapy. So it's really important for us to be knowledgeable about this to, provide that safe and effective treatment. So infusion roles are very common. We've also got specialty roles, pharmacists that are working in specialty dispensing pharmacies with a lot of our oral oncolytics, of which we have tons, and there's more approved seemingly every week.
Justin Cole:
06:03
Oh, there are.
Kelley Carlstrom:
06:04
So that's a really important role. We have clinical specialist positions that are, you know, more working hand in hand with the doctor, helping select some treatment regimens, really getting deep into treatment monitoring. We've got, managed care roles, so pharmacists on the payer side that are working on prior authorizations or developing formulary lists. What treatments are they gonna cover? How is the insurance company gonna pay for all of these very expensive treatments?
Kelley Carlstrom:
06:33
We've got informatics. You know, we have to build the treatment plans to treat all these patients. Investigational drugs too. Huge in oncology since we have so many studies. So the world is your oyster in oncology.
Justin Cole:
06:46
Absolutely. There's just so much opportunity there. So you're already doing a pretty good job of convincing me that I need to pay more attention to oncology for sure. So, I wanna turn to some of the innovative things that you've done. So you've clearly functioned in a clinical oncology pharmacist space for quite a while, but now a lot of your efforts are focused on KelleyCPharmD . So I would love to hear a bit more about the space of teaching oncology content to others.
Kelley Carlstrom:
07:17
Yeah. I think, it's you know, like, a lot of people, I was listening to one of your, your previous podcasts just recently and thinking about the detour that a lot of our careers take and, you know, we don't plan for these things. I did not expect to start a business. This was not on my bingo card. You know?
Kelley Carlstrom:
07:35
I went through residency. I got a specialist role. I was in bone marrow transplant, which is what I wanted to be in. My grandmother had a bone marrow transplant, and that's just kind of the role I thought I would be in for my career. And there's just been some interesting kind of opportunities that came up, and it made me pause and think, You know?
Kelley Carlstrom:
07:52
And I let my curiosity kind of lead me, and it led me into some very interesting places, one of which was starting my business. And that came about because a lot of pharmacists kept reaching out to me, specifically through LinkedIn. I would get direct messages from pharmacists that were new to oncology. A lot of them were at smaller community centers and, you know, they kind of fell into oncology or they were voluntold. You know, somebody somebody retired, somebody left, and they're like, we need a body in oncology pharmacy. You're going over here. And they were scared
to cause patient harm as, you know, any of us would be. Oncology is complicated.
Kelley Carlstrom:
08:31
And so they were saying, you know, hey, how can I learn oncology? Can you point me to a YouTube video? And I would just get the same question over and over again. And finally, one day, that light bulb went off, and I said to myself, okay. There's a big gap here. What can I do about it?
Kelley Carlstrom:
08:47
You know? And I had to ask myself, can I do anything about it, and do I want to do anything about it? And so as I thought about those answers, that's kind of how the business got started.
Justin Cole:
08:57
So how long have you been doing KelleyCPharmD ?
Kelley Carlstrom:
09:01
It's been around, I mean, since I formed the LLC, it's been about five and a half years. And I think it was probably about two years before that of where I was just, like, in the weeds of thinking about it.
Justin Cole:
09:13
So, when I think about that timeline, it's clear that you've had time to develop this and, make the idea become really bigger than life and and come to reality. So I I'm curious. When you had that initial spark, there was a need for this. What do you think some of the biggest challenges pharmacists face? What are those challenges when they're learning about oncology? And how does your program address the challenges? I guess the first thing I think of is there's both breadth and depth of content you need to know. But what are some of those challenges that pharmacists face when they're learning in this space?
Kelley Carlstrom:
09:46
The biggest one is the share overwhelm, and it's only getting more overwhelming. It was overwhelming when I was training in 2011, and that is 2011 I think it was 2011 was the first year that immunotherapy was approved. And immunotherapy has blown up, like, every disease. I mean, pembrolizumab has 40 plus indications now. Like, we've all lost count. It's crazy.
Kelley Carlstrom:
10:13
And so it's getting more and more complicated, and and somebody at the beginning is trying to, you know, develop their baseline knowledge while the goal posts are actively moving on them. You know, the lung cancer guidelines this year alone, they might be on the thirteenth update, maybe the twelfth. So they've had an update every month this year, which is just as mind blowing. So overwhelm is definitely the number one thing that people come to me and say that they're struggling with.
Kelley Carlstrom:
10:38
And the way that I help them with that is through a very structured program because there's vast amount of information out there, but access to information isn't the problem. Like, we're pharmacists. We learn to find all the information. It that's not the issue. The issue is how do I organize this in a way that I can get through it in a structured manner that fits into my day to day work? Because I'm not learning oncology eight hours a day. I'm working, and I'm taking care of a family, and I have to do laundry at some point. You know, you have to fit in all of these life activities. So it's really trying to break it down into little bite sized chunks.
Justin Cole:
11:18
Well, I think the analogy you've used of the goalposts moving while you're actually in the game is so accurate for the oncology space. Every year, I kinda take a moment to look at the new drug approvals by the FDA. If you look over the last eight to ten years, I believe it's over half of the new drug approvals have been in the oncology space, the oral oncolytics and immunotherapy, all kinds of stuff you've already talked about. So it's this ever evolving field that makes something very daunting to learn about. So I love that you've broken it down into this, stepwise structure.
Justin Cole:
11:57
So let's talk a little bit about it. So I know that you've, called this the L.E.A.R.N oncology framework. So how does this framework help pharmacists build that knowledge and confidence?
Kelley Carlstrom:
12:09
Yeah. So there's a lot of components, I think, about learning oncology. It's the information is certainly one big piece of it. So my L.E.A.R.N oncology framework is the acronym L-E-A-R-N. So there's five steps and they follow that the word LEARN.
Kelley Carlstrom:
12:21
So the first L stands for "Level Up" your oncology knowledge, and that is that's the curriculum. That's the content. That's the information. There's tons and tons of information. Inside the program, there are 24 of topics and so these are all the topics, typical PGY2 resident would cover, you know, breast cancer, lung cancer, even things like practice management and clinical research.
Kelley Carlstrom:
12:45
Most of them are are disease clinically based. But that's the foundation of any kind of learning process for oncology is you have to understand about the disease and the treatment. I think that sometimes some one thing that trips up pharmacists is when they're learning oncology, they're focusing on the drugs because we're the drug experts and that is very true, but disease biology is super important. Super important not just for you to understand, like, how the drug fits in the world, but also to understand how it how it relates to other maybe similar diseases because we use drugs across multiple diseases and so when you understand disease biology, you can better appreciate, oh, yeah, this is why we're using the same drug or this is the mechanism or maybe the drugs you like, we're relying on a different mechanism and a different disease. So it really helps to understand the disease piece. So that's something we focus on in the in the first step of this framework.
Kelley Carlstrom:
13:39
The other four steps are what I have found working with so many pharmacists over now this program is going into its fifth year. And there are pieces that seemed intuitive to me at the beginning, but were not part of the typical learning environment. And so the second step is, for E. It stands for "Engage With Experts and Peers."
Kelley
Carlstrom:
14:01
And what I think pharmacy doesn't do great at is community. And by community, I mean us all coming together and discussing things, discussing, like, learning and difficult cases and, like, hey. I've got this patient who got this drug and they've got this really bad uncontrolled blood pressure and they're on three drugs already and, you know, how do we do we need to change their cancer therapy or is there something else we can do for their hypertension? You know, having those discussions enriches everybody, but it also speeds up the learning process. Because if you're just reading and reading and reading, which we all love to do I love to do that. You know, you fall down these rabbit holes, and then it takes you a long time to get to the answer that could be, more efficiently achieved by having discussion with people who've been there. So that's really important part.
Kelley Carlstrom:
14:50
A in the process in the framework stands for "Accelerate your Critical Thinking." And how we do this in my program is on monthly live calls with experts. So I've got an expert.
Kelley Carlstrom:
15:01
I hire an expert for every of for all of those 24 topics in my program because I can't be an expert in every disease, nor do I want to be in this day and age in oncology. It's just there's too much. So I'm hiring the people that are in patient care right now taking care of these patients, and they're coming on live calls every month. And we're talking about patient cases and they're giving an overview of their disease and we're answering questions and having that discussion that really takes the information you learn to the next level. You know, trying to think through, okay, the the guidelines say we should use this treatment, But, you know, the study that approved that was in people that were 35 years old with an ECOG performance status of zero and my patient's 65 and is in bed half of the time.
Kelley Carlstrom:
15:46
You know, that's not the same scenario. So, how can we apply that and how can you use that information if you need to write, say, an appeal letter to the payer because they're not gonna approve it because it's maybe outside of the guidelines. You know, I think that's the tricky part when you're learning oncology is you really think the the national guidelines are the end all be all, and they are very important and, critical in how we treat patients. But they're not the they're not God. You know, they have they're they're written by people and, patients are, you know, have unique scenarios, so those are the things we talk about.
Kelley Carlstrom:
16:22
There's two other steps in the framework. R is "Reflect and Practice," so taking the information you've learned in the curriculum from the experts, from the community, and bringing it back to your practice and applying it to your patients that you see every day.
Kelley Carlstrom:
16:36
And then lastly is "Nurture your Growth" because we, you know, it's easy to get in the weeds
of our day to day careers and, like, going to work and coming home and cooking dinner and and doing all the things. But there's, like, bigger picture things in our career that we should think about, not just, you know, the the disease specific clinical topics, but also, you know, how can I get better at reviewing clinical literature because that that's really important in oncology? Or, you know, what about medication access? Should I know more about that? You know, I know my patients struggle to afford these drugs, so how can I can I do something about that, or can my system do something about that? What about other career opportunities in oncology? You know, if you wanna pivot and do something different, you know, what are what are other ways I can leverage the skills that I have? So it's a very comprehensive program that starts with the knowledge in oncology and and, walks you through the process of how to make progress in your career.
Justin Cole:
17:35
Kelley, I don't know how intentional you were in looking at some of the most recent science on learning, but, wow, you've got some great stuff going on. I think of the idea of scaffolding, right, where you're starting with that knowledge base, that framework that then they can start to expand and build upon as they go forward. You've built in this idea of learning together, right, where you're able to critically think through something and then hear the perspectives of others that inform your own thinking. You've got the idea of recall. Right? Simply having them recall and apply. So, wow, I'm already impressed with even the pedagogical approach and the the framework. It sounds like it's a great approach and probably a lot of fun too for those who get to go through it. I'd love to ask you a little bit more about the importance of mentorship in your programs. You've mentioned that that's part of the framework.
Justin Cole:
18:29
So what do you think are the biggest benefits from the, that the mentees get from having a mentor?
Kelley Carlstrom:
18:37
I think when you are able to connect with other people in your career, you know, it's really a fast track to learn from other people's experiences. And, you know, there's different there's different terminology, mentors versus coaches, and depending in the context right there, it it means different things. In the context of my program, so we kind of have mentors in a in a couple different capacities. One is in our community forum. So I have our experts in each of our topics.
Kelley Carlstrom:
19:07
They are in there answering questions during their weekly lesson. And I also have a couple what I call resident oncopharms, which are experienced oncology pharmacists that are hanging out in the community answering questions because they love that type of interaction. And I was just I was just messaging one earlier today, and she was telling me, you know, she really loves the idea to pay it forward because she has learned from all these people. You know, we're all standing on somebody else's shoulders of learning from the experience of other people. And so turning around and pulling somebody up behind us to help make their journey a little bit easier is, you know, what gives me personally fulfillment, and I know a lot of the pharmacists that I work with, that support my clients in my program also.
Kelley Carlstrom:
19:51
Additionally, I do have, kind of a stand alone mentorship program that, for example, I have a new client in and she joined because she is she's been in oncology a long time, and she just got an opportunity to give a CE talk in oncology. And that's her first oncology presentation, and so she recognized, okay. I need some extra support. She didn't do residency training. She wants somebody to, you know, bounce ideas back and forth and talk about, you know, what's the best way to present this.
Kelley Carlstrom:
20:21
Here's my audience. She's presenting to a mixed audience of, you know, some oncology, some not. So that's a different type of of presentation. Right? And and trying to, you know, get people interested because if you're not in oncology and you're at a presentation and it's not and it's an oncology focused, right, you might tend to zone out.
Kelley Carlstrom:
20:39
So we want people to be interested in oncology because there are so many opportunities and will continue to be. We want pharmacists to come over to oncology. I try to steal people all the time from other specialties. And that's something that mentorship can do. It's like it fast tracks you. You get to learn from the experience of somebody who's been there before and help them kind of show you the way.
Justin Cole:
21:03
So, Kelley, I'm sure there were people that helped show you the way even, when you were starting a business itself. So, did you reach out to other people when you were thinking about this idea, and how were they instrumental in helping you to get this off the ground?
Kelley Carlstrom:
21:19
Yeah. Definitely when starting a business, that was super overwhelming because I didn't know anybody. This was, you know, kind of at the beginning of the pharmacist entrepreneur movement. I know Blair at the Pharmapreneur Academy, is kind of was, like, the original pharmacist entrepreneur, and I remember chatting with her early on. She was super helpful.
Kelley Carlstrom:
21:42
I also had reached out to a pharmacist colleague in oncology I knew who had done some consulting work because when I first left clinical practice, I took, a consulting role doing EMR implementations. And at the time, I knew nobody who was doing that type of consulting. And, honestly, it didn't sound like a real job. So I had reached out to her, and I'm like, this seems a little weird.
Kelley Carlstrom:
22:03
What do you do in your consulting role? And, you know, that's where there's a lot of these questions we have that just aren't Googleable. Right? You know, you can't a lot of oncology questions, a lot of career
questions, I couldn't find the answers that I needed, so it's all like, who do you know? What's your network?
Kelley Carlstrom:
22:20
And also resources. Like, I listened to a lot of podcasts early on. So I mentioned, that I had about two years in, like, the thinking mode before I actually, you know, registered my LLC, and that was during I was traveling a lot consulting. I was on a lot of planes, so I listened to a ton of business podcasts, and 90% of them were over my head. I didn't know the terminology, but I kept at it. I kept, like, I got little nuggets from each one, and so it's just, you know, following the following the thread. You know, pulling on the thread that's interesting to you and following your curiosity is is really what got me here.
Justin Cole:
22:56
So a big part of what you're doing, now is also marketing. So how did you get the word out that KelleyCPharmD could help with all of the oncology training needs for pharmacists?
Kelley Carlstrom:
23:09
Justin, do you have a marketing class?
Justin Cole:
23:12
We do have some great marketing classes here, but, you're not gonna look to me to help you out with that.
Kelley Carlstrom:
23:19
Marketing is such an interesting, part of business that I knew nothing about because we don't get taught marketing. But, honestly, we probably should be taught marketing because we're always marketing ourselves as a as a professional. Right? Marketing ourselves to our doctors that you can trust us and take our recommendations, marketing ourselves to, you know, potential employers during interviews. So it's a critical part, and it started for me through LinkedIn because I had been active on LinkedIn for many years.
Kelley Carlstrom:
23:50
I mentioned that's how I got my initial idea for this was through messages. But I just started posting. I started creating, an email newsletter, and I was emailing people with ideas. And, you know, I remember I sent out, my first kind of offer idea and got crickets. Like, nobody was interested, and that okay.
Kelley Carlstrom:
24:11
That made me think, okay. Either it's a really bad idea or I talked about it very poorly. And it turns out it was me talking about it poorly. So it's really now now that I've had enough time under my belt, what I've realized is everything is an experiment. There's no right or wrong.
Kelley Carlstrom:
24:30
It's kind of the same in oncology. Like, everything is gray. There's very few right or wrong answers. It's all, like, what's best for this particular patient. It's the same in business.
Kelley Carlstrom:
24:39
It's like what let me do an experiment and see. Did that work or what resonated with people? What do they actually need? What do they want? And, you know, circle back and make changes because of that.
Justin Cole:
24:51
Well, you've just mentioned a a couple important things. One thing going back that you said was not everything is Googleable. Right? And I would argue today as we sit here in 2025 that not everything is
going to be AI-able either. Right?
Justin Cole:
25:06
That's kind of the next iteration of technology that's really coming to us, but we're still going to need clinicians with the expertise that you have to inform the AI that we use to contextualize it and to apply it to those given patients. So, that knowledge is critical. Another thing that I was just kinda reflecting on is as we bring on guests, there is this theme of using LinkedIn to gather a network and to connect with people. Our our guest last month said the exact same thing. And, honestly, that's how I connect with a lot of people that I we bring on the podcast.
Justin Cole:
25:43
And so I would encourage you as listeners, if you aren't on LinkedIn, wow, you're missing out on some great opportunities to meet people who can help you on your professional journey and to learn and grow as part of those connections. So, this isn't a commercial for LinkedIn, and yet I can say from my experience, and it sounds like yours, that it can be a powerful tool.
Kelley Carlstrom:
26:06
For sure.
Justin Cole:
26:08
So another thing, Kelley, you've had a lot of different experiences. You've mentioned consulting on EMR implementations. You've been in other different oncology settings. So you have a lot of experience. So how has working in various health care settings influenced the development of your oncology training programs?
Kelley Carlstrom:
26:28
Yeah. So my, I think if I had not worked if I had not worked in a community practice, I'm not sure if my business would have got started. So I worked, in academic medicine most of my clinical career, and I ended up working in a small community cancer center that had two physicians. So tiny practice. I was the only oncology pharmacist, which meant I did all the order verification, all the product verification.
Kelley Carlstrom:
26:55
In an oncology, that is not best practice. You're supposed to have two pharmacists sign off. But this is the majority of cancer centers across this country or that type of prep. Maybe not quite that small, but community practices. Eighty percent of cancer is treated in community practices.
Kelley Carlstrom:
27:09
And it's very different than academic medicine in the sense that, you know, like, physicians, for example, are generalists. They see all comers. If there's a myeloma, a patient with myeloma that walks in the door and then a breast cancer and then a melanoma, they're treating everything versus in an academic center, you've got more specialists, and that's where you typically find the pharmacist that are specialists as well because they usually mimic the physician model. And there are pros and cons to both. You know, I think one of the big challenges right now in community, both for the physicians physicians and for the pharmacist, is is the overwhelm of all the new drugs.
Kelley Carlstrom:
27:45
The doctors can't keep up anymore than the pharmacist can keep up. You know? It's just rapidly moving. I think they said
what our in oncology, it's like every 70 days, the medical literature doubles or some ridiculously obscene number. And, I mean, there's just no way for for people to handle that.
Kelley Carlstrom:
28:02
So I think that is, that's the big reason why I started recognizing the need that was out there because I got in that role, and I realized, like, I was leaning on my network a lot. I would call my my solid tumor pharmacist at my old job and said, like, hey. I've got this lung cancer order. Like, what am I doing with this? This does this looks a little weird.
Kelley Carlstrom:
28:26
And because I didn't work a ton in solid tumor, and that got me thinking, okay. What if I was somebody else who didn't have my network? What would they do in this situation? Who would they call? They don't have any colleagues in this I'm the only one.
Kelley Carlstrom:
28:38
Luckily, I had a really good technician there who, had been around a long time and helped me a lot. But that made me recognize the gap that there is in community. So that was super helpful and and critical in me developing my content. And how I even kind of broached the idea of starting a business was when I got into consulting because I moved from a w two role into a consulting ten ninety nine role. And all of a sudden, I was, like, working to put myself out of a job, which is such a strange career path.
Kelley Carlstrom:
29:12
I'm like, wait. Why? Like, I signed a twelve twelve month contract, but I'm like, technically, I'm putting myself out of work in a year. You know, so you're you're just constantly looking for the value you add instead of I'm pulling a paycheck. Like, yes, I'm taking care of patients.
Kelley Carlstrom:
29:28
I'm showing up to work every day and doing the work, but it's a very different mindset of I need to make sure people see me as valuable and the work I do is valuable because I need to get another job at the end of this. And that made me think more from the business mindset and the value forward mindset, And that's what triggered of, like, okay. This is, you know, kind of just the business learnings of people why do people buy things?
Kelley Carlstrom:
29:52
So, you know, when I was hired as a consultant, they hired me because they had a pain point. They could not get their EMR off the ground with the staff that they had, and it was painful. Painful in the tune of millions of dollars they are spending, you know, just spinning their wheels. And so when you start learning about, okay, people pay money to solve problems, painful problems, that that gave me a lot of perspective of kind of the business world, and that that really, jump started my path.
Justin Cole:
30:23
Well, I can't help but go back to the comment you just made about the amount of literature in the oncology space. So, I'm just curious. How do you personally stay updated with all of these advancements in oncology, and how do you then incorporate these updates into your training programs?
Kelley Carlstrom:
30:38
That's the million dollar question. It's so hard to keep up. I mean, there's a there's a lot of tools out there to help push information. You know, certainly, my favorite is the FDA, drug pushes when because we just have so many approvals in oncology. So that's kind of critical to get them in your inbox, both brand new drug approvals and label updates.
Kelley Carlstrom:
30:59
And, of course, there's journal articles that will push. You know, it's tough to read all of the journals that come out, even the table of content, so you have to be, you know, picky and choosy about what you're gonna get sent to your inbox. But what I do from the updating the program content and when I when I first started my business, I had to really think about this because, you know, what a lot of people do when you're teaching things online is you record, like, a video lesson at teaching something like didactic. And that's just not gonna fly in oncology because it's outdated in two days.
Justin Cole:
31:34
Absolutely.
Kelley Carlstrom:
31:35
So I had to think about, okay, what how am I gonna structure this where, you know, the content is gonna last a little bit longer? And and that got me into the model that I have now, which is both curated content, which means I find all the best information available worldwide online and pull it into one place, but I also hire that expert who works in that disease every day, and they're the ones that are up to date on it. They see this patient in and out and they you know, when somebody's seeing 30 brain tumor patients every day versus somebody else who maybe see one every six months, you know, it's a very different experience. So they are bringing their knowledge, their expertise, their up to date information, which, you know, we just had. So we're recording this in mid December.
Kelley Carlstrom:
32:19
We just had the big ASH meeting, which is a hematology congress, and there's gonna be lots of stuff coming out from that, abstracts that were presented, you know, practice changing things. There was just a big breast cancer conference too. So these are the things, these experts are hearing these conversations. A lot of them are at those meetings, and they're bringing that into the curriculum, into our community, onto our live calls, and that's a great way to stay up to date.
Justin Cole:
32:44
I love the fact that you've just tapped into this or maybe not even tapped into it, created this network of people who can contribute. I love that framework. I love that model for how you've done that. I'm guessing your experts are not just pharmacists, but probably physicians. Is that correct?
Kelley Carlstrom:
33:01
I actually use only pharmacists right now.
Justin Cole:
33:03
Great, OK.
Kelley Carlstrom:
33:04
Because I do target my target client is pharmacists. I have had a lot of, interest in spreading actually just got a message on social media today to, train doctors on new prescriptions, on new medications in
oncology.
Kelley Carlstrom:
33:18
So and particularly, like, nurses, nurse practitioners, physician assistants. We use, you know, a lot of mid level providers in oncology. But as a currently still one woman solopreneur shop, I focus on pharmacists, and I do find it beneficial for my clients to learn from pharmacists because, you know, we understand our our model, our, you know, training, the the information that's helpful, how to use a pharmacist in in practice, like, what's the impact we can make, the type of interventions we can make. And so, yes, my experts are all pharmacists that are in patient care.
Justin Cole:
33:55
Oh, that's great. And I think as an entrepreneur, you've just, taught a couple of lessons. You always have to know your why, and you've got to know who you're serving. Right? You you we can't solve world peace with anything new that we're creating as innovators. We we've gotta know who we're what we're working with, what problem we're solving, and sometimes that can bring the clarity we need to say no to really great opportunities when it's necessary.
Justin Cole:
34:19
But it also illustrates that the sky's the limit. You there's always new opportunity that you can dive into, if you're ready for it. So, I'd love to hear, do you have any particular success stories that stick out about someone who's used your training program and they've been significantly impacted as far as their career goes or the patient care that they can provide?
Kelley Carlstrom:
34:42
Yeah. Several different examples. There is I've one of my clients who works in managed care, so she was seeing orders from the payer side coming through for approval and saw a patient who was being treated for breast cancer, had HER2 positive breast cancer, and did not have an anti HER2 therapy in her order. And so on the payer side, she reached out to the physician, you know, a little timid. She was still learning oncology and said, like, hey. I think maybe something's missing. Did you wanna add trastuzumab? And they realized that, yeah, that was an error and omission, and the patient should have received that therapy.
Kelley Carlstrom:
35:22
And so she was just tickled because, you know, you don't often get on the managed care side, like, that big of an impact on a patient. Like, that could have made a big, a big change in her in her treatment success. So that's one great success.
Kelley Carlstrom:
35:36
I've also had a lot of of my clients come to me and talk about the confidence that they get from being able to develop their knowledge and also understand what is going on around them, both when their teams are talking, when they're at tumor board meetings. So, for example, one of my recent clients was talking about she had kind of put on the back burner, the fact that she could really develop this in-depth knowledge. She kinda thought, like, maybe she wasn't smart enough or, you know, she's an older pharmacist, so maybe she just, like she didn't go through her PharmD initially, so maybe, you know, it's just she's gonna relegate herself to kind of building the EMR care plans and doing the inventory management and still, like, taking care of patients, but not getting deep in the weeds of of the clinical. And she realized after joining my program that she can actually manage complex patient care.
Kelley Carlstrom:
36:32
It just takes time to develop that knowledge and to to be able to speak the language of oncology. It's like learning Italian or maybe more like Chinese because Chinese, you know, you have to be it's hard to get to the fluency of, you know, learning Chinese. It's the same with oncology, and it just takes a lot of time. So a lot of my clients have that that kind of confidence boosting.
Kelley Carlstrom:
36:57
And then when you get a boost of confidence, you you can see your progress. Right? And so you start making more, investments in time and and effort. And, you know, same with one of my early clients. She came to me in an infusion role. She got promoted to a clinical role. Then she was, teaching at the school of pharmacy. She was teaching the medical fellows at her site. She was interviewed on a podcast as a GU expert. I mean, it's just amazing, like, to see the progression that people can can make over time.
Kelley Carlstrom:
37:28
And I would encourage people I always remember this, this quote is that we grossly underestimate what we can do in the short term... we overestimate what we can do in the short term and underestimate in the long term. Right? So you think five years is a long time, and so you can't it's hard to envision that far in the future, but you really can make big strides. But, you know, when you think of just six months, there's a lot going on in the next six months. You know?
Kelley Carlstrom:
37:55
So it's hard to you're gonna you're you're gonna want to make more progress in the next six months than you probably will because you are kind of growing you're, like, growing the, the Chinese bamboo tree. Have you heard of this, Justin?
Justin Cole:
38:09
I don't know that I have.
Kelley Carlstrom:
38:11
So the Chinese bamboo tree, it grows underground for five years. And you have to, like, nurture this invisible tree for five years. It's because it's developing its root system. And when it grows up, it, like, shoots out of the ground. I'm like, I totally feel like that is oncology.
Kelley Carlstrom:
38:30
Right? You're you're nurturing your roots here, and you're not seeing much progress, and so you get frustrated. And I'm like, you're like, oh, I'm not smart enough for this. I can't do it. But once it starts clicking after, you know, time, you realize, oh, okay. Like, I'm starting to see the the Lego pieces click together, but you gotta you gotta be patient.
Justin Cole:
38:50
Well, I'm gonna have to use that analogy for a couple different things. So thanks for sharing it. Yeah. I can see where those who go through your program would definitely be developing that
confidence, and and sometimes it takes some of that hard work before suddenly it's like, oh, wow. A light bulb just went off. But it's a that's a fun moment.
Justin Cole:
39:09
So a couple questions as we wrap up here, Kelley. What advice would you give to pharmacists who are new to oncology and they're feeling overwhelmed by the complexity of the field? Well, number one, let me just suggest, go and find KelleyCPharmD. But what other advice would you have for these pharmacists?
Kelley Carlstrom:
39:25
Yes. Please come to me. I love giving pep talks. I do I give a lot of pep talks about the overwhelm. I the, you know, the thing is you gotta really embrace the madness that is oncology because there's always gonna be overwhelmed.
Kelley Carlstrom:
39:38
I am continually overwhelmed in oncology. It's just it's never gonna go away with the rapid pace that we've got. But I attribute it to or I liken it to the analogy of a hurricane. So at the beginning, when you're in a hurricane and you're on the edge of the hurricane, you are just getting whipped by the winds, by the rain, by lawn furniture flow floating around. Right?
Kelley Carlstrom:
40:00
It's just it's not a good place to be. But over time, where I'm at now is I've made my way to the eye of the storm. So it I still see all the chaos around me, but it's not impacting me as much. Like, I know kind of where to go to avoid that lawn chair flying happy, you know. So it it is the overwhelm's always gonna be there. Embrace it. Reach out for help, and you absolutely can get through it.
Justin Cole:
40:27
Oh, that's great advice. So are there any future trends in oncology pharmacy that you're excited about? And how do you see yourself in the future helping pharmacists to really embrace and lead these emerging, developments?
Kelley Carlstrom:
40:43
The the biggest exciting thing is just the growth in oncology. I mean, this is a this is the best time to be in oncology pharmacy. There are so many job opportunities. I mean, it's not great right now for cancer centers because they are mostly continually short staffed. You know, they've got there's just a lot of people, a lot of people that we need working in direct patient care, and there's a lot of issues with that.
Kelley Carlstrom:
41:08
We've had attrition of people leaving clinical practice. We've also had a lot of growth in cancer centers, so new cancer centers popping up, cancer centers, expanding, and this is this is countrywide. Like, sure, there's some areas where there might be, some centers that go under, especially in rural places that we know that's a difficult financial, situation. But for the most part, oncology is well, rapidly growing across the country, and that just leaves a lot of opportunity, especially for direct patient care. But that's not the only place that you that can see growth.
Kelley Carlstrom:
41:44
So I worked in tech, in the technology side of health care for many years, both on the EMR side, but also in the start up
digital health space. And that is still, like, not quite mainstream, but there's more and more roles. I've actually just in the past month or so chatted with a CEO of a of a tech start up that was looking for a pharmacist. Actually, initially, she didn't know what kind of role she wanted. Somebody told her, oh, you need a BCOP in that role. And she knew me through a connection, and so we got on a call. And I'm like, yeah. This is a perfect role for a pharmacist. Here's why. And so there's a lot of opportunity for us to work in nontraditional roles, and use use the knowledge we have.
Kelley Carlstrom:
42:29
Because oncology is so incredibly complex, a lot of people outside health care are just never gonna be able to grasp those complexities. So it's our job to be that clinical liaison, that operational liaison, that workflow liaison. Like, hey. This is how a patient goes through. This is what the throughput looks like in a cancer center.
Kelley Carlstrom:
42:48
This is what a typical treatment, experience would look like for a patient who's getting, intravenous therapy, oral, surgery, radiation. You know, there's, it's so complex, and that knowledge of the kind of bird's eye view of a patient's treatment is really where pharmacy can excel. Because if you think about our other professional colleagues, like, nurses, mid level practitioners, like, they all do great work in their particular lane, but they don't see everything we see, especially because we see the menus process. So our knowledge and experience can be used in a lot of different industries.
Justin Cole:
43:24
Yeah. I think it just after this conversation, there's no question that the opportunities are bounding in oncology pharmacy. So if you're a listener, I hope that some of you are inspired to jump in and to go be the oncology pharmacist that we need out there and learn a little bit more. Kelley, as we as we finish up, what's next for KelleyCPharmD? Do you have any new things you're working on that that you can share with our audience?
Kelley Carlstrom:
43:49
I do, actually. I am, I have just developed an assessment tool, and so this has been a long time in in the making. And the goal of this is for my clients that go through the program to be able to better track their progress. And it has it is a labor of love. It's taken many months, as I'm sure you can appreciate with, you know, any type of assessment, really trying to help pharmacists see the the global view of their oncology journey because it is it is, you know, the default to kind of get stuck in the day to day stuff, especially when you're learning clinical things.
Kelley Carlstrom:
44:24
Like, okay. I'm focused on diseases and drugs, but there's a lot of questions in this assessment that will help them, understand that, hey. I have made progress in, you know, this particular category because I forgot. Yeah. I participated in writing a a monograph for P&T, or I remember this physician asked me this question about this particular treatment, and I was able to look up x y z.
Kelley Carlstrom:
44:44
And, you know, I think that when you can when you can track your progress better, I think it just gives you that dopamine hit you need to continue to put in effort. Right? Again, growing that invisible bamboo tree. You need that constant work. And so that is, the assessment is written, and I'm in the kind of, development process of it now.
Kelley Carlstrom:
45:05
It's being, uploaded to a website and doing the the QA process and all the things behind the scenes o to launch something like that, but I'm super excited to get it out into the world.
Justin Cole:
45:16
Well, that's great. I'm excited to see all the the new things that you continue to develop. So where can our listeners go to learn more about what you do?
Kelley Carlstrom:
45:23
My website is kelleycpharmd.com. Kelley's with an E-Y here. And then, of course, please find me on LinkedIn, especially if you are in oncology, considering oncology. I share a lot of oncology content on LinkedIn, and I know pharmacists love to be lurkers versus engagers there, because I meet a lot of you at conferences. And you say you like my stuff on LinkedIn, but I don't know who you are. So send me a connection message and say hi.
Justin Cole:
45:51
Oh, that's great. Well, Kelley, it's been an absolute blast to talk to you, to learn about oncology and to learn about some of the great stuff you're doing. Thanks for joining us today.
Kelley Carlstrom:
46:01
Thanks so much, Justin. This was fun.
Justin Cole:
46:04
You have been listening to DISRxUPT, a podcast from the Cedarville University Center for Pharmacy Innovation. If you enjoyed listening today, please subscribe and share this podcast with others. Thanks for listening.