I recently came across an open letter from members of the medical community arguing that society should move more aggressively toward autonomous vehicles because thousands of lives continue to be lost on our roads every year. The central argument was compelling because it challenged the tendency many of us have to evaluate new technology against a standard of perfection rather than against the reality of the systems we already live with.

The authors pointed out that self-driving vehicles will undoubtedly make mistakes, but if they can ultimately reduce injuries and fatalities compared with human drivers, delaying their implementation also carries consequences. Every year we wait for perfection may be another year in which preventable harm continues at scale.

As I was thinking about that argument, I found myself wondering whether healthcare may be facing a remarkably similar moment.

The standard we apply to technology

Around the same time, there was news involving autonomous vehicles from Waymo after several vehicles reportedly drove into standing water during flooding conditions in Austin and required software modifications to address the issue. The reaction that followed was not particularly surprising. Headlines immediately focused on concerns about safety, questions about readiness, and speculation about whether these systems should be trusted at all. What struck me, however, was how familiar the pattern felt. Whenever a new technology experiences a failure, particularly one involving human safety, the conversation often becomes centered around whether the technology is flawed rather than whether the technology, taken as a whole, produces better outcomes than the alternative.

Human drivers make mistakes every single day. They drive while distracted, exhausted, impaired, or simply inattentive. Human judgment fails with extraordinary regularity, and yet we generally accept that reality because we have lived with it for so long that it feels normal. We don’t expect human drivers to be perfect because we know perfection is impossible (and we’ve all been on the road and seen it first hand; case closed). Instead, we continually seek ways to reduce risk, improve safety, and create better systems.

Increasingly, evidence suggests that autonomous driving systems may produce better aggregate outcomes than humans, even while continuing to make occasional mistakes of their own. The important question is whether they fail less often and whether the overall benefits substantially outweigh the risks.

It may be exactly the conversation healthcare needs to have regarding AI clinicians.

AI is competing with reality, not perfection

Much of the discussion around AI in medicine seems to begin with the assumption that AI must meet a nearly impossible standard before we are willing to trust it. I frequently hear versions of the argument that every AI-generated clinical recommendation must include a human decision-maker at every stage of the process. While I understand the instinct behind that thinking, I wonder whether it reflects a deeper discomfort with technology rather than an objective assessment of outcomes.

These concerns arise as we learn how to embrace new technology and find where to apply it in our daily lives.

Healthcare itself is hardly a perfect system. Physicians misdiagnose patients. Medication errors occur. Patients frequently fall through cracks in the system. Access remains limited in many communities, and there are countless individuals who delay or completely avoid care because appointments are unavailable, costs are prohibitive, or providers simply do not exist where they live. We sometimes talk about AI as though it is competing against some idealized version of healthcare, but that’s not the comparison we should be making. AI is competing against the healthcare system that exists today, with all of its imperfections, inefficiencies, and limitations.

The Triple Aim opportunity

What makes AI particularly interesting to me is that it has the potential to improve the three objectives that have long been described by the Institute for Healthcare Improvement as the “Triple Aim:” improving the patient experience, improving population health, and reducing per capita cost. Imagine a world where patients who struggle accessing care can receive hypertension screenings, behavioral health assessments, medication evaluations, and early interventions through AI-enabled systems. Imagine care becoming more affordable and more available to populations that historically have had difficulty accessing services. Imagine identifying patients earlier and directing them toward interventions before problems become more serious and more costly.

As you may know if you’ve been hanging out with me for some time, I’m bullish on AI. However, there will be instances where AI clinicians make mistakes. I also believe some of those mistakes will become highly publicized. Whenever a technology carries the potential to influence human lives, failures inevitably become amplified. To level set, we have to acknowledge (much to our chagrin) that physicians make mistakes and our healthcare system produces adverse outcomes, and at times, on a significant scale. The issue is not whether AI will occasionally fail. The issue is whether preventing those occasional failures is worth delaying technologies that may improve care for millions of people.

But what if it was your son or daughter in that autonomous car when it failed? What if it was your son or daughter receiving clinical instructions from an AI doc? How would you feel about it then?

Redefining human oversight

I sometimes wonder whether we unintentionally create barriers to innovation because we expect new technologies to achieve standards that we never apply to—but perhaps expect from—human beings. We appear willing to tolerate a certain amount of imperfection when those imperfections are familiar to us, but we become considerably less forgiving when technology is involved. In many cases, perfection becomes the requirement for progress, and perfection has always been the enemy of meaningful improvement.

None of this suggests that we should blindly hand medicine over to untested systems or remove thoughtful oversight. Transparent development matters. Rigorous research matters. Pilot programs matter. Responsible regulatory frameworks matter. The kinds of AI clinician pilots currently emerging in states like Utah (Doctronic) are exactly the kinds of efforts we should be encouraging because they allow us to evaluate these systems in controlled and measurable ways. And even a pilot study such as Utah’s has stirred controversy, where the Utah Medical Licensing Board called for an immediate suspension of the program. But the state ruled against the Board and is continuing the 12-month program.

What I am suggesting is that we may need to broaden our thinking around what oversight actually means. Human oversight does not necessarily require a human to replicate every single action an AI system takes. Healthcare already includes multiple safeguards throughout the process. Pharmacists review medications. Clinical pathways guide decision-making. Escalation systems identify higher-risk patients. Referral networks ensure that patients requiring additional expertise reach appropriate providers. Oversight can exist without eliminating the efficiency that makes AI valuable in the first place.

Healthcare's Waymo moment

Ironically, AI may ultimately make physicians busier rather than less necessary because these systems may identify more patients who need intervention and care. The challenge for healthcare leaders may not be deciding whether AI belongs in medicine, but rather determining how to thoughtfully integrate technology and human expertise in ways that improve outcomes for everyone involved.

The fear-based conclusion is that displaced medical physicians and pharmacists will be flipping burgers (until they are flipped by robots), when in reality, AI implementations are creating more opportunities to serve in all sectors, not just healthcare.

As leaders think about what comes next, we could remember that we’re already placing our trust in AI systems that influence life-and-death decisions every day. If we are becoming comfortable getting into autonomous vehicles and allowing technology to navigate crowded streets on our behalf, perhaps we should also become more open to the idea of having conversations with AI clinicians. I am not arguing that these systems will be perfect because they will not be. I am positing that they may ultimately help us create a healthcare system that is more accessible, more efficient, and more effective than the one we have today.

How pharmacy leaders can stay informed as well as sane in the ever-changing world of AI

I came back from the AMCP AI pre-conference (photos above capture me in action) with two competing reactions. First: real progress is happening. Second: there is so much happening that it’s easy to feel like you’re already behind.

If you attended last year’s session and compared it to this year, the shift was clear. What was once largely theoretical is now showing up in real environments, with real implications for how we operate. We’re no longer asking if AI will matter. We’re starting to see where and how.

But that clarity creates a different kind of challenge: how do you keep up without feeling overwhelmed?

The human response to too much change

In conversations throughout the conference, I noticed something less technical and more human. People are sorting themselves, consciously or not, into two camps:

• There are the ostriches

• And there are the excavators

Despite the ostrich syndrome of burying your head in the sand to willfully ignore AI, an ostrich response isn’t about denial. It’s more subtle than that. It’s the quiet assumption that AI will have a modest impact here because pharmacy is too complex, too regulated, too nuanced. It’s choosing not to engage deeply because the signal feels noisy and uncertain.

And to be fair, that instinct is understandable. The pace of change in AI is unlike anything most of us have experienced professionally. It’s amorphous. It doesn’t behave like a traditional discipline where you can read a textbook, master the fundamentals, and build from there.

Which brings me to a quote I shared during the session from Demis Hassabis of Google DeepMind: We have to learn how to learn about AI. That’s the real challenge.

Excavators don’t have all the answers

The excavators aren’t necessarily more technical. They’re not all writing prompts or building models. What they’re doing differently is simple: they’re digging. They’re actively trying to make sense of what’s real, what’s emerging, and what might matter for their organization. They’re asking better questions. They’re paying attention to early signals. They’re building context over time.

And importantly, they’re not trying to do it alone. At the conference, I encouraged people to walk out with six new connections: six people they could learn alongside. Not because networking is a goal in itself, but because one of the most effective ways to keep up with AI is through shared learning. This isn’t a space where any one person has the full picture. But collectively, you can get a lot closer.

What real looks like right now

If you’re looking for signs of progress, they are there. One example that stood out came from Nathan Frank, CTO at Aetna. He shared that AI agents are now outperforming humans in explaining member health benefits. That’s not a hypothetical use case; that’s being tested in an environment serving millions of lives.

It doesn’t mean call centers are disappearing tomorrow. It does mean that AI is already starting to reshape how core functions operate. And that’s the pattern we’re seeing more broadly. Not wholesale transformation overnight—but meaningful movement in specific areas.

At the same time, many organizations are still early. Evaluation phases. Pilot programs. Internal debates about risk, governance, and value. I’ve had plenty of conversations where skepticism shows up, not in a dismissive way, but in a measured, “let’s see where this actually lands” mindset. That tension is healthy. But it also reinforces why staying engaged matters.

Managing the noise without checking out

One of the biggest risks right now isn’t falling behind, it’s burning out trying to keep up. There is no shortage of information. Newsletters, podcasts, LinkedIn posts, research papers, vendor pitches. You could spend all day consuming and still feel like you’re missing something.

I don’t have a perfect system, and I wouldn’t suggest you copy mine. But I’ve found value in having a few consistent “anchors”—trusted sources I check regularly. They don’t cover everything, but they keep me oriented. Think of them as information security blankets. Not comprehensive, but reliable. Because the reality is: you will miss things. Everyone will.

The goal isn’t total coverage. It’s developing a rhythm that keeps you informed enough to engage meaningfully in the conversations that matter.

Beyond tactics: a leadership imperative

For many leaders, the instinct is to focus on tactical capability such as prompting, tools, use cases, etc. Those things matter. But they’re not the whole story. The bigger opportunity and responsibility is developing a clear, informed perspective on how AI could reshape your organization. Where it could create leverage, where it introduces risk, and where it challenges existing assumptions about how work gets done.

That requires more than hands-on experimentation. It requires context. It requires curiosity. And it requires a willingness to sit with uncertainty longer than most of us are comfortable with.

So, which one are you?

This isn’t about labeling people. It’s about awareness. Are you defaulting to distance because the space feels overwhelming? Or are you finding small, sustainable ways to stay engaged?

You don’t need to become an expert overnight. You don’t need to track every development. And you don’t need to have definitive answers. But doing nothing is a decision. The leaders who will navigate this well aren’t the ones who know the most—they’re the ones who keep learning, keep questioning, and keep adjusting as the landscape evolves.

Harry’s stay grounded in AI to-dos

You don’t need a perfect system, but you do need a system. Here are a few ways I’ve found to stay informed without getting buried:

1. Build your “AI signal sources” (and ignore the rest). Pick 2–3 trusted sources and check them consistently. For me, that includes The Rundown AI and the AI Daily Brief. The goal isn’t completeness—it’s consistency. (Here’s my cheat sheet of AI resources)

2. Create your own six-person AI brain trust. (I encouraged the attendees to the AMCP Pre-Con to do exactly this!) Identify a small group of peers who are paying attention to AI from different angles such as clinical, operational, technical, strategic. Stay in touch. Share what you’re seeing. You’ll learn faster together than alone. Plus, you’ll have some good laughs along the way.

3. Ask one better question each week. Instead of trying to master tools, ask: Where could AI meaningfully change how we operate? Start there. Let curiosity drive your exploration.

4. Track real use cases, not just headlines. Pay attention to where AI is actually being deployed in healthcare and pharmacy. Early signals matter more than broad predictions.

5. Get comfortable missing things. You will not keep up with everything—and you don’t need to. Staying engaged beats trying to stay exhaustive.

Want to go deeper?

If you’re looking for credible signals (not noise), these are worth bookmarking:

• Academy of Managed Care Pharmacy (AMCP) https://www.amcp.org Conference insights, policy, and managed care pharmacy trends—including emerging AI discussions. 

• Aetna https://www.aetna.com A window into how large payers are thinking about AI in member services and operations.

• Google DeepMind https://deepmind.google Perspective on where advanced AI research is heading—and how leaders are thinking about it.

• Food and Drug Administration (FDA) https://www.fda.gov/medical-devices/software-medical-device-samd/artificial-intelligence-and-machine-learning-software-medical-device Regulatory guidance shaping how AI is applied in healthcare and life sciences.

• Centers for Medicare & Medicaid Services https://www.cms.gov Policy direction that will influence how AI intersects with reimbursement and care delivery.

• Stanford Institute for Human-Centered Artificial Intelligence https://hai.stanford.edu Balanced research and insights on AI’s broader impact—including healthcare.

Do we want primary care managed by a vulnerable algorithm or by the unhackable clinical professional behind the pharmacy counter?

I’ve been tracking the headlines about the Doctronic AI hack in Utah, and frankly, it’s the kind of "I told you so" moment that should make every pharmacist in the country pause.

If you haven’t seen the report from Mindgard—the "Red Team" that pressure-tested the system—it’s eye-opening. They managed to get Doctronic’s AI bot to bypass its safety protocols completely. The irony is thick: while we are told these bots could be the future of "primary care access," the Mindgard team got the bot to provide instructions for cooking methamphetamine when it was supposed to be handling a limited set of prescription refills.

I’ve reached out to Byron Crowe, the Chief Medical Officer at Doctronic, and the State of Utah Office of AI Policy for comment (see below). As it typically the case in these situations, the headlines do not tell the whole story. I am not going to try to parse the details of the innerworkings of the Doctronic chatbot and Mindgard’s attack. The bigger issue is how will the pharmacy profession respond.

This incident reinforces a constant theme I’ve been beating the drum on for years: We already have a highly trained, unhackable solution to the primary care access problem. They’re called pharmacists. Steven Leonard and Tim Frost have written extensively on this. (Links to articles below)

The human in the loop

The "Techy Surgeon," Christian Pean, MD, recently wrote a thorough breakdown of this hack. He points out that while AI tools are great for orchestration and workflow, they lack the "human in the loop" necessary for high-stakes clinical decisions.

When a patient walks into one of the 50,000 community pharmacies across this country, they aren’t talking to an algorithm that can be "jailbroken" into giving dangerous advice. They are talking to a professional who knows that if a patient’s Lipitor has run out, the answer is a clinical assessment, not a recipe for a controlled substance.

We have a safe, existing system in place. We just need to activate it nationwide.

Why full practice authority matters now

The Doctronic incident is a "signal event." It demonstrates the need for additional layers of testing to ensure public safety. Kudos to the State of Utah for providing just the environment for this type of regulatory experimentation. Meanwhile, pharmacists are sitting on the sidelines in most states, restricted by outdated regulations.

Full Practice Authority would allow pharmacists to:

• Reauthorize prescriptions for chronic conditions like hypertension or diabetes.

• Perform screenings for the “big three:” heart disease, diabetes, and high blood pressure.

• Act as a hybrid partner with AI, using the technology to speed up research while providing the final clinical sign-off that ensures patient safety.

Currently, only a handful of states have granted anything resembling full practice authority. That leaves the rest of the country where the "access problem" may be solved by AI bots instead of proven professionals.

My take: the market vs. the bot

I’m not saying we should ban AI. I think there’s a happy medium where AI has a solo role or sits in a pharmacist’s pocket to double-check research in seconds. But we should let the free market decide: Do you want your primary care from a bot that can be hacked by a tech team in New Zealand, or from the pharmacist down the street who knows your history?

This hack isn't just a tech failure; it’s a reminder that pharmacists can do this better. If we are going to let the market decide, then pharmacists need a level playing field when compared to AI Bots and tech solutions. That is where you come in.

Take action: contact your state board

We need to move the needle on this, state by state. If you’re lucky enough to practice in a state that already has some form of full practice authority—like Idaho, Colorado, Montana, Indiana, Iowa and others trialing or implementing some form of standard of care for pharmacists—your voice is more important than ever. Reach out to your state’s Board of Pharmacy not just to ask for progress, but to provide them with any on-the-ground success stories they need to defend and expand these rules.

For everyone else, it’s time to remind our regulators that we are the safe, human solution to the access crisis that AI alone simply cannot solve. Ask them where they stand on Full Practice Authority and use the Utah hack as the reason why.

To make it easy, I’ve provided a template below. ☺️

Advocacy template: email your state board

Note: If your state already has full practice authority, swap the request for an "update" with a "thank you" and a brief example of how you or another pharmacist or pharmacy has used their authority to help a patient safely.

To: [Find your Board's email address below]

Subject: Urgent Inquiry: Full Practice Authority and Public Safety (Re: Doctronic Incident)

Dear Members of the Board,

I am writing to you today as a [pharmacist/concerned healthcare professional] regarding the recent security breach of the Doctronic AI pilot in Utah. As reported by the security firm Mindgard, this "AI doctor" was easily manipulated into providing dangerous, non-medical instructions, bypassing critical safety protocols.

This incident is a signal event that highlights the danger of relying exclusively on automated systems to fill gaps in primary care access. We have a more reliable, "unhackable" solution already integrated into our communities: the licensed pharmacist.

I am requesting an update on the Board’s current position and legislative agenda regarding Full Practice Authority for Pharmacists. In light of the vulnerabilities exposed in AI-driven care, what steps is the Board taking to empower pharmacists to provide the clinical services—such as chronic medication reauthorization and health screenings—that our patients desperately need?

Pharmacists provide the essential "human in the loop" that technology lacks. I look forward to hearing how our state plans to lead on this issue.

Sincerely,

[Your Name]

[Your Pharmacy/Organization]

Where to send your email

The National Association of Boards of Pharmacy (NABP) maintains a verified directory of every state board.

👉 Click here to find your state board’s contact information

Select your state from the list to find the direct email for the Executive Director or the general board inquiry inbox.

Related links

• Mindgard Blog:Doctronic is Now Accepting New Patients (and Unsafe Instructions)

• Techy Surgeon (Christian Pean, MD):When the AI Doctor Breaks

• Doctronic.ai

• Health Affairs’ Stop Pretending Pharmacists Can’t Meet Primary Care Needs

• Cicero Institute’s 2025 Policy Strategies for Full Practice Authority

• Utah Office of AI Policy website

One of the most routine yet resource-intensive steps in specialty pharmacy happens before therapy even begins: the intake call.

When a new prescription or clinical order arrives, someone from the pharmacy reaches out to confirm demographics, insurance information, and other required details. It is essential work, and it happens thousands of times each day across the industry.

It is also exactly the kind of process AI agents are beginning to automate.

From call centers to intelligent voice workflows

I am hearing from multiple companies building healthcare voice agents that specialty pharmacy clients are already seeing meaningful productivity gains. That should not be surprising. Intake calls are highly structured, rules-based, and repetitive. There is little creativity involved and no persuasion required. It is largely a transfer and confirmation of information.

Technologists often call these repetitive cognitive tasks, or RCTs. Anywhere RCTs exist, AI solutions are moving quickly.

Across healthcare more broadly, voice agents are already being used to collect patient information, verify insurance details, schedule visits, and conduct follow-up outreach. These systems can handle high-volume routine communication, reduce administrative workload, and improve response times for patients.

Some implementations report that automation can handle a large share of routine calls while maintaining high accuracy and improving staff efficiency, with measurable reductions in scheduling workload and improved satisfaction scores.

For specialty pharmacies facing staffing constraints, reimbursement pressure, and growing patient complexity, freeing trained staff from structured intake calls can allow them to focus on clinical coordination, problem resolution, and patient support that requires human judgment.

The adoption hurdle: memories of bad automation

If the operational logic is flawless, why are many specialty pharmacies resisting deploying these technologies?

History.

Earlier generations of phone automation often created frustration rather than efficiency. Patients remember rigid scripts, endless menus, and difficulty reaching a human. That experience still shapes how leaders think about automation today.

But the technology has changed significantly. Modern voice agents rely on natural language understanding and conversational AI that can interpret context, respond dynamically, and escalate appropriately when needed. They are not the “press 1 for billing” systems of the past.

In fact, conversational AI systems in healthcare settings are increasingly capable of maintaining natural dialogue and supporting patient interactions in ways that reduce delays and improve engagement. The technology barrier is shrinking as marketplace adoption gains momentum, especially as the technology improves. The strategic question is becoming something else.

Efficiency is only the starting point

Completing intake calls with AI will likely become table stakes. The real opportunity is how that interaction fits into the patient experience.

The intake call is often the first live touchpoint a patient has with the specialty pharmacy. It sets expectations and tone, especially for people dealing with complex therapies or serious conditions. If automation simply makes the interaction faster but less supportive, organizations may gain efficiency while weakening trust, especially with patients who require a higher-level of attention such as those with communication disorders, disabilities, or non-native English speakers.

Forward-looking pharmacy leaders should be asking:

• What impression should this first call leave with the patient?

• Where should the voice agent transition to a human for reassurance or clinical nuance?

• How can automation reinforce, rather than dilute, the pharmacy’s brand and service model?

In other words, do not treat voice agents only as a cost-reduction tool. Treat them as part of your customer-experience design.

Intake is just the beginning

Outbound intake calls are one of the most visible RCTs in specialty pharmacy, but they are far from the only ones.

Anywhere staff are repeatedly gathering structured information, confirming details, or executing rules-based cognitive steps, there is likely an opportunity for AI assistance. Across healthcare, organizations are already using conversational systems to automate routine communication, scale operations without adding headcount, and improve consistency in patient interactions.

The pharmacies that benefit most will not be those that automate one workflow. They will be the ones that systematically identify RCTs and redesign processes so AI handles the predictable steps while humans focus on judgment, empathy, and clinical coordination.

Voice agents may enter specialty pharmacy through intake first, but they will not stop there.

What you can do

• Map your intake workflow and identify which steps are purely structured information exchange

• Evaluate voice-agent vendors using both productivity and patient-experience criteria

• Define clear escalation points where a human should take over the interaction

• Decide what impression you want your first patient call to leave

• Look across your organization for other repetitive cognitive tasks that could benefit from AI support

Resources and links

• AI voice agents completing scheduling, verification, and refill workflows in healthcare (Examples of voice agents handling scheduling, prescription refills, and insurance verification at scale.)

• Automation of high-volume patient calls so staff can focus on complex needs (Explains how AI voice agents automate routine calls and allow human staff to focus on higher-empathy interactions.)

• AI agents executing workflows end-to-end across systems (Describes AI agents as autonomous systems that understand requests, pull data, apply rules, and complete tasks.)

• Healthcare call-center automation use cases including insurance verification and medication workflows (Details real operational uses such as eligibility checks, refill intake, scheduling, and follow-up automation.)

• Real-world example of AI voice agent handling verification calls and increasing efficiency (Reports AI agents performing verification calls, updating records automatically, and significantly increasing processing speed.)

We’re living at a hinge point in history, and I want to help you navigate it with confidence

I’m an avid podcast listener. Two of my favorites on AI are The AI Daily Brief and The Last Invention. This post was inspired by dozens of episodes from both shows, but not in the way you might think.

You can’t read an article about AI or watch the news without hearing some expert declare we're living at a “hinge point” in history. Everyone's searching for the perfect metaphor. More and more, I’m hearing AI compared to the discovery of fire, not electricity or the internet, but fire. That’s how fundamentally this technology will change how we think and live.

Here’s what I’ve noticed in my work: many of the conversations about AI swing between hype and doom. Neither extreme is particularly helpful when you're trying to run a business, plan for the future, or simply make sense of what's happening.

What I want to offer you is something different: a practical framework for understanding AI’s impact on your life and business, along with concrete ways to engage with these changes on your own terms. You don't need to become an AI expert or an activist. You just need to understand what’s actually happening and decide how you want to respond.

Let me share ten developments that are shaping our immediate future, why each one matters to you personally, and how you can approach them with clarity rather than concern.

Ten AI developments worth understanding (and how to think about them)

1. The pace of innovation means opportunity keeps knocking

We’re seeing major AI announcements almost daily now. OpenAI released its latest ChatGPT version on November 12 to rave reviews. Six days later, Google released Gemini 3, which tech reviewers now call the most powerful general use model available.

Why this matters to you: This rapid evolution means the AI tools available to you as a solopreneur or small business are getting better, faster, and more accessible every week. You're not falling behind, you’re watching the tools improve in real time. The constant innovation means you'll have better options six months from now than you do today.

Consider this: Rather than trying to master every new release, identify one AI task you’d like to automate in your business (email summaries, meeting notes, content drafting). Pick one tool and use it consistently for 30 days. As new versions release, you'll naturally upgrade into better capabilities without the learning curve starting over.

2. Scientific breakthroughs are accelerating, and that means hope

Edison Scientific recently released Kosmos, a scientific research agent that works exponentially faster than human researchers. Separately, OpenAI’s chief scientist published a report suggesting we might accomplish the next 25 years of scientific research in just 5 years.

Why this matters to you: If you’re in healthcare, pharma, or any science-adjacent field, this acceleration means solutions to problems that seemed decades away might arrive in your working lifetime. For those of us in specialty pharmacy, think about faster drug discovery, more personalized treatments, and breakthrough therapies reaching patients sooner. This isn't abstract: this is about diseases that affect people you know getting cured faster.

Consider this: Identify one healthcare challenge that impacts your clients, your family, or your community. Follow the AI research progress in that specific area for the next quarter. You’ll gain a concrete understanding of how AI acceleration translates to real human benefit, not just theoretical progress.

3. Education is evolving, and that includes how we all keep learning

There’s intense debate about AI in education: how teachers should use it, how students should access it, and how we ensure equitable benefits across socioeconomic groups.

Why this matters to you: If you’re a lifelong learner (and as a professional, you are), AI is democratizing access to expertise that used to require expensive degrees or exclusive networks. You can now have sophisticated conversations with AI tutors on complex topics. The question isn't whether AI will be in education, it's how you'll use it to keep your own skills current.

Consider this: Choose one topic you’ve always wanted to understand better but never had time to study formally. Spend 15 minutes a week having a conversation with ChatGPT or Claude about it, asking follow-up questions, requesting reading recommendations. Notice how this differs from traditional learning and whether it works for your learning style.

4. Energy infrastructure is expanding, and smart planning matters

Sam Altman stated we’ll need the equivalent of 250 gigawatts by 2033 for advanced AI development. That’s more than twice the power generated by all commercial nuclear reactors currently operating in the US.

Why this matters to you: This massive infrastructure build represents economic opportunity but will require strategic planning at the local and regional level. If you’re a business owner, understanding where this infrastructure is being built helps you anticipate economic development, real estate trends, and talent migration patterns. Data centers bring jobs, investment, and economic activity. Being aware of these developments in your region gives you strategic advantage.

Consider this: Look at your state or region’s economic development plans for the next five years. Are data centers being built nearby? This isn’t just about worrying over your electric bill, it's about understanding where investment and opportunity are flowing. If you’re in commercial real estate, economic development, or business consulting, this intelligence is valuable to your clients.

5. Water resources are needed, and transparency helps

Data centers consume significant water for cooling, roughly 2 million liters per day for a typical facility. This is creating important conversations about resource management and sustainable development.

Why this matters to you: Understanding resource allocation in your community helps you participate in informed civic planning. But more importantly, this challenge is driving innovation in cooling technology and sustainable infrastructure. If you're in technology, facilities management, or environmental consulting, this represents a growing market for solutions.

Consider this: Rather than viewing this as a crisis, ask yourself: what opportunities exist in water efficiency technology? Who in my network is working on sustainable data center solutions? How might my expertise contribute to solving this challenge? Every constraint creates a market for innovation.

6. The job market is shifting, and adaptability is your advantage

Since ChatGPT launched November 30, 2022, job openings have declined by 30-33%*, particularly affecting knowledge workers. A USC study suggests college graduates will face challenging job markets in the next five years, with AI being a significant factor.

Why this matters to you: If you're reading this newsletter, you're likely an experienced professional who has already navigated multiple career transitions. This shift isn’t about your job disappearing, it's about understanding which skills AI enhances versus replaces. The professionals who thrive will be those who use AI to amplify their expertise, not those who ignore it or compete against it.

Consider this: Audit your current role or business. Which tasks could AI handle, freeing your time for higher-value work? Start using AI for routine tasks this month (research, first drafts, data analysis, scheduling). Track how much time you reclaim and redirect that time to strategic relationships, creative problem-solving, or business development that AI can’t do.

*Some economists argue that the drop is more closely linked to the Federal Reserve’s interest rate hikes earlier in 2022, which naturally suppress hiring, rather than solely due to AI.

7. Cybersecurity is evolving, and awareness is your first defense

Anthropic discovered that state-sponsored hackers attempted to exploit Claude’s coding capabilities for cyber-espionage. These attempts were unsuccessful, which actually demonstrates that AI companies are building detection and prevention into their systems.

Why this matters to you: Understanding AI security helps you make informed decisions about which tools to use and how to use them safely. The same AI that creates new security challenges is also creating better security solutions. Your advantage comes from staying informed, not from avoiding AI tools altogether.

Consider this: Review your current AI tool usage. Are you sharing sensitive client information with AI platforms? Do you understand each platform’s data policies? Spend 30 minutes updating your AI usage guidelines for your business. This isn't about fear, it's about professional hygiene in a new technology environment.

8. AI companionship needs boundaries, and that’s a conversation worth having

There are ongoing lawsuits related to AI chatbots and emotional harm, particularly involving vulnerable individuals who formed unhealthy attachments to AI companions.

Why this matters to you: This isn't about chatbots being dangerous, it's about understanding appropriate use cases. AI is excellent for business tasks, learning, and productivity. It’s not designed to replace human relationships or professional mental health support. Understanding this distinction helps you use AI effectively while maintaining healthy boundaries.

Consider this: Have an honest conversation with your family or team about how you’re all using AI. Are you using it for tasks and productivity, or are emotional dependencies forming? Create simple guidelines: AI for work and learning, humans for relationships and emotional support. This clarity prevents problems before they start.

9. Creativity is being augmented, and your unique voice matters more than ever

The debate about AI and creativity is ongoing. Some fear it will replace human creativity, others see it as a powerful tool for augmentation.

Why this matters to you: As someone who creates content, communicates with clients, or develops strategies, AI can handle the mechanical aspects of creation (first drafts, outlines, variations) while you focus on the strategic and uniquely human elements (insight, relationship, nuance, authenticity). Maximize the value of your experience and perspective in concert with the technical application of AI to create something truly unique.

Consider this: Create something this week using AI as your assistant, and then refine it with your expertise and perspective. Notice what AI does well (structure, options, speed) and what only you can provide (judgment, taste, context, relationship). This isn’t about AI replacing you, it’s about you working 10x faster on the parts that matter.

10. The economy is being reshaped, and understanding helps you plan

Since ChatGPT launched, the stock market is up 70% as of October 31, according to Fortune. Approximately 75 to 80 percent of recent S&P 500 performance comes from AI-related companies.

Why this matters to you: Whether you’re planning retirement, managing investments, or running a business, understanding that AI is driving significant economic value helps you make informed decisions. Popularized in the 1950s by wealth manager, John Nicola, an investment truism says, “the stock market climbs a wall of worry.” Today is no different. The successful investors will find the companies creating value are those solving real problems with AI, not just talking about it.

Consider this: Look at your investment portfolio or retirement accounts. Do you understand your AI exposure? Rather than worrying about a correction, talk with your financial advisor about balancing your portfolio based on your risk tolerance and timeline. Understanding your exposure gives you agency in your financial planning.

Moving forward with clarity and confidence

The French writer and philosopher Joseph Joubert said, “It is better to debate a question without settling it than to settle a question without debating it.”

Here’s what I’ve learned from 35 years in business and the last two years deeply engaged with AI: the professionals who thrive during technological shifts are those who stay curious, informed, and actively engaged. Not paralyzed by fear. Not dismissive of change. Just thoughtfully engaged.

AI isn’t happening to you, it’s a set of tools and opportunities you get to decide how to use. The developments I’ve outlined above aren’t threats to manage, they’re contexts to understand so you can make better decisions for yourself, your business, and your community.

What resonates with you?

I’d love to hear which of these topics connects with your current experience. Are you already using AI in ways that have transformed your productivity? Are you grappling with questions about appropriate use? Are you seeing opportunities I haven’t mentioned?

Reply to this email or join our conversation in the RxRoundtable community. The smartest people I know are those who stay engaged with change while keeping their values and priorities clear.

You’ve got this. And I’m here to help you think it through.

Resources and links

• The AI Daily Brief podcast

• The Last Invention podcast

• Financial Times article, OpenAI says new GPT-5 model speeds up research in maths and science (subscription required)

• Futurism’s article, Sam Altman Says “Significant Fraction” of Earth’s Total Electricity Should Go to Running AI

• Bloomberg’s article, AI is draining water from areas that need it most

• JPM’s article, Is AI already impacting job growth?

• USC’s article, Study reveals graduates are facing the worst job market in five years

• The Economist’s article, How China-linked hackers co-opted Anthropic’s Claude

• The Wall Street Journal’s article, Seven Lawsuits Allege OpenAI Encouraged Suicide and Harmful Delusions

• The Atlantic’s article, A Tool That Crushes Creativity: AI slop is winning

• Fortune’s article, Since ChatGPT launched, job openings are down 30% while the stock market is up 70%. One economist says the true culprit isn’t AI, but monetary policy

• Morningstar’s article, There's no turning back on AI now, this firm says as it boosts S&P 500 forecast

The Association for Value-Based Cancer Care (AVBCC) held its 15th annual conference in New York City on October 22–24.

If you want to understand the business end of cancer care from the perspectives of the patient, employer, and physician, there’s no better meeting on the calendar.

Rather than attempt to unpack everything I learned in detail, I’m going to share a list of the most striking nuggets of knowledge I collected. Each one is worthy of deeper research and debate. Heaven only knows when I’ll find the time to do that. Here we go…

The generic drug market is broken

John Murphy, III, President of the Association for Accessible Medicines (formerly the Generic Manufacturers Association), confirmed what we already knew: the generic drug market is in crisis.

The race to the bottom on pricing and high regulatory barriers have all but eliminated the U.S. manufacturing base. Shortages of critical chemotherapy medications are now common. Murphy recommends The Great American Drug Deal as essential reading to understand the scope of the problem.

Value-based contracting remains elusive

Despite meeting for 15 years, there was general consensus that true value-based contracting in oncology is still out of reach. The problem starts with defining “value” and only grows more complicated as stakeholders attempt to collect and share data across disparate sources.

AI will transform the traditional HUB model

The traditional HUB service model exists to meet three objectives:

• Enrollment and activation

• Access and affordability

• Patient engagement

All three activities are labor-intensive and data-driven making them a perfect opportunity for AI disruption. The HUB service model of the future will focus more on the patient and less on the drug.

The rising cost of cancer care

The escalating cost of cancer care was the most frequent topic both on-stage and off. Cancer has now become the number one driver of healthcare costs for employers. Employers must take a more proactive role in motivating employees to get screened early. The population data already exists to target the right groups effectively. Meanwhile, troubling trends are emerging: measurable increases in colorectal and uterine cancers among younger adults with no clear explanation yet.

A looming shortage of oncologists

We are on the verge of a significant oncologist shortage. Retirements are outpacing the number of new graduates entering the field, raising serious concerns about future access to care.

Patient navigation and progress in melanoma

Encouragingly, there’s been great progress in treating malignant melanoma, and the patient journey has improved with the introduction of billable PIN (Principal Illness Navigation) codes.

More oncology practices are hiring patient navigators with excellent results, and AI tools are helping improve their productivity. Despite this progress, panelists estimated that only 50% of cancer patients currently have access to navigators.

The uneven patient experience

Despite all of the advances in treatment, a patient’s therapy journey is still largely defined by their zip code.

Treatment protocols vary widely by payer and region, and a single patient may have to navigate four distinct journeys simultaneously:

1. Clinical

2. Psycho-social (non-clinical)

3. Financial

4. Potential clinical trial enrollment

Alan Balch, CEO of the Patient Advocate Foundation, shared that one of the most requested items from a recent cancer patient focus group was simply free parking. Sometimes, it’s the small things that matter most.

Persistent system-level issues

High-cost sites of service for infusions remain a major challenge despite years of recognition by payors.

And as for 340B? If anyone can predict what happens next, they probably deserve a Nobel Prize.

Meanwhile, the U.K. and Germany continue to have 40% fewer oncology medications available compared to the U.S., underscoring how access remains inconsistent even among developed nations.

AI’s promise in research and precision medicine

There was universal agreement that AI will play a pivotal role in advancing research, new molecule discovery, and precision medicine.

As Dr. Mike Kolodziej quipped, “We will soon be living in a world where peer-to-peer reviews will be my bot talking to the payor’s bot.”

Final thoughts

I left the meeting energized by the empathy and dedication shown by the clinicians on the various panels, but also humbled by how hard it is to treat cancer.

For all the innovation, collaboration, and progress we celebrate, the system remains fragmented, inequitable, and deeply human.

Questions for reflection

As we move forward, I’m left with a few questions and I’d love to hear your thoughts:

• Can AI truly make care more humane, or will it risk widening the empathy gap?

• How do we align definitions of “value” across the patient, provider, payor, and employer spectrum?

• What would it take to ensure that a patient’s experience isn’t dictated by their zip code?

• And how do we balance scientific innovation with simple, human needs like compassion, communication, and, yes, even free parking?

What stood out most to you from this year’s AVBCC themes? Share your perspective in the comments below, I’d love to hear your take.

Cell and gene therapies, rare disease care, and the power of authentic communication

NASP25 was alive and well! With record-breaking attendance, the conference brought together a broad mix of specialty pharmacists, pharma manufacturers, providers, and industry partners.

The multiple educational tracks and session formats kept participants engaged and informed on the latest developments impacting our work. From clinical innovation to contracting to patient experience, NASP25 provided a comprehensive view of where specialty pharmacy stands today—and where it is heading.

Cell and gene therapies are no longer off in the future, but are here now

As a member of the NASP Cell & Gene Therapy (CGT) Workgroup, I was energized to see how NASP has embraced this transformative space. Our dedicated day-long workshop examined practical advances in CGT, insights from Centers of Excellence, payer and contracting considerations, and the indispensable role specialty pharmacies play in delivery and patient support.

One of the most profound experiences for me came midweek when I had the opportunity to meet my first gene therapy–treated patient, Taylor John. Taylor no longer lives under the daily burden of painful sickle-cell crises thanks to receiving gene therapy. Hearing her describe her journey—the hurdles, the doubts, the determination to qualify for and receive treatment—was both humbling and inspiring.

Her story was a powerful reminder that innovation is never about the science alone. It is about the patient—the human being whose life is changed. We must never lose sight of that. I want to extend sincere thanks to Karen Silverblatt Nameth (Inovalon) and Kim Tedesco (Walgreens) for organizing this moving panel, and to Taylor for her openness and courage in sharing her story.

Key takeaway:

• How is your organization preparing to manage the complexity of CGT? Identify one area—whether operational readiness, payer engagement, or patient education—where you can start strengthening today.

Rare disease programs: expanding and evolving

Another theme that struck me at NASP25 was the continuing expansion of rare disease care. These patients face long, complicated diagnostic journeys, fragmented care, and high emotional and financial burdens. Specialty pharmacies are uniquely positioned to improve their outcomes—but only if we move beyond a one-size-fits-all approach.

Customizing programs to reflect the unique needs of rare disease patients is essential. That may mean developing disease-specific adherence programs, offering expanded counseling support, or ensuring data flows seamlessly between pharmacy, provider, and payer. NASP sessions emphasized that the demand for rare disease–tailored pharmacy solutions will only increase, and our field must be ready to step up.

Key takeaway:

• Review your rare disease portfolio. Are there gaps where patient-specific education, counseling, or financial navigation could be enhanced? What small step could you implement this quarter?

The human side of communication

NASP is known for delivering high-impact keynote speakers, and this year was no exception. One presentation that resonated with me focused on the art and science of effective communication—something that is often overlooked in our clinically driven world.

The message was clear: communication isn’t just about conveying information. It’s about connection. Whether speaking with a patient, a colleague, or a policymaker, being fully present, authentic, and genuinely connected makes a measurable difference. The speaker emphasized that specialty pharmacists, in particular, sit at a critical intersection of science, access, and empathy. Our ability to communicate clearly and compassionately can determine whether patients feel supported, understood, and empowered.

Key takeaway:

• In your next patient or stakeholder conversation, pause and consciously commit to being “in the moment.” Reflect afterward: did it change the quality of the interaction or the outcome?

Closing reflections

Walking away from NASP25, I was reminded of the dual responsibilities we carry: to keep pace with the rapid innovation reshaping healthcare, and to keep the patient at the center of everything we do. Cell & gene therapy advances, rare disease programs, and human-centered communication are not just trends, they are imperatives for the future of specialty pharmacy.

Let’s continue to move forward with innovation in one hand and patient stories in the other. That balance will define our success.

From the Rockies to Central Florida, my takeaways on NASP ‘25

This year's National Association of Specialty Pharmacy (NASP) annual meeting in Aurora, Colorado, did not disappoint. With over 2,000 attendees, 100 exhibitors, and 80-plus educational and business sessions, every conceivable topic relevant to specialty pharmacy practice and business was thoroughly covered.

The perennial favorites were all there: biosimilars, 340B, cell and gene therapies, patient access, regulation, and patient engagement. But the up-and-comer that caught my attention? AI had truly arrived. Five dedicated sessions and at least twenty exhibitors with AI prominently displayed in their booth graphics told the story: this isn't emerging technology anymore. It's here now.

Where AI fits (spoiler: everywhere)

In my conversations throughout the conference, one thing became crystal clear: AI fits into specialty pharmacy at practically every patient touchpoint and every task involving data retrieval that moves prescriptions closer to shipment.

One AI vendor made a particularly bold claim that stopped me in my tracks: "If you hire us, you will never need to hire another pharmacy technician." Now, that's quite a statement. But it sparked something important for me that is if there's a simple way to characterize how AI will impact pharmacy operations, it's to think of AI as replacing tasks, not people.

Of course, I realize that when you total up enough tasks, you do end up with a person. But what's encouraging is seeing AI companies take a more employee-centered approach, focusing on task elimination rather than staff reduction. It's a subtle but meaningful distinction.

The "top of license" promise (and my concern)

If I heard that AI will allow pharmacists to work "at the top of their licenses" once, I heard it a hundred times. While I appreciate the sentiment, I worry there may actually be fewer pharmacists working at the top of their licenses as these efficiencies scale.

Here's my thinking: if AI can handle benefit verification, prescription intake, and customer service tasks, the operation will naturally require fewer pharmacy team members overall. The remaining positions may focus more on clinical oversight and complex problem-solving, but the total number of team members practicing at that elevated level could actually decrease simply because there are fewer roles needed.

The sweet spot dilemma

Here's what's fascinating: in my conversations with both pharmacy operators and AI vendors, there wasn't agreement on a universal "sweet spot" for a pharmacy's first AI implementation. AI-assisted benefit verification, patient assistance, customer service, and prescription intake were all mentioned as ideal "first projects."

The common concern I heard repeatedly? There are simply too many vendors pushing too many solutions for the average specialty pharmacy to properly evaluate and prioritize. This presents a clear opportunity for knowledgeable consultants to help pharmacies triage potential AI solutions, something I'm seeing more of in our RxRoundtable community.

The integration reality check

Here's my final takeaway, and it's an important one: the vast majority of AI solutions for pharmacy are "plug-ins" to existing dispensing and patient management systems. We're looking at years (many years) before these plug-ins fully integrate into truly smart, AI-powered patient management and dispensing platforms.

We're in the very early innings of what will be a very expensive game of vendor consolidation. As someone who's presented extensively on AI in specialty pharmacy, I'll be paying close attention to the players and potential winners and losers.

The AI revolution in specialty pharmacy isn't coming. It's here. The question now is how thoughtfully we implement it. What's your take on AI's role in specialty pharmacy? I'd love to hear from fellow executives who are navigating these decisions.

Recently, The RxRoundtable hosted two pharmacist-entrepreneurs that are operating charitable pharmacies in very distinct parts of the country. NOVA ScriptsCentral’s Executive Director is Donney John, PharmD and he runs a “charitable pharmacy central fill” operation that services 16 clinics in the Northern Virginia area. Rusty Curington, PharmD, Vice President of Pharmacy, St. Vincent de Paul Charitable Pharmacy joined us as well for this dialogue, and he oversees the operations and delivery of services and medications at three sites in the greater Cincinnati, Ohio region.

I have had the opportunity to visit with NOVA ScriptsCentral on several occasions and meet with their pharmacy team. The role of the charitable pharmacy is growing, and the entrepreneurial model that each pharmacy leader brings to their unique operations and the blend of clinical services they offer is what makes “meeting the patient where they are” and true patient engagement come alive inside of their four walls and in the greater broader communities in which they operate.

Together, the combined insights of these two individuals as to the critical role charitable pharmacies play in addressing access and affordability challenges for vulnerable populations across the United States was illuminating to this prominent group of consultants convening through The RxRoundtable.

By definition, a community charitable pharmacy is a pharmacy which serves with the expressed purpose of improving health outcomes among the vulnerable by reducing health disparities and increasing medication access. Common to both NOVA ScriptsCentral and St. Vincent de Paul Charitable Pharmacy are that these are mission-driven, nonprofit organizations, that exist primarily to improve health outcomes by reducing health disparities and increasing medication access for uninsured and underinsured patients.

From central fill to clinic-integrated, access grows via donation programs

Charitable pharmacies dispense a broad formulary of medications at no cost or significantly reduced cost, focusing on eligible individuals based on financial criteria, typically aligned with federal poverty levels. Their operations must comply with all local and federal regulations, and models vary from standalone pharmacies serving uninsured patients exclusively to mixed models integrated into clinics or hospital campuses, sometimes serving both insured and uninsured individuals.

When you have seen one charitable pharmacy, you have seen one charitable pharmacy. No two charitable pharmacies are exactly alike, as some operate solely under the charity model, while others adopt a mixed approach, dispensing medication for both charity and for-profit purposes or functioning within clinics and hospitals.

Additionally, many states have enacted legislation supporting drug repository programs, enabling the donation and redistribution of unused prescription medications. As of 2023, 48 states and Guam have some form of law permitting drug donation and reuse, with prominent examples like SafeNetRx in Iowa, Wyoming’s Medication Donation Program, Georgia’s Good Pill Pharmacy, Oklahoma’s program, and Ohio’s law that took effect in May 2023 which permits the donation of unexpired medications to charitable pharmacies, hospitals, or nonprofit clinics from the public. This includes medications that may be leftover due a change in regimen or the death of a loved one.

Philanthropy-fueled care with comprehensive services and volunteer-powered teams

Funding for charitable pharmacies is multifaceted, utilizing dispensing fees or flat fees per prescription, grants from foundations, individual donations, and partnerships with health systems and insurance companies. While charitable pharmacies charge nominal fees for medications, most revenue derives from philanthropic and institutional grants, which support their limited operational budgets.

The scope of charitable pharmacy services is broad, including medication access, medication therapy management, immunizations, health education, care coordination, diabetes management, substance abuse disorder services and participation in health disparities research. These services are delivered by a diverse workforce, including volunteers, clinicians, and pharmacy professionals, many of whom help develop workforce capacity within healthcare by serving as training sites for students and new practitioners.

When you look at the passion and commitment of Rusty Curington, as an example, his career in the charitable pharmacy sector began when he was a student, doing a rotation while in pharmacy school at a charitable pharmacy. He knew then that his calling was to serve the underserved in the greater Cincinnati area, and he never looked back.

National collaboration, measurable impact, and a donated medicines supply chain

The network of charitable pharmacy directors is a tight one. They collaborate, connect and share successes and challenges on a regular basis. Additionally, there is an association that supports the role that they play as well—and that is the National Association of Free & Charitable Clinics (NAFC). This organization provides resources and data insights that point to the impact of charitable pharmacies and free clinics nationwide. Interestingly, in 2023, over 1.7 million unduplicated patients received care through 1,400 clinics and charitable pharmacies in the U.S., accounting for 5.7 million patient visits. The majority of these patients were uninsured or earning below 200% of the Federal Poverty Level, with most belonging to racial/ethnic minorities and a significant proportion gainfully employed. Medication access and chronic disease management, especially for diabetes and cardiovascular conditions, are highlighted as core missions, with programs offering zero-cost insulin and supporting health education and care coordination for chronic illnesses.

While most charitable pharmacies will have a very specific formulary and treat mostly chronic conditions, using generic medications, there are a small number of pharmaceutical companies that provide brand name products, including insulin, through donations to one of the three primary “wholesalers” that service charitable pharmacies. The three primary sources of product for these charitable pharmacies comes from Americares, Dispensary of Hope and Direct Relief. Additionally, the drug wholesalers can also serve as a channel for donated product from pharmaceutical companies to a charitable pharmacy.

Expanding community partnerships to reduce medication insecurity

As pharmacy deserts continue to grow in pockets throughout the United States (Stu Beatty’s updated data) and as many individuals find themselves no longer eligible for Medicaid, the expansion of charitable pharmacies will continue and the need to continue to develop collaborative opportunities between charitable pharmacies and other community services will also expand.

Charitable pharmacies provide a unique practice site for pharmacy teams. The varied clinical service offerings, the strong patient engagement, and the opportunities to drive better patient outcomes within an underserved population drives professional satisfaction within these settings.

Ultimately, it positions charitable pharmacies as pivotal community resources fighting medication insecurity by leveraging partnerships, reusing donated medicines, and maintaining a strong commitment to improving public health outcomes amid persistent affordability barriers.

If you have not had the opportunity to visit a charitable pharmacy, I would encourage you to plan your next visit. The passion of their personnel is palpable, and the creativity is unparalleled. The impact of their services is needed now more than ever, and the growth of this sector will continue to remain strong.

Links to charitable pharmacies and resources:

• https://nafcclinics.org/

• https://novascriptscentral.org/

• https://www.svdpcincinnati.org/pharmacy/

First was the Air India flight 171 incident which tragically killed 260 passengers, crew members, and people on the ground. As I read more about it, I came across aviation YouTuber, Captain Steve, who thoughtfully interpreted the interim crash report and addressed the frightening possibility that this could have been a suicide. Aviation Week quoted other experts pointing in the same disturbing direction. I will come back to Captain Steve's simple advice for addressing our mental health awareness in a moment.

The second headline that caught my attention came from STAT News: The overlooked demo with the highest risk of suicide. The article highlighted that the suicide rates for men over 55 have risen more than any other demographic in the past 20 years; a statistic that hits closer to home than I would like.

The behavioral health crisis we can’t ignore

We don’t need reminders that America is in the midst of a behavioral health crisis. I asked my preferred AI assistant, Perplexity, to quantify the scope, and here’s what I found:

• Nearly 60 million adults experienced a mental health illness in 2024

• One in five young people ages 12–17 experienced at least one major depressive episode in the past year, and half received no treatment

• Substance Use Disorders (SUD) affect more than 45 million adults and 2.3 million youth

• There were 49,316 suicide deaths reported in 2023

• Annual emergency department visits with mental health or behavioral health diagnoses exceeded 5.9 million in 2022

Pharmacies: overlooked frontliners in behavioral health

Despite the staggering statistics, the pharmacies at the forefront of behavioral health remain largely overlooked. Some pharmacies serving this market include:

• Genoa Healthcare

• Altruix

• ArtexRx

• Advantage Healthcare Service

• PursueCareRx

• Mango Health

These and others are doing invaluable work in this space helping individuals with behavioral health challenges, but their efforts don’t get nearly the media attention that the struggles of independent or chain retail pharmacies do.

Pharmacists are in prime position to make a significant impact treating and identifying mental health conditions. With 90% of Americans living within five miles of a community pharmacy and patients visiting their pharmacists twice as often as their physicians, pharmacists are among the most trusted and accessible healthcare professionals. Access like this gives them an incredible opportunity to be a resource in a system where behavioral health services are in short supply.

A national opportunity: expanding pharmacists' role in behavioral health

We could see massive productivity gains in pharmacies with the increasing use of AI, giving pharmacists the time and tools to expand their involvement in mental health care. For example, a recent article in Pharmacy Times described how Yale New Haven Hospital collaborated with community pharmacists to implement a program allowing pharmacists to administer Long-Acting Injectable Antipsychotics (LAIAs), providing a powerful example of what’s possible when pharmacies are empowered to support behavioral health treatment.

However, even with such promising models, we need more trained professionals in the field. The American Association of Psychiatric Pharmacists has just under 3,000 members, of which only 1,500 hold psychiatric pharmacy certifications. With approximately 300,000 licensed pharmacists in the U.S., there’s a clear need for more specialized training and expertise to meet this growing demand.

The critical role of pharmacists in addressing behavioral health

With the looming cuts to Medicaid and policies supporting the relocation of homeless individuals, the country is going to need more trained talent on the front lines of behavioral health care. As community-based pharmacists are already the most accessible healthcare professionals, I believe they can play a major role in filling that gap. The fact that most people already trust pharmacists and frequently visit them provides a unique opportunity to engage in meaningful conversations about mental health.

A simple, yet caring question

Back to Captain Steve. In one of his videos, he recalls an experience as a military flight instructor when he noticed one of his students seemed distracted in-flight. Captain Steve simply asked, "How are you doing?" The student broke into tears, sharing his ongoing family crisis. Captain Steve safely landed the plane, and now, as an American Airlines commercial pilot, he starts every pre-flight check with the same question: "How are you doing? Seriously, how are you doing? Ready to fly today?"

Imagine if every community pharmacist in America had the time to ask that question to each of their patients. And more importantly, imagine if they had the resources to respond no matter what the answer.

So, I ask you: How are you doing? I truly care about every reader, and I hope you are all doing well. But if you're not, I hope you have someone like Captain Steve to talk to. If not, I’m a phone call away.

What are your ideas?

I want to hear from you. How do you think we can empower pharmacists to play a bigger role in mental and behavioral health? Whether you’re a pharmacy professional, policymaker, or someone who’s worked with behavioral health patients, your insights matter. Please share your thoughts and experiences in the comments below. Together, we can create a stronger, healthier future for our communities, one person at a time.

One of the most significant yet under-reported global health threats is hypertension. Google “Silent Killer” and you’ll find countless public health agencies sounding the alarm, not a horror movie.

Over 40 million Americans have undiagnosed hypertension, with prevalence especially high (over 40%) among Hispanic and underinsured populations. Hypertension is silent, asymptomatic, and deadly, contributing to 425,000 deaths from heart failure and 55,000 from end-stage renal disease annually.

And yet, it’s easy to detect and inexpensive to treat. A 60-second BP cuff reading can flag it. First-line medications like thiazides, calcium channel blockers, ARBs, and ACE inhibitors are all low-cost generics.

In 2022, the CDC and CMS launched the One Million Hearts initiative to prevent one million heart attacks by 2027. But recent proposed public health cuts cast doubt on the program’s future.

Now imagine: what if every retail pharmacy in the U.S. screened just one million people? The infrastructure is largely in place, and the benefits, both public and commercial, could be massive.

Pharmacists in states like Idaho already have prescribing authority. This model could scale nationally.

Meanwhile, massive investments signal that pharmacy chains are ready:

• CVS: $20B over 10 years for a tech-enabled health experience

• Sycamore Partners: $10B+ bid for Walgreens

• Walmart: $15B in net earnings (2024)

The cost of a national screening campaign? A rounding error.

Let’s start small: screen one million Americans. Even if just 10% have undiagnosed hypertension, that's 100,000 lives impacted.

To drive participation, why not gamify it? Imagine a national campaign: “Check Your BP. Win $1 Million.” We have the tech. We have the infrastructure. We just need the will.

Jeff Mazzamurro, PharmD and Director of Research and Innovation at The Travis Group, used AI to create a video ad for the campaign:

But before we go national, have you checked your BP lately? What about your loved ones? Million dollars or not, let’s walk the walk and see how many we can inspire to better health.

What you can do

• Check your BP regularly: no symptoms doesn’t mean no risk

• Encourage your pharmacy or clinic to participate in screening efforts

• Advocate for pharmacist prescribing rights in your state to expand access

• Support or contribute to campaigns like One Million Hearts

• Stay informed about public health policy shifts that impact preventive care funding

Additional resource

• WHO: Global Status Report on Hypertension 2023: Global context and progress gaps

Do you have plans to read a few books this summer? If so, I have a few suggestions. I’ll be spending two weeks in the Bavarian foothills in a few weeks, and between the long flights over and back and some quiet mountain time, I plan to knock out two or three titles.

Fair warning: I’ve fallen deep into the technology rabbit hole, but by choice. I’m genuinely enjoying it and my recommendations reflect that.

I’m convinced that this AI thing is real and it’s going to change the way we live and work much faster than most of us realize. Think back to prior technological leaps: did we really understand the impact of the PC when the first models shipped? Or the iPhone? Or Facebook? This time, I’m more intrigued and paying closer attention.

That belief is being reinforced by conversations in our RxRoundtable events with innovative CEOs and through my own research. Here’s one example: I recently listened to a summary of Mary Meeker’s new report on The AI Daily Brief. During the dot-com era, Meeker was a legendary former Wall Street analyst whose internet trend reports were required reading. She’s back with a new one: Trends – Artificial Intelligence (340 pages and free to download).

In it she argues that AI is not just another tech trend, but a foundational shift, like the invention of electricity or the telephone, with sweeping implications for business, society, and geopolitics. And unlike past innovations, this one’s moving fast. It may be a bit dry, but it’s a solid place to start your summer reading. Here are a few more…

Looking for a more human take on AI? Try these:

The Optimist: Sam Altman, OpenAI, and the Race to Reinvent the Future by Keach Hagey

A compelling biography of the perpetually optimistic Sam Altman. If you believe Moore, Grove, Gates, and Jobs helped reshape the world, you’ll want to know more about this 40-year-old technologist and his growing influence.

Empire of AI: Dreams and Nightmares in Sam Altman’s OpenAI by Karen Hao

A deeper, more policy-focused look at the power concentrated in a few hands and what that might mean for all of us. Hao explores the strange hybrid corporate structure of OpenAI and offers insight into the November 2023 boardroom attempt to oust Altman, referred to as “the blip.”

Pro tip: If you don’t have time to read both, listen to Kara Swisher’s dual interview with the authors on her podcast On with Kara Swisher. You’ll consider asking yourself, what is your “P-Doom?” Mine? I’m a 5.

Need a break from AI but still love tech and global strategy?

Apple in China: The Capture of the World’s Greatest Company by Patrick McGee

A riveting exploration of how Apple helped fuel China’s electronics dominance only to find itself increasingly dependent on a regime making ever-growing demands. If you're interested in the intersection of innovation, geopolitics, and power, this one delivers.

And for a true change of pace:

How to Think Like Socrates by Donald Robertson

A refreshingly accessible take on the life and lessons of one of the world’s great philosophers. When AI and global power dynamics feel overwhelming, stepping back into the minds of ancient thinkers might just offer the clarity we need.

Final thoughts…

Whether you lead in specialty pharmacy, PBM, or health services, these books offer more than just vacation reading. These titles provide context, foresight, and a challenge: to think critically, stay informed, and lead with eyes wide open. So wherever you find yourself over the summer months, the mountains, beaches, or just the backyard, bring a book that helps you meet the future with perspective.

Even in the age of AI, we can still slip into the soft pages of a good book for the sheer enjoyment of it. Finding your summer reading is as easy as browsing the Books section on Amazon.com or at your favorite independent bookseller. Trivia moment: When Amazon launched in 1995, yes, 1995, it offered the world’s largest collection of books. The first book sold on its platform was Douglas Hofstadter's Fluid Concepts and Creative Analogies: Computer Models of the Fundamental Mechanisms of Thought. The irony is not lost on me.

I will raise a stein to your reading enjoyment while in Germany.

I recently had the opportunity to attend the National Association of Boards of Pharmacy (NABP) Annual Meeting, where I saw firsthand the significant challenges and opportunities facing state boards of pharmacy. This meeting, along with other major industry events like AMCP and Asembia, shed light on the critical role the NABP and its member boards play in ensuring the safety and integrity of the pharmacy profession.

The NABP has seven core programs that it either directly administers or provides substantial support to the state boards:

• Pharmacist licensure transfer and verification

• The North American Licensure Examination (NAPLEX)

• Continuing Pharmacy Education

• Support of the Drug Supply Chain Security Act (DSCSA) through its Pulse program for participating pharmacies

• Accreditation—covering advanced practices from compounding to specialty

• Pharmacy Inspection in support of state board inspections

• Foreign pharmacist access and certification

And if this isn’t enough to keep the staff busy, in addition to the programs listed above, the NABP has committed to five key initiatives to further its mission to protect the public health. They are:

• Pharmacy Practice, Well-being and Safety – promoting the mental health and well-being of pharmacy staff. We’ve all seen the reports of pharmacists’ dissatisfaction with working conditions and early efforts at unionization.

• Safe Pharmacy Resources – educating consumers about safe medication practices. This has become an even greater issue with the proliferation of misinformation across various social media platforms.

• Medication Treatment for Opioid Use Disorder – promoting pharmacist-provided medication-assisted treatment for patients with opioid use disorder, which remains one of our nation’s greatest health challenges.

• US Drug Supply Chain Security and Integrity – this not only includes supporting DSCSA but also working with various state and federal agencies to monitor and safely implement drug importation programs.

One additional initiative has been added this year, and it ties directly into the future of pharmacy: the formation of the NABP Innovation Institute. This new initiative will explore the intersection of technology and pharmacy practice, including the use of AI-driven avatars for medication counseling when in-person consultations with a pharmacist are not possible.

We are already seeing the proliferation of AI tools that can generate near life-like videos and avatars. Google has just released a tool called Flow, which has stirred significant interest for its ability to quickly create realistic videos from text-based documents. When combined with AI sources, we will see avatars giving expert advice on a wide range of topics, with pharmacy and medicine being obvious targets for this technology. This is a potential game-changer for how healthcare services are delivered, but it raises important questions about how we will harness these productivity gains to improve access to primary care.

As we look to the future, it’s clear that the NABP and its innovation efforts will play a central role in helping state boards navigate these emerging technologies. Full Practice Authority (FPA) and the rapid advancements in AI are two areas where the NABP’s leadership will be crucial. We need to ensure that the gains from these technologies translate into meaningful improvements in patient care. I predict that the NABP Innovation Institute will become an invaluable resource for state boards, enabling them to stay ahead of technological advances that are moving far too quickly for individual boards to handle on their own.

The NABP’s work has never been more important. As it leads efforts to support state boards in their missions to protect public health, it remains crucial for those in the pharmacy profession to engage with their boards and stay informed about the regulatory changes that will shape the future of pharmacy practice.

If you are passionate about the future of pharmacy, I recommend reaching out to your state board to discuss how you can contribute to the ongoing dialogue around technology, Full Practice Authority, and improving public health. By staying engaged, we can help ensure that the profession continues to evolve in ways that benefit both practitioners and patients.

Broken hubs, soaring therapy costs, and what comes next

Asembia’s 21st Annual Specialty Pharmacy Summit brought together over 8,500 attendees and 200+ exhibitors in Las Vegas—cementing its place as a flagship event for the industry. Congratulations to Chris Benz and his team for delivering an event that combined top-tier content, unmatched networking, and an exceptional venue.

While Asembia doesn’t categorize sessions by topic tracks, I was curious to find common threads. I used ChatGPT to analyze and group the 75+ presentations into five themes. But even more compelling than the sessions were two persistent issues that came up again and again in panels, hallway conversations, and informal meetings.

The hub model is broken—and AI may be the disruptor

The traditional manufacturer-backed hub model for specialty medications continues to frustrate providers and patients alike. This came through loud and clear in a standout panel, “Specialty Pharmacy’s Next Frontier: Where Investors See Opportunity,” featuring insights from McKesson Ventures, Frazier Healthcare Partners, and LRV Health.

Even with the rise of tech-enabled service platforms and legacy tools like CoverMyMeds, navigating:

• Fragmented hub service centers,

• Limited distribution networks,

• Complex PBM restrictions, and

• Non-integrated real-time benefit tools
  remains a massive headache for prescribers.

As one panelist noted, “The traditional butts-in-seats model is about to be blown up by AI agents.”

What you can do:

• Reassess your support services—where is friction costing time or trust?

• Explore partnerships with AI-driven platforms that can simplify benefit verification or prior auth

• Engage directly with prescribers to understand which pain points matter most

Gene and rare disease therapy costs are becoming an employer crisis

The approval of more high-cost gene and rare disease therapies is a double-edged sword: groundbreaking for patients, but financially destabilizing for small to mid-sized employers.

One expensive therapy claim could destroy an employer’s annual benefits budget. There is currently no unified risk mitigation approach being adopted at scale.

What you can do:

• Stay engaged with payers and benefits consultants—this risk isn’t theoretical anymore

• Follow how stop-loss carriers and PBMs are evolving their strategies

• Support conversations around pooled risk and new funding models before the crisis hits

The mood: urgent but upbeat

Despite the challenges, the tone across Asembia was optimistic. From what I observed, most attendees believe we are making progress toward a better future for patients—and that solutions are within reach if we lean into innovation.

Postscript: Rite Aid’s bankruptcy is a signal, not an outlier

Just after the summit, Rite Aid formally began its Chapter 11 proceedings. The company, once a national force with 5,000+ locations, is now likely to be sold off in parts.

This event underscores a broader truth: we are living through a profound restructuring of community pharmacy. The final shape of the next-generation pharmacy model isn’t clear yet—but digital-first and AI-enhanced models are undoubtedly part of it.

What you can do:

• Monitor market signals: Which models are gaining traction? Who’s adapting fastest?

• Use this moment to rethink how you engage with retail partners, especially in underserved regions

• Stay informed and engaged—these transitions will shape the next decade of pharmacy care

Specialty pharmacy is entering a defining era. Whether you're a payer, provider, investor, or vendor, the actions you take now—streamlining access, reducing burden, sharing risk—will determine how prepared you are for what’s ahead.

On April 7, Shopify’s CEO Tobi Lütke sent an email to all employees where he laid out his six principles for incorporating AI into all aspects of Shopify's operation. The principle that made the headlines was his directive that, "Before asking for more headcount or resources, teams must demonstrate why they cannot get what they want done without AI.”

In some quarters this was derided as a backdoor way to impose a hiring freeze in the face of macroeconomic uncertainty. That is not how I see it. If you take a closer look at Lütke’s letter and read it thoroughly, you will see a very thoughtful, albeit aggressive, call to action by a forward-thinking CEO. He understands the potential of AI and wants his team to see the new reality.

Lütke lays out six directives:

1. Using AI is a fundamental expectation of everyone at Shopify

2. AI must be part of any new project prototype phase

3. We will add AI usage questions to our performance and peer review questionnaires

4. Learning is self-directed, but share what you have learned

5. Before asking for more headcount and resources, teams must demonstrate why they cannot get what they want done without AI

6. Everyone means everyone

I am not going to dissect all six, but I will comment on a few.

It is a management truism that if you want to change the culture of an organization, you need to address the incentive structure. Lütke puts a stake in the ground here by incorporating AI usage into everyone's performance review; a great move on his part.

Shopify has made significant investments in learning and collaboration tools. Lütke is challenging everyone to use company-provided tools to advance AI in all departments. He is turning everyone into AI trainers.

I believe that the headcount restriction is a good thing. Lütke isn’t saying that Shopify will not hire another human being; he is just raising the bar. And isn't that what we all want? Isn't it intelligence that has moved us from the apes in the opening scene of 2001: A Space Odyssey to where we are today.

If we have invented artificial intelligence, we need to rise above it with human intelligence. What can we do that a 200,000 GPU neural network can't do? The computers are chasing us and we need to pick up our pace. What better place to start than at work?

We can dig deep and use our powers of creativity, insight, and perception. I don’t believe that an AI bot will have the ability to look into a patient's eyes or listen to their concerns and have that aha moment that inspires a new product or service. What we want is for AI to give us the time to generate more of those aha moments and foster human connection often lost due to the overwhelming burden of administrative tasks.

If you’re skeptical the influence and potential of AI is real, consider that almost one trillion dollars has been invested in AI technology over the past ten years. Do you really want to bet against that?

Rather than waiting for your CEO to email you an AI directive, maybe you should take the hint, skill-up on AI, and incorporate it into your work now rather than later.

As artificial intelligence (AI) drives productivity gains in pharmacy, an important question emerges: How will pharmacists use this newfound time? Before we decide, we must first examine the scope of practice—what pharmacists are legally allowed to do.

The regulatory roadblock

Pharmacy practice is regulated at the state level, not by the federal government—except in rare cases of federal preemption, such as the COVID-era allowance for pharmacists to prescribe and dispense Paxlovid. This means that each state defines its own rules, creating a wide variation in pharmacist authority.

For example:

• Florida defines pharmacy practice in 628 words and has 163 pages of pharmacy regulations. Pharmacists do not have full practice authority.

• Idaho, by contrast, allows full practice authority with only 106 words defining pharmacy practice and about 20 total pages of regulation.

Regulation vs. innovation: the data tells a story

A study published in the Journal of the American Pharmacists Association introduced the Pharmacy Regulatory Innovation Index (PRII), which ranks states based on:

• Regulatory burden (word count of regulations)

• Innovation in pharmacy practice (scope of pharmacist-patient care activities)

The authors analyzed the regulatory scope of the ten western states in the US. The results? The more regulations, the less innovation. Idaho, with the lowest word count, had the highest innovation score, while Nevada, with over 1 million words of regulations, had the lowest innovation score.

AI is moving fast—can pharmacy keep up?

If AI is to revolutionize pharmacy, state regulations must evolve—and quickly. It took Idaho over a decade to achieve full practice authority. With AI advancing at breakneck speed, we can’t afford to wait ten years for regulatory changes nationwide.

Advocate for change

Regulations shape the future of pharmacy. If we want AI-driven innovation to improve access, improve quality, and lower the cost of patient care, we must expand pharmacist roles by leveraging AI to reduce administrative burdens among other opportunities to reduce, reform, and reinvent solutions that benefit patients.

We must:

• Educate policymakers about the impact of outdated regulations

• Advocate for legislative updates that empower pharmacists

• Collaborate with pharmacy boards to align rules with modern healthcare demands

How can we push for faster reform?

Share your thoughts in the comments or reach out to discuss how we can drive change together.

References

• Pharmacy Regulatory Innovation Index: Benchmarking the regulatory environment in 10 western states abstract

• Science Direct’s Federal pharmacist Paxlovid prescribing authority: A model policy or impediment to optimal care?

• Florida Department of State’s Board of Pharmacy’s latest version of the final adopted rue presented in Florida Administrative Code

• Florida Department of Health Division of Medical Quality Assurance Board of Pharmacy, Chapter 465, Florida Statutes Rules 64B16, Florida Administrative Code

• Idaho Legislature’s Title 54 Professionals, Vocations and Businesses (chapter 17) Pharmacists

• JAPhA’s Pharmacy Regulatory Innovation Index: Benchmarking the regulatory environment in 10 western states

• Joint Commission of Pharmacy Practitioners The Pharmacists’ Patient Care Process

The first installment in a multi-part series on the AI revolution in pharmacy: a new era of productivity and practice.

Throughout this series, I will cover the concepts and implications of full practice authority, standard of care, and provider status as explained in the Cicero Institute Toward Pharmacist Full Practice Authority by Tim Frost and Jonathan Wolfson. The series will also draw on my interview of Dr. Frost at the RxRoundtable Hot Topics session on March 12, 2025. Each concept needs to be thoroughly understood to interpret how state Boards of Pharmacy, the federal government, and ultimately payors, grapple with the evolving role of pharmacists. I will also be presenting a few of the practice scenarios and show how full practice authority can help solve the crisis of poor access to primary care in America.

The time is coming when pharmacists and their staff will be freed from the burden of endless administrative tasks required to fill prescriptions. Pharmacists have always wanted more time. “Be careful what you wish for,” may quickly become the watchword for the profession.

AI is the tool that will create more time for pharmacists and for all of us. I am not sure when it will happen, but if it follows the model of other tech innovations, it will happen slowly, and then fast.

Are we ready?

AI is fundamentally transforming the work of various professions and job classes. I have written about the experience of IKEA using AI to upskill 8,500 customer service agents. Dario Amodei, CEO of Anthropic, a leading AI frontier model developer believes that within six months AI will be able to perform 90% of the tasks currently done by software programmers. Why do we believe that the practice of pharmacy will not experience the same positive productive impact? How will we adjust to a world where pharmacists are five times, or possibly ten times, more productive?

Go West, young pharmacist!

Idaho, Montana, and Colorado may show us the way. In the well-researched and thoughtful white paper, Toward Pharmacist Full Practice Authority, by Tim Frost, PharmD and Jonathan Wolfson, Esq. for the Cicero Institute, the authors describe how these states have completely rewritten their pharmacy regulations using a standard of care regulatory model linked to a full practice authority model.

The three concepts

• Standard of Care is the regulatory benchmark used to measure the actions of healthcare providers and ensure they are performing their duties to prevent patient harm. The primary regulatory framework that was developed in the 1980s for medicine and nursing.(1)

• Full Practice Authority is best defined by Dr. Ross Tsyuki: Full-scope pharmacist services include all proactive and comprehensive interventions that prevent or manage illness and are within an individual’s competency to perform independently.(2) In adopting Full Practice Authority, the states reject the concept of collaborative practice agreements in favor of collaborative practice.

• Provider Status refers to the status conferred upon various healthcare providers by the various payor entities, be they state (Medicaid), federal (CMS) or commercial. In July 2022, the FDA issued an emergency use authorization for Paxlovid that demonstrated the concept of federal preemption allowing pharmacists to prescribe, dispense, and get paid for Paxlovid.(3)

We may be facing a generational shift in how pharmacists view their work and role in the US healthcare system. In her widely-acclaimed book Generations, Jean Twenge, PhD, argues that technology shapes how generations think and act. Today’s young pharmacists are entering the profession at the same time AI is changing the entire work paradigm. AI may provide the technological catalyst coupled with the regulatory reform of full practice authority to finally allow the profession to achieve its most productive place in the US healthcare system.

Pharmacists, young and old (or maybe “all of us”) need to learn the regulatory language that has been proven successful in these three states. We need to be able to confidently talk about Full Practice Authority and Standard of Care regulations. We need to make these terms part of our conversations with our friends either on the board of pharmacy or in pharmacy leadership positions if we are to reach the goal of Provider Status.

Citations

1. Kinney, Eleanor D., “The Origins and Promise of Medical Standards of Care.” Virtual Mentor 6, no. 12 (2004): 574-576. 10.1001/

   virtualmentor.2004.6.12.mhst1-0412.

2. Tsuyuki, Houle, and Okada, “Time to Give up on Expanded Scope of Practice,” August 17, 2018.

3. Adams, Alex J., and Deeb D. Eid. “Federal Pharmacist Paxlovid Prescribing Authority: A Model Policy or Impediment to Optimal Care?” Exploratory Research in Clinical and Social Pharmacy 9 (March 1, 2023): 100244. https://doi.org/10.1016/j.rcsop.2023.100244.

“Where is my order,” aka “WISMO,”

is the one customer-driven activity that adds more labor cost to a pharmacy operation than any other activity.

Depending on the type of medication and reimbursement methodology, the time to answer this question could take anywhere from a few seconds to a few days and could involve multiple customer- and patient-service representatives. Effectively answering WISMO can determine a patient's customer experience at that specific pharmacy being positive or not-so-positive.

The pharmacy business is not alone in its struggle to provide outstanding customer service. Any business's ability to quickly and accurately answer customer questions determines how it’s perceived, rated, and compared to competitors.

There have been many innovations adopted over the years to improve customer service operations such as Call Center as a Service (CCaS) or Interactive Voice Recognition (IVR). But nothing compares to the disruptive potential promised through the next iteration of AI, AI agents, and its impact on the call center business and staffing model.

You have probably already experienced interacting with a chatbot interface. It may have been a good—or not so good—experience, but these bots and their programmers are evolving to serve the growing demand of higher quality—and faster—results.

Klarna, a Swedish financial services company, announced in 2025 that it had employed AI technology capable of doing the work of 700 customer service workers.

As of February 2025, Ikea's AI chatbot “Billie” has become an integral part of the company's customer service strategy. Billie has been successfully handling a significant portion of customer inquiries. Since its launch in 2021, Billie has managed 47% of customer queries to Ikea's call centers. The chatbot's efficiency has allowed Ikea to retrain 8,500 call center workers as interior design advisors, enhancing the company's service offerings and increasing overall sales.

Rapidly evolving from IVR to Interactive Voice Agents (IVAs) 

Think about what happens when you call a customer service department. A representative is listening to your question and is looking up the answer on a computer screen. What if the screen could listen? What if the screen could talk? We are in the early stages of this transition.

Companies like Klarna and Ikea have learned how to take voice recognition and voice generation technology and merge it with their core operating applications. It will not be long before the tech companies supplying the pharmacy business begin to take the same approach. In fact, it’s already happening in the entrepreneurial corners of the market.*

Pharmacists and pharmacy technicians are paying attention and are cautiously nervous

The site Will Robots Take My Job is becoming frequently visited by a variety of workers concerned about the onset of automation impacting their careers and jobs. Using its proprietary econometric model, the site “predicts” the percentage of any career/job exposure to replacement by AI/chatbots/automation.

The irony is that their algorithm provides a “calculated” percentage but compares it to a “visitor poll.” A unique aspect of the site is that the user polling widget is embedded within the results display, which quickly changes the percentages on the polled percentages over time as site users submit their “opinion.”

Like anything automated by a human, you need to take it with a grain of salt. But at least we have something that gives us a sense of how people are thinking and things are moving fast…

When asked will robots take the job of pharmacists its model predicts a 31% probability, but reports that users rate the probability at 70% (and likely to be different if you test it today based on user input.) For pharmacy technicians it’s 67% and 67% respectively. General customer service representatives are predicted at 79% and 81% respectively.

The next time you call customer service, think about the representative (aka human) at the other end of the call. They are probably reading from data on a computer screen. How long will it take for that screen to become as smart as the representative? Klarna and Ikea have made the jump and are having success so far.

It’s not all bad news

As mentioned, Ikea used the productivity gains from Billie to help 8,500 employees learn and deploy a higher set of interior design and problem-solving skills. The pharmacy industry faces a similar challenge: how to upskill the existing PSR's and CSR's to be able to provide greater value to a market that is straining under the ever-rising cost of healthcare.

As the population ages, more patients are being prescribed multiple medication regimens and need more complex pharmaceutical attention. We’re also seeing manufacturers introduce more and more complex specialty medicines. The onset of automated customer service agents may give us the opportunity to upskill the existing workforce to better manage the increasing complexity of pharmaceutical care in the very near future.

As automation becomes more effective and comprehensive, we need to advance our unique human qualities to provide and even higher level of customer service.

*Our goal is to bring leading edge companies deploying AI tools to automate and serve gaps in the pharmacy industry. Twice monthly, they present to our RxRoundtable Members at our Spotlight Company meetings. Here are some of these very cool companies who have presented to the RxRoundtable.