Dr. Stephen Buksh, Northeast Tarrant Internal Medicine Associates in Texas (Part 2)

Contributors

In this new series from Stellus Rx, we’re exploring the perspectives and insights from our physician partners—healthcare providers who have dedicated their lives toward improving the lives of others.

In part two of this two-part interview, Dr. Stephen Buksh—a physician at Northeast Tarrant Internal Medicine Associates (NETIMA)— discusses the additional value his practice has received through its work with Stellus Rx, the value of team-based care and how he is able to reframe patients’ minds about receiving more high-touch care.

When you think about the way you work with Stellus Rx, how do you see that differentiated from what traditional pharmacies have typically delivered?

Dr. Buksh: The very top of the list of differentiators is that Stellus Rx makes sure that my patients are on their medicines like I think they are. It gives me a confirmation that what I think my patients are taking are actually the medications they’re taking. Because in a complicated patient—no matter what you’re telling them—if they’re not taking their pills, then their care can’t be managed.

The second part of Stellus Rx’s value comes from adherence. They’re ensuring for me that patients are continuing on their medications when a lot of barriers develop that I wouldn’t otherwise have visibility to … like, all of the sudden, they can’t afford the pills and they’re not picking up their medicines.

Or when patients just decide to stop their medications because they heard something or read something, that monthly touchpoint that Stellus Rx has with patients offers visibility and a chance to reframe patients’ understanding of the importance of medication adherence.

Ultimately, the pharmacists at Stellus Rx are impacting care in a way that I can’t. And in the process, together with patients, we’re able to reduce their risk for hospitalizations and emergency room visits. We’re improving patients’ A1C levels and helping diabetic patients move from uncontrolled to controlled; we’re reducing blood pressure and cholesterol and other metrics that truly help people live healthier lives.

What are the obstacles that you see toward getting folks to say yes for these higher-touch, personalized services and support?

Dr. Buksh: You know, many of my colleagues will tell me that they refer their patients to services like Stellus Rx, and their patients don’t like it. Their patients don’t want to do it. And I really believe that much of what creates that willingness to work with a pharmacist in a deeper way comes from me as the physician and how I frame Stellus Rx as a part of the care they receive from me.

I’ll often tell my patients things like, “You have a lot of complicated medicines. You have a lot of questions about your medicines. And I have a pharmacist that I work with named Emily, who works at Stellus Rx as an extension of NETIMA, and who has helped a lot of my patients. I think she’s going to help you tremendously if you let her.”

I ask the patient for permission for that to occur. But I’m really showing that I believe the service provided by Stellus Rx—by Emily, our pharmacist at Stellus Rx—will be beneficial. When I do that, it makes the difference. You have to bridge that gap on trust. Sometimes patients will come back to me and say, “I’m a little suspicious of that whole thing.”

And I’ve seen it help when I tell them that I believe this relationship with your pharmacist is going to be different than any other that you’ve had before. Give it a try. And oh, by the way, this service is included in your standard copay. This is a part of the care that I provide, that you get from my practice, because we’ve made this happen.

Sometimes patients still don’t enjoy the idea of talking about their health every month, but I encourage it because it’s good for them to reflect on their health and how it could be better. It helps to have another person in their Stellus Rx pharmacist who’s deeply invested in helping them change their health for the better.

How do you think about the importance and the practicality of team-based care, where the pharmacist is connected directly to your work in caring for patients?

Dr. Buksh: When I was a kid, my mom didn’t always take me to the doctor. If I was sick, she would go to Tom, the pharmacist. He lived on the other side of our neighborhood. She would walk there, talk to the pharmacist and come back with medicine. I still remember Tom. And I’m sure he’s retired, or he might have passed away already, but Tom would always give her solid advice. There was trust there. He was the guy to talk to about medicines.

I think that over time, that has gone away a bit as the overall healthcare delivery model has changed. People think about pharmacies as just the place to pick up pills.

Part of that is due to the demands on traditional retail pharmacies. Before medical school, I worked as a pharmacy tech and I saw that the pharmacists were burned out. It’s not that they didn’t want to build relationships with their patients. It’s that the role became a volume role where you had a lot of scripts to fill, and the more you filled, the better it was for the company and for you. The pharmacists answered the questions, but they were just really busy and tired.

Stellus Rx is different. When my patients have medicine questions, I know they can talk to their Stellus Rx pharmacist just like my mom used to talk to Tom. It’s impactful for patients, and it makes it easier to view Stellus Rx as part of our NETIMA team.

Team-based medicine is so much more effective. And as a physician, that’s kind of a newer concept, to be honest. I saw team-based physician leadership and team-based models when I did hospice care and when I did addiction care. And I realized in those complicated patients, you needed a team—in hospice, you needed a nurse, a chaplain, a social worker, a home health aide.

And in addiction care, we met in an interdisciplinary meeting once a week to talk about patients and the care they needed. Patients had physicians, counselors, nurses, and on and on. We would all meet once a week and talk about what we were hearing about the patient and learn things through these meetings that were very powerful in shaping care plans.

Stellus Rx offers us a component of that in internal medicine, pairing their work with the work of a broader care team, a social worker, a dietician—and be able to do so at a scale that I wouldn’t be able to do if I had to hire a pharmacist on-staff.

It’s an evolution in the way that many physicians think about medicine, but it creates a better level of care. And eventually, I do think it will be the model that patients should expect. They will see the benefit of having additional team members, and then will wonder why all practices don’t work that way.

The future of success in healthcare is team-based medicine. We physicians can’t do it ourselves. There are so many patients to take care of. When you work with a pharmacist and you work with other members of a team taking care of patients, it provides excellence that you can’t accomplish on your own.
 

Published: May 6, 2024