Becker’s asked pharmacy executives from hospitals and health systems, along with academic medical centers and universities across the U.S. to share what trends they deem dangerous.
The 14 executives featured in this article are all speaking at Becker’s Healthcare 3rd Annual Fall Chief Pharmacy Officer Summit, set for Nov. 4-6 at the Swissotel Chicago.
To learn more about this event, click here.
If you would like to join as a speaker or reviewer, please contact Mariah Muhammad at mmuhammad@beckershealthcare.com or agendateam@beckershealthcare.com.
As part of an ongoing series, Becker’s is talking to healthcare leaders who will speak at our conference. The following are answers from our speakers at the event.
Question: What once-core strategic assumption has your team fully abandoned?
Urshila Shah, PharmD. Senior Vice President and Chief Pharmacy Officer of Westchester Medical Center Health Network (Valhalla, N.Y.): One strategic assumption we’ve abandoned is that pharmacy’s primary role is medication distribution and cost management. As healthcare becomes increasingly complex, pharmacy must function as an enterprise strategy and growth engine, connecting clinical care, specialty pharmacy, ambulatory services, advanced therapies, access, and financial sustainability.
The organizations that will thrive are those that stop viewing pharmacy as a departmental function and instead leverage it as a systemwide platform for innovation, patient outcomes, and growth. For us, that shift has changed how we structure governance, prioritize investments, and create value across the health system.
Kelley Curtis, PharmD. Chief Pharmacy Officer and Vice President of Pharmacy and Lab COE at St. Luke’s Health System-Idaho (Boise): One strategic assumption we have fully abandoned is that pharmacy can be managed primarily as a cost center or as a collection of individual services. We now think about pharmacy as an integrated enterprise that has to follow the patient across the entire medication journey, from access and affordability to dispensing, specialty, infusion, home delivery, 340B and ongoing clinical management.
That shift has changed where we invest, what we choose to insure, how we use technology and automation, and how we measure success. It has also pushed us to be much more intentional about owning capabilities that historically may have been outsourced when doing so creates better access, a better patient experience and greater long-term value for the health system. In an environment where pharmacy is changing so quickly, I don’t think the old model of optimizing each individual service in isolation works anymore. The opportunity is in connecting the pieces and building an ecosystem around the patient rather than around the traditional boundaries of pharmacy.
Nicole Shoquist, PharmD. Chief Pharmacy Officer of JPS Health Network (Fort Worth, Texas): Five years ago, we believed data had to flow through a single platform to create value. We’ve abandoned that mentality entirely. Health systems now need the ability to unify insights across disparate systems without forcing painful integration projects. The friction was never the insight gap, it was implementation complexity we created.
Kevin W. Chamberlin, PharmD. Associate Vice President and Chief Pharmacy Officer of UConn Health (Farmington): I think this is likely more of an “us” than a general assumption that is palatable for the masses, but as we expand into a community network of four health systems, we have had to abandon the assumption that each hospital, or pharmacy operation in particular, should optimize independently. We have shifted mindsets that the greater value comes from standardizing platforms and contracts, policies and procedures, workflows and what have you, even when it means giving up a locally preferred solution. What was once the ‘what’s best for us?’ approach has morphed into, ‘ what’s best for the whole of us?’ approach.
Irvin Alfonso, PharmD. Director of Inpatient Pharmacy at Moffitt Cancer Center (Tampa, Fla.): At Moffitt Cancer Center, one strategic assumption we’ve abandoned is that retention is primarily driven by compensation. In the highly competitive oncology workforce environment, we realized that while pay matters, people stay because they feel connected to the mission, supported by their leaders, and invested in professionally. We shifted our focus from filling positions to developing people through mentorship, succession planning, leadership development programs, coaching, and cross-training opportunities. We also increased leader visibility and engagement through regular rounding and meaningful recognition efforts. One of our greatest challenges has been balancing growth, increasing patient demand, and workforce burnout while maintaining our culture. By investing in our team members’ development and well-being, we’ve strengthened retention, built a deeper leadership pipeline, and created a more resilient pharmacy workforce aligned with Moffitt’s mission of contributing to the prevention and cure of cancer.
Katie Thompson, PharmD. Director of Oncology and Infusion Services, Stephenson Cancer Center at OU Health (Oklahoma City): One core strategic function that our team has abandoned is that your job title dictates your duties. In the past 20 years over 800 novel drugs and biologics have been FDA approved. That may not sound like many drugs however, with new therapies comes increased complexity to which pharmacy jobs have moved beyond strictly dispensing to extensive therapeutic monitoring, patient safety reviewing and ensuring regulatory requirements are met. With the evolving landscape of medication reimbursement, pharmacists are transitioning from traditional dispensing roles to financial experts in billing and revenue cycle. With the speed that medicine and healthcare are changing, pharmacies must also adapt quickly and stay nimble.
Y-Nhi Carr, PharmD. Director of Pharmacy at Lake County Tribal Health Consortium, Inc. (Lakeport, Calif.): A once-core strategic assumption my team fully abandoned is the idea that simply providing access to medication was enough to improve patient outcome. In the past, we measured our success with prescriptions filled and patient’s adherence. Today, we shifted our focus to patient engagement and sustained clinical outcomes. Our clinic’s top drug spend yearly is GLP-1 but our patients weren’t losing the weight they had hoped on those drugs. In areas like weight management, we learned that medication alone rarely delivers results without structured coaching, provider oversight and patient accountability. That realization helped us to create our weight management and wellness clinic where patients have a collective team of weight management providers, dieticians, behavioral health providers, physical therapists as well as an app as part of a structured system with consistent and timely follow up to keep them accountable for their own results. We now invest more in a comprehensive care model that combines clinical services, technology and patient engagement rather than relying on medication as a standalone solution.
Yemi Abudu, PharmD. System Director of Pharmacy, Inpatient and Hospital Services at Texas Childrens Hospital (Houston): One core assumption that personally I’ve abandoned and ensuring my team align with as well is that pharmacy’s greatest value comes from efficiently dispensing medications. Early in my career, success was heavily measured by operational metrics such as turnaround times, inventory management, and labor productivity. While those remain important, I’ve come to believe that they are simply the foundation. The real value of hospital pharmacy lies in its ability to improve patient outcomes, enhance medication safety, support clinical decision-making, and help health systems achieve their broader strategic goals.
As a pharmacy leader overseeing inpatient and hospital pharmacy services, I’ve seen firsthand that some of our most meaningful contributions occur when pharmacists and pharmacy teams are fully integrated into clinical care, quality improvement, technology optimization, and systemwide transformation efforts. Today, I view operational excellence not as the end goal, but as the platform that enables pharmacy to have a greater impact across the organization.
Fatimah Muhammad. Director of 340B Pharmaceutical Services, Specialty Pharmacy, Drug Replacement, and ADM Pharmaceutical Services at Saint Peter’s University Hospital (New Brunswick, N.J.): One long-standing assumption my team has fully abandoned is that pharmacy should be managed primarily as a cost center. Today, pharmacy must be positioned as an enterprise-wide strategic asset that directly influences patient access, clinical outcomes, revenue optimization, and organizational sustainability. At Saint Peter’s University Hospital this means moving beyond isolated programs and aligning 340B, specialty pharmacy, medication access, compliance, and financial performance under one cohesive strategy. It also requires us to evaluate opportunities based not only on immediate savings but on their long-term value to our patients and the organization. As reimbursement models and regulatory pressures continue to evolve, remaining reactive is no longer a viable approach. Our responsibility as leaders is to anticipate change, build resilient programs, and ensure that financial stewardship ultimately strengthens our ability to serve patients.
John Mildenberger, PharmD. Specialty Pharmacy Manager, Senior Clinical Lead Pharmacist and Compliance Officer at Sidney Regional Medical Center (Neb.): The assumption we have fully abandoned is that volume and growth are the ultimate goals. When we built the specialty pharmacy program at Sidney Regional Medical Center, a 25-bed critical access hospital, success was measured largely by how many prescriptions we filled and how quickly we could grow. We learned that volume alone does not guarantee a sustainable program, especially in a rural setting where staffing, resources, and payer leverage are limited. Today, every current service line and every new service we consider is evaluated on its expected return on investment rather than its potential to add volume. That shift has made us far more targeted; we would rather offer fewer services that perform well than chase growth that strains the organization without improving margin. For example, we decided against launching a DME-based service line because the numbers did not justify it. The tricky part is that return on investment cannot be judged in isolation; a service line that generates little revenue on its own may still drive meaningful returns elsewhere in the organization, so we weigh those downstream effects as well. We saw this firsthand with our ambulatory care program, which delivers value well beyond its own revenue. For a small hospital, that kind of disciplined growth is what keeps a pharmacy program viable for the long term.
Matthew Webber, PharmD. Director of Pharmacy Business at Novant Health (Winston-Salem, N.C.): Health system pharmacy leaders should not abandon the strategic assumptions that have long guided their organizations, but they must be willing to challenge them. Consider the traditional three-to-five-year strategic plan: at Novant Health, our pharmacy senior leadership team now operates on a one-year plan that we reassess quarterly. In effect, our review cadence is faster than the planning horizon itself because the pace of change in healthcare no longer affords the luxury of waiting a year to adjust course.
The need for that agility is clear in the volume and velocity of policy and reimbursement changes unfolding across healthcare. Novant Health’s pharmacy leaders are navigating multiple disruptive forces simultaneously, including the proposed OPPS reimbursement cut, HRSA’s revised 340B rebate model, mandatory Medicare Part D 340B claims repository reporting, and the expansion of Medicare Maximum Fair Price provisions under the Inflation Reduction Act. For a health system operating on a July-to-June fiscal year, the proposed OPPS rule alone could upend budget assumptions given both the magnitude of the reimbursement reduction and the speed of implementation by CMS.
Patients now benchmark their pharmacy experience against Amazon and DoorDash, even as many health system pharmacy operations remain rooted in a more predictable era. The defining capability today is not how far ahead we can plan, but how quickly we can turn emerging signals into action. At Novant Health, we are building teams that expect ambiguity, adapt quickly, and view change not as a disruption to daily work but as the new steady state in modern pharmacy. That same mindset led us to launch MedVenta and accelerate its growth through NovaCatalyst, turning agility into action through transformative pharmacy solutions that improve efficiency, expand access, and deliver real-world impact while helping shape the future of healthcare.
Summer Abduqadir, PharmD. Pharmacy Compounding Specialist of Henry Ford Health (Detroit): We have abandoned the long-held assumption that sterile compounding must be designed and optimized independently at each hospital. While external providers, such as 503A and 503B compounding companies, remain an important part of the pharmacy supply chain, we no longer view local compounding and external sourcing as the only two options available to a health system.
Instead, we now see centralized sterile compounding as a strategic option that bridges the gap between decentralized hospital compounding and external outsourcing. By aggregating demand across multiple hospitals, a centralized model can achieve greater scale, standardization, and quality oversight while creating a more reliable internal source of supply. It also provides greater resilience during shortages, disruptions, or fluctuations in external availability.
Centralization further enables meaningful investment in automation and advanced technologies that would be difficult to justify at individual hospital sites. As a result, the role of the compounder evolves from repetitive production activities to operating and overseeing sophisticated systems while maintaining a focus on aseptic technique, ISO 5 environments, process control, and a zero-error mindset. In this model, technology enhances, rather than replaces, the expertise of pharmacy professionals.
As our thinking has evolved, the question is no longer, “Should this medication be compounded locally, produced centrally, or sourced through an approved external partner?” Instead, we ask, “What is the safest, most reliable, and most resilient way for our health system to produce and supply this medication?” Centralized sterile compounding has become a key part of that answer.
Nephthalee Edmond Tefera, PharmD. Director of Pharmacy at MedStar Harbor Hospital (Columbia, Md.): Our team has moved away from the assumption that every good idea needs to become a priority. In healthcare, there will always be worthwhile opportunities to improve care, expand a service, introduce something new, or solve a problem. The harder part is recognizing that we don’t have the capacity to pursue all of them well.
We have become more thoughtful about the cost of saying yes. It is not only financial. Every new priority requires time, attention, people, and often asks teams to make room for one more thing.
That has made focus an important part of our strategy. Does this solve a meaningful problem? Does it align with where we are going? And if we say yes to this, what are we willing to delay or stop?
Sometimes the right answer is no. Sometimes it is not yet. Both can be responsible leadership decisions.
Strategy is not measured by how much we take on. It is reflected in how clearly we choose what matters most and how well we execute it.
Amy Jones, PharmD. Director of Pharmacy, Oncology, Infusion, IDS at University of Virginia Health System (Charlottesville): In the healthcare area of oncology, immunology, and biologics the medication research and availability is fast moving. In years past, we tried to follow a specific linear approval and onboarding process. In order to maintain efficiency and bring therapy to patients quicker, we have modified into concomitant steps for medication onboarding. Our infusion pharmacy team is well versed in the needs of medication onboarding and loop in key players for the supportive tasks for medication onboarding.
Kathleen Kane, PharmD. Assistant Director of Pharmacy, Compounding Integrity and Compounding Regulatory Compliance at UChicago Medicine: One strategic assumption we have largely abandoned is the belief that compliance and quality can be sustained primarily through policies, annual training, and retrospective oversight. In today’s healthcare environment, especially in pharmacy operations, that approach is no longer sufficient.
Our team has shifted toward the understanding that quality and compliance must be built into daily workflows through continuous monitoring, real-time data visibility, ongoing competency assessment, and frontline engagement. We have invested significant effort in creating systems that identify risks earlier, standardize processes more effectively, and empower staff to take ownership of quality outcomes rather than simply adhering to requirements.
This shift has also changed how we think about leadership. Rather than viewing compliance as the responsibility of a select group of experts, we see it as a shared organizational commitment that requires transparency, collaboration, and continuous learning. The result is a more resilient operation that is better prepared to adapt to evolving regulatory expectations while maintaining a strong focus on patient safety.
