Intro: [00:00:05] Broadcasting live from the Business RadioX studios in St. Louis, Missouri. It’s time for St. Louis Business Radio. Now here’s your host.

Dr. Phillip Hearn: [00:00:18] So hello good people. I’m welcome back to another episode of Docs Discussions. I am Doctor Philip Hearn and we are extremely lucky to have our next guest on here today. She is a geriatric specialist. She is actually the founder of HBL PharmaConsulting. She’s a senior care pharmacy practice leader, and she’s an adjunct professor at the St. Louis College of Pharmacy here in St. Louis, Missouri. And she’s also an author. So the name of her book is Maybe It’s Your Medications: How to Avoid Unnecessary Drug Therapy and Adverse Drug Reactions. I hope I got that right. So I’m going to bring in and introduce Dr. Hedva Barenholtz Levy, how are you Dr. Levy?

Dr. Hedva Barenholtz Levy : [00:01:02] I’m doing wonderfully. Thank you so much.

Dr. Phillip Hearn: [00:01:05] Good, good. Glad to have you here on the show. So I want to tap into because when we get people that have such a subject matter expertise as yours, it’s always fun to kind of go back before going forward. So take us through a little bit of your background. How did you get to where you are? Is it a big family, or are you driven by family members who are already in the doctoral industry? What what does that look like?

Dr. Hedva Barenholtz Levy : [00:01:30] So I you fairly unique or I’m the minority of pharmacists and I come from a family that has no pharmacy or medical background. Really. My father was a housing developer, so he was in the business realm. My mother was bookkeeper. And, you know, again, not non-health related. And but I always had an interest in helping people, which I think is why most people go into medicine in the health field when they want to. They want to help people. So I. And I think my my model for getting into the senior care pharmacy piece, the geriatrics interest does relate to my grandparents. I watched how my different grandparents aged in different ways. There were two that I was. I grew up a little closer with and they both had their share of of health issues. I saw how they related to medications, um, how they were over concerned about every symptom. The hypochondriac, hypochondriac response. Um, but so anyhow, so I was part of watching them age and seeing a lot of, a little bit of, of how they fell in the cracks. There wasn’t a lot of support for them with, um, with some of their health care. So I think that sparked some of my interest in the aging population. But I went to the University of Michigan really not knowing what I was going to do. I was thinking business or medicine, and pretty quickly decided it wasn’t going to be the business route. So I was looking at the health route, and truly, it was being at Ann Arbor campus. Hearing about the different programs Michigan offered, one of them being a Doctor of Pharmacy degree at the pharmacy school. So I looked into that further, and I learned that pharmacy didn’t mean just filling prescriptions behind a counter.

Dr. Hedva Barenholtz Levy : [00:03:14] There’s this whole new thing called clinical pharmacy, and this doctor of pharmacy degree that opened up a whole new area of pharmacy practice. I could work in a hospital setting. I could be more hands on with patients evaluating drug therapy. So that was a that fulfilled my interest in being in medicine without the, I guess I can say, kind of honestly, the rigors of having to go through medical school and the internships and residency and all of that, that extensive training pharmacy has the same kind of process. I did go through a residency, but it was um, it was, uh, again, it was a little different and, um, more up my alley. But, um, so anyhow, so I became a clinical pharmacist and. Worked my way through to become my to start my senior care practice. Um. And I think if I, if I’m staying unfocused here as I’m wending my way. But as I graduated from the University of Michigan, uh, there was an article written about a woman who had a senior care practice in the community setting in the Washington, DC area. So I hung on to that article. And when the time was right, which turned out to be about 5 or 6 years later. I met with that woman, learned her business model, and when I moved to Saint Louis, I. I took that on. And so where I am today has been having is having this very unique senior care practice where I meet with seniors in their homes. Um. So that and need to fill in. Help me fill in the blanks here. But. Yeah. So.

Dr. Phillip Hearn: [00:04:44] And we’re definitely gonna help you fill in the blanks. So this is interesting. So I want to go back for half a second to your time at University of Michigan. Take us through that process. Right. Because not all of us are. In the, you know, same pharma or pharma focus, uh, discipline as you’ve been. How long was that process? And more importantly. Were there moments? Were there contacts? Were there professors that really allowed you to go? I think this is what I want to do. Sounds like coming into the university, but really helping to foster that long terme passion because you have a passion for it. And this is our most fun when we get when we get great interview subjects, because you can tell their brains are moving on this probably 24 hours a day. So take us a little bit through that.

Dr. Hedva Barenholtz Levy : [00:05:28] So there’s some fun stories I have when so with um, when I discovered this pharmacy program, I there were a couple of points that stand out in trying to understand what this doctor of pharmacy was, because that was new to me. And, uh, at the time. So this was in the mid 80s, early 80s that I was, um, at Michigan. And Pharm D was not the majority degree. Most people graduated with a BS in pharmacy. So I remember going to the school and, um, asking to meet with a pharm.d someone who had this degree. So an individual, one of the preceptors there, the professors at the, at the university, had me, allowed me to come on rotation with him, with him and his students. So we did the rounds in the hospital, and I always chuckle when I look back at that. I think today there’s no way that could happen with our privacy, regulations and security and all that. But I was able to, um, get a snapshot of what it looked like to be a clinical pharmacist in a hospital setting. So that was a turning point. That definitely led me to, uh, feel more confident that this was a program I wanted. Um, of of interesting note. I happened to find my. Entry essay. My mission essay that I wrote to the College of Pharmacy, um, back in whatever, 1984, 85, roughly. And it was interesting what I reflected at that time. I, you know, I knew I wanted to get into the clinical pharmacy. I’d done obviously intern for a couple of months one summer, and I knew that was the route for me. So, um, so that was step one. Then I got into the pharmacy program. It’s a four year program. Once you enter, uh, the University of Michigan, uh, has was unique at the time in that you it provided a pharm.d only as an entry degree, so I didn’t have to go the BS route and then add on a doctor pharmacy with additional years.

Dr. Hedva Barenholtz Levy : [00:07:19] So it was going to be a pharm.d entry level degree. And I’m starting my. So I did my first couple years undergrad and you know, just a general liberal arts, uh, material get into the pharmacy school and there’s a lot of chemistry, a lot of, um, hard science. And I’m like, this is not what I really love. I want the people aspect. I want the clinical side of it. So one of my summer internships took me to Washington, DC, and as industrious as I was, I needed to figure this out. The American Pharmacy Association, their headquarters, is right there on Constitution Avenue. So I truck on in there and I asked to speak with a pharmacist. I wanted to find out more about this clinical pharmacy world. And so I remember speaking with somebody at that time who was very instrumental to helping me see the bigger picture and where I could go with this degree and what lay on the other side of all the studies. Excuse me. So that was just a key. A key point there to help me along my journey. Excuse me. And to bring that full circle. It was only in the last, maybe, um, 7 or 8 years. I came across that woman again. She had since moved on to different practice areas, and I shared with her that story and how meaningful it was that she sat down with me and talked to me about pharmacy at that time. Um, so it was kind of nice to bring that full circle.

Dr. Phillip Hearn: [00:08:35] That’s cool. I love it, I love it, yeah. So you mentioned an article that seemed to really spur more of where you are or where you’ve ended up today. That almost kind of became, it sounds like your North Star, if you will take us through the depths of that article. It’s always interesting to tap into those quick sparks, right? So you’ve got a game plan. You’ve done the work to get the University of Michigan. Uh, you’ve done even your your extended work in terms of getting out to Washington DC, basically kicking in the door and saying, hey, I want to be taken seriously. I want to do this right. So there’s a passion piece there. But we always have those those opportunities to kind of really take it to the next level, take us through that article. What stood out and then how has it helped you, uh, to what you’re doing today?

Dr. Hedva Barenholtz Levy : [00:09:23] So the article was, uh, it it was just one of those professional profiles of this unique practice. Um, the. Yeah. So it described enough of of her model that she was an entrepreneur, that she was owning her own business. She was doing something creative. She was working with, uh, adults in the community setting. And, you know, some as I was going through my, my career at my studies at the University of Michigan, I obviously was getting wind of, um, and through my grandparents experience, the people falling through the cracks in healthcare that it even back then, it was a big, complicated system. And, um, people needed more of that personal touch and that care part of health care. Um, so this woman so her model was just was was described enough that, um, how she I think she did, you know, one on one meetings with people with with people, um, with patients to talk about their drug therapy. And I it intrigued me. I can’t remember much more detail than that. This was, you know, 30 years ago. Tucked it aside, though. Finished my studies, graduated, did my residency. I was in Gainesville, Florida for a year and then got my first job. I was still, um, doing the traditional path, if you will, of of clinical pharmacists at that time. I um, during my residency, I did focus on older adults a little bit. I did a couple extra rotations where I was able to stay with the senior care population. Um, because I knew that that was an interest of mine. I went ahead and took my first job in, uh, outside of Cincinnati, Ohio, which was working in a small community hospital, uh, being the clinical coordinator, that was the job of the day where it was bringing pharmacy out from the basement, bringing those clinical services up to the patient floors, where I was doing what I was trained to do and what I wanted to do, which was working with, uh, at that patient bedside of sorts and really looking at evaluating drug therapy for individuals.

Dr. Hedva Barenholtz Levy : [00:11:23] And, and I was plugging along with, uh, with my activities. I actually, uh, was coeditor at the time, also associate assistant editor of a national and international pharmacy journal at the time, based in Cincinnati. So I was doing one and a quarter time work. I mean, just ambitious as as we all, many of us can be at that young age, right? We’re starting our careers. So everything’s plugging along fine. And that article was still sitting in my files from of that woman in DC. So as life evolves, I met my husband there. We we got married in Cincinnati. And when we’re trying to deciding on relocating, uh, I knew I was I’d be moving to Saint Louis, which is where my husband is from. And that was when I pulled out that article, and I thought, I’m going to meet meet with this woman and find out more about her model so I can figure out how to implement that in Saint Louis and start my own business. Um, also in the back of my mind, I think as I’m going through my these early stages of my career getting married, I knew I wanted to have children.

Dr. Hedva Barenholtz Levy : [00:12:23] I knew I wanted to, um, kind of have control of my work environment, if you will. So that entrepreneurial piece was something very important to me so that I could, um, have a business, have my professional life, which meant a whole lot to me, obviously, but also raise my children and have that freedom. So kind of, um, wanted my cake and I wanted to be able to eat it too. So, um, I ended up in so this is the summer before we moved to Saint Louis, I there was a pharmacy meeting. It happened to be in in Washington, DC. And so I called this woman and I met with her. I remember getting on the metro and going out to the Virginia suburb where she was, and she, we she shared with me her, her model and what she did. And, and I think there was certainly that level of, you know, because I wasn’t setting it up next door to her. She was very free to share with me how she how she did everything. And and so I tweaked it as would work for me in Saint Louis. But, um, it was just that opportunity to sit down and speak with her directly, to have her share with me what worked. Um, again, memories a little bit hazy, but she shared with me enough that I knew this was the model I was going to work from work off of when I got to Saint Louis. That’s awesome.

Dr. Phillip Hearn: [00:13:35] So at this point early in your career, how long have you been in Saint Louis, by the way? I meant to ask this.

Dr. Hedva Barenholtz Levy : [00:13:41] I moved here in 1995, so okay, a long time.

Dr. Phillip Hearn: [00:13:45] So basically you’re in Saint Louis and that’s pretty much how this works now. So, you know, after a certain amount of time, they just claim you.

Dr. Hedva Barenholtz Levy : [00:13:51] The first thing I say is I’m not from Saint Louis. Yeah. Because, you know, we bonded together, right? There’s those from Saint Louis and those not from Saint Louis. Yes, yes, I have my Cardinals t shirt and all that good stuff. Of course. Yeah.

Dr. Phillip Hearn: [00:14:04] They just claim you after about ten years. That’s usually it. If you’re not from Saint Louis, the ten year demarcation plus, then you don’t have to worry about getting asked where are you from in terms of your high school? But that’s a whole nother that’s its own podcast, probably.

Dr. Hedva Barenholtz Levy : [00:14:15] Right? Right, exactly. Boy, is that a fun one.

Dr. Phillip Hearn: [00:14:18] Exactly. So being in Saint Louis as long as you have. How did you start to implement those lessons, knowledge points, etc. from that meeting, that chance meeting that you had in the mid 90s into what you’re doing on your day to day basis today, is that still something that you, you know, you kind of use as your focus? How have you tweaked it? What is that process been looking like over the years?

Dr. Hedva Barenholtz Levy : [00:14:41] Yeah. Um, probably it’s it’s all, it’s more in the, in, in the back of my mind as, as my foundation of just getting started knowing that this model. I could do this, I could do this essentially. Um. When I it was the when I came here and I knew this is what I wanted to to what I wanted to do, I did, you know, I did look around for some jobs where I could be employed, but nothing, just nothing felt right. So, um, I had to figure out how to move from being a clinician to a business owner, which, uh, you know, has been a journey. And I would still say I’m, uh, it I’m still struggling with certain aspects of it because it I’m not a business person by nature. I’m a clinician by nature. Um, so there was that was a there was a learning curves I had to go through. So I do a shout out to score. At the time I met with, I did a half day seminar with score that got me started with just the basics of establishing, uh, the nature of my business and the the accountant and the lawyer and what issues I needed to have, what issues with support. I needed to have, um, pulled together my business cards and my brochure and and the website and all that stuff had to come together.

Dr. Hedva Barenholtz Levy : [00:15:56] So it was it was a lot of learning on my own, I would say. I mean, I had the business model. I knew what I wanted to do with the patient from the patient aspect. Um, but the rest was really pulling it together on my own. A lot of, um, like I said, the business learning curve was part of it. Clinically. I’m trying to think where my other role models and ideas came from. I, you know, was strong in knowing what I wanted to do and the concern of older adults and medications. Um, you know, I had the background and expertise with, with that, uh, with that aspect of it, it was a matter of starting the business and getting getting patients and finding grant money. Or I had a private pay model at the time, which I still do, but also, um, I was able to start networking, I think. And that’s and that was then the referral basis. I’m trying to going back in time and thinking, how did I get started? It was finding the one coffee at a time, meeting people who then introduced me to another networking organization in Saint Louis. We’re very blessed in Saint Louis that we have a very strong senior service provider network.

Dr. Hedva Barenholtz Levy : [00:16:59] And, um, it’s very active. So it’s it was a great city to start this business in, I think, because there was this networking base that allowed me to meet a lot of people, get my name out of who I was as an expert. Um, I was a pharmacist that wasn’t behind the prescribing, the dispensing counter. I was this unique being with a lot of expertise and passion to to talk about drug safety or medication safety in the older population. Um, so I really took off, had to do a lot of work on my own. Um, I can fast forward about eight years. So let’s say it got started 96, 97. I’m really marketing more strongly. Um. I just kept problem solving one bit, one bit at a time. Um, I’ll fast forward about seven years or so. I happen to be at a pharmacy meeting in our state pharmacy group met in, um, whatever was Lake of the Ozarks at the time. It went to a breakfast meeting, and at that, the speaker for that breakfast meeting was a woman from a national pharmacy association called the American Society of Consultant Pharmacists. It’s the the one association that services that focuses on older adults and senior care.

Dr. Hedva Barenholtz Levy : [00:18:17] And I she had made a statement about, you know, pharmacists doing some work out in the community. And I raised my hand and I said, hey, I’m doing work with our area agencies on aging. And she’s like, we need to talk. So from that moment, um, she connected me with the leadership, with the leadership groups at that National Pharmacy Association. And all I can say is it was a matter of being at the right place at the right time. That enabled me to meet this woman, get into this leadership group, leadership group. And then all of a sudden, I met a dozen or so pharmacists who were doing what I was doing in other places around the country, and I had no idea. I had no idea. I had these colleagues also doing this. I knew the one woman in DC, right? But that was it. So all of a sudden I have more support and I it that was another moment to say I’m not crazy. I’m on the right track and I really am quite experienced. I’ve learned an awful lot in evolving what I had evolved on my own, so that was just another turning point, I guess, in my the evolution of my practice and my career.

Dr. Phillip Hearn: [00:19:19] I love it. It’s always fun when you can hear the aha moments, right? And and it’s even more fun. You’re going back in time, kind of thinking through, how did I get to that aha moment? What did that process look like? So this is uh, this is fascinating.

Dr. Hedva Barenholtz Levy : [00:19:33] And you don’t realize it, right. Because as I’m talking sometimes like, oh, wow, that really did happen.

Dr. Phillip Hearn: [00:19:38] There’s a ton of times where you go, oh, I actually did that. Oh, okay. That’s something in my in my bailiwick. So let me ask this question and again take us inside. As much as you’re able to of course, comfort wise into your model, kind of give us an overview of what that model looks like. Right. So this is something that you have been building for many years now. Right. So seeing the experiences, the positives, the challenges, making those adjustments, it sounds like, but also having those contacts in your professional networks as one as well as ones that you’ve gone out and reached out. Right. So you’ve done the work. What does that model look like? How does it really focus on patients, and how does it help remove those patients that fall between the cracks, as you mentioned earlier?

Dr. Hedva Barenholtz Levy : [00:20:25] So with my so this the senior care pharmacy practice I what’s unique about it is I meet with persons in their homes in their home setting. Right. So that it’s an unhurried atmosphere. It gives a whole different dimension to being able to talk about all of the medications they take and in a more very thorough manner, which in our very on our truncated health care system today, we have very short doctor visits. The pharmacies are very busy. There’s no time for deep counseling at the pharmacy counter, typically. Um, so. It. The the business model I have is to when I meet with an individual one on one, I provide a I evaluate all the drug therapy I might. Typically I will fax the physician’s office to seek lab test results. I need some additional clinical information. I provide a report that goes to the patient. If there’s family members involved, you know that’s all part of the story there. And but most importantly, I send a copy of the report with my highlighted information to the physicians. Right. Because my model is to really is to preserve the or and enhance the relationship between the patient and the physician to help them communicate better about drug therapy. My role has always been to, as this second, uh, second set of eyes, independent evaluator, if you will, to look at the drug therapy and identify.

Dr. Hedva Barenholtz Levy : [00:21:56] Issues that are pertinent to the patient that the doctor might not be aware of. But then from my pharmacy expertise, looking for dosage issues, drug selection issues, um, unnecessary medications, side effects that are people are not recognizing are really due to the drug that that are then being treated with more drug. So I really looking at those medical a lot of medication related problems to. Reduce to get rid of those to address those problems, fix what we can, and ideally decrease the number of medicines a person is taking. Because so much with healthcare today we’re using the problem. What is motivating me all along is this overmedication issue with older adults, right? So we just keep piling on more and more medications without stopping to think. So the model is that comprehensive. Review the report to the patient and the physician. And um, a lot I really leave it to the patient and physician to then discuss my material, because they know the doctor knows the patient best. I’m an intermediary, if you will. Um, so the the drawback for me has been the payment model. When was the last time you paid a pharmacist for clinical information? Right. For a consultation or something like that? We typically don’t. So our whole health care system has been is stacked up against pharmacists doing what I’m doing, which is being paid for our cognitive services.

Dr. Hedva Barenholtz Levy : [00:23:25] The there’s been so much shifting in health care that there are more and more opportunities. Pharmacists are doing what I’m doing. It’s not totally unheard of as much, but it’s still something I fight against because, um, there’s an internal struggle for me. Um, how do I charge for my services if there’s no co-pay? We’re not pharmacists are not medical providers, um, by CMS. So Medicare, uh, we cannot bill Medicare for our services and most other insurers follow suit of Medicare. So we have that inherent limitation as pharmacists. Um, so how do I bill and if it’s going to be a cash basis model? Then who? Who can afford it and then who cannot afford it, and the ones who cannot afford it really are the ones that have more often more disjointed health care system. The physicians are changing more frequently, and that’s where we have a lot of the the need exists. So one of I was very fortunate, as I started my business to work with the area agencies on aging, which at the time prior to 2010, there were there was health promotion money, disease prevention and health promotion money that we could use towards with for medication reviews. So that helped me reach out to a wide range of people. I was able to, um, access hundreds and hundreds of patients through the area agencies on aging in, in the Saint Louis area.

Dr. Hedva Barenholtz Levy : [00:24:55] Um, and. Help reach those people where it falls between the cracks. I still had my my private pay model going, and that was a matter of, you know, when families were made aware of me. And that was where the word of mouth came in. Um, so filling the between the cracks piece comes in with, um, really a large part of it is for anyone I spoke with, be it, um, regardless of the socioeconomic status, if you will, um, taking time to talk about their drug therapy. So many times people would say to me. I never heard that. No one explained that to me. I didn’t understand that. So being able to give people that time would help fill in those cracks, to help them know why it’s important to do this follow up or take that medication, or ask certain questions about your health condition. So that’s where I would just try on an individual basis. To fill those cracks. And then, of course, all of this does lead to why I put this book together, which we’ll get to. But everything built as I’m in people’s homes for 25 years, seeing what the gaps were in the system, what people didn’t understand, where the errors were occurring, and the types of errors that were occurring in medication use. Interesting.

Dr. Phillip Hearn: [00:26:19] Okay. I like it and what it sounds like you’re putting together. And we’re going to tap into your book here in a second. And for those who are just joining us, uh, midstream, you’re on Doc’s discussions with Doctor Philip Hearn. We are talking to Doctor Hedva Barenholtz Levy, uh, who is the author of Maybe It’s Your Medications How to avoid Unnecessary Drug Therapy and Adverse Drug Reactions. Where can they find the book? Let’s start with that. Where is the book located?

Dr. Hedva Barenholtz Levy : [00:26:49] It is. I’m so excited that it’s traditionally published. Which means which means it is everywhere, right? So you can get it on Amazon, Barnes and Noble. If you go online, you can go to there’s a, uh, it’s bookshop.org. You can find independent booksellers anywhere in the country. Um, but it’s here in Saint Louis. I’m thrilled to say it’s even in our libraries. I’ve seen that there’s copies that have been on hold, which is really nice to see. And it’s in a couple of the bookstores. Um, I know there’s some copies, uh, in certain bookstores, if those copies sell, which I hope they do. Um, you can they the bookstores can order the book in. So it’s available anywhere. I’m just I’m trying to get stores to carry them. And actually, I had some success with, um, some of my, um, independent pharmacy colleagues are carrying the book. So, so, uh, various spots around town.

Dr. Phillip Hearn: [00:27:36] I love it. Very cool. Good. So with all of your knowledge, the background, the depth of the work that you’ve done over this last 25 plus years, take us through what the reader can expect when they’re digging into your book, right from from the surface level, from how I, I hear it based on your passion, your knowledge about it, it’s almost as a roadmap of do’s and don’ts, if you will, right of here’s what you can expect. Here’s where you know some of the the tougher spots are. Here’s where some of the, um, easier roads are to kind of go down when it comes to such a complicated matter of health care. And we talked about this offline. We talk about business a lot on on our podcast and how people are business leaders. But if you don’t have health, it’s very difficult for you to run your business. So they they are interchangeable and go hand in hand. So take us through what the reader can expect when they’re digging into your book. What are some of the highlights? What are some of those pieces that they probably will. They might go, aha, maybe I didn’t know this or this helps me to better understand the system.

Dr. Hedva Barenholtz Levy : [00:28:41] So I divided the book into four major sections. I as I. The book is it starts off. The first part is describes the um what’s the problem? And it is written towards. Older adults 65 and older, and the medication issues that are more unique to that age population. But I also say right, right off in my introduction, the principles apply to people of any age, really anyone who takes a medication, right. And we’re all aging. So at some point we’re going to hit that 65 mark ish with that magical demarcation in health, um, that defines older adults. Yeah. Um, but that’s and it’s such a diverse population, right. You know, you know, frail 60 year olds and very robust 91 year olds. But so I talk at the front part is about the what’s the problem? And I describe a perfect storm that we have in health care. And it so it it builds up to why we need to talk about our medications. Um. I describe the nature of the problems. As we get older y, older adults are at greater risk. I talk about the components of a medication review. Why get a medication review? What? But I go into depth explaining the types of medication related problems, for example, in one of my chapters, because I want people to understand it’s not just looking at the list and are you taking it twice a day? Great.

Dr. Hedva Barenholtz Levy : [00:30:13] Everything looks fine, Mr. Smith. It’s looking for. Is it helping? Are you having side effects? Maybe there’s something that’s not being treated that really needs to be addressed. So I talk about that background of, you know, what’s going on, what and why we need to why we need to worry about it if we will, if you will or think about it. And then the the last third of the book is what to do about it. I lay out um, about was it 7 or 8 chapters that talk about actionable steps, how to advocate for yourself, how to reduce medication errors, how to avoid the high risk medications or things like that, how to find good information on the internet. So what we can do about the problem. So as I say, and I’ve always I describe myself always. I’m never one to bring up a problem without a solution to go with it. So I describe what the problem is and why we need to care about it. But by golly, I’m going to give you some tools that you can, um, take home and apply at home, at your pharmacy or at your, with your physician. As, as I have these checklists in the back of these last seven chapters.

Dr. Hedva Barenholtz Levy : [00:31:25] Um, but I also address there’s a section in there where I address non-prescription medications. So the supplements and over the counter products, which some people tend to not think of them as drugs, but we do have to consider them as medications. It those matter. So I explain why those are so important. And I also talk about non-drug approaches to managing our health. And some some people might say you’re it’s a book about medications. Where does that come in? However, any health condition we can be treated with drug therapy, some some type of intervention, but also these non-drug ways strategies go with it. Um, and I think that applies just about to any health condition. There’s always something you can do that’s not related to the medicines that will help the drugs work better or will help your health condition. Um, so I really set it up as a resource. It gives you tools in your toolbox. I don’t know what questions to ask my doctor. What? What do I say at the pharmacy counter? I give you some of that information. Um, so it’s to help people know that it’s okay to question what’s going on, but what kinds of questions they should be asking, because a lot of people don’t know where to start.

Dr. Phillip Hearn: [00:32:41] Yeah. I mean, again, if you just take health care, right? A lot of people just take it as the grand, you know, uh, situation to try to figure out there’s a lot of moving pieces. Right. So you bring up a very interesting point about over the counter drugs, basically, which are drugs in some way, shape or form. So you have to understand what that’s going to do versus a prescribed drug. So that’s interesting. Here’s a follow up question to this. And I and I appreciate the depth that you gave as well. The follow up question, there are a ton of people who are can be deemed as subject matter experts in their fields. I think it takes a special person to not only. And you gave me one of my my favorite sayings, don’t just give me a problem, give me a solution. Having someone to really draw out a road map and and again, write a book in general is a labor of love. I understand that process. What led you to go okay with everything that I’ve done, everything that I still want to do, now is the time to write a book. Tell us about that process. How long did it take to write? I can only imagine the the depth of research and knowledge and, you know, and editing. Right. That’s always the fun part that nobody thinks about in the book. You write something down and you go, absolutely not. This is not going to end up in the final chapter or the final draft, if you will. So take us through that process of writing something like this with all of the background knowledge that you’ve had over all of these years.

Dr. Hedva Barenholtz Levy : [00:34:11] Yeah. That’s a it’s a fun that’s a fun question to to that that look back is so interesting as because we just plug through life. We charge through, we do what we need to do. We get things done. And then you have to pause and look back. I it’s really been on, on um, a couple of friends recollecting how long I’ve been talking about a book and I also I found some, some of my, my notes easily dating back to 2012 or so, where I have notes about the book, this and that. So I say it’s close to 20 years in the making. I mean, just the, the idea that I, that a book is I want to write a book. I at the time, I didn’t know who the audience would be or what that book would look like. Um, I. I maybe ten years in trying to in honing in that audience I because the possibility of writing a textbook if you perhaps for like a gerontology um course was is something that is very much needed as well. Um, so I focused on I wanted for the consumers. I wanted a way to have a broader reach. I guess when you ask about how do I fill those cracks and stuff, I can only meet with one person at a time, but if I can put a book out there and help reach more people to understand that older adults medication use is a is a concern, we need to talk about better as a country.

Dr. Hedva Barenholtz Levy : [00:35:32] That was that kind of focused in focused me in on why I wanted to write this book. So I um, so I knew I wanted to I wanted to make it a consumer oriented book. I had, but some so much of it came naturally to me. I think I have to attribute a lot of this to a gerontology course. I taught at Umsl many years ago. Three credit course that was about, um, medications and aging. And so a lot of the chapters come from that material. So I had aspects of it. Um, I put together my proposal. Um, I’m trying to think about, you know, 5 to 5 to 3 to 5 years, going back 3 to 5 years. I had to figure out how to become. How do you become an author? Do I do the traditional route, the self-publishing, whatever. So I knew I wanted to go to traditional. I knew I wanted to find an agent. How do you do that? So that whole learning curve of how to be an author then really consumed the last five years or so, put together my nonfiction proposal three years ago. Um, and then started seeking an agent. Um, I always joke that Covid was kind of helpful to me because an in-person pitching opportunity at a literary conference went virtual. I had six more months to kind of work on it before the conference was rescheduled virtually.

Dr. Hedva Barenholtz Levy : [00:36:46] And that was at the start of Covid. And I was very fortunate to, uh, connect with an agent at that virtual meeting. So then it was the point of I. So with the proposal, I had all my chapters sketched out, certainly a good detail of each paragraph summarized, but then all the paragraph, the the full chapters roughly sketched out, except for my first chapter was completely well done. And then I get the contract with Skyhorse, and then I have to go back and do that revision, which really was a lot of writing. So I had a, I will say, six and a half months to get that done. I met the deadlines, but it was a lot of writing and I and fortunately with my business, I was able to kind of put some work on on hold and focus on the book. And I, I worked very hard to. Fully, fully write it, revise it I was I finished section one. I sent that off to my beta readers. I worked on section two and I just kept kept moving on through. So it was a a full out process. Um, but I think condensing it, having a deadline that I had to meet, I just put my nose to the grindstone and got it done. Um. If that addresses most of your question, but, um. Yeah.

Dr. Phillip Hearn: [00:38:05] Well, I think it gives some light because and again, I, I’ve had friends that have said I’m going to write a book about whatever the topic. Right. But there’s so much detail with it. You can be a subject matter expert in your field and be a leader in your field. Writing a book is a is a whole new challenge, especially if you’re not a day to day author, right? Like that’s not your focus to write 3040 books. So writing something like this and giving, you know, the viewers some insight on that, I think is extremely interesting because like you said, this was 20 years in the making. That’s the other fun part too.

Dr. Hedva Barenholtz Levy : [00:38:41] Right? Because you’re you’re always thinking about it. And then I’m trying. The challenge is for me. So I published plenty of articles in the medical literature. So that’s technical writing. And I got that. So and but the other interesting thing though is in writing my consult letters to patients, I have always been consumer friendly language. I’ve had to write it for the lay person to understand. So I think that skill set that that experience helped with the writing here. What was the funnest challenge or most interesting challenge, I think was getting in, weaving in the stories, the anecdotes, because that’s what people want, the story and. If I, you know, I can be self-critical of this book all over the place, but I’ll stop because I know I got it done, and it’s a decent book. But of course, I’m paging oh darn, could have done that. Should have done that. But trying to get in those stories and make them written, writing them in an interesting way. Um, and I’ve gotten some feedback from straight people who are not not so close to me that I distrust that that I, that they’re being true. I think when they tell me it is very readable and, you know, and it’s relatable. So I accomplished that to an extent. Of course, I would have liked to add more, but again, I hit that deadline and I really there’s some level of it’s just going to be good enough at this point. But I think I, I did it’s a good enough feature as it is second edition. I’ll improve it more, I’m sure, but let’s just get this first edition going.

Dr. Phillip Hearn: [00:40:13] Well, that was actually going to be my next question, because you kind of teed that up perfectly. I know the first edition has been out for keep me honest, approximately 7 or 8 months now.

Dr. Hedva Barenholtz Levy : [00:40:22] Yeah. July. So yeah, about six months.

Dr. Phillip Hearn: [00:40:24] So yeah, from the time of this, about six months, which is crazy to think. So are you looking at a potential, you know, second volume or second uh, second book in the works.

Dr. Hedva Barenholtz Levy : [00:40:37] And it is it. The ideas are brewing okay. Right. So and it’s interesting there’s because there’s things I could do to improve this one. Right. So you know, God willing, if we can do a second edition of this one, I know some things I’d want to update and also update in there. Right. So things things that get outdated. Um, but there’s also more that I want to do that would. Yeah, there are other ways to maybe do a related type topic. I think there’s a lot we can a lot more. We need to understand about the risks and benefits about drug therapy, but also the role of nutrition. That and interactions with drugs and nutrition and so much more. So I think there’s there possibly is something out in the future. But again gotta focus on the first one two. Right. I want to make this a, you know, get get the word out about this. And but yeah it it was an interesting process. Part of me is thinking how do I do? I want to put myself through it again. But, you know, once you get it to the point where it’s something that can benefit other people, even if it’s a small number of people, um, you know, it’s worth it. So.

Dr. Phillip Hearn: [00:41:43] Well, you that that makes you actually more of a business owner than you think. We I think we’re all gluttons for punishment. Right? So it’s like, I know this hurt, but I’m going to try this. I’m going to try to make it better. Yeah. So, so yeah, you’re I’m more of a business person than you think. So. Yes. Congratulations. You’ve made it. Good to know. With all the things that you do for others. And again, you you have a passion for this process. You have a passion, it sounds like, for your patients. I love the concept that you talked about how you basically are able to write and deliver your information for all different types of education levels when it comes to health care, right? So even if you’re educated in health care, you’re really not educated in healthcare. It changes on a dime on you. What do you do to recharge the battery refresh? How do you stay as passionate as you are about the main thing? By taking a little bit of time. What does that look like to you?

Dr. Hedva Barenholtz Levy : [00:42:39] Like on the personal side or just how I recharge. Yeah. Um.

Speaker4: [00:42:46] Yeah.

Dr. Hedva Barenholtz Levy : [00:42:46] Put me on the spot here. No, no, I like to be, I like to, I laugh, I like to be so private. But then also, when I’m putting myself out here with this book, I’ve got to be blogging and writing and talking about myself too. No, I laugh, but we all need to recharge. So, um, it’s good to to. Yeah, have those hobbies and really remove yourself. I what’s interesting is I’ll, I’ll answer the question but but I also part of that enjoyment is just reading the pharmacy literature reading being up to date. I love learning about making sure I understand a new a new medication, how it works in the body, what the interactions might be, how it impacts an older adult. So I just I do love pharmacy, the profession I chose. So there’s a lot of enjoyment there when I have time just to sit down and really catch up on the literature. Um, but I’m, I was a gymnast when I was growing up. I turned that as an adult. I’m a dancer, so I still take dance classes. And to me, that that’s endorphin of of, um, I it’s jazz dance.

Dr. Hedva Barenholtz Levy : [00:43:44] But I recently started tap dancing. I haven’t done that since I was four years old. I had a short stint when I was about 25 years ago. But if you want a tip for for holding off dementia. Yeah, learn something new. Right? So, um, I laugh. So I’m a dancer. I love reading, um, when you can just get into someone else’s world music. And it’s important to try and to find those, um, moments of where I can disconnect and fully put my brain somewhere else, because I do. I can get caught up in this an awful lot, and we need to take a break as we kind of started offline about that a little bit, um, you know, a little meditation every morning can’t hurt just to ground us and get me psyched for the next day. Um, because a lot of this is new territory for me to promote a book to put myself out there. But it’s so important because I guess when it when push comes to shove, I just if I stop and think about the passion that I have, about the overmedication concerns in America.

Speaker4: [00:44:50] And.

Dr. Hedva Barenholtz Levy : [00:44:51] Why I wrote this book, why why it was so important for me to put this together. And my whole career, right, has kind of come to this in different ways. Um, that passion will reground me as well and remind me to keep doing what I’m doing.

Dr. Phillip Hearn: [00:45:05] I love it, and I always ask this question as one of the closing questions, because I like to understand what makes leaders tick. Right? So it’s a little private. Yes. Which I appreciate you, uh, you playing along with that. But it does give some insight because again, and I think we talked about this as well, um, uh, starting over for this interview in that so many times we don’t sit still long enough to almost tap back into those aha moments or, oh, I’ve actually done that. Right. So it sounds like this mythical, uh, concept, but we’ve actually been doing more than we almost give ourselves credit for. So even tapping into, uh, those endorphins, as you say, mine is golf now, used to play sports growing up. So we, you know, we all have those things. And some days it’s, it’s chucking of the club. But you know, we’ll deal with that later too. Uh, but it’s important to understand how leaders are great at what they do because they do take that time to tap their brain. And even the research component, you know, like you said, reading through your materials and understanding what’s still happening in your industry, that that has to be fun if you’re going to be this passionate about it, too. So I always love that question, which is fun.

Speaker4: [00:46:14] Well, no.

Dr. Hedva Barenholtz Levy : [00:46:14] Good, no problem.

Dr. Phillip Hearn: [00:46:16] So before we close this thing out, give us one more time information on the book. Where can our viewers find it? I want to make sure that we, uh, that we highlighted as we are supposed to and properly supposed to. So give us that to close us out, please.

Dr. Hedva Barenholtz Levy : [00:46:30] Well thank you. So the book is maybe it’s your medications. It is available online at your at Amazon or Barnes and Noble, um, and at any independent bookstore. I always just want to put a plug out for those, those independent bookstores, um, and I, I just the timeliness. I know this this will be outdated, but subterranean books and Main street books in Saint Charles. I know they have copies in store. Ledoux Pharmacy, Webster Pharmacy and Lindenwood Drugs has some copies. And if you call your any any independent bookstore, they can order it in. Um, so I encourage people to, to take a peek at it. Like I said, it’s for anyone who takes medications and we’re all aging, so we all need to think about it. I’m my goal is to prevent medication related problems, avoid those adverse effects. And um, and if you do check out the book, put a review for me I that’s a, that’s a plug I need to start asking for. But those reviews matter, uh, for better or worse on Amazon. So throwing a review for me, I’d love to hear what you think about the book as well.

Dr. Phillip Hearn: [00:47:36] So yes, let’s make sure we throw in a couple reviews for Doctor Levy for sure. That’s, uh that’s awesome.

Dr. Hedva Barenholtz Levy : [00:47:42] So and my, my website. Can you post the website or.

Speaker4: [00:47:45] Yeah, give us your.

Dr. Hedva Barenholtz Levy : [00:47:46] Website here please. Yeah. So there’s two and I because Barenholtz Levy is a mouthful. But if Barenholtz Levy. Com is my author website, I also have the URL of maybe it’s your meds.com. That’s maybe easier for people to to think about to remember. And that’ll get you to my The Author website, more about the book and links to order it. So thank you very much. And I do have a newsletter. So, you know, lots of ways I’m trying to promote safe medication use. You can join on my newsletter from that website.

Dr. Phillip Hearn: [00:48:17] Good. And we’ll make sure that our viewers get the transcript. Have access to all of this. So that’s perfect. That’s awesome. Very cool. So Doctor Levy, it has been an absolute pleasure. Really appreciate your time sharing your knowledge. This has been, uh, interesting. Again, the the world of healthcare is definitely, uh, a bit of a complicated, uh, subject, but but using tools like you’ve created, uh, like your book, uh, it, uh, it at least helps to start to explain how you can maximize your health. And, uh, without your health, you can’t do anything else business wise anyway. So they are very much hand in hand. So we really appreciate having you here on the on the show.

Dr. Hedva Barenholtz Levy : [00:48:56] It is a pleasure. Thank you so much. It was fun, fun to talk with you I appreciate it.

Dr. Phillip Hearn: [00:48:59] Yeah yeah ton of fun again. So that is another episode of Doc’s discussions. I am Doctor Philip Hearn and this is Saint Louis Business RadioX.