Connecting Physicians to Pharmacies | Nandita Koodie, PharmD., Telehealth Network Liaison

This transcript was generated automatically. Its accuracy may vary.

[00:00:15] Mike Koelzer, Host: Well, hello. Nandita. Hi 

[00:00:17] Nandita Koodie, PharmD: there. Thank you for having me 

[00:00:19] Mike Koelzer, Host: pleasure to have you on, and indeed it for those that haven't come across you online. Give us your name, then tell the listeners why we're talking today. My name 

[00:00:28] Nandita Koodie, PharmD: is Dr. Nandita Cudi. I am a national tele-health network liaison. Basically what I do is I connect physicians to their local independent pharmacies through telehealth services for diabetic patient men.

So essentially my goal is to establish local practices as the health hubs in their communities, to establish a continuum of care from the doctor's office to the patient's homes, through the guidance of a pharmacist who utilizes his biotechnology to maintain a relationship with the patients that they share.

Mutually, 

[00:01:01] Mike Koelzer, Host: Tell me what you mean by nationality. Why did that word get in there versus you just saying you do this? What does that mean? I 

[00:01:10] Nandita Koodie, PharmD: realized when I was designing my program, that it was so much bigger than me. It was so much bigger than the patients I had. It was so much bigger than the community I was in, but what tele-health has really allowed for our profession is to take it to a national level.

If I could take it globally, I would, however, the laws and the regulations behind it are currently limiting me to our nation. 

[00:01:37] Mike Koelzer, Host: I own an independent pharmacy, and I hear a lot about it. Tele-health how familiar are pharmacies with tele-health in their own usage? 

[00:01:52] Nandita Koodie, PharmD: Well, I feel like in the realm of pharmacy, it's very well talked about, you know, it's like a buzzword right now, telehealth telemedicine.

It's a buzzword. 

[00:02:03] Mike Koelzer, Host: Has anybody touched one? I mean, does anybody know about it in their pharmacy 

[00:02:07] Nandita Koodie, PharmD: though? I feel like the pharmacies that are operating in the inpatient setting have actually touched on it and are using it in some, um, 

[00:02:17] Mike Koelzer, Host: in a hospital or a nursing home or something like that. 

[00:02:20] Nandita Koodie, PharmD: Exactly, exactly.

And I feel like in the independent space they know of it, they know it exists and they're starting to hear that if something they could use. But they just haven't connected the dots. They don't know how to use it, a practice. And even the physicians that I've been talking to are very curious to see how this works in practice, in conjunction with independent 

[00:02:42] Mike Koelzer, Host: pharmacies.

I can picture three people involved. I'm picturing a doctor, I'm picturing a patient and I'm picturing a pharmacist. Is this the doctor and the pharmacist who's on the outskirts? 

[00:02:57] Nandita Koodie, PharmD: Well, this is what makes the interweb a little tangled. Essentially. What happens is that pharmacists would be employed by the independent pharmacy.

That's local to the physician. 

[00:03:09] Mike Koelzer, Host: That's local to the physician. Who's on the camera? We've got three people here. We've got the patient. We've got the doctor. We've got the pharmacist. I'm always used to just two people talking back and forth though. 

[00:03:24] Nandita Koodie, PharmD: We have Dr. J. He is a primary care physician in grand rapids.

He works in the same Plaza as Bob's pharmacy. Okay. And now Bob's pharmacy has just employed a brand new clinical pharmacist. Okay. That's Dr. Joe pharm D all right. So Dr. Joe pharm D will then come in and work. Part-time for Dr. Jack in his physician office. He can work part-time in the pharmacy to provide support.

There are things such as prior authorizations, interventions, you know, MTMs and then he can work part-time from home monitoring the patients that go between the pharmacy and the physician's office. When you 

[00:04:13] Mike Koelzer, Host: talk about these three different areas where. That pharmacist is working. Is there a secret sauce to that, that they have to work at a certain place so much time in order to be able to bill certain insurances?

Or could I just say Nandita, you know, this pharmacist just loves working at home. They're going to do that the whole time, or they're going to be at the doctor's office all the time, in three different places. Was that just an example or is there some 

[00:04:46] Nandita Koodie, PharmD: need for that? So essentially what makes my program unique is that I'm a proponent of making sure that that patient physically knows their pharmacist basically knows their doctor what's happening right now in the tele-health world is there's a ton of outsourcing going on where the people who are doing this and are familiar with it are marketing it to physicians without the independent pharmacies.

And without that face-to-face interaction with the pharmacist, that's providing the tele-health services. They may have an intern working at the physicians office level doing, you know, the primary baseline encounter, so to speak, but they don't have that relationship where I can say with confidence, I know you.

And that's where I really want to bring healthcare back to is the basics of actually having a relationship with your pharmacist and with your physician, and then working together as a team to bring you to your health goals. So it's not like it's necessary for billing to answer your question, the parts that are necessary for billing our time spent with the patient, having that documented, um, you know, the, your action plans, things like that.

And then also where I come into the scheme of all, this is kind of making sure that it's being done in accordance with. Guidelines for reimbursement. Okay. So when is it appropriate to provide these services, which services can be provided in conjunction with other services, things of that nature where candy services be provided, do they have to be provided in the doctor's office or can they be provided remotely different services, have different rules, different CPT codes, et cetera, et cetera.

We're 

[00:06:31] Mike Koelzer, Host: slow up here in Michigan. Our brains are always frozen. It's a good idea to have the pharmacist and the doctor. Some time for the pharmacist to be in the doctor's office. Let's, let's take the patient out of this for now. There's a value though, to have the pharmacist in the doctor's office at some point, so they can rub elbows together once in a while.

[00:06:55] Nandita Koodie, PharmD: Yeah. We really want the pharmacist to add support to both sites. You know, the physicians really enjoy having a pharmacist on staff that they can lean on for treatment alternatives for their prior authorizations for kind of relieving that burden of all of the requests that come in from the pharmacies and things of that nature.

Those are things that the pharmacist can handle and just be there for the patients. I feel like one of the biggest things that we as practitioners miss is that not so much that the patients need our expertise or that we have these keys to knowledge about their bodies and about their health, that they don't have a lot of them know what they're supposed to be doing.

And they just want someone to be there physically. And I feel like that's the piece that will allow the pharmacist to act as an extension of the physician. So he's not having to depend on his nurses, medical assistants and PAs to do all of that back and forth with the pharmacy. 

[00:07:57] Mike Koelzer, Host: I've got that part down now where it's good for them to be in the same building so they can bump into each other and, and no, no, the team and so on.

All right, now I gotta put my second layer of devil's advocate in. So where is the tele-health part of that? If the pharmacist is in the same building as the doctor or the doctor and the pharmacist tell a health thing, or is this just for the patient and the doctor and the pharmacist 

[00:08:27] Nandita Koodie, PharmD: it's actually for all three, essentially what happens is once that baseline interaction has occurred between the pharmacist and the patient.

They can then see if they're a good candidate for continuous monitoring. Uh, so my program is specific to diabetic patients. The pharmacist would then offer a glucometer that is equipped with cell technology that transmits real-time data to the pharmacist for tracking. So the pharmacist can identify hypoglycemic, hyperglycemic episodes, uh, make recommendations for insulin dosing or for which medications can be substituted for cost benefit or whatever it is that may be needed there.

Um, and then basically present a very succinct version of that data, you know, just digest it down to the little bite sized pieces for the physician to where it's really easy for them to make those interventions. And so they're basically streamlining the monitoring piece, you know, because a lot of times the physician, yeah.

They're barely getting by with diagnosing the patient. Right. But the followup, the actual maintenance monitoring piece of it is missing, like the treatment aspect. They can give them a prescription, but who's checking with the patient to make sure they're actually taking it and that it's working for them.

And then now we have a lot of these, um, like outcomes Mirixa and other companies that are pushing for the 90 day supplies, where we have even longer periods of time where the patient doesn't get to find out if it's really working for them. So having something like this in place where a pharmacist is there from the beginning, you know, to walk the patient through their treatment.

And then the PA the patient is also getting to see the pharmacy 10 times more than they would see the physician's office, you know? So they have additional opportunities to interact with the pharmacist and check in with them, even when. The tele-health isn't happening, but essentially when the pharmacist is working remotely and that third practice site is where the tele-health is happening.

They're basically, they're all looking at all of the data that's coming back from these devices and basically selecting the patients that are out of range and that need that connection and connecting with them. 

[00:10:45] Mike Koelzer, Host: Do you define the information coming in from these machines in your definition? Is that tele-health yet?

Or is that still just background information? When you say tele-health, you're talking two heads on the screen talking to each other? 

[00:11:04] Nandita Koodie, PharmD: Not necessarily sometimes just the data tracking piece is great because it allows for a lot of. Intervention that happened between the pharmacist and the physician before they even circle back to the patient.

So that communication that's happening from the data being digested and then communicated to the physician. That's also, tele-health right. What about 

[00:11:25] Mike Koelzer, Host: if it's all numbers, like it's all data and graphs and so on and it goes back and forth. They haven't talked remotely on the, on the screen. Is that still considered telehealth?

When you say tele-health, you're talking to people, looking at each other on a screen and talking to each other 

[00:11:44] Nandita Koodie, PharmD: telehealth is much more than that. I feel like just the analysis of the data and the communication between two health professionals to provide interventions for patients, whether they're on the screen or not just that piece alone, I feel like it is tele-health.

Although it's not billable as tele-health until that patient is involved, the health piece, the actual. You know, us working to bring our patients closer to their goals, whether they're directly on the screen or not, it's still healthy in my opinion. Right. Because that intervention would not have been made without that platform.

[00:12:29] Mike Koelzer, Host: All right. So some things flash in front of me, and I think they've probably flipped in just the last year or two, because up until probably before this COVID stuff, I would say, well then DDA, you got to get some gear in place to do this and so on. And now if any benefits can come out of this, a good percentage of people have finally used on-screen communication.

I remember when I was about seven, I remember being in Disney world. And I remember going by one of the like future living rooms, I forget what it was called. I think it was sponsored by general electric. It was one of the programs that showed how things would progress every decade or something like that.

And they showed two people talking to each other on a telephone, basically, you know, face to face when I was seven. I thought that's the future that is defined. The future for me, I mean, was black and white. So anything before people could talk to each other was not the future. And when they could talk to each other, that was the future.

But when it came, it's been around, but it hasn't really caught on. But I think with this COVID now it's almost like the future is here despite the terribleness of COVID that the future is upon us right now, as we're, as we're talking over the last few weeks. So my point is, I think that's a non-issue now talking about the tele-health part because you'd have to be almost under a rock, not to hear about, uh, zoom or Google meet or something like that.

What are your thoughts on that? Has that helped? 

[00:14:23] Nandita Koodie, PharmD: Yeah, absolutely. It really has. From what I've seen with the statistics, they say one in five physicians are actually using tele-health now. And when we think of physicians, you know, in school, they told us, listen, a lot of them may be very traditional and resistant to change, you know?

And you guys have to kind of go with the flow with whatever drug they're prescribing, even if you haven't seen it since, you know, 50 years ago, some doctors what they've used and what they've been using for years, that's what they're going to continue using for years, because that's what they're comfortable with.

Yeah. So I agree with you and say that recent times have basically allowed for physicians to change for the better and embrace modern medicine and then two. Actually see the benefits of what tele-health can do well after a pandemic or in preparation for the next one, because as we all know, no history is going to repeat itself in different shapes and forms.

[00:15:24] Mike Koelzer, Host: People have seen this. Now they seen people talking to each other, but is this going to be special equipment like HIPAA, something or other, or, or can these people just be using, you know, zoom how's that gonna work 

[00:15:38] Nandita Koodie, PharmD: out? So what makes me unique is I'm not biased to any one platform. And so I'm not pushing just one service provider, right?

I can give you a menu of different providers for different platforms based on your clinical service needs of what you're interested in having in your pharmacy. Right. But what I can say is standardized across all the platforms is that they have had to develop and redevelop. Their software to where it's HIPAA compliant and to where it's CMS compliant for billing purposes and for security purposes for patient information.

[00:16:22] Mike Koelzer, Host: But what are those? Can I see indeed? Yeah, I'll do this. All right. Give me my laptop. I'll throw a Zuma. Does that count? Or are there certain companies that I would have to go through to be compliant? HIPAA wise, 

[00:16:38] Nandita Koodie, PharmD: there are certain companies you have to go through. 

[00:16:39] Mike Koelzer, Host: You can just use Google Hangouts or something.

You've got to use something fancier. 

[00:16:45] Nandita Koodie, PharmD: You have to choose one of these vendors that have worked with a developer to make sure that their software is meeting HIPAA compliance for security. Right. That 

[00:16:54] Mike Koelzer, Host: sounds really expensive. 

[00:16:58] Nandita Koodie, PharmD: What they've done, what most of them have done the software companies themselves is they are charging.

From the reimbursement of the data collection from month to month for the patient being on the device. So that transmission of data back and forth, kind of, if you, like, if you have a plan with a cellular company and you pay for the data on a month to month basis, the same idea, as long as the patient has a device, you pay for the data for it.

But the payment comes out of the reimbursement from the third party payers, and that's how they get their money. Now what's happening is there are other companies that are acting as middlemen, okay. To basically roll out these same platforms almost as an affiliate of the software companies. And they're collecting an additional percentage on top of the reimbursement, carved out from the software companies.

[00:18:05] Mike Koelzer, Host: Everybody wants to get their hands on the money. 

[00:18:09] Nandita Koodie, PharmD: That's right. That's right. And, and they're capitalizing on the fact that the, that people are interested in telehealth, but they maybe don't know where to start, 

[00:18:21] Mike Koelzer, Host: where there's mystery, there's margin. They put the smoke and mirrors in to make it more expensive.

[00:18:31] Nandita Koodie, PharmD: Correct. And then now all of a sudden the physician is getting a smaller reimbursement rate from those services that they're having provided to them from whatever staff they have working as ancillary staff, underneath them to provide that service doesn't have to be a pharmacist. I'm just suggesting pharmacists, because I know that we are perfectly modeled for this service.

We're perfectly positioned 

[00:18:59] Mike Koelzer, Host: for it.

A doctor or a pharmacy does this. And all of a sudden I've just jumped from little old Google Hangouts or Facebook, this or that. And all of a sudden you start talking about HIPAA and it's gotta be compliant as these vendors and they'd take data and all that kind of stuff. And I start seeing dollar signs and I say, nah, not yet.

What's the plan to get past? Or how do you get past something that seems like such a high hurdle yet without proof of what's going to happen 

[00:19:43] Nandita Koodie, PharmD: without giving you the secret sauce? Basically what I've done is I've developed a program that is self-funded right. So the pharmacy isn't going to have to put it out.

Thousands and thousands of dollars just to get on board with software platforms. And I developed it in a way where I'm taking the pressure of paying a pharmacist salary off of the physician as well, because I know that's something that the pendant pharmacies may not mind, right? Because they hire pharmacists all the time.

So if they see a benefit in ROI and the pharmacist salary is covered, they'll do that. So what I recognized right out of the gate is that independent pharmacy owners are not takers. They require concrete evidence. You know, we were raised, used in pharmacy school to have clinical evidence to support every decision that we make.

Right. So how is business any different? We were not taught business in pharmacy school. We may have been taught what end caps are, you know, and how to model a pharmacy and what permits we need. But we were not taught business. We were not taught what risks are worth taking or how to expand upon one services, doing things that may not exist, but I'll tell you what what's going on right now with the big chains and the PBMs independent pharmacists are starting to look outside of the norm to look outside of the box, to figure out how to be more competitive.

And they're becoming risk takers. Students that are coming out of pharmacy school are not just settling for the big box chains anymore. We're seeing a huge burst in entrepreneurship and in the creation of positions that didn't exist. Almost because we have to, right. Because the ratio of what's available to the amount of pharmacy students that are coming out on an annual basis in every state is just way out of whack.

Right? Right. So, because of that, I feel like right now pharmacy is going through global warming. Right. And we have all of these pharmacists contributing to the heat and the environment is just screaming for change. And because of that, it's been easier for me to then kind of talk to independent pharmacy owners and talk to physicians about how this can be a solution to kind of lower that heat.

[00:22:32] Mike Koelzer, Host: I listened very carefully. And you said it's not fountains and thousands, but it still can be thousands. So I'm assuming you have to do some face-to-face stuff on this to sell this. 

[00:22:46] Nandita Koodie, PharmD: What do they teach you about assuming anything in pharmacy school?

[00:22:53] Mike Koelzer, Host: Will you be talking to a pharmacist face-to-face to try to sell this 

[00:22:58] Nandita Koodie, PharmD: program? I think what's important with what you just said there is that anyone who's looking to go into entrepreneurship has to understand that they're not selling anything. Right. They're sharing something that is a solution. And if the person they're sharing it with is a right fit for it then they are, but I'm not going to chase clients or to sell anything.

Basically what I do is I share what I have. Okay. Which, and if you want to call it marketing fine, right. It is in a sense, oftentimes what we do in pharmacy, we don't realize we're selling when we are, but it's because we're being genuine. Right? So you genuinely, you have someone like, so someone, my prospects of people that I collaborate with to share this program, they come to me because of the content that I put out there about what I'm doing, because I'm loud because I'm vocal.

Okay. And that's something we weren't really taught in school. We were taught to go. And where are you? Loud and vocal. So I use different social media platforms and I leverage the relationships I have on those platforms to attract. The people that I'm interested in sharing with. So your 

[00:24:20] Mike Koelzer, Host: prospects are coming to you and when they come to you, they're saying how much money am I going to have the pleasure to pay you?

[00:24:30] Nandita Koodie, PharmD: No, absolutely. They're like, what's going to be required of me. Yeah. They want to know, Hey, I want to know a friend, what is it? That's how much is this going to cost me? What do you say to them? I tell them that the program is designed in a way that it is self-funded and that the payments that I receive from this come directly from your success in the form of 

[00:24:53] Mike Koelzer, Host: reimbursement.

I'm going to break that down and say, define self-funded because I've seen some fundings that were self-funded in pharmacies that have put pharmacies out of business because they were self-funded. But oh yeah. I forgot to tell you they're refunded. Self-funded so to find 

[00:25:15] Nandita Koodie, PharmD: self-funded I agree with you there.

And I give transparency with that. I basically tell them, okay, you need to see X amount of patients and you need to build up your client base to X amount of patients before you will be receiving and in reimbursement. And so you will have to come up with the upfront funds to pay a pharmacist.

Okay. And then to pay me to implement those services over a six week period of time, I'll 

pay 

[00:25:48] Mike Koelzer, Host: Nan data for time and knowledge, and I can be a pharmacist. I'm still stuck on the technology. How much do I have to willingly share? Somebody to get this HIPAA technology. Well, that's where 

[00:26:03] Nandita Koodie, PharmD: you have to be creative.

And as an entrepreneur, I've basically figured out how to roll that into the fee that I charged for 

[00:26:09] Mike Koelzer, Host: myself. You have. So it's kind of a lease thing of sorts, right? Are they getting any plastic or glass or circuits in this deal in, in their pharmacy? Um, 

[00:26:24] Nandita Koodie, PharmD: the one thing I request is an iPad to make it easier to talk about.

All of the interactions with the patient. 

[00:26:33] Mike Koelzer, Host: You're not getting a computer or anything like that. It's all cloud-based okay. That's where I was going. It's all cloud based. 

[00:26:41] Nandita Koodie, PharmD: The only thing that's physical is the devices that the patients receive directly to their homes. 

[00:26:48] Mike Koelzer, Host: Nope. 

[00:26:49] Nandita Koodie, PharmD: They're not different. Um, companies are manufacturing 

[00:26:51] Mike Koelzer, Host: them now.

Well, you're not coming in to see me. That's okay though. I'll track you down. 

[00:26:57] Nandita Koodie, PharmD: I will be very honest with everyone though. You cannot expect prospects to fall out of the sky. You have to connect with them first and say, Hey, I exist. You know? Um, I like, even with you, Mike, I was like, Hey, you know, I've listened to your podcast.

I love it. You know, thank you for what you do and then boom opportunity. Right? Like I did not ask to be put on this pod. Yeah. And that's something I attracted by reaching out to you and expressing my interest in what you do. 

[00:27:32] Mike Koelzer, Host: Gotcha. Gotcha. Yeah. They're not going to fall to the sky and that's, and that's exactly how I would want to do it too.

You attract someone online, you're talking to them and they say, oh, okay. I'm past the hurdle of thinking that I needed all this stuff to do. What's the next part that they have to fall in love with? And if they don't fall in love with it, they may not do it. I just want to call it an objection and DDA, but you're making me go through all these word games of saying 

[00:28:04] Nandita Koodie, PharmD: the biggest objection that I find.

You're 

[00:28:06] Mike Koelzer, Host: actually going to say an objection. I thought you were going to get on me and say, Mike, it's not an objection. It's just not a match made in heaven. 

[00:28:13] Nandita Koodie, PharmD: No one is, it is an objection. Okay. I will say that whatever it is that you're doing will not be for everyone. Okay. It's important to know that it's also important to choose.

One group that you are servicing. Okay. Who do you serve and not feel like your program is for everyone? Because as many faces as my program has, right, I could market it to the pharmacist, independent pharmacy owners. I could market it to the patients. I could market it to the third-party payers. I could market it to the physician.

How do I decide who I'm marketing to? Well, that comes with doing, if you're inventing something that doesn't exist, if you're creating a program that hasn't been tested and you don't have any testimonials, how do you figure out if it's not being done somewhere else, what's the best way to go about doing it?

Well, you could learn from other people's failures and say, well, I'm not going to go down the same route they did. Or you could say, I'm going to go down that road, but I'm going to do it better. Right. Or C you're going to just start testing the waters. Right. Right. And that's essentially what I did. I started off doing patient to patient, you know, I did pop up green markets in my community where I would spend my Sundays selling teas.

This is like the very beginning of perfect balanced health. I was selling therapeutic teas that I customized myself based on knowledge. I gained studying abroad in China, in Japan and in England and France doing homeopathy as well, and came up with teas that were specific to patients, disease states. So a T for hypertension, a T for stress, a T for diabetes or whatnot, but you can't leave like that, obviously because of branding and all of this can help to relieve your stress and things of that nature.

And so basically let's say you came to my table and you selected pazazz okay. That's a tee. That's really great for weight loss and for energy that tells me what you have going on without you saying anything, just from what you selected. So then I can open up a conversation with you to discuss what it is you're going through.

And why does he feel like you need this? T why did you pick this particular one and then offer my services after you basically have to start testing. Okay. Which patient am I talking to? What works for them and how do I get them into working with my service? And what I found is, okay, great. My patients are interested, but I'm only getting one patient at a time, right?

Because I'm only one person and I can't afford to hire three of myself and train them to do this right now. So then you say, okay, I'm going to shift my model from patient to patient, to business, to business. And now that I've done that, how can I test different phases of my program? Well, I started with the independent pharmacy owners and what I found was a lot of resistance because you know, you guys are not risk takers and you need that concrete testimonial that exists in order for you to believe that telehealth works.

Seeing is believing. Great. And what I've found is in the physician space, they are seeing it. And so they already believe in it. And so it's not like I have to market anything. It sells itself. If you just present it in a way that shows them how, what you're doing is different from what they're already doing and what they're already seeing or hearing about, and then showing them how that could fit in.

So I found that, um, what's happening is the biggest objection I'm getting from the pharmacies and the independent pharmacy side. When I was marketing it to them, they did not have confidence in me to establish a relationship with physicians in their area. They were not even willing to tell me who they were.

You 

[00:32:17] Mike Koelzer, Host: nailed it there because when I was first looking at your stuff and indeed as you and I were chatting, Through texting before the show. I thought no pharmacist believes in that really they've had their hands slapped too many times. They've been told no too many times. And even though I was talking a lot about the technology and things, that is the, the one that I think deep down is the, the true objection.

We don't have that connection. Right. 

[00:32:56] Nandita Koodie, PharmD: It comes down to shifting the mindset of that pharmacist, reminding them of where they came from when they decided to start their own independent practice. Instead of joining one of the big box chains, it's a risk you took, right. From nothing with nothing and create something that didn't exist in your community because you believed in it.

Right? But I'm not asking you to believe in me. I have proof that the platforms that I use are being used in over a thousand pharmacies. I have their testimonials to lean on, but I haven't even been using those. I haven't needed to. I've had multiple pharmacy owners that I'm working with right now to implement this program into their practice, because I've been able to articulate the value of what I'm doing from my own personal experiences, my own ability to connect with physicians and to break past that barrier that they find going through their front office and having to face that front desk staff looking like a farm rep, you know, and trying to figure out how they're even going to get hurt.

You can have the best program in the world, but if the physician can't hear it, it doesn't matter. 

[00:34:09] Mike Koelzer, Host: What do you mean by the thousand, um, people you mean in general across the country? There's a lot of pharmacists doing tele-health already 

[00:34:20] Nandita Koodie, PharmD: yes. Specifically using the platforms that I am presenting, 

[00:34:24] Mike Koelzer, Host: a lot of pharmacies are doing this and you would be selling the same one that is successful at a lot of different pharmacies.

Not that you sold them, but, but you know, you know, it works. 

[00:34:43] Nandita Koodie, PharmD: For the people who are interested in doing this, and haven't really started exploring it. They feel a little overwhelmed because there's so much out there right now that they can't decide what's good for them or not, or who's trying to rip them off or what deal is the best.

And they don't even know where to start because they want to make sure that what they're doing is by the book and, um, that it's meeting all of the requirements for it to be compliant. And essentially what I've done is I've done all that research for them. I've demoed, you know, dozens and dozens of platforms to kind of identify what would fit best in an independent pharmacy.

You know, which platform is offering the most versatility to where you're getting your usage worth out of it, to where you're not having to contract with 12 different developers just to provide. All of the services you're interested in providing to your patients, how can we get it all under one umbrella?

Well, I basically act as that umbrella and I have it built out to where they can access all of these platforms through me without having to go to a million different places or explore a million different platforms to see what's best. 

[00:35:55] Mike Koelzer, Host: Okay. We talked about the biggest hurdle though, being the doctor relationship.

And

I remember as a kid, I know people find this hard to believe, but I was not a big ladies, man, when I was like in sixth grade or seventh or eighth grade, I know, but just, just slow down and bear with me a second here at Andy to, but I would never, I mean, someone could tell me a million things to do to get a girl to skate with me.

We'll spend a while at the Plainfield skating center or something like that, but I was not going to do it unless her friends came up to me and said, so-and-so wants to skate with you, or they drag me over there and make me skate with them. Picture that. All right. So you can say all you want about the doctor relationship.

Are you going to pull me over on my roller skates? So, and tell me that doctor wants to hold my hand or are you just going to say here's how you do it? When you find a doctor that you think would be receptive to you going for all skates, have you ever roller skated right? So I didn't want it to be lost here.

Couple skate, not all skate, couple skate, right? Right. I'm not going to go up and ask a doctor. I want someone to roll me over there and say, this doctor wants to skate with you. 

[00:37:36] Nandita Koodie, PharmD: And it's because you guys have been rejected so many times every time you call over to their office, you can't even get a chance to talk to the doctor or your.

You know, you're, you're fighting just to get a clarification done. So how are you supposed to build a whole relationship now? That's where I come in. I'm that Cupid matchmaker that starts with the physician and said, here's this great program. Are you interested in collaborating with your local pharmacy to do this?

Do you have a pharmacy in mind that you feel like you share a good amount of patients with and nine times out of 10, they have an answer for me and I'm like, all right, well, let's do. 

[00:38:12] Mike Koelzer, Host: So you're going over there. You're the Cupid. 

[00:38:15] Nandita Koodie, PharmD: Absolutely. And I just say, Hey pharmacist, I have an opportunity. You cannot refuse 

[00:38:21] Mike Koelzer, Host: with Dr.

So-and-so or maybe not. You might not tell them the doctors 

[00:38:27] Nandita Koodie, PharmD: it's like on a silver platter and the platter is covered, you 

[00:38:30] Mike Koelzer, Host: now, but it's waiting there for them. 

[00:38:33] Nandita Koodie, PharmD: And it's just up to you to take that opportunity or let your competitor take it. 

[00:38:38] Mike Koelzer, Host: Now, this is getting interesting. 

[00:38:41] Nandita Koodie, PharmD: I just brought the hottest girl in the middle that was doing all the technical skating in the middle ring.

I just brought her to the outskirts of you and said, Hey, you want to skate with her? And that's 

[00:38:52] Mike Koelzer, Host: it. And you're doing that. 

[00:38:56] Nandita Koodie, PharmD: Precisely. And there, I don't have to convince them that I'm capable of building that relationship because it is all right. 

[00:39:03] Mike Koelzer, Host: This changes everything now. So wait a minute. Devil's advocate doctors.

Ain't on the internet, 

[00:39:09] Nandita Koodie, PharmD: right? This is a struggle of mine. They're not even on 

[00:39:13] Mike Koelzer, Host: Facebook. No, they're not on Facebook. Well, and nor are attorneys. I'm not sure why either they're above it, they think, or they don't want to get into an advice thing or they don't want to get into a legal thing. Why is that?

They don't have 

[00:39:30] Nandita Koodie, PharmD: time. They don't want to be bothered. Uh, they don't want to give free advice. They're, you know, we, as pharmacists are so willing to give for free, because it's what 

[00:39:41] Mike Koelzer, Host: we do. Do you think they're aloof? Do you think that they, do you think they think it's too cool to go on? 

[00:39:46] Nandita Koodie, PharmD: No, they don't want to be bothered like they are.

Overwhelmed with people reaching out to them for their advice and for having to see patients and to have to meet all these metrics that I am recently finding out that they also have to meet quotas, you know? And, um, they don't want to be bothered. They don't want to do anything for free. They don't want to collaborate with people for free or to help others as much as we do as pharmacists.

And I mean, that's that right there? What I just said, right. That's the misconception, that's a belief. Okay. This is the reason why pharmacists are not making these relationships on their own because they have this mindset. Right. So I just said that just to kind of like, have you gone through the thought process of what an average pharmacist thinks about why it is that they can't reach a physician.

Right, 

[00:40:42] Mike Koelzer, Host: right. Yeah. Right now, listen. All right. Then why aren't they on the internet? 

[00:40:47] Nandita Koodie, PharmD: That is a body. That is a belief.

You have to ask yourself, where are they on the internet? Doximity 

[00:41:00] Mike Koelzer, Host: maybe right. Maybe you have a secret potion of where they are. 

[00:41:08] Nandita Koodie, PharmD: Right? You have to get creative if you want to track. 

[00:41:12] Mike Koelzer, Host: No, you have a secret potion. That's part of your sauce, where they are, where they are. It's the secret light of Colonel Sanders.

[00:41:25] Nandita Koodie, PharmD: It's not because actually what I've done now is I've created a sandbox for them to play with us. 

[00:41:32] Mike Koelzer, Host: The 

[00:41:32] Nandita Koodie, PharmD: doctors. Yeah. I created it. I created groups on, on different social media platforms for physicians and pharmacists 

[00:41:42] Mike Koelzer, Host: on social media platforms that we know of. Yeah. I don't know. I bet none of them are there.

You can say you set them up.

Oh, the physicians and 

[00:41:58] Nandita Koodie, PharmD: pharmacists

[00:42:02] Mike Koelzer, Host: Are any of them biting? 

[00:42:04] Nandita Koodie, PharmD: Yeah, they're in there. They're just not talking because they're scared. They don't trust us yet. That's something we have to work on as a profession is earning their trust. Your belief that they are not on social media is a belief. 

[00:42:22] Mike Koelzer, Host: Well, I have a lot of beliefs that are true, just because I believe it doesn't mean it's false 

[00:42:27] Nandita Koodie, PharmD: or are we just not partying when they're partying?

[00:42:29] Mike Koelzer, Host: So you're saying that the physicians are on social media. I don't know. I don't know. 

[00:42:43] Nandita Koodie, PharmD: I'm done stuffing my face on your.

[00:42:48] Mike Koelzer, Host: That's good. I mean, I mean, it's good. You were able to have a little snack. How do you draw them out? 

[00:42:54] Nandita Koodie, PharmD: I just connect with them, you know, and I think that's the scary part is, you know, saying why not. And if they do reciprocate my desire to be connected to them then great. And if they don't, then they're not a fit for what I'm doing, because I'm looking for physicians who want to work with pharmacists or that care about us, or that see the value in working with us.

So that's basically how I was able to shift my own mindset and just get over that at home. 

[00:43:33] Mike Koelzer, Host: You reach out to them, you reach out to them 

[00:43:36] Nandita Koodie, PharmD: and not just reaching out to them, but reaching out to them in a way that's convenient for them. That's I think what's key when it comes to attracting whoever your prospect is, make sure that you're doing it in a way that's convenient for them.

[00:43:51] Mike Koelzer, Host: What does that mean when it comes to social media? 

[00:43:53] Nandita Koodie, PharmD: Let's say for instance, Mike, he wanted me on his podcast. Right? You didn't just say, Hey Nan data, are you available at 5:00 PM on Friday to do a podcast with me? No. You sent me a link to your calendar to choose a time that was suitable for my availability.

Right? So that was accommodating, correct? Correct. So it's kind of that same mindset. How can you accommodate a conversation with your prospect? 

[00:44:27] Mike Koelzer, Host: Right. I wanted to make it as easy as comfortable, personable, personable. Hmm. And one of my steps, even my last thing was, Hey, you don't need to bring anything, just, just come.

And I'll, we'll, we'll take care of this as far as the conversation goes and things like that 

[00:44:46] Nandita Koodie, PharmD: and not just telling them, Hey, um, would you be interested in doing this for me? No, no, no, no, no. Invite them. Right. You even invited me onto your podcast. Right? So I'm inviting them to a conversation about solutions for them, right?

Not for me. It's about 

[00:45:08] Mike Koelzer, Host: that. I got to say this as politically, correct as I can, but it probably helps that you're not a fat old guy with gray 

[00:45:16] Nandita Koodie, PharmD: hair, you know, as much as you would think that that would be a beneficial thing. I have struggled with being a female B, I look like I'm 12. Okay. 13. Okay. Maybe.

And see, I look like I probably don't speak clear English or American English because I look like I came from either Pakistan or India. I've had people approach me speaking Hindi before I've had older Caucasian males tell me I cannot serve them in the pharmacy before at stores that I've floated. Okay.

And I literally today had a physician that I invited to share some insight about some of the challenges he may be experiencing in his practice. And he said, sure. And I sent him a link to my calendar to set up a conversation. And he said, oh, I didn't mean for there to be mass messaging between us. I just wanted to chat you up because I thought you were attractive and it's like, isn't this Tinder?

And I'm like, you know what? I'm glad that you said that. So I didn't waste my time getting into a conversation with you to offer you solutions for your practice, as much as you would like to think that this is like a beneficial thing. I think it might be beneficial in getting people to listen to me. If they maybe came across one of my videos talking about what I'm doing, right.

Um, because it may be easier to look at someone who has their shit put together and, and listen to what they're saying. Um, but at the same time, sometimes I'm afraid of that. And that's something I had to shift my own mindset about because I experienced it. At the store level where if I wasn't wearing makeup or if I wasn't put together at work, people didn't even recognize me as the pharmacist.

You know, um, part of 

[00:47:20] Mike Koelzer, Host: it is just self awareness of the market. I probably came out about three years ago and I was just messing around with some different pathways, not podcasts yet just different pathways of branding myself, I guess, away from my corner pharmacy. And I was doing things like pharmacy, social media, and I had bought the URL.

And so on. I knew though, before I even started, I knew though that the way that I was trying to brand that was not something that you could do with a guy with gray hair, right? Social media, people were thinking of, you know, younger people. Now I couldn't be the face. If I branded it like social media for old farts or something like that, but I couldn't just be the social media one.

Now this, you know, this may be, I can do business, you know, pretending like I have some wisdom and those kinds of things, but not the social media thing. So the problem is reality is out there. And so, yes, you've got to know what your audience is going to think. And a lot of things you can't fight, right? 

[00:48:37] Nandita Koodie, PharmD: I mean, like I put you in my dining room

[00:48:42] Mike Koelzer, Host: as, as a statue. 

[00:48:44] Nandita Koodie, PharmD: No, I think that's a painting or a portrait. You know what I'll tell you. The day that my program is fully functional is a practice between a physician and a pharmacist, because I just started doing this a couple of weeks ago. Right. And I have prospects that I'm working with to implement it, but it's not really, the wheels are turning quite yet.

There's no patients onboard right. The day that a patient is on board with my program, I'm going to take a portrait of you and I'm going to put it in my dining room. How does that sound? Okay.

[00:49:17] Mike Koelzer, Host: Uh, Boston,

but not a bus, a bus as in like the shoulders up. 

[00:49:26] Nandita Koodie, PharmD: Oh, I thought you meant a bus. Like it's not happening. 

[00:49:30] Mike Koelzer, Host: No, no. Shoulders up shoulders up back in 2009, 2009. So 11 years ago I started a grand rapids healthcare company, LinkedIn. Group. And now it has like 1300, 1300 healthcare people and so on, but I don't think there's a lot of doctors on it.

I knew I needed a platform and eventually with my different groups, I was using it to promote this podcast, which then came, you know, 11 years later. But, I don't think as many physicians in it, but if there are, I've never really used it for much, but if I went out there and started offering things that would be beneficial to them.

That's what you're 

[00:50:16] Nandita Koodie, PharmD: saying. Right, right. It's about what you put out there, you know, it's about how you position yourself in their space and being there as a beacon of light to guide them to what it is that they need to find the solutions they are looking for. I 

[00:50:30] Mike Koelzer, Host: know that you've made the shift Nandita over from business to business more.

Correct. What makes you think that you are able to. Connect with these physicians. Have you? 

[00:50:49] Nandita Koodie, PharmD: Yeah, I have, my schedule is full every week since I started doing this about a month ago, my schedule was just full of time, blocked off to chat through web conferencing with physicians, with physicians and with independent pharmacy owners, because I want both sides.

Right. Are you going to do one at a time? I do one at a time. They're independent of each other, but I've been chatting because I want to make sure that I'm developing the program to serve both sides and that I'm getting the insight. I need to position myself appropriately. 

[00:51:25] Mike Koelzer, Host: That's really impressive that you've said.

I mean for me setting up just one of them would be really cool. 

[00:51:34] Nandita Koodie, PharmD: I think the challenging part isn't necessarily setting them up. It's finding time to accommodate them when your schedule is already stacked. I work full-time yeah, I work full-time overnights at a long-term care pharmacy. Most of my shifts are from nine to five 30 in the morning.

And then I'll have like a small window of time between 6:00 AM and 9:00 AM before my significant other leaves for his nine to five. And then I'm on baby duty. I have a one-year-old and I have a 13 year old and I'm a mom from nine to five. And then after five is when I can start seeing prospects. And connecting with them.

So this actually works out for me because most of them are working nine to five too, or they work in a pharmacy till seven or eight. So it's okay for now. Right. But a lot of them, when they go into my calendar schedule, they're like, what is this? Like, how are you only available for like three or four hours a day?

And they get it though? They get that I'm probably working. Right. And, um, although they think I'm working nine to five, I am, but I'm working as a mom, you know? And so my challenge has been okay, what am I doing to set those up? Like, where am I finding time to set those up and to maintain my presence on social media, as well as develop my program.

And then what I'm also working on is, uh, taking my CPG to be able to practice in California because I would like to take this business model. I live there, but I would like to have my California license. If I'm going to live there, I live in south Florida right now. 

[00:53:22] Mike Koelzer, Host: Why do You want to go to California? 

[00:53:24] Nandita Koodie, PharmD: I'm not about to swamp life.

I really want to be in a place where it's not too hard to get to mountains or desert or the coast, or, you know, the valley or, or anything without having to go too far. And I really fell in love with the scenery out there. And I've been traveling back and forth there for a couple of years. I have a couple of really close friends that live out there that I would love to be closer to.

And actually there's a city that not many people know of. It's called Menifee. It's in the Temecula wine country area in between LA and San Diego. And it's a really similar cost of living to where I am now in Coral Springs, Florida and south Florida. So it wouldn't be a difficult transition. Uh, to, to start, but then eventually where I would like to stay is somewhere in the north coast, somewhere where the forest meets the ocean on a bluff somewhere.

[00:54:20] Mike Koelzer, Host: Sounds like a hallmark card. 

[00:54:22] Nandita Koodie, PharmD: Yeah. 

[00:54:23] Mike Koelzer, Host: For us Michiganders, Florida and California are the same. What, what don't you like about Florida? What do you mean swamps? 

[00:54:31] Nandita Koodie, PharmD: We are 10 feet below sea level. Here we deal with hurricanes. It's actually storming out right now. It's been, yeah, well, especially south Florida, um, more Florida doesn't flood as 

[00:54:44] Mike Koelzer, Host: bad.

Well, how come you're not under water? You don't, you don't have walls like in new Orleans 

[00:54:48] Nandita Koodie, PharmD: floods, super easy. Um, and there's nothing. The only Hills we have are landfills. There's nothing out here to see there's alligators and fish, but I really, really want to be. Like where I can watch whales or where I can watch Eagles, you know, and, and not have to drive all the way up.

Eight hours up to the panhandle to see them. I know you get the bald Eagles out there in Michigan, right? I was up there last, maybe a year and a half ago. 

[00:55:26] Mike Koelzer, Host: We do, I have a, I have a cottage about 30 miles north of grand rapids. And we've got, um, we have bald Eagles on the lake and I told my son who worked at a zoo last year.

I told him to really make his day. He should go up to people and do this. Like, let's say someone because they have bald Eagles there. And if I was working there, I told him I'd go up. And I would say to people, I'd say, you know, contrary to popular belief, bald Eagles are not actually bald. They've got white feathers that give them the appearance of being bald.

But they're not actually 

bald. 

[00:56:06] Nandita Koodie, PharmD: Mike, is that what you tell people? 

What is that? What you tell people 

with regard to your hair?

Did you get that from your son or did you make that up? Let's be honest. 

[00:56:20] Mike Koelzer, Host: Yeah. How'd, you know, I was being symbolic. 

[00:56:24] Nandita Koodie, PharmD: How majestic abuse. 

[00:56:27] Mike Koelzer, Host: I was saying that about the 

Eagles. 

[00:56:29] Nandita Koodie, PharmD: I know. Where are you really though? Was it about the Eagles or was that some subliminal? 

[00:56:34] Mike Koelzer, Host: It might have been about me It might have been subliminal 

[00:56:35] Nandita Koodie, PharmD: I think it was 

[00:56:36] Mike Koelzer, Host: all right in Adidas. So listen, you have these appointments set up with doctors.

You have them set up with pharmacists. What's your next roadblock? 

[00:56:44] Nandita Koodie, PharmD: Initially, what I was doing was always building out a list of pharmacies that were interested in what I was doing and a list of physicians that were interested in what I was doing. And then I was going to eventually match them up. But what I realized was.

That because I was operating on a national level, it would take forever before a physician would come along and you're here, right? So it's like, how long are you going to maintain your prospect's interest if they're waiting forever for you to make a match? Right. So basically what I had to do was shift out of that completely and start an affiliate program to where I had to take that same mindset that I had when I shifted from patient to patient.

And I shifted into business to start figuring out how I can multiply myself. Right? So what I'm doing now is offering an opportunity for any pharmacist that would like to do what I'm doing, but make it their own, right. I want to empower other pharmacists to be entrepreneurs and to start their own businesses, whether they want to call it a consulting business.

If they want to install themselves as the clinical pharmacist, that's doing this, or if they want to take it to a level like what I'm doing, and I take them under my wing and let them use my business and what I've built as a springboard. To build something of their own in their own way. So let's say for instance, I'm doing this for diabetes and you have a passion for COPT.

You can model what I've done and fashion it to COPT. And then basically as long as you are promoting the same platforms that are within my umbrella, and you're doing it under me, but under your own name, of course, with my guidance, your success becomes mine. And now you don't have to go through the whole process of incorporating a business and, you know, marketing and figuring out how to make these relationships happen.

And all of that, all you would have to do is do what I do to get over that fear, get over those misbeliefs of who's available and not, and where they are, and just reach out to physicians in your area. And tell them what you're doing and show them the opportunity that's there for them. And for every contract that is successfully made between that physician that you found and any pharmacy or any pharmacist, I would award you cash $500 cash in my affiliate program for any successful contract that is done through perfect balance health care, 

[00:59:18] Mike Koelzer, Host: you get money because they're using your platforms, technology platforms.

So it does come back to the technology that I'm promoting, that you're promoting and you're going to get paid from those technology people. If someone uses, uses that all of your money comes 

[00:59:38] Nandita Koodie, PharmD: from reimbursement and from the installation, the implementation from the independent pharmacy. Once I showed them that silver platter.

[00:59:47] Mike Koelzer, Host: They pay for that. They pay for those connections and they're paying for the technology part of 

[00:59:52] Nandita Koodie, PharmD: it. And then I think what's the main component that's missing here that I haven't even began to talk to you about because there's so many different facets to this is most people were in the space that are doing tele-health are presenting the platforms and the options for those correct, and the different services and how they get billed, but nobody else has married.

What has now been coined as functional medicine that I've been doing for over a decade, married, functional medicine with tele-health and that's essentially the piece that I'm offering that nobody else has. You can slap a glucometer on a patient and say that you're watching them, but how is that actually going to let them meet the goals that they have set with regard to A1C, or if they're obese and they're on their type two and they're obese, how are they getting that weight loss?

What I've done is I have trained pharmacists to coach my life program, my PBH life program. And from that, the pharmacy can earn revenue per patient per month. That's on the program, but the patients are not slaves to the program. They don't have to depend on it for life. The idea is to transition them from the program to healthy habits, that we install into their life through little micro habits of change, and essentially empower them to make the right decisions with regards to their health going forward.

And it really comes down to nutrition. That's like one of the main things, but it's very important for patients to know that health is not synonymous with. And that there are so many different components that contribute to our status. It could be your surroundings, your mental health. It could be the relationships that you're in your work situation, your financial situation.

There's just so many different things that go into what your health picture looks like. And so having a pharmacist that they trust and they know, guide them through becoming more aware of where those issues are and what those underlying problems are that are contributing to their need for medications, then we can work alongside the doctors to de prescribe and really get to the bottom of what the chronic disease stay crises in our country.

I think, uh, what I've been seeing a lot in telehealth has a huge focus on elderly care because there's a lot of government incentives for Medicare and also for Medicaid patients. And I would like to help practitioners shift that mindset from. There were incentives to do what's morally correct. And really focusing on the larger subset of the population of the patients who are between the ages of 30 and 50, we're going to put a strain on the healthcare system because they already are.

Right. And they're already struggling. It's all about the money though, but then that's the other misconception. That's the other misbelief that patients are like, I told you, I want to leave here.

It is raining cats and dogs that they're welcome to Florida. Okay. This is what we deal with. If you don't like the weather, wait five minutes. 

[01:03:18] Mike Koelzer, Host: Okay. And it never rains in California. You don't remember that song. That was a sign when I was a kid, though. I'm not going to sing it, but people can look it up. No, I'm not going to give you that one.

It's all about the money and there's no money there yet. There's no money in not dispensing. 

[01:03:33] Nandita Koodie, PharmD: I beg to differ because of what I can say from my experience. I was offering MTM cash and people were paying for it. How much were you charging? I was charging $125 and they wouldn't stop there. They would also buy into my therapeutic 

[01:03:49] Mike Koelzer, Host: teas.

You're charged 125, like our 

[01:03:52] Nandita Koodie, PharmD: first EMR. And it wasn't based on time. I was doing house calls. I would come and make it very convenient for them. A lot of them have. Barriers to transportation barriers to, um, you know, who their caretaker was and what their schedule was like. And really coming in and speaking with these patients in their home is what made the difference.

And that's why I've chosen to shift the tele-health because it allows me to do that without having to drive 

[01:04:18] Mike Koelzer, Host: that I got you that that's, that's where this all comes down to the big circle. That's the big circle. The tele-health is the medium 

[01:04:27] Nandita Koodie, PharmD: allows you access into the patient's homes to bring healthcare back to the 

[01:04:31] Mike Koelzer, Host: basics.

Okay. All right. All right. So, you were billing, you were billing cash and people were paying for that. They 

[01:04:37] Nandita Koodie, PharmD: were, and they were paying way more than that. They were paying for supplements. They were paying for me to do their transfers for them. They were doing, uh, they were paying for my cost benefit program that I would do to help them save on medications.

They were paying for a just reminder system. They were paying for anything that I offered that could benefit them in some way, shape or form. I even did nutritional grocery walkthroughs with them. It was my internet because I heard it on the internet too. Hey, you never, you could create anything, you know, 

[01:05:21] Mike Koelzer, Host: Tell me your philosophy of, oh, that's so pretty.

I can hear the rain in the background and 

[01:05:28] Nandita Koodie, PharmD: alligators, alligators are coming. I'm telling you the 

[01:05:31] Mike Koelzer, Host: snakes. Tell me when you know, it's time to refocus. You're doing it because somebody else would say, Hey, that's pretty cool. I get to, you know, I get to drive around in these people's houses and make a couple hundred bucks an hour, this and that.

I'm going to move it up to this level and, you know, work with these people, but tell them to get a computer and I'll do this and that. How do you know to keep reaching up? And when do you know, to give up those $200 visit house calls and spend your time doing this with your limited amount 

[01:06:12] Nandita Koodie, PharmD: of time? Well, Mike, to be honest with you, this is something that I really, really struggled with.

Uh, it's actually been a year and a half since I was doing those house calls. I took a break. I got to the point where I realized I was capped out on how many patients I can see per month with my schedule being where it was and not having the confidence to take that leap or having the cash base saved to take that leap, to do it even part-time.

Gotcha. And so I felt like I either needed to save enough to be able to make that leap or had to come up with a different way to do it. Or C just gave it up because I was pouring money into my business and not seeing the return. And I think one of the best things I did from a very young age, and I recommend it to anyone out there who's listening is to hire a financial advisor because my financial advisor asked me, he's like, is this a hobby?

Or is this something that you want to do more than a hobby? And if it's a hobby, are you willing to spend more on that? You know, where is your alignment as to what you feel comfortable with spending towards your hobby? And I started off as a car enthusiast. I still am, and I was pouring money into my car and I stopped because I realized that it wasn't going to do anything for me.

You know, I actually got into pharmacy initially to fuel a business as a car enthusiast, customizing high-performance cars for other people who may not have access to the people who create the parts and sell them and, and helping people come up with those designs. How did I shift out of that thought?

Well, you know, I ended up falling in love with pharmacy and doing that. And so now I had to decide, is this going to be a hobby or do I want it to be not just a side hustle, but a full-time job? And of course we want it to be because a lot of us are miserable with where we are. Right. So then you're stuck with the old how, because we weren't taught anything about creating businesses.

Luckily, I came from a heavy business background. My parents were business owners and their siblings are all business owners and their parents are business owners. And so it was kind of engraved in. A couple of things, culturally, that helped me with this were engraved in me. And one of them was just taking that leap with nothing.

And knowing that you will find a way cause I've 

[01:08:48] Mike Koelzer, Host: cultural background, 

[01:08:49] Nandita Koodie, PharmD: I'm from Trinidad and Tobago in the west Indies. It's the last of the Caribbean islands right before Venezuela. Yeah, that's interesting. So a lot of the Indian people that are there were brought over initially from India when it was colonized by the British.

Okay. And so we were like prop people who worked in the fields and did crops and stuff like that. And um, and then we only in the seventies gained independence. And so a lot of us as Indians and having that Indian background, it was very easy for us to become business owners. And we became very prominent on the island for running most of the businesses there, the Asians that were there, 10% of the population.

Became known for doing the foundational work, all the construction work. And so it was just a melting pot of different cultures that were brought there, African Indian, Chinese, um, that were just all working together to build this country from nothing. And we had all the resources there to do that. And so that's basically my mindset here is that my parents came to this country with nothing, but the clothes on their back and $1,500.

And now, you know, they were able to provide for me to where I could be a doctor or pharmacy. So I want to do the same thing for my children and create something that they have my legacy and can say, yes, I can do anything that I want to do to be where I want to be and just teach them that willpower.

And so that shift came from finding willpower and saying, okay, What is it that's making you uncomfortable? Is it having to hire someone else and trusting them with the backend of your business? Because that made me super uncomfortable. How am I going to trust someone with my finances? I don't have time to sit here and book key cause it's, it was taking me more time to book Kate than it was to even provide my services, you know, and to like come up with marketing campaigns and to, um, work with vendors, to set up markets.

In my spare time, it was really time-consuming to create the teas myself and manufacture them. And so I had to shift out of a product centered focus and shift into a service side focus, which is essentially what I'm encouraging independent pharmacy owners to do is to shift away from that product centered focus and have it there when your patients need it.

But focus on the clinical services that you can offer to generate more revenue and not have to come up with the menu, the inventory, and all of these other things that you have to manage. And 

[01:11:19] Mike Koelzer, Host: Yeah, but you saw that your service business, you couldn't scale 

[01:11:25] Nandita Koodie, PharmD: it though. I was only one person and I couldn't bring myself to hire somebody else.

I was doing too much, you know, I was doing too much. I hadn't figured out ways to automate a lot of what I was doing back then. Um, and I was uncomfortable with hiring someone to do anything for me. I was, I was really a control freak, you know, I didn't, although we're really big on delegating in the pharmacy when it comes to like your money and your personal life, it's a whole different ball game.

That was something I had to kind of accept that it may not be the quality that I want it to be because I can't do everything. But if you want to move forward with this, you're going to have to accept the help of 

[01:12:04] Mike Koelzer, Host: others. What is success 

[01:12:05] Nandita Koodie, PharmD: for you? Most people who are in my space, success may be defined as okay.

That first paid client, but for me, success is a product. Moving forward towards whatever goal I have set. So it could be very simple or it could be very complex. And so for me, right now in this space, my success has been monumental compared to what I thought it would be a month ago when I started my pivot.

And I have been able to position myself as an expert in what I'm doing. And I'm being recognized as that person, that person that's making the connection between physicians and pharmacists. I mean, recognize. Yeah, it's huge. It's huge that people are reaching out to me and congratulating me on my achievements as not just an entrepreneur today.

Someone called me a woman preneur and you know, and that's great, but I think one of the biggest things that second cultural influence that I have is. We're really big on unity and on equality and coexistence. And that's something I've been hashtagging on, almost every piece of content that I put out there.

Yeah. Yeah. And I feel like it's nice to be recognized as a woman who was finding success in her space. But what I really want to promote is that it doesn't matter if you're a man or if you're a woman or if you're black, white, brown, yellow, if you're older or younger, if you look older or younger, 

[01:13:44] Mike Koelzer, Host: thanks for throwing the older part in.

I know you don't usually say that it was right near the end. And I saw you look at me and say, Ooh, got to get that in there. 

[01:13:54] Nandita Koodie, PharmD: You Michael talking to you. And I know that there are going to be people who are going to be screaming at me and inboxing me and you know what? Go ahead and delete me off your list.

But by saying that we are advocates for a special group of people. I don't think that that is a great niche for your business. I feel like by doing that, you're discriminating against other groups. Right? My opportunities that I have for pharmacists for pharmacy owners for positions goes, no matter what race, color, creed you are, I am a proponent of equality and of coexistence, not just based on how we look or, you know, what language we speak, but also for whatever hat we wear, whatever coat we're wearing.

Because at the end of the day, all of our coats are white. What 

[01:14:49] Mike Koelzer, Host: would it be the opposite of that, that you're talking about? 

[01:14:52] Nandita Koodie, PharmD: So let's just say, oh, okay. I am a matchmaker for telehealth services for women of color. Okay. You see what I'm saying? I'm not, not to say that women of color haven't had their battle to fight and that's fine, but now you're excluding Caucasian males from your opportunity, but 

[01:15:14] Mike Koelzer, Host: you're specializing in diabetics.

What about telling other people? 

[01:15:18] Nandita Koodie, PharmD: Right. So, but what I've done is when I'm giving that presentation, I make sure to tell my prospects, this is somewhere for you to start. But what I would like to see you do is replicate this for other disease states. I want you to include your COPD patients on a separate pharmacist platform, get another pharmacist to do CBD, right?

But what I'm doing is giving you a starting point because my passion comes from diabetes because I struggled with gestational diabetes last year. And it was an eye opening experience to me, for someone who comes from a strong family history background of diabetic parents and aunts and uncles and grandparents.

[01:16:02] Mike Koelzer, Host: Your success is moving towards a goal and goals can be nebulous sometimes and rightfully so. I think they should switch around, but tell me exactly what you're doing on a weekday in 

[01:16:31] Nandita Koodie, PharmD: 2030. So my weekday starts at 5:00 PM. It doesn't start in the morning. Like most people do I 

[01:16:40] Mike Koelzer, Host: in 2030 still. 

[01:16:42] Nandita Koodie, PharmD: Oh, in 2030.

I'm sorry. In the future. Okay. So like where I see myself 10 years from now, 

[01:16:50] Mike Koelzer, Host: 2030, 

[01:16:53] Nandita Koodie, PharmD: I know you're asking me to go through what my day is like now I'm like, it's 

[01:16:56] Mike Koelzer, Host: crazy. You got to listen to the question.

[01:17:01] Nandita Koodie, PharmD: I'm sorry. The thing cracked outside, I was like 

[01:17:04] Mike Koelzer, Host: distracted. Um, in 2030, what are you doing during the day? Where are you? Where are you in 2030? I know you're in California, but what, what do you really want? 

[01:17:14] Nandita Koodie, PharmD: And by then, I would have wanted to establish myself as a national spokesperson for 

[01:17:21] Mike Koelzer, Host: tele-health attention.

[01:17:24] Nandita Koodie, PharmD: Not just the attention, but I want to be able to speak where people can hear me. I see 

[01:17:28] Mike Koelzer, Host: the goal, but let's say someone else did it. Let's say you told me. And I said, ah, I'll do that. And I'll guarantee you I'm going to do it. So no problem. Nandita why do you want 

[01:17:44] Nandita Koodie, PharmD: to do it for me? I feel like there is a lot of miscommunication going on between physicians and pharmacists.

And there's a lot of misconceptions and there's a lot of bad blood that doesn't necessarily need to be there. And I feel like there are beliefs that either side had about the other side that don't even really exist, 

[01:18:07] Mike Koelzer, Host: but I've taken care of all that. Why do you want to do 

[01:18:10] Nandita Koodie, PharmD: it? It's fulfilling. It's fulfilling to be a part of that.

You know, even if you're doing it 

[01:18:16] Mike Koelzer, Host: to be a part of it. 

[01:18:17] Nandita Koodie, PharmD: Yeah. I'm not the only one that is. Installing pharmacists into physician offices. That's being done. It's being done in the inpatient setting a lot, but what makes it different is I'm creating a sense of community. And I want to be a part of that. I want to be a part of what binds practitioners together to establish themselves as health hubs in their community, where they can be seen as places of health, where patients go to get healthy and where they know their pharmacist and their physician.

Because what I see right now with technology is there's a lot of shift away from that in-person relationship. And the reason I want to do it is because I want to 

[01:18:57] Mike Koelzer, Host: bring it back. You want there to be more unity? Yeah. 

[01:19:00] Nandita Koodie, PharmD: Not just that, like I even a part of my program is philanthropy, you know, getting in touch with your local institutions and.

Create a rotation site out of it where you can have students come in and give back to your community and be involved in that and maybe do CS with them. If you're so concerned about the revenue side of it, I feel like if we are a unified as one, and we're speaking as one as health practitioners at the very least, our patients wouldn't be so confused as to what they're supposed to be doing when the right hand says one thing and the left-hand saying something else, you know, I think it starts there, 

[01:19:37] Mike Koelzer, Host: not a confusion.

[01:19:39] Nandita Koodie, PharmD: Well famous representative of the independent pharmacy advocate, patient advocate, physician advocate of unity of health professionals. 

[01:19:49] Mike Koelzer, Host: What's gratifying about that. 

[01:19:53] Nandita Koodie, PharmD: He didn't really say you made it, you know, you can, you can show that to your kids and be like, listen, anything that you want to do. You can make it happen that all you have to do is just believe in yourself and figure out what it is that you need to do to get where you want to be and find the willpower to do it.

You know, and I have no doubt that I'll get there. How much of 

[01:20:15] Mike Koelzer, Host: it is high when you make it to the front of time magazine, whose face are you shoving that in 

[01:20:22] Nandita Koodie, PharmD: You guys, if the independent pharmacy owners didn't believe that it was possible for these relationships to occur, you would hate us. I do. I love you guys.

And I want to save you, but you have to want to save yourselves first to accept my health 

[01:20:36] Mike Koelzer, Host: is part of this. You being on time, magazine's front cover. You're almost showing that to yourself and you're saying, look, you proved it to yourself. 

[01:20:47] Nandita Koodie, PharmD: Even I have to say. Honest to God truth. The bottom of my heart, I feel like I had capped out as a pharmacist, working for other people.

I couldn't find a culture I could stand behind every year. I was switching companies trying to find somebody who I felt like was really putting the focus on patients and allowing pharmacists to do a quarter of what we went to school to do instead of just, you know, things that could be automated eventually and doing this has given me so much fulfillment because I've been able to rise above the practice sites that I've been working at per salary.

And I found so much more fulfillment from working with physicians and pharmacy owners to even begin to think outside of what they're doing to collaborate together. Before this has even really even taken off, I'm finding fulfillment from it because I'm working as a pharmacist beyond where I would have ended up if I had just settled for my first job out of pharmacy school and you're in control and I'm in control.

And I feel like I'm, I didn't waste my time in pharmacy school, you know, and that I'm here. And I, I love when other pharmacists reach out to me and say, can you tell me about what you're doing? It's so great. I have chills right now talking about it because I'm inspiring other people, whether it be for them to do something similar to what I'm doing or to pick up whatever it is they're passionate about.

It means so much to me to inspire others. And I found so much fulfillment from doing round table events with my school a couple of years ago, or, um, they had a career. Expo that I was a part of, and I got a chance to have a booth there alongside these big box chains in the community. And it's like, I exist.

Like I had built something from nothing and created something that didn't exist. And you know, now it's been, that's been coined functional medicine, what I was doing before, but now to be able to create something else that doesn't exist and take it to another level using tele-health and marrying the two it's so fulfilling to do so much more than what was presented to us as options in school.

[01:23:15] Mike Koelzer, Host: Right. It sounds like your success is very attainable and, and that success is being an inspiration. 

[01:23:27] Nandita Koodie, PharmD: Yeah. Honestly, this has been the most rewarding part of what. Been doing is even before I shifted into business to business and started being really loud about what I'm doing and positioning myself as the expert in what I'm doing now, even when I was just working patient to patient, this is a, I know you guys can't see it on the podcast, but the shirt I'm wearing right now is the shirt I used to wear in the marketplace with my original logo, when everything on it and having that, and then seeing pharmacists that would ask me, what is that?

You know, and, and me owning that and saying, that's my, that's my creation. That's what I do. And something that I'm putting that hat on, you know, even I had a dinner I was invited to, and this is what allows you to think outside of the box. A good friend of mine is a drug rep for Novo Nordisk, and she invited me to dinner with other physicians and.

I sat down alongside them. And it was, for me, it was just to learn a little bit more about the insulin. Um, but what it ended up being was a networking opportunity where I was in their space outside of work at their convenience. And if the doctor next to me, I was working for a big box chain at the time.

Next to me asked me what I did. I put on my head. I said, I'm the CEO of perfect balanced healthcare. And I do medication therapy management for patients in their home at their convenience. And I work with their doctors to streamline their medication therapies. Do you prescribe them and find out what the underlying issues are that are contributing to their health and to help them address those through lifestyle modifications?

He said to me, how would you like to work out of my practice? You know, you just throw me $500 a month for overhead and you can work out of these examinations. Mike, if I could have afforded $500 at that time, I would have done it. I wouldn't do it because nothing meant more to me, you know, but that proved to me that they care about their patients.

They see the value in pharmacists and that they'll hear us if we talk to them at their convenience. And that's how I got into doing what I do now, what's really been helpful for me to do that, to be able to adapt and shift based on what's presented to me as opportunities is keeping my eyes open for that.

And not just closing myself out, putting blinders on to what I'm doing, but being open to hearing what people are saying they need, you know, and being able to not, not to say, oh, I'm going to serve everyone. And. Do everything and provide all of, you know, I think that's, that's a problem. A lot of us fall into as entrepreneurs because we want to not miss out on an opportunity to help someone and to earn money from anyone.

I'm not saying I don't need to lower my niche. Right. But within that, be adaptable and listen to what your prospects are saying to guide you into crafting what you're doing and honing it to where it's more effective and, and has a bigger input impact. And I think what's really key. Mike is learning that the influence that you have on others starts from within, and it starts from the way that you view yourself.

Because if you want other people to view you a certain way, that has to start from, from inside and radiate outward. And, uh, an example of that is a pharmacist that I connected with through. You know, this tele-health path that I've taken out of Washington state. She asked me, she's like, how do you wear the title of doctors?

So confidently in a world where pharmacists haven't been using it and especially in the outpatient setting, maybe. So in patients that have not really been in the outpatient setting, how are you doing that comfortably? I said, you know, if you really expect people to respect you and to start reimbursing you for your consultations, the way they reimburse their doctor, why wouldn't you wear the title you earned?

I didn't go to school for all these years, you know, just to hold a spatula and accounting tray. And so I'm going to put on that coat and I'm going to wear it. I'm going to wear it verbally. I'm going to wear it with my social skills. And people will recognize me as that. And that shift of our profession has to start from within, you know, what she did.

She wrote a letter to the company of the big boss. She works to suggest all of the reasons why it's important for their pictures to have a doctor written on there at the pharmacy and what it would do for the way that the patients view that pharmacy and the services that they're looking to roll out in the future.

[01:28:52] Mike Koelzer, Host: Yeah. Think of how many people your inspiration inspired others right there. 

[01:28:58] Nandita Koodie, PharmD: Like I just impacted an entire chain from sharing my view of the importance of us to call ourselves doctors when we are, if chiropractors can do it, why aren't we. Yeah, it's just, it's beyond me that we're not doing it, you know?

And so, that those shifts in the path come from within you start shifting your mindset from within, and people will see you the way that you see yourself. If I say I'm a national tele-health network liaison, I'm a national tele-health network. We use on 

[01:29:34] Mike Koelzer, Host: independent pharmacy owners. They've been slapped down so often, you know, and, and by the insurances and by the doctors and whomever and, and, you know, by themselves, you know, looking at their bank accounts sometimes what could somebody do tomorrow to begin to start to maybe have a little bit more belief in themself?

That's been knocked 

[01:30:04] Nandita Koodie, PharmD: down. I think there's three things I would recommend for anyone that's listening. Number one, whoever it is that you call God. And whatever capacity that is, even if it's just philosophical, lean on that, meditate on that, you know, I'm not saying schedule it in and make it a chore of a checklist, but find a consistent relationship to be mindful and to focus yourself, whether it be through yoga or just some activity that you do on a regular basis that allows you to connect with yourself on a higher level.

That's number 

[01:30:41] Mike Koelzer, Host: one, that force has maybe higher knowledge of the purpose for you than, you know, yourself. The 

[01:30:50] Nandita Koodie, PharmD: path is that's where it comes from. You know, it comes from another dimension. So that's number one, and then trusting in that. And listening for it and paying attention to it and not getting stuck in what you're doing, right.

That's number one, number two, I recommend getting a financial advisor. You don't want to be making investments, you know, just jumping into them and you want to stay on top of what your own personal situation is. And having a financial advisor there to guide you is key. Someone who can help you to save more, to fix their financial situation.

If you're in debt and to give you the strength, to make the right decisions and to have that second stop before you make the wrong financial decision is super important. Uh, number three is a business coach. Guys. I don't care how confident you are because as pharmacists or as anyone who's listening, you may feel like you have this all figured out.

And that what you're doing is working because you found small success with it and or you have people around you who are doing it that you can do. You need to get a business coach, a business coach is going to help you to shift your mindset, to allow you to elevate what you're doing to the next level, and to make sure that you're not selling yourself short and that you are doing business in a way where you are attracting the right people with less effort.

And they're going to share with you, you know, all of the things that they had to struggle through for years condensed into, uh, a form that will allow you to bypass all of that stress and just, you know, supersonic your way into Lightspeed with regards to your business. And if it wasn't for my business coach, I would not be experiencing the success I'm experiencing right now.

I would probably still be on a patient to patient model. 

[01:32:58] Mike Koelzer, Host: Thank you so much. 

[01:32:59] Nandita Koodie, PharmD: Pleasure has been mine. Mike, I hope I've earned the privilege of your time and everyone who's listening. It's 

[01:33:05] Mike Koelzer, Host: such a pleasure. And I know it will be for the listeners too. This 

[01:33:08] Nandita Koodie, PharmD: has been fun. I hope that it's been enjoyable. Um, anyone who wants to see what I'm doing gets inspired.

Uh, you can visit my website. It's perfect. Balance. Health care is the name of my company, but you can find me@pbh.life. You can also schedule there. If you'd like to do a quick collaboration call, maybe you're interested in the affiliation program I discussed earlier. That's something I'm always down for.

You just click the link at the bottom. You can schedule a time and I'll be happy to see how it can help. 

[01:33:37] Mike Koelzer, Host: It's a nice website. It's a pleasant website and you have all the pictures of your nice teas and things like that on there too. 

[01:33:44] Nandita Koodie, PharmD: Thank you. Most of it, it's actually very symbolic for me. I didn't realize until after it was done, but the pictures are a combination of pictures that I took in Florida.

And, um, pictures I took in California and bridges, and I'm basically trying to bridge myself from Florida to California. I 

[01:34:04] Mike Koelzer, Host: want to just encourage everybody if they're going to go to your site and see the beauty of it and so on to do it soon, because in not too long of time, my picture is going to be on there from the picture in your dining room, front center.

[01:34:25] Nandita Koodie, PharmD: I think they would enjoy that. I'll make sure you get in there.

[01:34:32] Mike Koelzer, Host: You got it.

[01:34:35] Nandita Koodie, PharmD: You too. Stay safe. We'll be in touch. Of course. Take care of it.