Pharmacy Education Needs a Major Overhaul | George Zorich, Pharmacist Author of Entrepreneurs in Pharmacy and Other Leaders

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Mike Koelzer: George, introduce yourself to our listeners.

George Zorich: I'm George Zorich. I'm a University of Wisconsin School of Pharmacy grad. Worked in the pharma industry for over 40 years now. Last half of it, I ran companies for private equity. And I retired about 10 years ago, just doing board work. But recently, one of the large investor groups on one of the boards I sit on, asked if I would come back in and take over as CEO and chairman of the board.

So I've been doing that since February, really enjoying it. And it's been an exciting part, kind of reinvigorating in my life.

Mike Koelzer: You were retired. And now, You're back and you love it.

George Zorich: I love it. It's an interesting company in that we have an ophthalmology division and then a critical care division. And so each is distinct and different and has its own set of issues. So, yeah, I'm enjoying that. I can really take the first 40 years of being in the industry and apply a lot of it to this company right now. 

Mike Koelzer: Did you have an inkling that they were going to invite you to do something like this or along the way?

Did you think that one of the boards might be inviting you to do anything more? How did that come on?

George Zorich: It was nothing I anticipated. I was very happy just doing board work on several pharmaceutical company

boards. And I was enjoying it because it provided a bunch of balance in life. Being able to travel, spend time with family, grandchildren, do a bunch of stuff with Shark Tank at the University of Wisconsin and do some mentoring and volunteer work in parts of Chicago.

So I was not expecting it and we happened to have an FDA issue come up on our myopia product in the ophthalmology division and we had to go back to the well, raise some money and our investor groups wanted a change. Simple as that. So, I was there at the time. It's kind of like everyone stepped backward and I was just standing there and they said, how about you?

Mike Koelzer: Usually those are the people that are picked when they're not even at the meetings, but you can't do that for a corporation. At least you have to be there and have the people step back.

George Zorich: Yeah, right. Exactly. But I have the experience working at that company on the board for seven years. So I knew the people, I knew the products, I knew the basic strategy and It seemed like it was something that I could take on and help get the company over the finish line.

Mike Koelzer: George, how many people are on the payroll company? How many employees would you say they have?

George Zorich: Well, that's one of our issues. We had over 70 at that point, and it's now down to just around 30. So, when we had an FDA issue, And had to raise more money. We also had to cut expenses. So that part usually comes with having to cut expenses. You have to have a headcount reduction.

Now, most of those were made prior to me taking this position.

Mike Koelzer: Did you have to lower headcount because of the true numbers or was it a gesture for the investors to see. Was it truly you needed some downsizing for the company?

George Zorich: we needed downsizing for the company based on our projected revenue. And when you don't have an FDA approval, when you expect it for what could be a blockbuster product and still could be, But we have to go revisit it with the FDA.

Things have to get cut. And you see it every day.

If you read Becker's Healthcare, Becker's Hospital Report, any investment. The Wall Street Journal, Financial Times. Companies don't, the Phase 3 results they wanted. And one third of the company is cut. One half is cut. Share prices drop 90%. 50%. So that's just part of the risk reward in this industry.

Mike Koelzer: And a lot of that might be. Outside of the corporation, which you would naturally cut, maybe some marketing firm or this or that, but there's enough that's in the business to the managers and different people that there's just not room for them when you don't get that FDA approval you were looking for at the time.

George Zorich: Right. And it's always such a tough thing for any of the senior management team to have to do. And part of it is many of the senior management team then goes too. Because they tend to be some of the more expensive headcounts. So it's nothing a company ever wants. No one ever wants to have to go through it.

But in capitalism, that's going to occur. Because not everyone can be an Elon Musk. Not everyone is going to be successful the first time. They may have to go back to the well, raise more money, and be successful the second time. But, not everyone's going to be successful the first time. And, Mike, I do think people understand that when they come onto a company.

That there's no guarantee. And, as tough as it is, ever to let people go. That is part of what can happen. Things don't happen. Things don't occur as according to plan. Typically headcount has to be reduced.

Mike Koelzer: This isn't a popular opinion I have, but I don't share it with a lot of people. Well, I guess I do share with a lot of people. I said it here. So, 

George Zorich: I guess it will be shared with a lot of people right now.

Mike Koelzer: It always seems like the employees that come in when they give you their two week notice as a leader, you give them a pat on the back and thank them for their time and wish them well.

And hope for their success in the future and all this. When you're the business that does it, you're the devil. And it just doesn't seem comparable, it seems like it should be even up, like, Everybody's at will and the employee can quit and you can fire, but the company always looks like the devil.

And people have said to me, well, Mike, that's because they don't have a livelihood at that point anymore. They can't maybe feed their family, but the corporation still goes on. It's like, I don't know, maybe. Maybe four weeks before that when they weren't pulling their weight or the company wasn't doing what had to be done.

At that point, they were eating and the company was losing. So, I don't know. I'm told that's harsh, but don't you think it should be more even with that, George, or not?

George Zorich: I do. I think when people get hired at will, and they're talented people, and they get paid, in a representative way for that talent. They get paid well, they get paid bonuses, and there are two things that can happen. If they don't do well, and it's just not a one time thing, they don't do well, and then they don't do well again, maybe the next quarter they should and they can expect that maybe they're not going to have a job there. That I think is how we built this country. I mean, this is really how America was built in the 17, 18, 1900s. People were successful where they start

And employees, I think, have to look at it the same way. And I agree, it can be a little bit harsh, but. You must get results to continue to get that good pay and benefits.

And bonuses. If you don't, you are at risk of not having that job.

And that's the livelihood you've chosen. I'm not saying it's great. I'm not saying it's perfect. I'm not saying it's fair. But if someone wants a job where they don't have any risk at all, then their pay and their upward mobility reflects 

Mike Koelzer: It's commensurate with that. I was surprised by George on the um, I was watching the assassination attempt hearings, and I was surprised how quickly they said to the Let's say the Secret Service in this place. Who have you fired yet? Who's been fired? You know who's been let go who's been fired and I think that's I along with many of the listeners come from the the home style Pharmacy where you know people make a mistake and you give them a chance and probably a chance way too much You know, there probably has to be more of that going on, but it seems like I've never heard that before, that when someone makes a mistake, somebody has to go.

And I suppose that the congress people are showing their toughness. I suppose when you have a company that has a lot of people, either you have a lot of stockholders or a lot of people depending on it. You want to see that black and white action. I had just never heard so much of that before that somebody must be fired for something.

George Zorich: Well, we have had that comment for, I think, centuries that the buck stops here.

Mike Koelzer: Yeah, you're 

George Zorich: And, And maybe decades then, with like a Harry Truman and others 

Mike Koelzer: And I'm not saying that's wrong, George. I'm just saying I'm not used to it, 

George Zorich: Well, my philosophy is this. If the Secret Service in a attempted assassination of Trump

really dropped the ball in communication with local police.

FBI. Someone needs to take the fall. Remember in pharmacy school we had vicarious liability in jurisprudence? The store owner was still responsible for that assistant or someone in the pharmacy that made that major mistake that killed a patient. So there was still some liability there. I don't think we have it enough in this country.

I don't think we have it enough in healthcare. Simple as that.

Mike Koelzer: When I took over my dad's store back in the mid 90s, in retrospect, I should have fired half the people right off the bat for various reasons. One of them is just because some people can never get over the thoughts of nepotism even though I rose up through the ranks and worked as hard as anybody else did with my efforts and degree and things like that.

So I'm not against it at all, it seems like in these you have to have that symbolism Of someone being let go. That's what people are looking for. That's where the buck stops. Because if you don't, it could happen again. And then they're going to say, why don't you do something about it?

So it seems like you have to wipe the slate clean sometimes. It hurts, but you have to sometimes,

George Zorich: I think we do it a little bit more in business. in the private sector than the public sector.

Uh, the private sector will fire people a lot more. We don't do it enough for poor results in the public sector. We give too many excuses. I mean, come on. Come on, Mike. How can we be 29th globally in math and science scores and not fire a few superintendents or teachers or, you know, heads of the Department of Education.

With all the money we spend per capita versus the rest of the world and we have Estonia ranked fifth and we're ranked 28th in math or whatever in a given year, how can that be? Why don't heads roll there? Because they're failing. They're failing the children of this country.

Mike Koelzer: And for our listeners a lot of my former guests, I, Follow, maybe just naturally it comes up in the algorithm on LinkedIn and so on. And when I see George's stuff, it's often focused around education and not just upper education, but the whole system. And so that wasn't just an example you grabbed out of the air.

You're very much into the education system, George. So when you're saying this stuff you've been there and you put your money where your mouth is and that kind of stuff. So you're saying that a lot of the superintendents should be gone. And I agree. if they're not gone, it seems like they're working in some other state.

You always hear about a superintendent and they always come from somewhere else. And I think they just move them around, 

George Zorich: yeah, it's the lemon dance, where they just keep trading off lemons. Look, some might be great, some might not be. You're right about, I have a passion for kids that want to learn. But they are in an environment where they can't learn well, or they may not be able to learn well. So when I retired originally back in 2014, I did spend a lot of time in one pretty tough area, had a 48 percent graduation rate in high school and got involved with some serious mentoring programs, work study programs and really enjoyed the time. But I learned a lot along the way.

If If I could expand on that,

Mike, it would be, 

I saw a couple of interesting things. We had 16 young men and 14 of the 16 did not have a dad in their life. 48 percent graduation rate. 

We spent four years with them, six of us. It was put together by the athletic director at the high school and you know by their senior year I think I'd spent 400 hours in their senior year with these kids taking them to University, Wisconsin basketball football games breakfast lunch dinners We had a Thursday meeting with them every Thursday at the school and we got 15 of the 16 to graduate so way better than 48 percent So it's like, wow, this is really good. But within a year of them graduating from high school, a couple of things had happened already, 16 babies were already born by that time.

That was not good because none of them were married. None of them really had a livelihood. Two of them had been shot, one critically. And then if we fast forward to today, I mean, two are serving five year sentences for attempted murder and gang violence, but we have tremendous success stories too.

And so you get that interesting point of view of, wow, our education system can work, but it doesn't work well, even for those kids that I'm calling a success. They really didn't learn a lot in high school.

Mike Koelzer: I was just commenting on someone's podcast last weekend. I was just commenting about the Education system and George you and I may have spoken about this but in the u. s The first two years of college you're repeating what you should have done in a good high school I mean, it's really hard to believe my kids, they'll go to most of them have gone to community college in town before they went to a bigger university, but it's like the same stuff.

And I called it a money grab, maybe it is, maybe the kids just aren't coming out prepared. Maybe if they haven't got it by then, they don't need it. But it seems to be just extending college in my mind. Pharmacy instead of a four year program, now it's six, something else, it's five for engineering instead of three or four.

And so it seems like they're just repeating high school again. Maybe we've given up on high school.

George Zorich: Yeah, maybe we need to re imagine. Everyone uses the term reimagined. Maybe we need to reimagine education in this country and not act like we're in the 1850s. So, why not change that? I agree with you about the whole PharmD program, the Doctor of Physical Therapy. Which, if you speak to a lot of people now they're just getting a glut of physical therapists and they're not making a lot of money. So what happened, did you have a Bachelor of Science in Pharmacy or PharmD?

Me, yeah, me too. So I did three years of pre-pharmacy. I should have done two. Three years of pharmacy school and then a year internship. So, the PharmDs I'm seeing at the, at UW today and other places, oftentimes, they just don't go two years pre pharmacy.

Many of them go four. So, they have four years in, four more years of PharmD, and then they're, they ever want to work in a hospital, they expect them to do a two year residency. So, a lot of these kids are doing ten years of schooling. and education to work in a hospital. What?

Mike Koelzer: And George, I'm gonna come out and say it as long. I can't let you be the only Cobra on this show. I got to come out and say it too because You're wearing off on me, but pharmacy what kind of bugs me my wife said to me last week She said you could go get your pharm D sometime.

I'm like, I don't want a farm D I don't think she really got What it was that it was just, more clinical stuff. I was thinking about it and it's funny to me that people come out over the years and they still really need permission from the doctor.

To really do anything. They're not really making a decision and people can say, no, we're making a decision because we've got this clinic and the doctor signed off. And it's like, yeah, but just by definition there, you've spent eight, 10 years in school and you're not really making a decision at all.

And I would even say that the BS, I mean, maybe my decisions aren't as. Grandiose, maybe I'm just deciding what size of a bottle to put something in or what to price something, but I'm making a decision. But a lot of these clinical people, they spent so much time, but they still have to sign off or get it signed off on,

George Zorich: Right. They're not in control of their own destiny. Put it that way. And I find it interesting that I seem to remember we had written rotations at the VA hospital and university hospital, my third year of pharmacy school. And then I had to do that one year internship after graduation at.

Kind of scut wages. I remember I was making 3. 25 an hour. That's 3. 25 an hour for one year. So, it was a real benefit. I was cheap labor for all of the preceptors out there. 

So, I look at it now with the FarmD. And last year, because we do this entrepreneurship club and we have Shark Tank at the University of Wisconsin and so I interact with a lot of the students, and in their final year, they're on rotations quite a bit.

So they're all over the state doing these rotations. And I have to say, I'm wondering if the PharmD program is just extra revenue? It's a one year revenue grab where the university collects tuition, whereas with me and you. We had to go out and do an internship and we got paid minimum wage or a nominal wage and preceptors benefited from that. But we had a good experience. Now they just have to pay one more year of tuition and they have a little bit more clinical expertise, I get it. But is that a good trade off? I don't really know. I don't really know. But hey, come on, we've got what's, what do most people, what are they geared for?

Mike, how do you see it with a PharmD degree? hospital, right?

Mike Koelzer: Well, yeah. I. I think, George, that it's a false carrot and stick, I guess. You've got these kids going through college. A lot of them never stepped in a pharmacy before until their last year of pharmacy school. They're getting taught how to do all this clinical stuff and they're coming out and just getting smacked in the face of people, they're not paying for it.

A lot of people don't have the time for it. A lot of people don't care about it. And so I think there definitely is a place for clinical practice. When I was at Purdue back in the day, it was about right. About 10 percent of the class ended up going the next year. And that was about right.

And now I think pharmacists are overeducated. Too much clinical for what the reality is. And the reality may only take a year or two of pharmacy school. Maybe that's all that's needed. I know, Maybe it's a year or two of pharmacy school, a year of internship, entrepreneurship, something like that.

Get rid of the first two years of redoing high school. So now you've gotten pharmacy school down, the whole thing, you've gotten it all down to like three years, maybe four years, you know, but then you get the entrepreneurs out there who are, maybe they're 20, 000 in debt and not 220, 000 in debt.

And. It's maybe reality, but nobody asked me, George.

George Zorich: But I think we do have to address the debt issue part because when I was going to school, I could haul garbage every summer for the city of Milwaukee. And then when I went off my freshman year to UW, I had to pay 275 a quarter for a meal plan and a room in Celery Hall. And tuition was 275, so for 1, 550.

I had pretty much, except for spending money, and a few books, that was what it cost my freshman year of school. Room board and tuition 1550. I could make that in the summertime. So how did it get so screwed up, in the coming decades, so that some kids got 200, 000 in debt? It's just not worth it. the bloated administration at these universities and the layers just blow me away.

There's just far too many headcount there and who pays but all the moms and dads and the kids out there trying to, you Get their son and daughter to go to college, or for that individual to have to go themselves and take on debt. 200, 000 is typical for a pharmacy student

Mike Koelzer: got the debt. And then you've given up a few more things. You've given up another degree probably because, instead of going four or five years and then saying, Hey, I'm going to be an attorney or I'm going to be a teacher. I'm going to be an engineer or whatever.

You've given that up. Nobody's going to go for eight, ten years and then go another five years. And you've given up the earning power of those three or four years that you're spending in college. Let's say you're going years five through eight instead of working five through eight, not only is it 200, 000 debt, it's another 300, 000 that you're not getting for three years of work at minimum.

So that's like a half million dollar swing by extending this expensive college, which arguably 5 percent of the pharmacists are needed with that level of clinical, that's just reality. I wish it wasn't, but that's reality.

George Zorich: And there's no guarantee of a job that they want to have getting out of school. At the pay that maybe they thought. I just happened to see some Indeed jobs postings for pharmacists around the country. And some of them were actually like vaccination pharmacists. I didn't even know they had that position.

And it was like 65 bucks an hour. And, which I'm not saying is awful. But, I don't know if it's that great considering you go 8 to 10 years to school maybe.

Mike Koelzer: And it's not gonna go up. I mean, it's gonna go up with inflation maybe, but it's not gonna go up like you see in some professions.

George Zorich: It's not, I don't think it's going to go up. And when you have, what do we have, 330, 000 licensed pharmacists out there? Half of them are in some sort of retail setting, so community, retail, chain, grocery, whatever you want to lump them in as, but over half. And if we're graduating 12, 000 to 15, 000 a year, but we only lose about, what would 330 divided by 40 years of work be?

Around 8, 000. 8, maybe 8, 000 people retire a year and you have 12 to 15, 000 graduating. Are we going to have that many new jobs every year for them? Maybe we will. But how many are we going to lose in the whole retail segment each of every year in the next 20 years?

You think Walgreens is expanding?

CVS? Walmart? Are they going to really be a big employer?

I doubt it.

Mike Koelzer: I just heard CVS is setting up AI for their voice messaging. So no longer is it pressing one and two, it's the AI listens and they respond back. I read that. And as I'm thinking now, it's like. They're going to do a hell of a lot better job than I would do now.

 I'm in there playing with my podcast or doing something, goofing around, looking up YouTube something and somebody calls in and I give them an answer that I think is correct, but maybe I'm impatient for one reason or another. So now maybe an impatient half ass answer and I'd be better off setting AI to be like a UK voice. You can switch the voices around and have some pleasant butler guy answering these questions.

I mean They're gonna get better service and they're gonna get from me with some of this stuff coming down the pike,

George Zorich: I would think so. If you can get Watson to, play chess and beat like a chess champion, a world champion, grandmaster.

If you can get Watson to interpret x rays better than a human can. If you can get artificial intelligence and technology doing a much better job with calcium CT scans for, cardiovascular detection of calcified arteries, why wouldn't we think AI is not going to be a useful tool for Walgreens and CVS in the future in getting rid of some pharmacists?

Mike Koelzer: Well, and here's a problem. I guess we're going full circle. Here's a problem I have too is what the pharmacy schools have done and the profession has done. I think instead of Responding to that or responding to things, you know, to the PBMs, whatever. There's a whole basket there but 30 years ago on reimbursement and all that stuff. Instead of finding ways, I guess to Make people clamor for pharmacists and pay for that.

The answer has been Well, they're not paying for anything now. Let's teach the pharmacists more. Let's get them in there longer and teach them more. And then maybe society will want to pay for it. It's like, no, there's plenty of knowledge there. That's, you don't have to put that cart before that horse. And now you've gotten like the things we've talked about, but also these rose colored glasses of what the profession is going to be when they come out.

 They're trying to shove it down the throat when people don't want to eat that right now.

George Zorich: yeah. And I think pharmacists with the training, no one is better at understanding drugs and pharmacology. than the clinical pharmacist graduating from schools of pharmacy today. Full stop right there. So instead let's have them do vaccinations. So Walgreens and CVS jumped all over that. And who benefits from that?

You go to a Walgreens and a CVS and half of the pharmacists look like zombies because they feel like their work life isn't that good. They got all these vaccinations dumped on them. Clearly COVID. Brought in a tremendous amount of revenue for CVS and Walgreens. So why wouldn't Walgreens want that going forward?

But is it best for the profession? When they're really experts in drugs, nurses can give vaccines

Mike Koelzer: George, I completely agree and I think that schools have to respond to that. I think pharmacists are drug experts and if the need's not out there or if the need is out there 

But the remuneration is not there.

Mike Koelzer: , the schools owe it to the students to be realistic, to say, you know what, you are the drug experts but it doesn't seem in the community that.

That much is needed. Some is needed, like a year and a half of education about drugs is needed, but people aren't asking you things that you learn in six years. So let's face reality. Let's train you for a year on drugs. And let's then train you for a year on the stuff we're talking about, but don't call it pharmacy, call it a new tech position or something like that.

But to call it pharmacy and then to come out and not practice pharmacy, your or a nurse, but you never signed up for that.

George Zorich: I could see the current PharmD degree Being very effective, plus or minus a residency of one or two years, to be the next directors of pharmacy and all these, all the pharmacists that are in teaching hospitals. I get that. I had a classmate, Jim Reinhart, who always spoke of, we need two levels of degrees.

Let's get one degree that is less for all the chain workers out there, which, like we talked about, Mike, it's half of all the licensed

pharmacists. Why not give them the, even a BS Pharm Light? That's really all they need.

And then use AI, use every tool conceivable to assist them in doing the best for the patient customer.

And I think we're ahead of the game, but for everyone to have a PharmD degree. It's a waste of an individual's dollars. I don't think it's a good return on investment. For 100 percent of future pharmacists to all have PharmDs. I just don't think it works. I think their moms are proud of them. And they're proud of what they worked for.

And that's great. But I don't think they'll get the return on investment of that education.

Mike Koelzer: Yeah. As I think it through now, Let's say the colleges and the profession don't come out and do this like you and I say it should be done. But then these places with the AI, they're no longer gonna hire Pharm D's Too expensive. They don't need them

Or pharmacists in general. They're going to hire somebody at a third of a pharmacist wage to handle this stuff. Well, now maybe pharmacists should have been trained for a year or two and say, look, don't pay us a third of what farm D's made.

Who are now unemployed because the chains don't need them, but don't pay us what a tech would make because we should make more than that. So Train us for a year or two of college and call us this, call us a pharmacist, but give us that employment for 60 percent of what pharmacists used to make back in 2024.

Give us 60 percent of that, but we've gone to less school and all this kind of stuff. But I think pharmacists, if schools continue like they do, they're going to squeeze pharmacists right out of this market. And there's not going to be any. Any roles for a pharmacist. 

George Zorich: I'd like to see that. I'd like to see a pharmacist degree. And then a doctor or pharmacy degree would be fine. That's the one that is going on rounds at the teaching hospitals, and they're using the degree at probably the highest level. But we need the pharmacist because that's where all the prescriptions get dispensed in this country today.

I mean, 90 percent of all the prescriptions are for generics. And they are about 15 percent of the total drug spend in this country. So it's a volume machine out there and it's repetitive. It's all the top 100 generics. It's very repetitive. So how much do we really need? This isn't, Going on rounds with the surgical unit or the neurosurgery group, ICU group, oncology group at Johns Hopkins or Mayo Clinic. That's the doctor of pharmacy. Get the pharmacy degree, a pharmacist, like you said, 60, 80 percent of what that wage is. Maybe we can preserve some of those jobs in the future.

Mike Koelzer: AI. I That's going to make someone like me back in the day, maybe. With AI, I can put out a hundred times what I'm doing, let AI look at everything and, three or 4 percent are going to come up and be flagged because AI knows that out of the 8 billion people in the world, there seems to be problems with this percent of these.

And then I'm going to, I'm going to answer those questions and I'm going to use my degree for that. And it's gonna be 20-30 prescriptions a day or something that I'm gonna need for and I don't know. It's just I guess I'm glad I'm done.

It's not my decision anymore. I'm not making that decision. I don't really care. I don't have a dog in the fight. I don't really care. It's just kind of sad that people come out and they, and I think they're slapped across the face with this two by four of reality and they just don't know what's coming.

That's what kind of makes me sad.

George Zorich: could see a great application of AI though. And that is instead of giving the elderly, womanher eight prescriptions, maybe AI specializes them and personalizes them based on her lab values and all the different, the eight different drugs she's on. So that they're adapting the dose based on kidney function, renal function, and AI has actually made the pharmacist into this personalized medicine machine, really helping out the individual. That's maybe where AI can help out. But, In general, it's probably going to take away jobs, not

Mike Koelzer: will. 

George Zorich: jobs.

Mike Koelzer: I heard last week somewhere, but it said that competitive businesses, I guess they were saying that they should not be afraid of AI. You should be afraid of people that know how to use AI. Because AI is just not going to create robots and solve pharmacy stuff, but people who are using it are going to be so much more powerful.

George Zorich: I wonder if instead of having the same classes in pharmacy school, maybe part of it is really to apply drug therapy and AI at the top schools of pharmacy around the country and be innovative in that way. Maybe that's one, one approach too.

Mike Koelzer: my son's an English teacher at a high school. And He's a recent grad and I was telling him, hey, you can just use AI, just, spend time on the people that need the time on, but don't not use AI because of busy work. And he didn't want to touch it.

He felt it was kind of sacrilegious to be an English teacher and dealing with AI. And so thankfully their school, they had some kind of a district thing or something, brought him in and they said, yes, use this. Here's how we're going to use it. Here's how you should be using it. This and that kind of stuff.

And my thought always is that don't be afraid of this as pharmacists, because let's say AI came out and if you told me tomorrow, if you said, Mike, AI is going to come out and tomorrow we're going to cure obesity. We're going to have people live to be a hundred. There's going to be no more heart disease and no more cancer.

AI is going to do all of that. I would say, Whoa, that's kind of scary. Reality is. AI comes out and maybe we move, the death average from 80 to 82. And maybe we bring obesity down 5 percent and cancer down this. And compliance, maybe that goes up.

And so, we can't be afraid of these robots coming out and doing this, but I agree, George, school. That should be like classes and classes on this stuff. Bring it in fast and heavy because it's going to be going that way.

George Zorich: I think there could be a revamping at the School of Pharmacy level, definitely. AI is definitely an area that could be an area of instruction. But I also think that talking about insurance, formularies, PBMs, global healthcare, isn't really covered maybe as it should, too, because students get out, and they kind of get smacked in the face on, on all of the things that they really have to deal with if they work in a, let's say, a drugstore setting.

And it's all the pre authorization stuff

 the formularies and the insurance companies and global healthcare and Medicare, Medicaid, how it all works, the government part of it. It's just part of what should be a component of their education.

Mike Koelzer: Well, George, I'm not benevolent on this show. I do this for my own kicks and, like to hear myself talk and things like that. But if I had to pretend like I was benevolent, I would say that my goal is to have this there for pharmacy students, people while they're in school to be hearing some of this stuff from real people.

Real material, things like that. Well, that's the benevolent part back to the selfish part. I'd love to have the stuff we're talking about here, have the students listen to it each week and then have to do some kind of a Q and a on it or something like that, something to get that conversation going, because I haven't been to pharmacy school in a long time, but everybody says there's virtually no Some schools are 

I know I've talked to different people from Pitt and things like that really do a good job on it. Maybe other pharmacy schools do too. I just maybe haven't heard it, but I don't think so.

George Zorich: Yeah, the goal ought to be pharmacy education and. Get them a livelihood. And are we doing enough to really get them in the right direction? I knew when I was in school, Mike, they would not let us talk about industry. So everything was, you could go to graduate school, hospital, 

retail. And it's like, well, I want to go into industry.

I want to go into farming. And they went, oh my God, the farm is awful. Farm is terrible. And so, Even today, it's the same way when I talk to the students and I'm there each semester with our entrepreneurship club, leading to the Shark Tank and I'm amazed that they still don't want to talk about all the jobs in industry.

Even with the medical science liaison position, really becoming a popular position that's kind of between sales and clinical consultative services, with physicians. So it's really a cool position. And it's probably growing faster than pharmacy jobs in hospitals or retail. So why not get kids prepared for that?

The MSL position is a great job out of school. It used to be that you couldn't do it right out of school. They wanted experience for three to five years. Now they're hiring kids right out of school and those are great jobs for them. Yet I don't think we talk about it enough.

Mike Koelzer: where I went to school, when I went to Purdue. I'm just guessing. I have no idea if this is right, but I know that compared to another pharmacy school in Michigan, Purdue being a lot of research and their labs and all this kind of stuff, I heard more about industry than I would have at another pharmacy school in Michigan, and I don't.

Bring that down at all. In fact, they probably got a better day to day education because they had people that were in the real pharmacy world, like we're talking about now. So I don't denigrate that at all, but I think the same thing can be said about business too. It's hard, I think, to learn business from a lot of people that are clinical.

A lot of the teachers that are clinical and maybe haven't, they don't have to own a business, but haven't even touched their feet in business too much. And, of course the education is going to be slanted to what kind of teachers there are. And I'll say this, George. I wish that in my, and this is getting down to the nuts and bolts, but I wish in my internship or externship, whatever you call it, but I wish I would have spent a day going around with the nurses, a day in ER, a day riding around with the sales rep, a day sitting at the phone with some, calling center with this or that I could think of 10 or 20 things that would have been cool to spend.

A day from now you get two weeks out of a two month program or something like that. But there again, nobody asked me.

George Zorich: Well, it would have been good because I was pretty naive coming into pharmacy school, so I really didn't know all the opportunities. But I really was convinced pharmacy could be a springboard, like engineering or finances. And if I gave any advice to students today, I'd say try and get an internship at a big pharma company. And then try and get those experiences. If you can work a day, do it. with a pharma rep, do it.

You might hate it. You might say, I wouldn't do that in a hundred years, but you might also go, hey, you know what, based on talking to this person, this might be an interesting profession and I don't have to stay there forever.

If I'm good at it, I'll get promoted and do a bunch of other stuff in that pharma company. So the schools, I think, owe it to the students to expose them to as much as they can. to give them the best chance for success in life. Not just retail, hospital, graduate school, or residency.

Mike Koelzer: Yeah. It used to be that. What'd they call those in high school tech training schools or something like these are the kids 

that would leave at the fourth hour and go work on cars and things like that. But it was geared towards getting a job in pharmacy. You never had to do that. Because there was plenty of jobs around, but now as you alluded to, some of these people are going to have problems maybe coming out finding

jobs. 

George Zorich: I think we're going to have such a glut and no one will agree on this 100 percent because one could argue pharmacy is such a great springboard profession. There'll be jobs for them in all different sectors. But I can't get over the fact that if we have 150, 000 plus working in retail, those jobs are diminishing every year for the next 20 years.

So, how do you replace that lost headcount? Where do those people go?

And, to me, Mike, all it means is, instead of 65 bucks an hour, being a vaccine pharmacist, It's suddenly 45 bucks an hour because there's a glut of headcount out there.

Mike Koelzer: And it's not fair of the schools to think that's not going to happen because now you're, let's say schools think that people can pay off, The average pharmacy loan in so many years of work, or so many hours and things like that. And now to have 'em come out, if the wage goes down, 30%, now you've just added 30% on top of whatever years they have to, piss away to get caught up on that.

George Zorich: Yeah. And you can never take away a person's education. It's phenomenal. They learn so much, it adds to their life. But anyone who's got 200 K of debt

Is facing a big burden coming outta school. Kind of hard to consider the first house you want to buy.

A few years down the road when you have that big of a debt.

Oh, what kind of car can I get? Well, I'm also paying off 200, 000 in debt. It's a tough, tough road. I feel for the kids coming out of school, but the answer is not, as my alma mater suggests alumni giving more scholarships finding other ways to contribute to these students. It's like, no, get tuition affordable.

Mike Koelzer: Get it affordable. Get education realistic of what's going to happen when they're out, all that kind of stuff.

George Zorich: Yeah. I'll give you an example. underserved areas, kids where I was teaching a work study class. It was in honors history, so typically half the school is not going to graduate. The freshmen, half of them aren't going to flunk out. And the number's gotten a little bit better in the last five years.

But I gave an example. Trying to inspire the kids that you don't have to go to college. You can make 74, 000 a year at this private company, entry level warehouse. Problem is, they hire 50 people every quarter through an outside agency, have them work 90 days, and pick only five. Five out of 50. And I simply said, what percentage is that to this group of seniors in honors history? And nobody could get five out of 50. And it went to class, after class. Nobody knew that was a senior in honors history that 5 out of 50 is 10%. And I went to the superintendent and said, How could we be failing these kids that much? I get it. They have iPhones with calculators.

But at some point, your battery dies. If kids don't even know that, what are you doing for 13 years, K 12? Is it just a daycare center? And unfortunately, that's in If you're poor in this country It's like a daycare center. And sometimes it's like a rough daycare center. That's not gonna help increase our math scores versus Estonia

on the global market.

Mike Koelzer: with my son's school. It's like, first of all, you're teaching down to the lowest skill, maybe not IQ. I don't know. You're teaching down to the lowest students or else you lose them. then you're dumbing it down to the lowest behavior. You got to take care of the kids who are fighting or doing this or that. And so everything's really brought down, I think, unless you have some elite that Something or other.

It's just a big divide.

George Zorich: Yeah, I think education's just gotta be almost blown up in this country. We're just not doing it right. And it doesn't mean that if your parents aren't very attentive and you live in a fairly nice area, you won't do well in school. That will occur, but there's just a lot of kids who aren't going to do well because of disinterest, disengaged parents, they're poor, they don't have the resources, and these kids just, they're not going to be the next group of engineers, put it that

way. They're not going to be building bridges.

 It's a brick and mortar thing. It's kind of like you can't get into pharmacy school if you never understood chemistry.

You can't be an engineer if you never could understand math or pass a math course. You're not going to do it. So we kid ourselves in this country, but China's kind of got it right. They understand the value of education. I think we're losing the ability to grasp that nationally. Obviously there are tons of smart kids. We see them all the time, right?

Mike Koelzer: My dad used to get upset cause we went to parochial schools and My dad would get upset when our school would put out Updates or maybe even in the paper or something about like here's our kids meet scores or this or that score You know versus, some of the public schools in the area My dad would get mad that people would compare when they should be doing better.

You look at two schools. I mean, you have to be blind to not realize that on a whole, some kids will do better than the other population.

George Zorich: Yeah, we have a school here in a poor section of town. It's kind of like a charter school. It relies on private funding. And they have students wear uniforms. What happens is the parents are extremely engaged. They're all poor, but they all want their child to succeed. And 100 percent of these kids are college eligible. 

Now, they grew up poor, they didn't have a lot going for them, but that school is a mechanism for them to jump to the next level.

But it wouldn't have occurred without a parent or parents that were engaged and wanted to help. better for their child in that next generation. Better than they had. And that's the formula of success, I think. You don't have to go to a fancy school. You don't have to go to an expensive affluent suburb.

You just need parents that are involved and a decent academic program where it encourages you to learn.

That's the formula.

Mike Koelzer: One thing I think is kind of cool is, George, back when we went to high school if you weren't college bound and someone said they're going to trade school or plumbing or something, you'd kind of, at least I would kind of scoff at them, like, Oh you're not doing this now.

If someone came to me, one of these kids and said, you know what, I'm going to forego college. I've got this great idea. I'm going to do this plumbing. I'm going to have social media do this or that. I'm going to have an online TV show for this and this, and I'm going to do this and that.

There are some big possibilities for people that have plans. You have to have a plan, but there's some big possibilities for, for, for, for young adults college it seemed the only way to go back in the day.

George Zorich: It really was. And it did make sense. But even then, Mike, I don't think we ever got past 35 percent of the population with a college degree. 

So 

we still had the majority not go to

college, but, But to us, and I know my parents instilled it in me, they felt that would be a better life 

for me than what they were doing.

And they did, they had not gone to college. I think that was important. I don't think it is anymore. I think the trades, I mean, The plumber, the electrician, the contractor, the welder. These guys have great occupations. They're making six figures within a number of years. They typically might work in a union setting and have a pension.

So, it's really a pretty good gig for them.

College shouldn't be for 

everyone. 

Mike Koelzer: What happened? It was a big con game because they told all of us guys to go to college so that we didn't know which side of a hammer to hold, then all these guys swoop in, in these trades and they charge us an arm and a leg because we don't know what the hell's going on.

 Our garage opener broke the other day. So one of my sons is a mechanical engineer. So he goes up there and farts for all of it. And I said, bro, you don't have to, you don't have to do that. And he's like, yeah, I can't quite figure it out. So our garage door is up there now, but the motor's out.

It's hanging in like a. You know, Those white grocery plastic bags. It's in one of those, like a diaper hanging up there because we didn't want to undo all the wires. And I call up these garage door places. And it must be nice only, half of them call me back and you can see what they're charging me.

And it's like, I know what those parts cost and you're charging me, 60 percent more than that. But what the hell am I going to do? I don't know how to get up there and change a garage door. I'm just a college graduate.

George Zorich: exactly. Well, we had a plumber come in a few months ago with, like a sink issue and it was leaking. And so it took him five minutes to fix and he apologized and he said, I'm going to have to charge you, for an hour. But it was like, Hey, whatever, that's great. That's fine.

Hand him the check.

And it's like, I'm so happy because you came here right away, great service, and you fixed it. I don't care if it's five minutes or 60 minutes. And it's like, man, that's not a bad job that guy's got now. We weren't encouraged to do that.

We were told, college was the way you had to go.

But I would encourage a lot of people nowadays to forego the expense of education unless they really know what they wanna do. It's like, I wanna be an engineer. I want to be a pharmacist, I want to be a lawyer, whatever. But if you're going there like, Hey, I just want to chill out for a few years, I want to learn some things. Maybe you ought to just work for a year or two and then determine that.

But,

 College isn't for everyone.

Mike Koelzer: I've heard it real close to that George, and that makes a lot of sense. This guy had a slightly different twist. He said, if you have a plan coming out of high school, it doesn't involve college, but it's a plan, kind of the stuff we talked about. He said, go for it. Don't even think about college.

If you don't have a plan, college might still be in your future, but it's like, Free community college in town for two years. And then it's, scholarship, this and that. Maybe you're getting out of college for 10, 000. You probably know you won't even use your degree. Maybe you'll do the stuff that we're talking about with the trades later.

It's kind of a place to kill time. But I think what we're both saying is if you don't know. Don't come out with 200, 000 or 100, 000 debt thinking just gonna light up the world. If you don't know, stay close to zero.

George Zorich: Well, why'd you go into pharmacy? You went to college, you went into pharmacy. What got you into

Mike Koelzer: I did it because if my dad can do it, I'm smarter than he was, I could do anything he did.

Plus, we had 12 kids in our family and I knew at the time I was one of the younger ones. I knew that no one else would be going into the business. So I knew that it would be a one man show as far as, you know, a family tradition business, and I was terribly interested in business.

So for me, it was saying, I don't want to go just to get a business degree because those are a dime a dozen. I don't want to get out of college and be selling toilet paper, nothing wrong with toilet paper. That just wasn't my gig. I loved business. I knew it would be good to have a skill in the business.

I sort of had a business waiting for me. So that's kind of the reason why I went that route. If my dad wasn't the pharmacist, there's no way in hell I would have ended up here. Not because I disliked it. I just never would have pictured myself with that.

George Zorich: You weren't exposed to it. You wouldn't

have been 

exposed to 

Mike Koelzer: Wouldn't have been supposed to do it. How about you, George?

George Zorich: I wanted to be a baseball coach and I was going to be a PE teacher, but they started talking about what you could make as a teacher at that time in the seventies. And it was like, 7, 000 a year.

And it's like, Oh, maybe I want to do something else. And I really, I always liked chemistry and science.

So I was actually a microbiology major for a while. And then one of the professors came over and said, Hey, are you going to go to graduate school? Because an undergraduate degree will get you nowhere in micro. And I said, graduate school? Are you kidding me? And he goes, yeah, you need the master's program, maybe PhD.

And I went, I don't know if I could stand the smell of this lab that long. So, He actually introduced me to people in the school of pharmacy. And that was my entry point to pharmacy.

 Hey, what do you think about all this Medicare negotiated drug pricing that they're talking about right now? Isn't that a scam? Well,

Mike Koelzer: The listeners know this. My wife doesn't like me sometimes when I am not pessimistic when I get cynical about stuff, because I'm just cynical about a lot of stuff. I've been tarnished by the PBMs and all this stuff.

And I told her that my job is to be cynical all day. I'm paid to catch mistakes, to catch stuff that other people aren't catching. That's what I do for a living. So I'm, I'm cynical. I'm cynical. Ultra cynical. So, when you say Medicare, I don't know exactly what's going on, George, but if I have to pick a side, I'm gonna pick that it's whatever you said, a scam or whatever.

I'm with you and I don't even know what the hell's going on.

George Zorich: it was part of the Inflation Reduction Act. So, taxpayers are on the hook for, what was it? 1. 3 trillion of extra spending, a lot of it in green energy. But part of it was, we're going to those bad drug companies to reduce pricing. And so they've been announcing all these price decreases.

in the last few days, but if you look at it, it goes into effect January 1st, 2026, and the products that they're talking about are all going generic in 25, 26, and 27, so the generic's going to be dirt cheap anyway. So it's such a scam. they're putting out these headlines acting like they're going to save Medicare so much money, but in essence, the multitude of generic players in the market.

will save Medicare money because of capitalism and competition, because all those drugs are going generic. Do you really think Big Pharma was going to negotiate on a patent protected product

if they didn't have to?

Made no sense.

The American public's so naive

actually believe this stuff.

Here in front of me it says Eloquus by Pfizer has agreed to a maximum fair price of 231 for 30 tablets starting January of 2026. So do we really think Once that goes generic, it's going to be more expensive than 231.

Mike Koelzer: Yeah. Right. for a 30 day supply.

 all they did is look at market analysis, like they always do on those things probably. They brought it down another nickel and said, Oh, you guys are tough negotiators, but they would have been at that price anyways, probably.

George Zorich: They know what the pricing model is for a generic entering, a second generic, a third, a fourth, based on the availability of the raw materials, the active pharmaceutical ingredient, and whether it's from China, India, or made in the U. S. or Europe, and they can model that pretty well. So they know exactly

what they're

doing. Pfizer is a smart company, obviously, and when they offer that price up to Medicare, the politicians can then wave the flag that they're saving money, but in reality, the generic industry will save the money. That price decrease will be meaningless in approximately a year and a half.

It won't matter. 

Mike Koelzer: thought it was a pretty smart cookie here, George, thinking it was just going to be a percentage talk. I didn't know they were going to give an actual price on anything. I've never really thought about that. I just figured they don't do that.

George Zorich: Yeah I think they probably determined it was a low risk based on what price they were thrown out there, 

because 95 percent 

gross profit 

Mike Koelzer: on 

Yeah. What do they care about? What do they

care? 

George Zorich: But the 

generic will be below that.

Mike Koelzer: George, I was listening to a podcast. I was out for a walk and one of the podcast hosts said that this is the first time in history or recent history that the children of the current generation Our generation generation X, baby boomers and so on.

The generation below us is the first one that's going to not trump what we have done, not have as good of a house, not have as good of a job, not have as good of wages, this and that. True or not true. And what do you tell a college student? Well, let me back that up. What do you tell a high schooler who's reading those kinds of headlines?

George Zorich: Well, number one, I think it is true. I think our children's generation won't do as well. They clearly have more anxiety, depression and that next generation is going to have even more. So, what do you tell a high school kid right now? I would say Learn something and become an expert in something. Be really good at something and something that you like doing because you'll do it the rest of your life. I typically, when my kids were growing up, Mike, it was more, a commentary of, look, do something you love, but you're going to have to pay your own bills. And you're going to have to spend for yourself and be able to support yourself.

So, you may say, well, I want to go to college and play the guitar and it's like, well, that's great. But you're going to have to support yourself with that college degree, playing the guitar. So I hope you're Eric Clapton or the equivalent coming out of college. I probably would.

I mean, I'm getting to the point where I'm kind of softening it a little bit. Just saying, hey, number one, don't take on a lot of debt, but get good at something. And that's where these young entrepreneurs, I think, are kind of interesting. I was talking to a young kid in a poor high school that wanted to start his power washing business.

And just, wash the sides of houses and garages and stuff. And it's like, go for it. You know what? You don't need to go to college. Try that out. See how it goes. And you know what? You might be the most successful power washer in 10 years in the area. But don't automatically go to college. 

Mike Koelzer: That's so odd because now if somebody came and said I'm going to go to school and get a business and a marketing degree. And you'd say to him, Ah, you sure, son? Maybe you want to start a car washing business or something like that. It's like the first time that we hesitate when someone says college now.

George Zorich: still like college, the concept of it, but it needs to be very focused. The degree has to be something that you really want to do and you feel passionate about for your life. So if you want to go into teaching, go for it. Because there could be a good career path there, you get a pension, all that's good.

You want to be an engineer, Build stuff. Go for it. But if you just don't know what you want to do, go work for a year or two. Save a little money. Get something in the bank.

Mike Koelzer: Yep. 

George Zorich: You can always go to college at 20. 

It won't be the end of the world.

 Well George golly love having you on but I'm afraid that we solved all of the world's problems now 

Mike Koelzer: now.

We have to wait at least a year to talk again because more problems have to build up since we solved them all so We'll be patient

George Zorich: It was just fun talking to you, Mike. I don't know if we solved much, but it's always fun. Fun talking to you just two guys around the water cooler, 

Mike Koelzer: you're a special guest, George, because you Trust the process of having an unscripted conversation so I appreciate your openness and it's always a pleasure, George.

George Zorich: Anytime.

Thanks, Mike. 

Mike Koelzer: Talk to you soon. 

You've been listening to the Business of Pharmacy podcast with me, your host, Mike Kelser. Please subscribe for all future episodes.