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Pharmacy Careers
Experienced Oncology Pharmacist Seeks MBA to Better Prepare for Future of Healthcare An interview with Scott A. Soefje, PharmD, BCOP By Karen Rosenberg
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cott A. Soefje, PharmD, BCOP, has more than 20 years of pharmacy experience. He started as a hospital staff pharmacist, has held several positions in academia, and worked briefly in industry. Currently, he is director of pharmacy operations and director of the oncology residency program at The University of Texas Health Science Center at San Antonio. Just this past summer, however, he embarked on a new venture—a master of business administration (MBA) program at George Washington University. Soefje is part of a new trend, with more business schools offering programs geared specifically to students with an interest in healthcare administration [see story on page 24]. He hopes that with a combination of clinical experience and management training, he will be able to help his institution deal with the financial and administrative challenges in oncology practice today.
How did you get started in oncology pharmacy? I got my bachelor of science in pharmacy back in the ’80s. I then worked in a hospital pharmacy and, during that time, I started working on a master’s in hospital administration thinking that the administrative route was the way I wanted to go. But I was accepted to the doctor of pharmacy program at the University of Texas before I finished the master’s, and I felt that I couldn’t do both programs at the same time. I chose the doctor of pharmacy program and then went on to a residency at The University of Texas Health Science Center at San Antonio and a fellowship at The M. D. Anderson Cancer Center. When I completed the fellowship there were no oncology jobs, and I
heard about a position at Texas Tech University in Lubbock, where they were just starting a pharmacy school. I was the first pharmacy practice faculty to arrive on campus, 6 months before my boss. After a few years, a position opened up at the Veterans Affairs hospital in San Antonio, which is my home town, and I moved there. I took a position in industry for awhile and then moved to my current position at The University of Texas Health Science Center in San Antonio, where I am director of pharmacy operations and also director of the oncology residency program.
So why did you decide to go back to school at this point in your career? I’ve always enjoyed the administrative side of things and found I understand it. But in my role as a director, I began to realize that there were things that I was discussing with the CEOs, CFOs, and accountants that I didn’t fully understand. I thought I had two options. I could do on-the-job training or I could get formal training. About 1 year ago, I started looking into online MBA programs and, ultimately, enrolled in the George Washington University program in August. It has a healthcare focus and a very strong leadership focus, and it offers classes that I think will be very relevant to my job. There are 120 people in the program, all with an interest in healthcare. Some are just out of a bachelor’s degree program, while others are quite advanced in their careers. There are several physicians in the group, some clinicians who want to be better able to manage their practice, and some hospital administrators who want more formal training.
“We’ve set up monthly management training sessions where we sit down with the residents and go over things like strategic planning, pharmacoeconomics, and budgeting to help prepare them to deal with these issues. ” —Scott A. Soefje, PharmD, BCOP Do you think now with the current economy and concerns about healthcare reform concerns it’s more important than ever before for pharmacists to have management experience as well as clinical training? Yes. I remember back in the ’80s when I was talking to Roger Anderson at M. D. Anderson he said that in the future, those who reach the level of director will be clinically trained people who understand the business side of hospital administration, not someone with an MBA or a master’s degree who doesn’t understand the clinical side. That’s one of the reasons I went back to school. With the changes coming in healthcare, I figured that someone with a clinical background who understands clinical practice and has an MBA, has to be marketable. Considering that cancer care is not going to get cheaper over the next few years and that we’re going to have to make decisions about what drugs to use and when, about how to integrate all of these factors into oncology protocols, somebody with both clinical and administration training is going to be in a good position. Some schools are now offering programs that combine pharmacy training and business administration. For in-
stance, the University of Florida has an online program in conjunction with Stetson University that offers a combined degree, an MBA and a master’s in hospital pharmacy. I can already see how I can apply what I’m learning in my present position. Even though the Cancer Therapy and Research Center is part of The University of Texas Health Science Center, we practice as a physicians’ practice, much like community practices. We’re not part of a hospital system, so we’re dealing with the same sort of economic issues they’re facing on a daily basis. We’re thinking of opening a retail pharmacy here, and this program will prepare me to do that. Just taking the marketing class has gotten me thinking about how I can apply marketing to clinical pharmacy practice, even within the institution. As part of our oncology residency program, we’ve set up monthly management training sessions where we sit down with the residents and go over things like strategic planning, pharmacoeconomics, and budgeting to help prepare them to deal with these issues. I think this will serve them well in the future, whatever direction their careers take. ●
BREAST CANCER
Combination of Agents Shows Promise in MBC NATIONAL HARBOR, MD—Pre liminary results of an ongoing trial suggest that a combination of trastuzumab, bevacizumab, and docetaxel is safe and effective as first-line therapy in women with metastatic breast cancer (MBC). Fourteen of the 18 patients treated to date had a partial response or stable disease, a clinical benefit rate of 77.7, the investigators reported. Previous studies have demonstrated the efficacy of trastuzumab combined with bevacizumab in MBC but the high
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rate of cardiotoxicity was a concern. Docetaxel has also been shown to be effective alone or combined with trastuzumab or bevacizumab. In the current study, Bhuvaneswari Ramaswamy, MD, of Ohio State University, Col umbus, and her colleagues studied the safety and efficacy of the three drugs combined in previously untreated women with HER2-positive MBC. Their findings on the first 18 patients enrolled in the ongoing trial were reported at the 2010 American Society
of Clinical Oncology Breast Cancer Symposium. All patients received six cycles of trastuzumab, bevacizumab, and docetaxel, after which docetaxel could be discontinued at the physician’s discretion. The other two agents were continued until disease progression or development of unacceptable toxicity. Median progression-free survival was 56 weeks. Eight patients had a partial response and six had stable disease. Grade 3 and 4 nonhematologic tox-
icities included nausea, fatigue, diarrhea, wound dehiscence, retinal edema, pulmonary embolism, neuropathy, nephrotic syndrome, and hypertension. Grade 3 and 4 hematologic toxicities were neutropenia and febrile neutropenia. One patient had an asymptomatic drop in left ventricular ejection fraction after three cycles of therapy, but no grade 3 or 4 cardiotoxicity was observed. Accrual in the study is continuing at two institutions. ●
www.TheOncologyPharmacist.com