One never sits down to write about oneself without a certain amount of hesitation. Even so, I wish to share some relevant life and professional experiences so that clients and potential clients can know me better. After all, the Pharmacist-In-Charge of your sterile compounding pharmacy is someone very important in your life – and the lives of your patients. Your “PIC” needs to be transparent, open, available and authentic. My goal is, and has always been, to be an “open book” with a true “open door” policy in which you can believe and trust.
First and foremost, I am a scientist – and my chosen field is pharmacy. I have been a pharmacist for 30 years, my father and my brother are fellow pharmacists, and I grew up in the family business. My dad was a successful businessman – as well as a talented, competent clinician. He was very knowledgeable on all drugs and medical conditions, so he was anything but a passive professional. He was not seen simply as a doctor’s referral, but as an integral contributor to the care of their patients – and doctors and their patients trusted him. People would talk with him at great length in his office. He had a small waiting room, four leather chairs, and prints of Greek and Roman individuals holding botanicals or roots in their hands depicting the origins of pharmacotherapy.
My dad was appreciated by so many in his life that there was probably a point where I said, I’m going to be just like you, Dad: driven and determined – in some ways, good and some ways, bad. One of my father’s beliefs was very appealing to me: Be the best you can; and especially always be the best in pharmaceutical matters. You’ve got to know everything so when a doctor comes to you, you can answer his questions succinctly and help him make a decision in the care of a patient. Having stated this, I also know my limitations.
When I graduated from the Pharmacy School at the University of Arizona, I had accumulated extensive knowledge in sterile compounding. I immersed myself in this area of pharmaceutical science and its new treatment modalities, and I brought its new disciplines to my family pharmacy where I began my career. We began offering compounded sterile preparations to long term care facilities, home care and hospice patients – all of which presented their own special challenges and therapies over time. I also took a keen interest in various specialties of medicine as I began developing relationships with many physicians and health care providers.
By 1996, I observed significant deficiencies in the traditional treatment of chronic pain management with oral medication. I was very intrigued with the concept of treating chronic pain in the intrathecal space; and I was fascinated to learn that different pharmaceuticals administered in this area achieved great results in relieving pain and spasticity. It was clear that providing medications for the intraspinal space would require a higher level of care for sterile compounding – i.e., a cutting edge environment. That was the “ah-ha” moment. I realized that I had to change my organization by building a clean room environment that exceeded then-current standards.
Nothing is more important to me in the pharmacy than safety for patients and staff. In 1986, for this reason, when we built our first clean room – a separate, dedicated, and enclosed sterile compounding room. At that time, this was a very advanced engineering controlled environment to safely compound medications. In 1997, we upgraded again to provide a larger environment with enhanced air quality. Then, in 2008, we moved to our current location which doubled our clean room capability – this time with superior air quality exceeding federal and state guidelines. To manage and mitigate risk, we enhanced many procedures at our new location to provide an extraordinarily high level of quality and, therefore, safety for our patients. I consider safety to be the most important part of our Patient-First Culture. Safety is peace of mind for our providers.
I admit it: I’m a traditionalist when it comes to service. You’ll see some drawings of me in our marketing materials and on our website in a “Norman Rockwell” style evoking the pharmacist as a reliable, friendly and trustworthy member of the community. I like that ideal of looking you in the eyes and shaking your hand warmly. I visit my clients regularly. I find very few of my competitors – many of which are funded by venture capitalists – willing to travel and meet their clients to establish a long-lasting relationship.
I’ve always believed that, as a pharmacist, I must make myself available to address your questions and help you understand the care of your patient. Increasingly, as our intrathecal work expanded, I found myself working closely and consulting with many physicians in the then-new field called interventional pain management. It was instinctive for me to come from a feeling of I’m here to help you in whatever way I can. This mindset is a cornerstone of Hartley’s culture.
Each of us has experienced the feeling of many “corporate” impersonal, cold clinical pharmacies where you are treated more as a number on the prescription bottle than as a human being. We know that we can provide a far higher level of service and quality than the “corporate” providers. We also provide the small town feeling of personalized caring – authentic caring – about what happens to our patients and their physicians as well as the nursing in-service and operations teams.
Every Hartley team member is trained in our “Patient First” philosophy. Our pharmacists choose daily to adhere to strict standards with deep clinical knowledge. Our Q-A team is motivated to assure quality for all of our patients. Our customer service representatives are warm, responsive and skilled in helping you place and track orders with ease. The folks on the “business side” of Hartley work hard to assure ethical and fair business practices such that we transcend the prevailing standard.
Our intention is to backup on a daily basis what we say about setting the standard™.
In the beginning of providing compounding services for interventional pain physicians, I intensively studied the agents and regimens employed for relieving chronic pain. I educated myself about the nation’s leading publications for pain physicians. This enabled me to converse with physicians and other health care professionals on a greater level of mutual scientific understanding.
In early 1996, I convinced a handful of pain physicians to trust us to provide services. As months progressed, I reached out to many physicians in the Southern California and then Northern California. I enjoyed driving or flying to see prospective clients and encouraging them to choose Hartley Medical as their trusted provider. From California, we expanded northward and eastward.
Our growth initiative propelled Hartley to first become the dominant, leading compounding pharmacy in the Western United States (including Alaska and Hawaii) specializing in intrathecal medication. We continued to expand nationally; and, at present, Hartley has hundreds of physician clients and thousands of patients lining both coasts and numerous states in between.
As we have grown, we have chosen to lead. What Setting the Standard means to me is that all participants in the chain of custody of compounded pharmaceuticals need to be aware of – and support – best practices in the complex and ever-evolving field of sterile compounding. Patients are well-served that the conventional standards of care such as Pharmacy Law and USP <797 / 795> provide sets of guidelines and laws that govern our conduct and decision-making as we go about the task of compounding prescriptions using highly-regulated drugs.
As a pharmacy that is involved in interventional pain management, we believe – and we practice this belief daily – that our duty goes far beyond simply applying the conventional standards. We vigorously seek out carefully considered new methods and procedures to exceed the guidelines with which all providers must comply. Hartley views industry standards as the minimum; and we strive to achieve ever-higher standards to manage risk and provide a higher quality, superior product. I am of the mindset that the act of setting the bar higher than the conventional standard is the bedrock of Hartley Medical.
We owe a duty to our physicians and patients to think ahead by following and exceeding standard protocols and procedures. This is especially critical in clean rooms which are like complex organisms in that every relevant variable has to be considered for its impact on the safety and purity of the pharmaceuticals made within its walls.
It’s not just a superior clean room – it’s hiring, quality assurance, testing, service, culture, communication – a seemingly endless list of focus areas, all of which must come together to present a cohesive, effective, and compelling organization that our physicians and patients can fully trust. All pharmacies are not created equal; we work daily to earn and keep your trust.
There’s a famous phrase, “Trust, but verify” which I routinely practice. Our processes are a culmination of years of professional practice; thus, we trust those protocols. Yet, we constantly verify and test to make certain that the end result is safe, accurate and pure. We encourage you to undertake similar verification by putting us to the test.
Please consider the following question with complete self-honesty:
Do you, as the physician or a member of the physician’s team, know enough about your current sterile compounding pharmacy to say unequivocally that you confidently trust your pharmacy with the safety, well-being, and literally the lives of your patients?
We want our physicians and their teams to put us to the test because we seek to practice what we preach.
We fervently believe in performing due diligence with our vendors – specifically, our chemical providers and our analytical laboratory services. It logically follows that we also strongly encourage our clients to perform due diligence in respect to their choice of a compounding pharmacy. Over the years, I’ve had many professionals come visit Hartley Medical to see our operation, educate themselves regarding sterile compounding practices, and perform their own independent process of approving us as a trusted source.
When I speak at various industry and scientific meetings, I always emphasize “You need to have a specific conversation with your compounding pharmacist provider to determine if that compounding pharmacy is conducting itself in the provider’s best interests.” The common assumption that all compounding pharmacies are equal has been obliterated in light of the 2013 New England Compounding Center Pharmacy tragedy.
Hartley Medical warmly welcomes opportunities to exchange information and address questions from prospective clients and health systems. We strongly encourage all providers to seek out their compounding pharmacies, perform due diligence and become informed – all for the highest standard of care of their patients. This effort provides peace of mind and a greater understanding of the level of risk you’re taking with your compounding pharmacy. The small investment of traveling to physically see your compounding pharmacy will pay handsome dividends in the long run.
Before you trust a compounding provider, please take me up on my genuine invitation to come visit us. My door is always open – both literally and figuratively – so please know that I am serious about your visiting. After our tour, maybe join me for a round of golf, a glass of wine at the 19th hole, and a chance to get to know each other.
Thank you for considering Hartley Medical . . . and for reading my story.
William A. Stuart, RPh
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